I had the dubious pleasure of attending the LMC conference yesterday. The GPC are not on the side of General Practitioner nor patients. They are covertly backing the Gov't destruction of the NHS and betrayal of the public interest.
The conference opened with an announcement that BMA Law advise that any industrial action is unlawful. We need a new GPC and new legal advice. With the current complicit shower we are doomed.
Stevens 5YFV is the conversion to the American HMO system This will:
End GP autonomy
Destroy Patient continuity of care
Remove high quality care with vital gate keeping and holistic overview
Replace GPs with down skilled workforce.
LMCs and GPC have capitulated to the privatisation and now collude in the ongoing propaganda.
The duplicity is blatant with our leaders give rousing speeches stating the obvious but conclude with agreeing to Stevens decimation of the NHS.
Grassroots GPs need to develop a collective spine and call out the leadership. We are being sold out and patient care will nose dive as will overall cost of healthcare.
We are in the midst of a great betrayal of the public interest aided and abbetted by a minority of mercinary sociopaths.
Personal Health Budgets are a discredited scheme with high costs and open to fraud. They have been withdrawn in Holland.
NHS England is using PHB for achieve the following:
1. Assist private insurance industry takeover. Bribing the most expensive patients with generous PHBs will keep them away from insurers whilst the fit and well transfer over to schemes like Virgin Vitality which offers free gym membership with health insurance. Expensive sick patients will not be taken on by such schemes so PHBs bung avoid bad headlines in the press. When the majority of profitable people have transfered out of the NHS, PHB subsidy to to sick can be withdrawn.
2. Anti-NHS propaganda - stories of extravagant and evidence-free squandering of PHBs fuels increasing disillusionment with the NHS. This is by intended by-product of sucessive privatisation steps. The percieved failings will be used to further undermine faith and loyalty to the NHS.
Our leaders are not stupid or incompetent. This is a very cleverly planned deceptiin and remains highly effective. Most medics still haven't joined up the dots. The public and professiin are being betrayed fir corporate profiteers. Learn more at www.selloff.org.uk
The medical profession has been conned for years now. The NHS has been re-purposed for a public body delivering care with minimal administration to a top heavy bureaucracy, marketised and sliced apart a bit at a time by private companies. Stevens remedy will kill the NHS and give us the American Health Maintenance Organisation Model. This grossly expensive and inefficient but highly profitable system is design to maximise profit extraction. Patients and staff are the least powerful players in this system. Deliberate and unnecessary funding cuts and increased workload burden on staff are all part of the premeditated and cynical manipulation designed to keep us too busy and weak to see and react to the big picture and desperate for any offer of help. Cue New Models of care, dumbed-down delivery, telemedicine etc etc. None of which are designed to restore our once robust public service but to reduce access and delivery.
The NHS has to be crippled to drive people to private insurance. Hence we have ex-UnitedHealth senior exec Simon Stevens in post to deliver large NHS budgets to his mates in the US insurance industry.
The manufactured GP crisis always had PAs a an intended solution. Given the blueprint we are following is from the American Kaiser Permenente. Goal is to dismantle high quality evidence based primary care and replace GPs with telemedicine, HCAs and PAs. Our compliance is nolonger required. We have served our purpose which was to shaft our hospital colleagies by tendering out perfectly good hospital services. By building in conflicts of interest we have also being painted as self serving and overpaid. The scapegoats for the demise of the NHS ready to be rescued by the Private Health Insurance industry. As for our leadership, with friends like these who need enemies. No doubt many of them will enjoy for fruits of their betrayal in the form of gongs and directorships.
Start telling your patients we are being screwed and where we are heading. Only public opinion can save the NHS from corporate capture.
There is an easy way to fix the recruitment crisis. Stop privatising the NHS and scrap the diversion of £10-£20Bn pa needed for the bureaucracy. Reinvest in primary care and remove work which lacks evidence eg health checks and admission avoidance care plans. There is of course no prospect of our corporate puppet politicians reversing their commitment to gifting NHS budgets to US multinationals. After all UnitedHealth have their ex-executive in the top job. Simon Stevens will dutifully deliver primary care to his HMO friends at UH, Kaiser P, etc.
To get GPs HMO corporate takeover ready they need to be herded into federations and encouraged to facilitate mass closures of practices. Doctors will be replaced by cheaper and less qualified staff thereby abandoning the highly skilled triage and gatekeeper role which made the NHS the success it was. The dumbing down of delivery can be justified as the solution to the manufactured recruitment crisis. Access will become geograhically and financially restricted with fewer local surgeries and patient charges.
The cost to the public either through taxation or out of pocket fees will escalate delivering and inferior, bureaucratic, fragmented system. Not forgetting highly lucrative for private corporations and the complicit enablers, many of them leaders within our profession who calmly sell out their colleagues and the blantant public interest. Learn more at www.selloff.org.uk
Keogh is managing down expectations and standards. The NHS is being transformed to the ludircous US Health Maintenance Organisation and private insurance model. The transition requires the dismantling of cost-effective and high quality public services to act as the driver for the Insurance industry which can not compete with the Beveridge system. The middle class flight to private insurance will be facilitated by transferable Personal Health Budgets.
We are witnessing the cold and calculated destructiin of our world respected universal single payer health service to be replaced by skid row provision for the uninsured and the insured to the mercy of the insurance industry, experts in maximising profits through fleecing the worried well and denying expensive care to clients deemed unworthy for one arbitary reason or another.
All these issues are exposed in Michael Moore's film 'Sicko' essential viewing for GPs wishing to see our future clearly.
The NHS heist by corporations in the UK is explained at
The incremental attack on Primary care and the NHS continues. The 'Boiling frogs alive' tactic seems to be working well. The GPC is either ineffective or complicit. Sitting back and spouting strong words but without concrete action.
Prof Steve Field, having provided cover for HASCA 2012 during the meaningless 'pause', has been rewarded with a high paid job. Front man for the GP closure program, he provides the spin to conceal the controlled demolition of GP surgeries behind a veneer of 'quality'.
The Kaiser model being followed does not require high quality, easily accessible, large network of practices. This is not attractive to Virgin et al, lining up to take over GP services. Far more profitable to have services concentrated on fewer sites and provided by a cheap dumb-down workforce.
GP morale is irrelevant as most will no longer be required.
So how long will it take before enough of us start to fight back? No point waiting for our pathetic representative bodies. Many of our leaders support privatisation and will be moving on to lucrative positions on corporate boards or NHS England posts.
learn more watch 'Sell Off' on YouTube
What a joke! The architect of GP destruction pledges support to keep GP surgeries open. Pulse is risking its reputation by publishing this crap. Should be asking Hunt what exactly was MPIG phase out, removal of seniority payments, dumping of hospital work on GPs etc etc was designed to do?
The shameless deceit peddled by Hunt and published by Pulse knows no bounds. Politicians' confuse and conceal tactic still being employed to assist Corporate takeover of vastly down-sized primary care. US private insurance industry set to take control of CCGs. Those GPs that remain will be salaried with little autonomy and even less self-respect, kept silent by revalidation, CQC and fear of unemployment.
Una, you are spot on. Tory/NuLab collusion on destruction of GP and NHS with mutual friend Simon 'Sicko' Stevens. We are witnessing the McDonaldisation of our profession and the BMA, RCGP are absolutely f***ing useless or worse, complicit.
Please follow on @drbobgill for DM
Ex UnitedHealth executive Simon Stevens lecturing GPs for daring to mention the devastating impact of the privatisation agenda is beyond belief. It's a bit like blaming a torture victim for screaming which results in more punishment.
The shameless destruction of the NHS continues unabated as our representative bodies stay silent on the end game. Insulated from or indifferent to the impact of the changes on patient care and professionalism.
Our NHS has been infested by armies of unnecessary intermediaries restructuring the service to divert as much money into their balance sheets. The staggering extend of the conflict of interests are difficult to believe.
The time for waiting for others to act to protect our profession and our patients is over. Every doctor needs to see the reality that is unfolding start fighting back.
Dear Maureen Baker,
The pressure in practices has been deliberately created by Government policy to soften us up for more dismantlement. The NHS is being privatised and GP destroyed to fit the HMO model through 'Federation' and the Field/CQC GP practice closure program. Next step will be corporate take over.
The Deregulation Bill will remove requirements that affect 'economic growth' or profit. This will include the necessity to have medical qualifications to deliver healthcare. This race to the bottom will reduce GPs to pieceworkers providing medicolegal cover for non-medical staff. Continuity of care will disappear and with it job satisfaction, autonomy and self respect.
The RCGP seems to be blind to these threats. Whether through ignorance or collusion the effect is a betrayal of the profession.
This is not a principal versus salaried argument. Divide and rule always works. The fact is the Deregulation Bill will allow US corporates to maximise profits by delivering dumbed down care provided by unqualified people. UnitedHealth and other multinationals are waiting in the wings to grab the profitable aspects of the NHS. The HSCA gives enormous discretion to CCG to decide which services to provide. As the transition to insurance model continues, insurers will try to attract the fit and young with free gym membership etc whilst the sick and old will be kept away by Personal Health Budgets until the majority have taken out their top-up insurance which they will need in the contracted NHS.
QIPP 2009 sets out the sell off of 2/3 publically owned hospitals. The reduced access will be the driver for the insurance industry.
We are continually being softened up by 'zombie' policy suggestions by the pro-privatisation think tanks and groups eg King's Fund and Reform.
The evidence of the Commonwealth Fund report 'Mirror Mirror' ranked the NHS 1st for quality, access and efficiency. This means nothing to our media or greedy political elites who do the bidding of the Corporations. Their betrayal will be made irreversible with the adoption of the Transatlantic Trade and Investment Partnership (EU/US trade deal) which elevates corporations to the level of sovereign states and will sweep away protections on food safety, environment and employment rights.
Medics need to get informed and become active defenders of the NHS themselves. Don't sit back waiting for the BMA or GPC to act. They have been shown to be impotent and complicit prior to 2012.
To understand this policy you must appreciate it has no relevance to current model of GP delivered primary care. Fast forwards a few years into the down sized, large primary care centres left behind after many surgeries have been shut down by the financial destabilisation (MPIG and seniority defunding) and Prof Field's CQC practice closure program. Primary care contracted ready for corporate takeover. The HMO Kaiser model does not want profit extraction to be limited by practice boundaries. Their million plus patient lists will not be entitled to visits. Only those with transport and medical insurance will be welcome. The rest? Who cares. They are unprofitable and must either find the means to access care if there is a still a hospital close by that has not be closed and land sold off to property developers. Welcome to the brave new world to which the GPC still remains blind or atleast pretend to be.
The analysis from ex-UnitedHealth Global executive (job description - secure new markets for health insurance), Simon Stevens, is so deliberately missing the point it is almost embarrassing to witness the blatant charade. He know full well that GP workforce crisis is manufactured and only set to get worse with the Prof Field's CQC inspection or 'GP closure regime', and further implementation of 2009 McKinsey QIPP. The end game is the US HMO model which does not need so many doctors but will replace MDs with HCA, NP, and the new (borrowed from the US) doctors assistant. The deregulation bill will allow the use of unqualified staff to deliver healthcare. This dumbed-down delivery will maximise profit for corporates that will take over primary care. The remaining rump of GP workforce will be salaried, performing conveyor-belt medicine on piece-work and providing medico-legal cover for others.
Dumbed-down delivery will be presented as the quickest solution for a problem of political creation.
Meanwhile our representatives (largely approaching retirement and/or doing very little clinical work) spout strong rhetoric but have no plans for any action. Indeed they fail to warn us of the true threats in the medium and long term. Is the phoney opposition the worked out joint strategy and collusion by any other name? Is it the quid pro quo negotiated along with the 'bribe' of the 2004 contract? The chickens are now coming home to roost whilst those that sold out the patients and the profession to the privatiser sit back soon to collect their fat BMA/GPC pensions and honours.
As for the Insurance industry's man at the helm of NHS England, well I am sure his former employers will be delivered handsome share of NHS contracts for 'commissioning support'. Stevens is well qualified to advice on the transition to private insurance model.
Orwellian double speak in action - 'Unplanned admissions' really means keep the acutely sick at home. Why? because we are shutting your local hospital and there are no beds available. We can't afford hospitals. Why? because too much money has been diverted away to pay for PFI debts, bloated management and pump-priming privatisation.
By engaging with this latest DES, GPs are bestowing the policy with some credibility. In fact there is no meaningful evidence that producing care plans and trying to guess which of our chronically sick patients identified by expensive risk stratification tools may become sick, will produce any significant cost-effective benefit. It does not work in the UK where we have a well established and good quality primary care network. The policy is adopted from America where it is called 'managed care' and part of the HMO model. We are copying the most expensive and unfair system in the world.
We are being softened up to accept yet more US healthcare lunacy. Destruction of NHS capacity and reputation is key to drive the middleclass flight to private insurance, the end game. To assist the transition we have Ex-UnitedHealth Global executive Mr Simon Stevens as head of NHS England. Given his previous job was to find new non-US markets for private medical insurance, he seems to be in the right place at the right time. How fortuitous!
Voltaire - "Those who can make you believe absurdities, can make you commit atrocities"
It's time to wake up and smell the coffee folks!!
Here we go again. The usual suspects spouting the Government propaganda lines. Pro-privatisation GPs with personal financial interests in this covert agenda need to be treated with the same contempt they demonstrate for their fellow GPs who they continue to sell out at every opportunity.
To claim that there is no privatisation demonstrates a serious lack of respect for peoples intelligence.
Mike Dixon et al need to read the Commonwealth Fund report (Highly unlikely given their track record of evidence-free opinion and spin). The analysis ranked our single payer system as the best out of 11 developed countries. The USA was ranked bottom. Yet it is this model our politicians and their colluding GPs espouse.
There needs to be an awakening of grass roots GPs to the serious threat to patient care and their own professional survival from the privatisation and conversion to an insurance based 'managed care' model. As described by HMO chief architect Dr Kaiser, to Nixon in 1971 'all the incentives are towards providing less care'.
CCGs are designed as transitional bodies to assist the conversion to the insurance model. GPs have, for now, the honour of deciding which hospital services they wish to dismantle and invite private profiteers to take over and run with staff on poorer terms and conditions. A race to the bottom disguised as 'innovation and efficiency'. Dumbed down and fragmented services are no substitute for comprehensive and publically provided services.
This is not clinical leadership but complicit enablement of a gross betrayal of the public interest. There needs to be a forensic analysis of the financial interests of those GPs cheerleading for the destruction of the NHS. I find it hard to believe their views are based solely on ignorance and stupidity.
As for Andy Burnham and the Labour Party. Well they spend 13 year privatising the NHS and established the 3 key pillars for the coalition to finish the job.
1. Foundation trusts - break up hospital network into smaller units which are easier to privatise
2. Private Finance Initiative debts - the financial millstone used to justify the mass closure of publically owned hospitals
3. Unsustainable provider regime - the regulatory mechanism for the closures.
We can not trust our 'leaders' or politicians to protect the NHS. It is up to the public and professionals alike to fight to defend our NHS and not be misled by the treacherous and self-serving minority.
How many times are we going to fall into the traps set by our political masters? Increased workload and patient demand is largely as a result of government policy of hospital closures and privatisation. GP income is falling by design. There needs to be some reimbursement which reflects our activity, but there won't be.
Patient charges are NOT the answer. User charges deter the sick and poor as much as the 'worried well', expensive and bureaucratic to collect. Evidence shows patients delaying seeking medical advice when user charges are introduced. Delay in diagnosis can cause significant harm. If we know this to be fact, to introduce charges appears to suggest that our incomes are more important than any potential harm to the patients. Is this ethical?
The current crisis in Primary care has been manufactured to create a pressure from GPs for charges. It seems to have worked in Wiltshire or perhaps they have been brainwashed by McKinsey & Co. We set ourselves up as scapegoats, yet again, as over OOH and commissioning, for the Governments agenda.
We should be demanding increased resource from Government and not our patients. The NHS returned £5bn underspend to the treasury in the last 3 years.
The cost of the purchaser-provider split exceeds £10bn pa yet delivers absolutely no patient gain at roughly the entire cost of primary care!
There is vast resource being squandered on PFI debt servicing, management consultants, internal market and commissioning. This needs to be re-directed to the frontline.
Funding delivery of care is being deliberately and unnecessarily restricted.
We need to stop jumping on command, to every stupid policy the DoH dreams up such as remote monitoring (for the benefit of IT companies), pre-dementia screening (for the benefit of Big Pharma), Health checks (poor cost-effectiveness) etc, etc.
At danger is the Dr-Pt relationship, our respect in the eyes of the public and our professional integrity.
We need to identify the correct target and demand our representative bodies are more effective rather than the incompetence/collusion with Government we have seen in recent past.
The minority of pro-privatisation GPs leading the call for charges need to be recognised for what they are. We must not be persuaded by the 'greedy and dims' amongst us.
I am a GP in SE London and have been very actively involved in fighting the attack on the NHS. During this time I have been part an independent documentary project which tries to give a clear narrative on the stealth privatisation. It has been a steep learning curve with the realisation that our Governments have been betraying the public interest. Handing over a well performing cost-effective single payer tax-funded system to corporate interests.
Demoralising NHS staff is a key tactic in this betrayal. Contraction of public provision and creation of a crisis of care is designed to lead to a middle class exit to private insurance, leaving skid row services for the rest. We all end up paying more for health care as transaction cost will spiral up (5% 1990, 15% now, 30% projected with US insurance model)
Trust in doctors will collapse as we have been set up to take the blame, being in 'the driving seat' via CCGs. In reality we have the power to decide only where the axe will fall as budgets are deliberately restricted.
Too many on the BMA have fallen for all the bogus reassurance from Lansley and Hunt, time and time again. Naïve or complicit, take your pick. No matter, as those responsible are close to the end of their careers or look forward to some other reward. The need to go for all our sakes.
As for those who believe in the NHS and want to fight for it, we must wake up to the reality. Primary care is being prepared for corporate takeover. Many principals will not think twice to sell up their large 'federated' practices to the highest bidder and leave their salaried colleagues to endure corporate management with even less freedom to speak up about poor care.
Please watch the documentary trailer on:
Read 'The Plot against the NHS' by Leys and Player
Read 'NHS SOS' by Davis and Tallis
Please use your BMA ballot paper to elect those who have acted to defend colleagues and patients alike.
I am standing for election as are the following:
Allyson Pollock, Jacky Davis, Kevin O'Kane, David Wrigley, Beth Banks, Jonathon Coates, Rosemary Scott.