The danger to our NHS posed by Integrated Care Systems

 Guest post by Liz Wood of North Devon Green Party. This was originally a letter to her local newspaper. I asked for permission to post as a guest article as it sums up the issues so well.

Anyone would think the Government doesn’t want us to know its plans for the NHS.  The consultation period on its current white paper was half the normal time and ran from 26 November till 8 January, when we were focussed on family and Christmas and New Year festivities, and also somewhat preoccupied with Covid.  Hardly anyone knew a consultation was taking place.  No effort seems to have been made to inform the public.  So we are left to conclude that the wide support claimed by the white paper must be from private companies (many of them American) already doing rather well from the NHS and from others now also expecting to pocket taxpayers’ hard-earned money.

 

The NHS in England is rapidly being reorganised into 42 regional Integrated Care Systems.  ICSs are, in fact, American style insurance-based ACSs, with the name changed slightly in an attempt to prevent us recognising them for what they are.  They are based on a “population health” model from the United States, which aims to spend less on care.

 

Some 83 corporations and businesses, including 22 from the US, are getting heavily involved in developing ICSs and possibly will sit on their boards, putting them in a prime position to guide decisions in their own favour.  It is significant that the head of NHS England, Sir Simon Stevens, previously worked for the American company, United Health, and that Boris Johnson’s medical adviser, Samantha Jones was CEO of Operose, a subsidiary of Centene.

 

Unaccountable ICS board plans will be binding. They could well mean more private contracts awarded without safeguards, more down-skilling and outsourcing of NHS jobs, deregulation of professional standards, reduced services (partially replaced by ‘digital’ options and volunteers), data-sharing to suit the system, and significant spending cuts.

 

Local authorities will lose the power to refer decisions on Reconfiguration (e.g. service closures) to the Secretary of State.

 

Unfortunately the Government’s successful and welcome vaccination programme seems to have made us forget the earlier incompetence and failures.  Tens of thousands of lives could have been saved by a prompt and adequate response to the first inklings of the threat of Covid.  Even before the onset of the pandemic the NHS was already stretched to breaking point by cuts and too frequent reorganisations.  Huge sums had been given to overpaid managers and consultancy firms to work out how many hospital beds they could close, which services they could cut and how many hospitals they could shut, whilst frontline workers were so overworked and underpaid that they were leaving the service in droves. 

 

Successive Conservative Governments allowed stocks of PPE to run down and decided not to replenish them, despite being warned in 2016 of the imminence of a pandemic.  When Covid did arrive, the Government refused offers from several firms to manufacture PPE, and instead handed millions of pounds of taxpayers’ money to large corporations lacking the necessary expertise and experience.  

 

Professor Anthony Costello said that the Government’s failure to set up adequate testing and tracing meant that Covid could never be properly suppressed in the UK.  Again, the Government had handed out billions to private companies who were inexperienced and incompetent, instead of giving the tasks to local authorities, who did have experience in contact tracing and hospital labs, who had experience in testing.

 

The heroic efforts of our health professionals have been consistently undermined since 1979 by successive Conservative governments bent on destroying the NHS, in order to replace it with an American-style, insurance-based system that in the US has led to bankruptcy, both for individuals struggling to pay astronomical health bills and for companies saddled with huge insurance costs for their workforce: a system that can even leave people lacking adequate insurance to die on the streets.

 

We must insist that the white paper be paused and a proper consultation conducted.  We need to read the proposals in the current white paper on ICSs very carefully and oppose them with all our might, or else we shall lose our precious health service altogether.  We must demand that Eleanor Smith’s National Health Reinstatement Bill be enacted.  For all our sakes we need to save what is left of the NHS and get back what we have lost.