Calderdale TUC motion: Oppose Accountable Care

Update An updated version of this motion was also passed unanimously by the Yorkshire and Humber Trades Union Conference in March 2018 and an abbreviated  version (to fit rules for motions) will be presented to the National Trades Council conference in Manchester.

Calderdale Trades Council has passed a motion opposing Accountable Care. Accordingly, Calderdale TUC will:

• Refuse to cooperate with plans to develop Accountable Care;
• In coordination with TUC affiliates in the Region, educate trade union members on the international track record of Accountable Care, and the circumstances of its introduction in England;
• Inform Councillors in West Yorkshire and Harrogate local authorities of our opposition, calling on Labour Councillors to implement Labour Party policy on this issue;
• Support the campaigning activity of Keep Our NHS Public, Defend Our NHS, 999 Call for the NHS and Health Campaigns Together to oppose Accountable Care;
• Support the wider defence and reinstatement of the NHS as a health service which is universal, comprehensive, publicly provided, publicly accountable, publicly run, publicly and adequately funded through general taxation, free at the point of delivery, with  decisions on treatment taken by NHS clinical staff on the basis of clinical need.

Here’s the motion in full.

Calderdale Trades Council Motion
Oppose Accountable Care
Whereas:
  • The Government programme for the NHS (“Five Year Forward View”) entails at least a  £22bn cut to the annual NHS budget by 2020/21, and the current version (“Next Steps on the Five Year Forward View”) mandates the formation of Accountable Care Systems across England;
  • Accountable Care Systems (ACS) and Accountable Care Organisations (ACO) are a form of local NHS and social care organisations based on the business model used by the USA’s Medicare/Medicaid system which provides a limited range of “managed care” to the elderly and people who cannot afford private health insurance.
  • “Managed care” means health insurance companies limit the care clinicians can offer patients to the cheapest treatments
  • Accountable Care is being introduced without legislation, without Parliamentary or public debate or consultation, and without robust evidence that it will improve services or deliver savings in England;
  • The West Yorkshire and Harrogate Sustainability and Transformation Partnership, which aims to cut NHS and social care spending in region by just under £1bn by 2020/21, in order to meet a £1.07bn funding shortfall by that date, aims to set up a shadow Accountable Care System in April 2018 with the aim of it going live in April 2019
  • Accountable Care Systems are also being developed by NHS commissioners and local authorities as part of the Locality STPs
  • Labour Party policy, adopted unanimously at its 2017 Conference, is to oppose Accountable Care Systems and Sustainability and Transformation Plans, and to cooperate with unions and NHS campaigns to oppose them.
Calderdale TUC further recognises that:
  • ACSs and ACOs will be subject to financial “control totals”, regardless of the actual needs for healthcare, and the Accountable Care Organisation contract payment mechanism is based on “capitated budgets” with fixed payments to cover the whole population. This will increase current pressures to restrict patients’ access to elective care and accelerate the development of a two tier health system, where those who can afford to pay go private and the rest are left with limited NHS care.
  • ACSs and ACOs will increase the risks of NHS privatisation, driven by a number of  features of its business model. These include:
  • cutting acute and community hospital services and replacing them by community services – the fastest growing area of NHS privatisation;
  • urgent care centres, which are being set up to replace A&E departments, are likely to be privatised;
  • replacing traditional family doctors by huge commercial practices;
  • integration of NHS and social care, which is largely privatised and means tested, and the drive for patients using out of hospital services to commission them through personal care budgets;
  • centralisation and privatisation of pathology, pharmacy, and radiology; and
  • the use of private companies to set up ACS and ACO governance structures and processes and advise on hugely complex contracts. It is also possible under the ACO contract that a private company could run an ACO, and therefore be responsible for an entire area’s NHS and social care
  • ACO’s use of long term single contracts for the whole of health and social care, to be held by bodies which need not be NHS or local authority organisations, is a direct threat to public services and to the terms and conditions of existing staff.
Accordingly, Calderdale TUC will:

• Refuse to cooperate with plans to develop Accountable Care;
• In coordination with TUC affiliates in the Region, educate trade union members on the international track record of Accountable Care, and the circumstances of its introduction in England;
• Inform Councillors in West Yorkshire and Harrogate local authorities of our opposition, calling on Labour Councillors to implement Labour Party policy on this issue;
• Support the campaigning activity of Keep Our NHS Public, Defend Our NHS, 999 Call for the NHS and Health Campaigns Together to oppose Accountable Care;
• Support the wider defence and reinstatement of the NHS as a health service which is universal, comprehensive, publicly provided, publicly accountable, publicly run, publicly and adequately funded through general taxation, free at the point of delivery, with decisions on treatment taken by NHS clinical staff on the basis of clinical need.

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