The questions Hunt must answer on his americanised-NHS plans

hunt gormless

Jeremy Hunt is in the middle of an enormous stealth-reorganisation of the NHS into ACOs (accountable care organisations), modelled along the lines of the hugely inefficient US healthcare system. According to healthcare experts:

  • Like Sustainability and Transformation Partnerships, the introduction of Accountable Care Organisations is being done in replacement of a single, English NHS, with the loss of all national risk pooling and finance pooling.
  • ACOs are designed to not automatically serve everyone in a given area, the way the NHS would have done. E.g.: They are only obliged to deal with individuals who are registered with them.
  • They have artificially restricted, pre-set budgets that are cut so as not to cover all of people’s healthcare needs, the way the NHS otherwise would have done. This means people will be denied care, which the 2012 Health and Social Care Act laid the groundwork for by removing the state’s duty to provide comprehensive healthcare to the population.
  • ACOs are set up so that all the services can be outsourced to a single private company, or to a shell company which can include all sorts of players, from a GP consortium, to a private healthcare multinational, which can outsource, even to an NHS body.
  • Even to the extent they are in the hands of public bodies, ACOs are designed to end the basic NHS principles of comprehensive healthcare for all. These founding NHS principles recently found extraordinary support among the population, around the 90% mark. No government has ever had a mandate to dismantle our access to healthcare in this way, let alone in blatant avoidance of parliamentary scrutiny.

The nature and consequences of the reorganisation are so damaging that leading health experts are going to court to try to stop it, but the issues with ACOs will be a mystery to a majority of the public.

Some of the key problems and concerns with the system – apart from the obvious increased privatisation almost certain to ensure – are laid out in these questions, which have been sent to the Dept of Health (DH):

  1. What is to stop a large private company tendering for an entire ACO and then sub contracting out the various functions?
  2. What will be the legal basis of the NHS parties to the contracts involved?
  3. To whom will the CEO of an ACO be accountable and how – i.e. what forms of accountability will exist?
  4. What happens to the legal responsibilities of CCGs involved within the footprint of an ACO?
  5. Who will employ the staff contracted to provide services by the ACO?
  6. Will ACOs be able to use the prime and subcontractor contractor model in procuring services outside hospital trusts and general practices?
  7. If so what prime contractors will be eligible to be used?
  8. Will private providers who have been convicted of, or agreed settlements when accused of, fraud be eligible to be used?
  9. Will all providers of services commissioned by ACOs be fully subject to the Health Service Ombudsman and the Freedom of Information Act?

Hunt’s new structure appears designed to be opaque, unaccountable and confusing for the public – campaigners say this is deliberate in order to facilitate privatisation without public awareness.

The DH’s responses to the question above will either shed light on the risks of the system – or confirm that Jeremy Hunt and his party want to keep the public in the dark about this massive ‘top-down reorganisation.

But given the tendency of Jeremy Hunt to run and hide from awkward questions, don’t hold your breath.

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    1. yeh but thats what they plan to give us. I am hoping that a future labour government will revers these changes and begin to reverse many others

  1. Well, this should make Luke Akehurst whimper in pleasure being an Atlanticist but really how Simon Stevens get away with the selling off our NHS amazes me. It old Simon and the Government pulling the strings here they have been all along. On hiring Stevens to run NHS England was one of the cleverest moves that David Cameron has made because he “knows more about NHS problems and market solutions than any man alive”.[9] So any money given to NHS now goes directly into his American mate’s pockets.Not bad for an ex-labour councillor and if you agree with selling our NHS of course. Simon Stevens has been named the most powerful person in healthcare.I would agree with that.

  2. ”In the early 21st century Atlanticism has tended to be slightly stronger on the political right in Europe (although many variations do exist from country to country), but the political centre-left in the United States. The partisan division should not be overstated, but it exists and has grown since the end of the Cold War”

  3. Check out Mo Stewart’s book ‘Cash Not Care’. this gives details on how the tories have been colluding with the insurance company’s of USA since 1992 to destroy our welfare system. Shows just how disgusting these people are. Thatcher must have hated the people of this country to deprive them of a future and her worshippers have continued in her path.Such Malice is almost unbelievable.

  4. Good questions.
    Hunt will keep on running, I remain convinced he is the political foil (or mannequin) to distract and confuse while the final big NHS prizes are passed into private hands at knockdown prices to be rented back to the public in one form or another after the spoils are distributed between corporate cronies and banks.

    Let’s not forget other aspects of the ongoing privatisation of NHS England and assets are still pushing ahead eg. under the Naylor review which the government is following… https://www.youtube.com/watch?v=4TQrTJLnia8

    NHS Property services lists the board members… a corporatist dream team but I wonder who actually owns this company and is there a public liability if it, along with NHS, is asset stripped?


  6. Yes ACOs sound like A Conservative Outrage.
    Tories have always hated the priinciples of the NHS ever since they voted against it being set up in the first place.
    I am afraid it took 20 years for Neo-Liberalism to capture the Tories in the 1980s and people need to realise we are dealing with Tory Barbarians!

  7. Reblogged this on The Night Owl and commented:
    So many of the people I know are totally clueless about what’s going on with the privatisation of the NHS, so I really hope you get some answers to your questions, though I’m not going to be holding my breath waiting for any!
    Far too many people are listening to the lies being constantly put out by the media – and especially the BBC, about all this, and it frightens me that there is still so much ignorance about it, despite the constant, mostly harrowing, results of Tory Austerity plans.
    To have an American system of health care (which is only care if you are rich enough to afford it), will be a total disaster to millions of Britons, brought up with the ethos of complete health care, from the cradle, to the grave!
    When the tories got the American Insurance companies involved, they started an avalanche that will cause the poor, benighted, people of this country incalculable harm – but then, that always was the tory way – and I’m gobsmacked that people didn’t remember this when they voted the bumbling ididots back into power!

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