Health & Care Bill 2021: the NHS, the law and democracy

The long process of reducing services and closing hospitals in the NHS has a new name 'Integrated Care Systems'. Private companies will be represented in new organisations deciding how to spend NHS money. Democracy has taken a back seat while corporate America created the system it will benefit from.
Read the briefing at publicmatters.org.uk/2021/05/...

[@rockulabacchus3786]

Everyone who claims to care about the NHS should watch this and share it wherever they can.

[@camacassie]

done

[@adrienneking9563]

Absolutely - I've just seen this and completely astonished it's been viewed over 13,000 times yet only got 345 likes! No wonder people don't know about this.

[@martinryan8101]

And watch The Great NHS Heist also on this platform.

[@andrewashdown3541]

This is beyond appalling - the state this country has got into is nothing short of a nightmare

[@bluebottle1617]

@andrewashdown3541 - I agree with you. We all have to say "NO" loudly and often until these money-grabbing couldn't-care-less clowns get the message and bugger off back to the USA. And if they won't go voluntarily, deport them with an exclusion order to boot. And the treacherous Tories and their allies? It's all very well people calling for them to be sent to the ICC, in The Hague, but the one thing that will hurt them more than anything else and would be the most fitting punishment for them is to be stripped of their wealth, land, assets, indeed, everything, like they have the people of the United Kingdom, to help put right the damage they have done to this once great nation.

[@TerryLefteri]

The video excellently exposes the complex and perverse risk-reward sharing arrangements within the NHS, involving influential entities like UnitedHealth Group and the Centene Corporation. The insights provided in this video serve as a wake-up call, urging us to demand the original Beveridge NHS.

[@naxieysadventures5506]

yeah this needs to be made more public. so people know what the governments both labour and tory have done and are doing to our health service.

[@publicmatters1748]

We hope you will share the video as widely as possible, so more people will know.

[@shyguy778]

Thank you very much for this informative video. Content like this is exactly what is needed to educate people living in communities that the NHS is supposed to serve, and I feel is a fundamental part of the solution needed to tackle the corporate owned media narrative that has established itself in our country at a time when government is taking measures to takeover state media institutions like the BBC and even Channel 4. Do Deborah and Jessica have a Twitter account?

[@publicmatters1748]

Yes, it’s @ThePublicMatter

[@gwenp5886]

Thanks for assembling this useful information 🙏👏

[@helenobe]

Prior to dismantling free health care for the U.K. population on the basis of the US care system the U.K. should reflect upon the National issues in the US such as resulting social discrimination, debt and bankruptcy and resulting collapse of social systems in policing a society deprived of its ethic of care

[@ASLEFshrugged]

I'm afraid you've misunderstood, the Tories want to turn the UK into a carbon copy of the USA, for them the USA is the perfect nation, the only difference is that we'd have a monarch instead of a president

[@laxeystu8096]

The video doesn't say that the government are going to do this, and none has ever proposed this I don't think. It does imply it, because showing a corporate logo and linking it to the NHS will 'corrupt the pure ethic of the NHS'. Private companies have been involved across government for years. Why did Mrs Thatcher and her ministers, and subsequent ministers, think that the NHS needed to be opened up to private involvement and an internal market? As a warm-up to privatisation? Maybe, but it could have been what they said which is that they needed it to be more efficient. Why not show this reasoning in the video?

[@publicmatters1748]

@@laxeystu8096 We don’t say that in the video because it isn’t the reasoning. When Margaret Thatcher walked into her first cabinet meeting she put Hayek’s ‘The Road to Serfdom’ on the table and said it should be read by all Tory MPs. Hayek wrote of what he called “the danger of tyranny that inevitably results from government control of economic decision making through central planning.” He argued that the abandonment of individualism and classical liberalism inevitably leads to a loss of freedom, the creation of an oppressive society, and the serfdom of the individual. This is political, not about management. If you genuinely wanted a fully universal, comprehensive system that provides care for everyone irrespective of income then a publicly owned and provided service would do it better than any other. As all the evidence shows the more the private sector is involved (and more so if co-payments are involved) the less equitably care is distributed.

[@laxeystu8096]

@@publicmatters1748 But when Blair came to office pledged to roll back Thatchers reforms, he found that the NHS was complex and unreformed and old-fashioned, as well as being highly complex, and kept some of what had been done in the prior few years as well as his own reforms. Ministers of both parties and civil servants believed (they are in positoons to know) that the top down management didn't work (which equates to it being too expensive ). You could have had Corbyn, McDonnell, Abbott etc arriving to lead the NHS in 2017, and I think within months they too would have been looking at ways to save money and reform the internal management to make it more efficient.

[@laxeystu8096]

@Alex Thornton We've had 30 years of NHS reforms, from Labour & Conservative govts, based on 100% taxpayer funding, free at point of use. Both parties have respected that basic principle, which has been comprehensive. You can make all the videos you want, but I don't think you're going to see a return to the treasured '100% in-house' NHS. This is an ideological priority, whereas the NHS has more important practical problems, such as staffing, and other matters (see recent C4 dispatches documentary). I also think you are 'doing down' the private providers. I know someone who is providing services to the NHS at lower cost than NHS in-house, including the profit margin. These are people who care about the service, but they seem to be, controversially, more efficient than the default in-house provider. I would not accuse them of putting profits before patients. This idea that 'only unlimited funding equates to true patient care' is an obviously impractical way to run it, which will give the health service a bad reputation.

[@missymoppel]

Thank you for this information. I did not vote for Blair, and I was right. This is frightening. And disgusting.

[@Gypsydoggy1]

PEOPLE! YOU cannot TRUST the NHS to the Tories! EVER!

[@biblechampion81]

👍👍👍.

[@belltond1527]

Even though labour started this mess

[@ASLEFshrugged]

@@belltond1527 Wrong. Privatisation of the NHS started under Thatcher with the Griffiths report in 1983

[@rickybreen7828]

Wrong! It started with Labour! conservative have never privatised even 1% of the NHS unlike Labour who sold an entire hospital to the private sector! Maybe do some research before making yourself look a fool.

[@ASLEFshrugged]

@@rickybreen7828 Bullshit. Privatisation of the NHS started under Thatcher, continued under Major and continued under "Red Tory" Blair

[@manuelabeste1980]

Complusive historical summary. Thank you for posting. Why is there not more of this on the BBC????

[@publicmatters1748]

If only…we wouldn’t be where we are now. There have been some good articles in the press and Channel 4’s Jon Snow really grilled the government over privatisation at the time of the Health and Social Care Act 2012, but there’s been no coherent continuous story been told by anyone in the public eye about this. On the contrary we have well read journalists like Polly Toynbee and Denis Campbell in the Guardian enthusiastically endorsing NHS England’s plans.

[@AlexLR]

Unfortunately the BBC is run by friends of the tories so is inherently biased

[@martinryan8101]

You know the answer to this don’t you.

[@Ethericrose]

This will explain why millions of people suffering with debilitating mental health distress, especially since the pland-emic can no longer get help. It would seem these corrupt individuals have forgotten, the public own the NHS - NOT the UK government and the UK government seem to have also forgotten WE pay their wages.

[@callumstewart7230]

Interesting video, worth reading more into I suspect.

[@publicmatters1748]

Thank you. Please check out our other videos. You can also read more at www.publicmatters.org.uk

[@bettyboop6690]

Thank you for the TRUTH

[@marktrinidad7650]

Its nice to see Americans running and profiting ofthe UK.

[@cjwcymru]

Folks in Wales,Scotland and NI. This bill doesn't apply to us. Our health service in Wales won't be privatised.

[@momentumnhs5747]

Check for the influence of Kaiser Permanente and accountable care in Wales, Scotland and NI.

[@cjwcymru]

@@momentumnhs5747 worth delving into. I guess we are not totally protected here

[@stevenclarkson8676]

We have consultants offering a worse service to push people into paying for private health care

[@imwithstupid00011]

I did not know that" sir" simon stevens was that closely linked to boris johnson, it now makes sense to methat there was and is always something funny about the head of the nhs.

[@momentumnhs5747]

His close links with US healthcare are a lot funnier.

[@imwithstupid00011]

@@momentumnhs5747 and a lot more profitable.

[@laxeystu8096]

He was also a Labour councillor. He's done a lot in his career. He was CEO of a major US healthcare company, but then also CEO of the NHS. I never heard it said he didn't believe in the ethic of the NHS, although obviously reform was part of the agenda (for reasons the video doesn't explain, but it simply has to to be understandable) These people are able and sophisticated and I would suggest not jumping to conclusions about what he thinks.

[@momentumnhs5747]

@@laxeystu8096 His policies involve doing away with the local family GP and the local A&E/district general hospital. It's very clear what he thinks if you study it. The fact there is a "CEO" of a 2012-founded QUANGO called "NHS England" whose purpose is to convert the NHS in England to HMOs is a big part of the problem. Who is jumping to conclusions here?

[@laxeystu8096]

@@momentumnhs5747 I know who I'm replying to here; but the OP says that Simon Stevens is a great buddy of Boris Johnson, but I'm also saying that he was politically Labour for a while, and therefore what does he really think about the NHS? I don't know what it means to 'do away' with GPs - we'll all still have GPs won't we? We'll all still need to 'go to the doctor'? Perhaps there are good reasons to reform GP provision? As I understood it he's in favour of the NHS working better, in general. Similar with hospitals- there are reforms to hospitals - to centralise care or save money or whatever. I couldn't say here 'yes what he wants is obviously wrong'. I've seen him interviewed and as far as I recall he and others are trying to reform the NHS for supposed efficiency reasons. The neccesity of this to improve the productivity of it. But not as far as I know departing from the basic socialised NHS principles. Presumably NHS purists would say this is unnecessary, and that if we just returned to the top-down 100% in-house NHS etc then it would be fine/cheaper/better. All I can say is that successive ministers and civil servants who have run the NHS don't agree, as the political memoirs show. Feel free to point out which bits of my summary are wrong. I'm pro-NHS, I just want to understand its problems as they have occurred, and why we (ie they) are doing what they're doing....

[@thattombell]

Very interesting and useful, thank you.

[@GaryWhite-jf7zr]

Prey that you or your loved ones never get seriously ill.

[@fionamcgauley7027]

OMG private corporations taking over NHS

[@katarzynatom784]

Good morning England NHS- restriction 😷

[@andystow]

Vote accordingly....

[@kailashpatel1706]

Tony Blair never said he would remove the internal market, he said he would manage it..

[@momentumnhs5747]

His wording probably varied according to the occasion, but for instance the 1997 manifesto reads: "We will save the NHS [...] End the Tory internal market[...]" www.labour-party.org.uk/manifestos/1997/1997-labour-manifesto.shtml

[@billkosses3808]

@@momentumnhs5747 Unfortunately they just rebranded the Tory internal market the Labour internal market. So they ended it in a sense. 😄

[@momentumnhs5747]

@@billkosses3808 Correct. Not a word came out from lawyer Tony Blair not drafted as if by a lawyer.

[@benstevinson764]

❤️ NHS 🌈👏🇬🇧

[@huyu3007]

I'll sort it out! Boris says for as much profit as possible, what a liar. keep the yank's grubby hands-off.

[@igypop.]

so NHS is gone..

[@telectronix1368]

Another interesting look at 'what a conservative government would do to the NHS' is the, thankfully scrapped, TTIP.

[@publicmatters1748]

At the time of the TTIP Deborah had a presentation called ‘The NHS, TTIP and Democracy’ which she showed at various meetings round the country including at one of the Green Party conferences and at Labour conference alternative fringe. The opposition to the TTIP in this country was massive, for very good reason, including but not limited to its impact on the NHS. Our primary concern at Public Matters is the serious question of how we can be considered a properly functioning democracy if Westminster and Whitehall are operating a different agenda from the one they present to the public? Democracy relies on transparency, accountability and understanding what you are being asked to vote for. Did people know it under the Tory, New Labour, Coalition or current Tory governments? They got a good grasp of it around the TTIP. But it is woefully absent from much of the rest - education, social security, the legal system, social services and broader local authority issues, as well as the NHS. Governments that hide their real ideology behind platitudes about ‘being responsible with the economy’ are not transparent, not accountable and ultimately are undemocratic.

[@kirstywilson4289]

@@publicmatters1748 would you happen to have a link to one of those presentations?

[@publicmatters1748]

@@kirstywilson4289 Unfortunately they weren’t recorded.

[@kirstywilson4289]

@@publicmatters1748 okies thanks for not letting me trawl through internet searches for days ha. Thankyou for setting up this channel and website. I don’t know what I can do to help the situation right now but I will keep sharing. I follow a Lawyers for Liberty on a few of their social platforms. Will try to get the conversation going.

[@TheBurdenOfHope]

A question for everyone - a genuine one too, mind - where does this lead to? Because the English people don't actually have the stomach for this, do we? How is a country going to watch as it's birthright, the NHS, is replaced and we need private health insurance etc It is suicide for the government that enacts that change, surely?

[@momentumnhs5747]

People would have to know that the government had done it, wouldn't they? It would be really hard to do without a cross-party consensus to do it.

[@AlexLR]

As we can see from the way the government has conducted itself around brexit, they are able to do as they please because we don’t have the systems in place to hold them accountable. By the time the electorate has realised what’s happening it’s too late and those seeking to gain have already filled their pockets. That’s if they ever truly realise at all as the tories will blame it on a perceived enemy, do some flag waving, say they’re fighting ‘for the people’ (that they’re simultaneously screwing) and round and round we go until eventually everything is owned by a select group of greedy, power hungry narcissists.

[@sososoprano1]

I’ve been trying to tell people about what’s being done to the NHS for years. They didn’t believe me and thought I was some kind of crank.

[@TheBurdenOfHope]

@johnny burt stunning response. Thank you. Really interesting

[@frankhynd885]

The USA has the best trained doctors, best hospitals and best laboratories in the world. However the American medical system is ruinously expensive as it consumes 17.7% of US GDP versus the UK NHS with 10.4% of UK GDP. US citizens have a significantly shorter life span than Europeans with their government provided healthcare. The US medical system caters to the very rich and many poorer Americans cannot afford any access to doctors and hospitals. British people should vote against having an American style medical system in the UK as it does not suit our needs and it would be too costly.

[@momentumnhs5747]

Except we missed a chance to put it to a vote when one major party leadership disagreed with it. (The 2017 promise to "halt" the hospital closures that are at the core of US-style "Integrated Care" was as close as we got to an opportunity for a vote to decide it.)

[@benstevinson764]

❤️ NHS 🌈👏🇬🇧

[@Jessicajanelove]

Does anyone understand the new bill that passed on Christmas eve?

[@jaargent]

People don't care desspite what they say. It's inevitible that the uk will end up with a sysytem comparitable with insurance

[@frangriffiths377]

Why would anyone in this country think America had anything to teach us about running an efficient effective health service when their system is so outrageously expensive and fails to provide more than the most basic of basic care to so many? Well if course they aren't looking to America to teach those things. They are looking to America to teach them how to make money by providing as little care as they can get away with, as cheaply as possible.

[@publicmatters1748]

That’s it in a nutshell.

[@dewanshirin1990]

Amin.

[@davidbox2354]

what is the point people love being lied to

[@carolesutton3082]

The government put Ravi Baines on a committee looking into home care, his company forces working conditions of 70 hours or more a week just to earn some kind of a decent wage the man is a disgrace.

[@entertainment1443]

What? You getting taxes from poor and reach, but you aren't helping them?

[@SCCGunny]

Sadly that bill has just been passed

[@publicmatters1748]

It has passed its 3rd reading in the Commons. But it is clear that some Tory back benchers are aware that the Bill has serious problems. And it is now going to the Lords where some of the peers are already aware that this Bill is not what the NHS needs if it is to continue as a national and public service. We can only hope they make their voices heard and kick up as much opposition as possible.

[@Ander01SE]

Imagine using American healthcare as a guide for how you want your own healthcare to look like... better have a few million pounds saved up in case you get something chronic like diabetes. :/

[@ellastarrr1st149]

Anything that involves the USA should be ditched like the war in Ukraine. Not a day goes by without more and more American influence in our life in the UK by the press radio and social media, nothing any good came out of the US.

[@kuzumpacis8471]

Simply very Criminal

[@tomhermens7698]

Tories clearly have turned out to be charletans. Fooled me too but no more.

[@virginiaupton7540]

Who are you kidding you making money for your own bank account

[@laxeystu8096]

The horror of this video is one reaction However, if you look at the reaction of Labour, and for example the Guardian, it is more muted. They are saying 'yes there are things we don't like, greater involvement private companies, cronyism, power grab etc', but they aren't making the accusation that this is a fundamental destruction of the NHS. The Guardian is also saying the Tories are nervous about this bill because it is complex and there may be a lot of resistance, and it gives Labour a lot of ammunition.

[@momentumnhs5747]

That's true. The Guardian has completely failed to side with the NHS and has basically acted to advertise the commercial New Care Models. Labour won't use the ammunition, as you point out, because they are committed to the same commercial ends, which involve shrinking away from the complete NHS.

[@laxeystu8096]

@@momentumnhs5747 It is a belief in the NHS as a market as well as public service. The last Labour govt espoused competition (within the NHS obligation) as a means of providing value for money/choice. Without knowing more, I can only conclude that the 'public NHS' that is desired by some is unaffordable, or unmanageable. kzbin.info/www/bejne/aGLJeIV_oKuqqpo

[@momentumnhs5747]

@@laxeystu8096 It's one we had for 40 years and is why the NHS is so loved.

[@laxeystu8096]

@@momentumnhs5747 I don't doubt that it is loved, but as the video explains (and supported by a whole series of Labour health secretaries & PMs), the NHS as a market with purchaser/providers & diversity of suppliers is argued to be more affordable. These discussions of economic structure of the NHS seem rather abstract. Today the NHS has severe practical problems, such as vacancies, capacity, and escalating costs. The people who have been running the NHS in recent years do not appear to be saying that a return to an in-house only structure will solve these issues, although I appreciate seemly you are arguing that.

[@camacassie]

Blair is a warmonger

[@mmcfarlane001]

Bore off.

[@laxeystu8096]

The video makes statements that aren't supported Nobody is seriously promoting US-style healthcare in this country, and few voters want it, correct? What politicians believe - which is worth debating - is that the NHS is too expensive and needs to be more efficient. Monolithic organisations with huge funding needs tend not be. This is what the internal market was trying to do, correct? Blair wanted NHS reform, as did Thatcher, Major, Cameron etc. None ever proposed US-style healthcare, and Blair did raise funding to EU average levels. Is this the problem, that we basically don't pay enough?

[@publicmatters1748]

The history of the NHS being buddied with Kaiser Permanente in particular is well documented. But the US-UK relationship is a longstanding one in all things political. Everything in the video is supported - indeed you can see the evidence with your own eyes and ears, out of the mouths of politicians and others. The NHS is not too expensive, although as the marketisation has grown so have its costs. There are not enough people left around who understand how public administration and accounting used to be done. It was on a very tight rein and the public service ethos- and the awareness that it was public money being spent - led to extreme care with budgets. The myth of ‘monolithic’ public services is just that - a myth. Public services can adapt without expensive contract changes (because they don’t provide services under contract) and can put services in areas the private sector would consider unprofitable but where the need is greatest. Public services can also respond to emergencies with great facility again because no-one is stopping to ask ‘whose budget does this come out of/are we contracted to do this’ According to the latest Office of National Statistics report (released in 2019) In 2017, the UK spent £2,989 per person on healthcare, which was around the median for members of the Organisation for Economic Co-operation and Development: OECD (£2,913 per person). However, of the G7 group of large, developed economies, UK healthcare spending per person was the second-lowest, with the highest spenders being France (£3,737), Germany (£4,432) and the United States (£7,736). As a percentage of GDP, UK healthcare spending fell from 9.8% in 2013 to 9.6% in 2017, while healthcare spending as a percentage of GDP rose for four of the remaining six G7 countries. And these costs, of course, have been greatly inflated since the introduction of the market in 1990. Had everything remained public no doubt we would be well below the median whilst offering a better service. Privatisation of public services costs a lot. So do the management consultancies, lawyers and accountants that the market seems to automatically entai; These are deadweight costs to a public service. But you didn’t watch the video, did you?

[@laxeystu8096]

@@publicmatters1748 What, because I question the logic of the statements in the video, or find it lacking information, or one-sided, that means I didn't watch it? I'm not against the NHS at all, but this video is clearly written from one perspective (however well-intentioned) which devalues it as an educational resource. There seems little writing about the way our healthcare system is run for the general reader. To say that reforms designed to reduce costs have all increased costs defies common sense. I know the situation is complicated, but it needs to be broken down more. When Tony Blair arrived in office he needed more from the NHS, and was advised that some of the previous Clarke reforms worked well. This video seems to be just promoting the line that we're on the way to US style health care, which nobody wants.

[@laxeystu8096]

@@publicmatters1748 I don't know whether Kaiser being involved in the NHS is a sinister thing or not, they may be a great company with well-motivated healthcare professionals, or whether to be worried that GP surgeries are run by US companies or not. What I think I know is that the NHS is going to remain taxpayer funded and free at the point of need or use long term. If the NHS feels the need to include an internal market, or novel fundholding, or management approaches, that's probably because they think they need to save money somehow. I was under the impression that there is no way the NHS can be funded along the pure original lines (continuous expansion, 100% internal, whatever that may be...) because, as I thought, it can't be afforded. 'Contractorisation' has occured across the government (lots of military training, repairs, support is done privately, AWE etc). I can only conclude this does save money and is not based on back-handers and favours. The important thing seems to be to keep control of all the parts and keep critical capabilities in-house, which the NHS does I think.

[@publicmatters1748]

@@laxeystu8096 First of all Tony Blair, Alan Milburn, Patricia Hewitt, Simon Stevens, Mark Britnell, Penny Dash & many more in the New Labour administration were already ideologically wedded to the private sector. And yet Blair’s barnstorming performance at the 1996 Labour Party Conference was all about rolling back the market and the early Tory privatisations. There was no question of believing the Tory market had worked well in any way. But it did open the gateway to the private sector which was what Blair believed in. In fact he was willing to greatly increase funding in order to make it happen. And no, not because you question anything, sensible questions are fine, but because you said no one is promoting US healthcare, despite the fact that the NHS is currently actually being remodelled on the lines of a US Medicare model of Integrated Care Systems as evidenced in the film. Jeremy Hunt said we are on the way to a funding model like Kaiser Permanente. What did you think he meant by that? Perhaps you think something else is meant by the US system? That we’ll all have to pay private insurance for the NHS, perhaps? You won’t find that in the film. Perhaps you don’t understand what’s meant by Medicare? The fact that the actual evidence doesn’t support your view doesn’t make it one-sided. There isn’t ‘another side’ to the 42 Integrated Care Systems. If you want to argue that these systems are better go ahead, provide some evidence. These systems are NOT designed to save the government money. They are designed to cut the cost of care to allow for profit margins. We now have a hybrid system where funding is diverted into a plethora of private sector profit opportunities while care is rationed and staff pay fails to keep up with inflation. These systems are designed to bring the private sector into the heart of the NHS. As David Locke, QC (who often advises and works for the government) said the legislation you use for the private sector is very different from the legislation you use for the public sector. And cumulatively the legislation since 1990 is designed to favour the private sector. If you believe the private sector is more efficient in healthcare then please provide the evidence. There is a wealth of evidence from across the world that the more healthcare is privatised the less equitable it is and the more its funding is spent on frictional costs at the expense of patient care, ie the less it is like the NHS.

[@laxeystu8096]

@@publicmatters1748 It is in the book Broken Vows (p21-30) that Blair and his first health secretary Frank Dobson came into office wanting to roll back Tory health reforms, and Dobson wanted to revert to an 'old school' NHS, but were advised that yes the NHS wasn't working very well but that the hated Clarke reforms had been one bit that was working well. Edit: It's far from true that Alan Milburn was 'wedded to the private sector' - along with Dobson and Blair to some degree they were opposed to private provision. Can you read p21-30 and let me know?

[@edwardhodgson3994]

No one voted for this

[@edwardhodgson3994]

No one voted for this