Revolving door merchants like Simon Stevens, Michael Macdonnell, Lord Darzi and Matthew Swindells – who make and impose NHS policy while spinning between corporate, academic and public service jobs – present Accountable Care (now rebranded as Integrated Care) as a means of providing quality healthcare more cheaply, through innovations in care models, workforce and commissioning and payment methods.
Beneath the spin, Accountable Care is just another neoliberal disruption aimed at increasing corporate profits. It cuts the labour costs of healthcare by a combination of making patients care for themselves and systematically replacing skilled, qualified staff with capital, in the shape of big pharma, biomedical/life sciences and digitech products.
This is designed to extract a growing stream of profits from the NHS for these corporations. Aided and abetted by charities and third sector organisation whose boards are in many cases stuffed with precisely these corporations’ representatives.
In this way, the NHS becomes a delivery system for the extraction of profit to big pharma, biomedical and digitech companies. Just as Facebook sells its users to corporations, Accountable Care aims to sell patients to big pharma, biomedical/life sciences and digitech products. This is the real privatisation of the NHS.
It’s all a long way from healthcare driven by patient needs.
May’s 3%/year NHS funding increase over next 5 years is tied to “integration” – ie money to boost the profits of life sciences and digitech companies
Remember the leak a few weeks ago, reported by the BBC, that the government intends to scrap some of the 2012 Health and Social Care Act, as part of its Future Funding Review of the NHS?
Put that together with this Simon Stevens tweet today:
“And the invitation to develop consensus proposals for legislation will help accelerate the move to more integrated care…”
This “invitation” echoes the proposals for “consensus”-based primary or secondary legislation for integrated/accountable care, in the Health and Social Care Select Committee Report on Accountable/Integrated Care and Sustainability and Transformation Plans. This is no substitute for the NHS Reinstatement Bill.
New business alliances between English universities, NHS hospitals and life sciences companies are are key to the implementation of Accountable/Integrated Care in the NHS.
These alliances are exemplified by Academic Health Science Network companies. Licensed by NHS England , their agenda is
“to identify, exploit and commercialise innovations that will have national and international significance”.
The business opportunities this transformation of medicine and healthcare opens up for Life Sciences are extolled in business documents that range from Ernst and Young’s 2012 Global Life Sciences Report, Progressions – the third place: health care everywhere, to the government’s Office for Life Sciences/Department for Business, Innovation and Skills ‘Strategy for UK Life Science’, and on to the World Innovation Summit for Health (WISH) 2016 Accountable Care Report, with a foreword by WISH founder Lord Darzi (infamous for New Labour’s Independent Sector Treatment Centres).
The Darzi connection continues in a Health Affairs article, ‘Unlocking Innovation to Reduce the Labor-Intensity of Care’, co-written with Michael Macdonnell – former director of the World Innovation Summit for Health and now Director of the Strategy Group at NHS England, and notorious for saying that Sustainability and Transformation Plans:
“offer private sector organisations an enormous opportunity.”
Update: True to his own word about the enormous opportunities for private sector organisations, Michael Macdonnell jumped ship from NHS England – first to Deepmind, the artificial intelligence technology company acquired by Google in 2014 for £400 million. Deepmind has a clinical app “partnership” with Imperial College NHS Trust that “builds on a relationship between the Trust, Imperial College, and DeepMind”.
Darzi is a key player here: the task management features in the app “are underpinned by a world class programme of widely published research and early product development carried out at Imperial College London and the Trust, as part of an app called Hark co-founded by Lord Ara Darzi.”
Macdonnell then moved on to a job as director of global deployment at Google Health, and in Sept 2020, to a job as Chief Operating Officer at Sensyne Health, a company owned by former New Labour science minister, Lord Paul Drayson.
In November 2018 Sensyne Health announced a partnership with EY (the company set on ‘capturing value from the human body as data platform’).The agreement with EY is to scale up the Sensyne Health business and build on its business model. This is based on Sensyne Health’s linked partnerships with NHS trusts to analyse anonymised patient data using its clinical AI technology to accelerate medical research. Here’s an example of the “partnerships” – this one with Somerset NHS Foundation Trust:
Non-exclusive agreement covers a total of 1.1 million anonymised patient records and brings total number of records available to Sensyne for research to over 5.6 million
(Update 26.6.21 – Sensyne Health’s dataset now stands at 18.2m records, after the company signed deals in May 2021 with the Colorado Center for Personalized Medicine for 7.3m patient records and with St. Luke’s University Health Network in Pennsylvania and New Jersey. Sensyne mines the patient data primarily for use by life science clients. When Sensyne commercializes these discoveries, they will share proceeds with CCPM and St. Luke’s respectively. Sensyne Health Access has also tripled its access to patient records in the UK during the financial year, following the signing of six new strategic research agreements (“SRAs”) with NHS Trusts. One of these is with NHS Somerset Foundation Trust. This brings its UK patient records to 8.5m, covering around c.13% of the UK population and “a significant step towards the target of c.20%.” The company says its FY2021 trading performance is ahead of market expectations, its revenues are growing rapidly and it is poised for accelerated international growth.)
Darzi’s long-term funding and reform plan for the health and social care system
And on again to Darzi’s long-term funding and reform plan for the health and social care system, in partnership with IPPR, launched to coincide with the NHS’s 70th birthday, at a Westminster conference where keynote speakers included the usual suspects :
- Simon Stevens, Chief Executive of NHS England
- Lord David “Scrap hospital beds” Prior
- Dr Geraldine Strathdee, National Clinical Director for Mental Health, NHS England
- Neil Mulcock, Vice President of Gilead Science , biopharmaceutical innovation company
- Hilary Neiwiss, National Voices – a coalition of healthcare charities
- Hannah Farrar, Partner at Carnall “shocking conflict of interest” Farrar
Sure enough, although it makes the good point that the government needs to put health in all policies – which would mean outlawing fracking, bringing air pollution within legal limits and ending austerity as a proven driven of ill health, for a start – the Darzi/IPPR funding and reform plan endorses the current direction of travel towards accountable care – although with yet another name, calling for “Integrated Care Trusts” for all out of hospital care.
With May’s announcement of an average 3% annual NHS funding increase for the five years to 2023, this is where the extra money will go. Straight into the life sciences/digitech corporate profits siphon.