Here is the Don’t Blow It! campaign message to MPs at the #ScrapNHSBill rally outside Parliament yesterday, delivered by Steve Carne and Melissa Darcey
Hello MPs! We are here to talk about the really shocking dangers of Integrated Care Systems and this Health and Care Bill.
Constituents in 379 English constituencies and around 20 Welsh, Scottish and Northern Ireland constituencies have written to you as follows
Please find enclosed a handkerchief with an urgent embroidered message from your constituents:
Don’t Blow It!
Kill the Health and Care Bill before it kills us.
There are compelling reasons for our call:
• The Bill really will kill some of us – it reduces the government’s obligations to secure NHS care for us all; and it will worsen the current NHS staff shortage, by deregulating clinical professions and continuing the moral injury to NHS staff that has occurred during the pandemic.
• It is a Bill for big business – putting big business at the heart of NHS decision-making and the delivery of services.
• It will do nothing to solve the NHS’s problems.
As our MP – Don’t blow it!
The Health and Care Bill, which passed its second reading in July, is beyond amendment. Tinkering with it will not create a Bill that meets the needs of the NHS for the 21st Century.
The Bill must be stopped by MPs. Please vote against it when it comes back to the House of Commons.
NHS and social care legislation must be deferred until a Bill can be drafted that will enable:
- world class health care for all,
- a national publicly provided health service, adequately funded and free at the point of need,
- providing comprehensive treatments based on the patient’s best interest, decided together with clinicians not on the basis of financial calculations,
- with national NHS staff pay and conditions and professions regulated independently of government politics.
The Bill reduces the government’s obligations to secure NHS care for us all – potentially this would breach the government’s duty to provide an effective framework for protection of the right to life.
Please Don’t Blow It! Kill the Health and Care Bill before it kills us!
This is the letter that thousands of members of the public have sent to their MPs. We hope you MPs will act on it and vote against the Bill at the Third reading.
Here are some more reasons why.
The Health and Care Bill would not save the NHS from big business – instead it props the door wide open for it
This is despite the Health Minister’s promised amendment to prevent “individuals with significant interests in private healthcare from sitting on” statutory Integrated Care Boards.
Because there are lots of other hidden routes for private companies to pull out NHS plums from Integrated Care Systems.
NHS England’s August 2021 guidance on Provider Collaboratives would allow private companies to have significant decision-making power in Integrated Care Systems.
This includes decisions on finance – and on the preparation of Integrated Care Systems’ forward plans.
These forward plans would determine:
- what NHS services the Integrated Care Board would fund and commission,
- what staff they would employ,
- what capital investments they would make and
- how they would manage the NHS estate, among other key matters.
There is nothing in the Health and Care Bill to permit statutory Integrated Care Boards to delegate their commissioning function.
But NHS England has directed that the Boards’ constitutions should enable them to do just that.
On the basis that Integrated Care Boards’ delegation of functions will be legislated for by Department of Health statutory instrument and statutory guidance – with no Parliamentary scrutiny – if and when the Health & Care Bill is passed and becomes law.
This underhanded move would open the NHS door wider to increased influence from private companies.
So we have worked with a barrister to create an amendment to Clause 12 of the Bill, that would prevent Integrated Care Boards from delegating their commisisoning function
An MP is seeking to table this amendment.
The Health and Care Bill Clause 14 – people for whom integrated care boards have responsibility – is unclear that Integrated Care Boards will have responsibility for providing NHS services freely to everyone.
But Tory MPs are telling constituents who’ve sent them the Don’t Blow It! letter,
“The NHS will always be free at the point of use.”
This is why the Don’t Blow It! campaign has worked with a barrister to produce an amendment to Clause 14 – that requires Integrated Care Boards to provide NHS services freely to everyone, without restrictions based on geographical area or anything else.
This amendment is vital to prevent Integrated Care Systems from turning away patients from a cost-centre which doesn’t receive the funding for that patient, under the new fixed, per person Integrated Care System budgets.
This is already happening and it needs to stop.
Last month, the Northern Care Alliance Foundation Trust sent a woman with agonising burns away from TWO hospitals in Greater Manchester, after she fell foul of new rules meaning people have to get urgent care at a unit closest to home.
Hospital services will fall foul of the Health and Care Bill’s duty to promote innovation and integration
Campaigners have forced a Health and Care Bill amendment that clarifies Integrated Care Boards do have the duty to commission hospital services.
This is necessary but not sufficient to make sure each area of the country has adequate hospitals.
The Health and Care Bill puts lots of obstacles in the way.
Huge global companies on NHS England’s Health Systems Support Framework have already driven the formation of the 42 ‘shadow’ Integrated Care Systems.
They have already imposed systems developed for the US ‘managed’ health care market.
‘Managed’ means cutting costs by restricting patients’ access to care, deprofessionalising clinical staff and introducing clinical staff such as physician and nursing associates without professional regulation and competencies.
This managed health care market will be entrenched in the NHS by the Health and Care Bill’s imposition of a “duty to integrate” and its creation of a power to “create a separate procurement regime”. This would follow the Bill’s abolition of current legislation and regulations that require open accountable tendering processes for the award of contracts.
The spin by both government and by Labour Party MPs such as Karen Smyth – a member of the Public Bill Committee – that this Bill represents the end of the era of marketisation, could not be further from the truth.
The default commissioning process will be secretive and unaccountable. Just like the contracting process for Covid 19-related health services.
Since “integration and innovation” was mandated by NHS England in 2014, there’s been no substantive evidence of any improvements in health outcomes – and a lot of evidence of a disastrous decline in capacity and provision of care.
England now has far fewer hospital beds and intensive care units per 100K population than comparably wealthy countries.
Hospital black alerts have become increasingly common.
The waiting list for elective operations will take years to clear – and not just because of the pandemic.
Ambulances can’t respond to emergency calls because they are queued up caring for patients unable to be transferred into A&E for want of space.
Private hospitals are increasingly profiting from an increase in both NHS patients and self-pay patients.
Hospitals have routinely been running at far higher bed occupancy levels than the 85% recommended by the Medical Royal Colleges.
Even the Conservative Centre for Policy Studies has recommended that the Government should:
“ Drop from the Health and Care Bill legislation to put ICSs on a statutory footing.”
The Dont Blow It campaign has collected your constituents’ signatures at street stalls and through social media. People have told us how NHS staff working conditions and patient experiences have sharply deteriorated over the past years of “integration and innovation”
A care worker told us a terrible story of discharge to assess. In the USA is it called “patient dumping”.
A person she cares for was discharged from hospital in the evening and deposited inside his front door where he collapsed. He couldn’t move and she found him there in the morning in a terrible state.
She said these unsafe discharges are frequent and the care company she works for is up in arms about the Health and Care Bill’s aim of normalising Discharge to Assess.
A theatre nurse at a North West hospital for 34 years, recently emailed the Trust, the Care Quality Commission and her MP about her dreadful experience of being,
“forced to work in other areas of the hospital to cover shortfalls in staffing levels, even though every department is different with unique and complex needs.”
The Bill would normalise this practice.
The Health and Care Bill aims to install a “passporting” system for NHS clinical staff that will allow them to be transferred out of their normal teams/wards/hospitals, to wherever in the Integrated Care System is short staffed.
The theatre nurse explains the dangers of this:
“Two things drummed into you during your nursing career. Don’t do anything you are not capable or qualified to do you will be struck off. Always remember you are the patients advocate and you should speak up for the patient.
“These two ideals are so fundamental but have been completely unachievable by me because of my management.”
“I personally, was involved in an incident following being redeployed to the ward, an area I had not worked in since my nurse training.
“I was asked to look after a detoxing patient who was very agitated and sexually aroused, I had no experience or training to draw on. It escalated to such a point I was sexually assaulted along with another nurse and other patients were terrorised by him…
“When COVID-19 first hit the hospital, theatre staff were told they would be supporting ITU. We were given very limited training and everyone was frightened, however we all wanted to do our bit. I was dressed in full PPE and sent into the room of a ventilated COVID-19 patient, completely on my own. The doors were shut and I was told to put the speaker on the phone so they could tell me what to do. I had to give bolus’s of drugs intravenously because the patient was agitated, which I have no training to do.
“The alarms were going off and I was told by an itu nurse the co2 sensor was wet I didn’t know what it looked like but I was told I had 20 seconds to change it or the ventilator would blow out showering me with the contents of the patients lungs. I said I couldn’t do it but I had to.
“Three days later I had covid and it was in my home.
“When I went back I was suffering from stress and anxiety my husband was still ill in bed with COVID. I refused to return to ITU because I had no qualifications or experience. I was called inappropriate and unprofessional by my matron. Matron has been promoted and my contract has been terminated…
The Dont Blow It! campaign, run by small groups in the street and on social media, has received by far the biggest public response of any Protect the NHS campaign we have run.
We strongly suggest that – unless you want endless appeals for help from your constituents about problems with the NHS, and if you want a chance at re-election – you vote against this Bill at its 3rd reading.
So far, only 2 MPs have told their constituents they will do this.