Your NHS Needs More Than Clapping

[Buelligan]

Thought I'd pass this on it seems pretty important for you people living in Britain who might get ill one day -

While generations of us have been lovingly patched up by our NHS, and proud to fund it with our taxes, successive UK governments have been quietly privatising this cherished institution. Decades of academic research, and the brave campaigning of doctors and nurses, has exposed how this privatisation plot smuggled in private providers and US corporations while selling off NHS land and buildings.

Now, public health experts are sounding the alarm that the current Health and Care Bill is likely to be the nail in the coffin for our public health service. They are warning that the Bill will pave the way for the English NHS to be replaced by the profit-driven American system, in which private health providers are incentivised to cut and deny care to increase profits.

Take our five actions to stop the bill, and build the campaign to renationalise our NHS before it's too late.

Five actions to save your NHS!
1.Sign and share this petition
2.Email your MP
3.Create your own video
4.Tweet politicians
5.Alert 5 friends!

https://www.yournhsneedsyou.com/

[flotemysost]

Cheers, signed and shared.

[bgmnts]

I just dont understand it.

With the world literally on the precipice, or probably already sunk, and most of us are fucked, why are evil capitalist bastard going EVEN HARDER? I dont get the end game here.

[thenoise]

In a post work economy, your position on the ladder will be determined entirely by the assets you already own.

[Buelligan]

And they don't give a fuck about anybody else.

[Zetetic]

Further, it is important not to be confused by the current calls for more public money to pay for the NHS. The NHS has only become so expensive latterly because it is funding not only an unnecessary market administration, and Private Finance Initiative profiteers, but also an ever-increasing range of profit-driven health industry corporations.

Hmm.

[Johnny Foreigner]

Well, I do like to be informed before I commit to anything, but bleedin ell, I'm not reading all of this.

https://www.kingsfund.org.uk/publications/health-and-care-bill-key-questions#what-will-the-new-system-look-like

Probably doesn't apply to me anyroad, as I'm in Scotland.

[Shit Good Nose]

Well, I do like to be informed before I commit to anything, but bleedin ell, I'm not reading all of this.

https://www.kingsfund.org.uk/publications/health-and-care-bill-key-questions#what-will-the-new-system-look-like

Probably doesn't apply to me anyroad, as I'm in Scotland.

I know and work with quite a few people that work in various parts of the NHS and the general consensus is that the basic intent of getting all the different parts of it to be more joined up (at the moment it is very much often a case of the left hand not knowing what the right bollock is doing and vice versa, and they never bother telling each other or anyone else what they're doing) is A GOOD THING (NOTE - something that has been promised many times over the years, but never delivered).  The problem is that none of them are convinced that how they are proposing to do it will work, and it leaves doors wide open for any private sector (which for this bill has been renamed THE INDEPENDENT SECTOR [strokes chin]) provider to be contracted in due to procurement changes.  The new bill also allows central government (i.e. the tories) to make decisions which override those of top NHS staff, which is a...well, you know what kind of thing that is. 

If I've understood what I've been told correctly...

[Zetetic]

What decisions?

[Shit Good Nose]

What decisions?

I think (again - I can't guarantee I've understood it correctly as I hear it in NHS-speak, which is a patois I'm not totally on top of) things like awarding contracts, and so the cynical thinking is that, for example, some tory cunt (take your pick) wants to award his mates who run a private sector firm in the mental health sector a contract and, hey presto, they get it without anyone else having to agree to it.  I mean this is already being done of course - you've quoted it yourself above - but I'm assuming the insider suggestion is there's going to be a LOT more of it.

[Zetetic]

The problem is that none of them are convinced that how they are proposing to do it will work,

No change to organisational structure can affect this at this point - England is the only part of the UK to have persisted with its commissioner-provider-split-everywhere lunacy and it has made almost no practical difference because England, Wales, Scotland and NI are all so completely fucked capacity-wise, particularly in the dreaded area of management.

[Zetetic]

I mean this is already being done of course - you've quoted it yourself above -

To be clear, the bit that I quoted from the website are the ravings of an absolutely fuckwit who presumably believes that NHS Scotland and NHS Wales and HSCNI are absolutely rolling in cash.

[Shit Good Nose]

No change to organisational structure can affect this - England is the only part of the UK to have persisted with its commissioner-provider-split-everywhere lunacy and it has made almost no practical difference because England, Wales, Scotland and NI are all so completely fucked capacity-wise, particularly in the dreaded area of management.

Management is the main complaint I keep hearing for...probably getting on for 15 years now.  I'm amazed that so many of these people have remained working in the system for so long, but then I guess they're a particular type of person that has a want/calling/whatever you want to call it to...hell, keep people alive regardless of whatever bollocks is going on above them and in the wider political field.  Hats off to all of them - it's certainly a field that would drive me to drink and drugs and a severe dive into depression in no time at all.

[Zetetic]

To give a broader view:
The Integrated Care Systems stuff is basically fine and an attempt to formalise workarounds for the provider-commissioner split being so clearly broken for so long. Don't like the idea of private companies being represented on some ICBs but eh, really.

The changes to procurement rules will mostly involve avoiding pointless competitive tendering processes where there's no even slightly credible alternative to existing NHS provision. There'll probably be some miserable but minor counterexamples.

Most of the English NHS isn't worth privatising - the spend on many services is so far below what's needed to provide them that there's little commercial interest in providing them under the current circumstances. Counterexamples (e.g. long stay mental health and learning disabilities hospitals) are already heavily infected by privatisation and NHS provision is often being driven out by other ideological commitments.

The real threat to the NHSs of the UK is the growth of privately-funded elective healthcare, not privately-provided NHS care. Post-COVID waiting lists will provide fertile ground for this industry. (NHS-funded waiting list initiatives aren't completely irrelevant here, but the Bill is irrelevant to these, I think.) This could justify a vicious circle of defunding English NHS elective care (perhaps initially on the basis of shifting priority to emergency care) in the first place, with knock on effects for the block grants to the other countries of the UK.

[Shit Good Nose]

So, as you're CaB's Mr Statistics, is your general opinion that the NHS is going to be okay, or at least as okay as it can be?  (and that's a genuine sincere question, not some cynical retort)

EDIT - I should, perhaps, say "unchanged" rather than "okay", but I will leave it as-is with this as a footnote.

[Zetetic]

The NHSs of the UK are utterly fucked by multiple workforce crises, now decades-long, which at this point are only partly funding crises (and aren't entirely within the NHSs).

Some parts of the UK were showing signs of catastrophic failure in unscheduled care in 2019[nb]Arguably for far longer in NI.[/nb] - lockdowns briefly interrupted this - but now we are returning to that state with less capacity than before.

We've all already handed the most vulnerable people with the least choice about their care over to US-owned private companies.

Whatever the English government does to the nominal structures of their NHS doesn't matter a huge amount, and they're going to do it whether you write to your MP or not. Personally I'd suggest spending the energy elsewhere.[nb]I should take my own advice on this at 0200.[/nb]

[Bigfella]

I'm lost at sea here. Isn't it already the case that the NHS has been delegated on a franchise basis to private companies? I don't claim sound knowledge, that's just what I've picked up from reading the papers.

[Buelligan]

The NHSs of the UK are utterly fucked by multiple workforce crises, now decades-long, which at this point are only partly funding crises (and aren't entirely within the NHSs).

Some parts of the UK were showing signs of catastrophic failure in unscheduled care in 2019[nb]Arguably for far longer in NI.[/nb] - lockdowns briefly interrupted this - but now we are returning to that state with less capacity than before.

We've all already handed the most vulnerable people with the least choice about their care over to US-owned private companies.

Whatever the English government does to the nominal structures of their NHS doesn't matter a huge amount, and they're going to do it whether you write to your MP or not. Personally I'd suggest spending the energy elsewhere.[nb]I should take my own advice on this at 0200.[/nb]

All well and good Zetetic, all well and good.  So what avenues would you suggest people spend their energy on?  It's incredibly easy to tut and tell people they're wrong but, fact is, as you've said many times, NHS has giant issues.  Something needs doing.  So what are the alternatives?  What should we all be doing?

IMO, most people want to help, they love the NHS, them reminding MPs and so on of this stone cold fact is no bad thing.  A great deal better, IMO, than sitting on their arses watching Gogglebox or whatevs.

It's not as if protest energy is a one time thing, there's plenty more where that came from and all silence gets us, eventually, is a bolt in the forehead (and notional thanks from those stripping our assets for not making a bad noise about it).

[Zetetic]

All well and good Zetetic, all well and good.  So what avenues would you suggest people spend their energy on?

That's a fair question. I think the answers are mostly going to be local, even if you're focused on the NHSs - keeping particular services open.

Pay is a national and UK-wide campaign that might be winnable. Write to your MP about that, find local groups that might support Unison and other unions in direct action (if you can't join those unions yourself).

... them reminding MPs and so on of this stone cold fact is no bad thing.   ...

It's not as if protest energy is a one time thing, there's plenty more where that came from ...

I increasingly don't think these things are true.

[Buelligan]

I'm interested to know why, Z.  Obviously, there is the undoubted reality that most MPs are sociopaths who don't give a fuck about anybody else but they do love themselves.  And they do know, even cunts like Streeting know, there are a few sacred cows you'd do well to keep your hands off - one of them being the NHS.

IMO, no politician (except the mad ones looking in) but no UK politician would dare to come out and fully say, right, let's kill the NHS.  They absolutely know that would be the end of their career (they might get lucrative gigs in the private sector on the back of it but even then, it's deffo a political career-killing move).  So these cunts (of all stripes), who want to butter their bread with our hard-earned and fought for NHS, do it quietly.  Bite by tiny bite.  And to do this, they rely on us not making a fuss.

We need to make a fuss.

[Zetetic]

Letter-writing goes a long way towards demonstrating that you're not going to make a fuss, particularly at this point[nb]a decade since the 2012 bill, three decades since the provider/commissioner split in England[/nb], on this subject. Repeatedly engaging in the same failed strategies shows your enemy that you're not able to escalate, and makes you feel powerless.

It has its place. For example, when someone in a position of power needs to make an argument to their peers for something that they already want to do.

[Huxleys Babkins]

Yeah, that MPs are reporting complaints they don't agree with as hate speech shows where this is going.

Reminding them that we love our NHS is of little value. They know this. That's why they are cynically rebranding private contributions like "NHS Test and Trace" as such. To blur the lines of accountability and responsibility. To blur the lines between what's publicly funded and private. So that if they ever do decide to wholesale sell it off, the plebs won't even notice.

[Buelligan]

Yes, I'd agree that in some, perhaps many, cases individual letter-writing is pissing in the wind.  However, I do believe that, when MPs receive remarkable levels of letters on a particular subject, they notice, even if it's just being aware that someone is coordinating, paying attention, watching and possibly preparing further action.  That's better than sitting quietly waiting for the axe to fall, has to be.

I also wonder if it has another use.  If one cares deeply enough to poke your head out of the duvet and scribble something, hoping.  Maybe one in ten of those people, being soundly ignored, gets angry enough to actually get out of bed and do something more.  That's a thought too.

[Fambo Number Mive]

Signed and will share. Thank you for starting this thread, I wasn't aware of this campaign before.

[Buelligan]

Anyone wondering whether or not to do anything about this should probably watch this new film from DoubleDown News https://www.youtube.com/watch?v=IwM-JwoCvlI

[Kankurette]

I've signed it. It will do sweet fuck all but it's better than nothing.

[Chedney Honks]

Thanks so much for everything.

[Zetetic]

Anyone wondering whether or not to do anything about this should probably watch this new film from DoubleDown News https://www.youtube.com/watch?v=IwM-JwoCvlI

This is a mess, with respect to the English Bill.

"The NHS bill will convert our NHS into an American style managed care system where profit will be maximised by denying patients care."
What profit? Is the suggestion that ICSs will themselves be private for-profit setups?

(If there's a real risk about private-representation on ICS boards it's probably that they'll reinforce existing mechanisms for providing very specific types of "care". That's how you actually profiteer from the NHSs in the UK. The video letter later touches on this and highlights an example where a private company still walked away because there was no fucking money in it!)

"Now we know the American system is twice as expensive as what we spend on health care in this country."
What's the plan then? Introduce this English Bill and then double NHS spending on healthcare, so there's some money to be skimmed by profiteers from whole-system setups?[nb]Excited to see what the Barnett consequentials on that would look like.[/nb]

How does this Bill do anything to transform the English NHS into an insurance-based system? English "NHS" Foundation Trusts can happily become providers to private insurers already. People who can afford it are already being pushed towards private healthcare in droves, where there's profit to be made, by the impact of the decades of workforce crises plus COVID.

[Buelligan]

"Now we know the American system is twice as expensive as what we spend on health care in this country."
What's the plan then? Introduce this English Bill and then double NHS spending on healthcare, so there's some money to be skimmed by profiteers from whole-system setups?[nb]Excited to see what the Barnett consequentials on that would look like.[/nb]

Another alternative might be to provide less or lower quality product (care) for the money available.  Or pay less to the carers.  Or both.  That would free up some dosh for the shareholders and directors.

[confettiinmyhair]

An example of that would be mental health services using Kooth, which will eventually lead to some company like Better help.com working with 'NHS patients'.

It's lucrative https://www.thetimes.co.uk/article/online-mental-health-counsellor-kooth-floats-to-fund-expansion-rcn8z7k88