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The biggest privatisation in NHS history: why we had to blow the whistle

Another reason why we should all keep our eye on the ball


Powered by Guardian.co.ukThis article titled “The biggest privatisation in NHS history: why we had to blow the whistle” was written by Kate Godfrey, for theguardian.com on Monday 16th March 2015 12.16 UTC

I’m not a journalist, but as of this morning I know what it feels like to be part of the biggest leak in NHS history.

Published on openDemocracy, the memorandum of information for the £700m sell-off of Staffordshire cancer services is now available for the 800,000 directly affected and 3 million indirectly affected patients to read online.

That document, together with others relating to the joint £1.2bn privatisation of cancer and end-of-life services in Staffordshire, was sent to me. They are commercially confidential, secret agreements that will rebuild NHS services for hundreds of thousands of people, but are for the eyes of the bidding companies only.

Not only is this the first billion-pound NHS privatisation, it is the first time that it has been deemed acceptable to put care designed to meet the needs of our most vulnerable patients on sale.

Uniquely for a privatisation on anything of this scale, there has been no public consultation, simply a series of weak “engagement” events led by paid “patient champions”. For the past year unpaid patients have not been able to have their say. Thanks to the brave person who shared the documents, now they can.

The background is this: Staffordshire commissioners want to hand the management of all care for cancer and end-of-life patients to a private company, a “prime provider” that will take responsibility for the delivery of care, subcontracting and performance management.

There are lots of firsts here. It is the first time that cancer or end-of-life care has been contracted out. The first use of the prime provider model on anything like this scale. The first privatisation without formal consultation. The first huge international NHS contract that could fall under TTIP. Transfer these services out of the NHS now, and we may never get them back.

The leading bidders are all US private healthcare companies, some of them implicated in failures of care elsewhere. One is Optum, the US brand facing allegations over the American hospice-packing scandal. (Optum is defending itself against the allegations.) It is the first time that the commissioning responsibility held by local clinical commissioning groups (CCGs) – the right to spend a billion pounds on behalf of the NHS – will simply be gifted to a private company.

And it looks like it will be a private company. There are clauses in the published document that simply have no place in a project that will stay within the NHS. Bidders are encouraged to explore a “VAT efficient model”. Not only is this disturbing in its own right, but NHS bodies don’t pay VAT. This is a strange level of detail to find in a document that is otherwise so imprecise.

There is no plan here, no benchmarks against which a bidder could be selected; just a hope that the shape of the contract will resolve itself as bidders make their own suggestions and time goes on.

To me, it looks as though local commissioners simply got bored, and decided they didn’t want to be responsible for cancer care any more. To the health expert John Lister, it looks worse. He says the contract is “no more than a blank cheque for whichever private firm is the most ruthlessly willing to cut services to shore up their own profits”.

The winning bidder will be free to decommission or disinvest as they like – cutting contracts with local hospices, therapeutic providers or even frontline healthcare such as radiotherapy and surgery. The bidder could simply replace them, delivering services such as radiotherapy themselves, further fragmenting the services that mean most to patients. Or they could just squeeze existing contracts. No payment structure is specified. Bidding companies can decide for themselves what they are worth, as long as their fees are self-funding within the current budget. Based on similar health privatisation contracts, £100m in fees is the minimum that a private provider will accept. This money will be diverted straight from funds currently spent on frontline care.

Those hospices and providers will be told that they can still provide care – it just has to be for 20% less, with the remainder meeting the fees of the winning bidder. They might just reduce costs, or they might cut services that cancer patients depend on. It is the postcode lottery written into an NHS contract.

The question the document doesn’t even try to answer is why. Commissioners’ own figures show cancer care in Staffordshire to be above national average. Only one of the four CCGs backing the change list cancer as an area where they could make significant improvement. There is no clear case for change, but there is an opportunity.

Time and time again we have seen Staffordshire used as the proving ground for the 2012 Health and Social Care Act. Cancer and end-of-life privatisation has been introduced here because it was politically convenient. Our history is used against us; our patients pay the price again.

Not only was there no formal consultation, but local patients were meant to get no say on this contract at all. The original plan was to sign the deal in March – before people could have their say at the polls. Labour has said it will not let the project go ahead.

The campaign group I work with – Cancer Not For Profit – fought for more time. When the awarding of the contract was put back until June, we thought that we had won a small victory.

Our source heard differently. The project wasn’t delayed, they were told, but simply hushed up. The political implications of pushing through the biggest privatisation in NHS history two months before a general election were too serious. It had to move forward with speed, and if the contract lacked benchmarks or risk management, forget it. It could all be resolved later. (It is the essence of contract law that weaknesses are generally not resolved later.) The only thing being delayed until after May was the announcement, which would now be made in June. And then a gamble that a new government couldn’t go back on a contract already awarded.

“I’m going to publish,” I told the source. “Tell me if you don’t want me to publish.” I never heard from them again.

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Gong founder Daevid Allen has died, aged 77

Gong were one of the many bands that inspired me to create music. I was never really  a hippy but found a lot that appealed to me in the music. It is also in many ways on a totally different track to much of present day societal point of view. Many of the musicians and creative folk that influenced my thinking have sadly passed in the last couple of years. The gong albums I have are on Cassette and I don’t have anything to play them so I can’t have a nostalgic listen at this moment. 🙁

 

Powered by Guardian.co.ukThis article titled “Gong founder Daevid Allen has died, aged 77” was written by Guardian music, for theguardian.com on Friday 13th March 2015 07.59 UTC

Daevid Allen, the leader of the legendary prog-jazz eccentrics Gong, has died aged 77. The news was confirmed on the Facebook page of Allen’s son, Orlando Monday Allen.

And so dada Ali, bert camembert, the dingo Virgin, divided alien and his other 12 selves prepare to pass up the oily way and back to the planet of love. And I rejoice and give thanks,” he wrote. “Thanks to you dear dear daevid for introducing me to my family of magick brothers and mystic sisters, for revealing the mysteries, you were the master builder but now have made us all the master builders. As the eternal wheel turns we will continue your message of love and pass it around. We are all one, we are all gong. Rest well my friend, float off on our ocean of love. The gong vibration will forever sound and its vibration will always lift and enhance. You have left such a beautiful legacy and we will make sure it forever shines in our children and their children. Now is the happiest time of yr life. Blessed be.”

Last month, Allen announced he had been given six months to live, after cancer for which he had previously been treated had spread to his lung. “I am not interested in endless surgical operations and in fact it has come as a relief to know that the end is in sight,” he said. “I am a great believer in ‘The Will of the Way Things Are’ and I also believe that the time has come to stop resisting and denying and to surrender to the way it is.

Allen was born in Australia in 1938, but his springboard to musical legend came after he moved to the UK in 1961. He was a founder member of Soft Machine in 1966, but became best known after starting Gong. The band are best known for their Radio Gnome Trilogy, made up of the albums Flying Teapots, Angel’s Egg and You. Although he left Gong in 1975, he resuscitated the band in 1991 and played with them on and off until he became too ill to tour in 2014.

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Eddie Izzard locks horns with landlords over Chelsea social housing estate

London is possibly already past saving.


Powered by Guardian.co.ukThis article titled “Eddie Izzard locks horns with landlords over Chelsea social housing estate” was written by Robert Booth, for The Guardian on Thursday 5th March 2015 12.36 UTC

First came Russell Brand with his messianic locks and born-again radicalism, crusading for families on an east London estate facing eviction by US investors.

Now it is the turn of Eddie Izzard, sporting a pink manicure and Cuban heels, to set down his comedian’s microphone for a tilt at politics.

Like Brand, the 53-year old stand-up has decided to take on Britain’s affordable housing crisis. With trademark whimsy and a steely conviction that he hopes will see him enter parliament or become London mayor by 2020, he has broken off from a world tour to confront a landlord over its plans to rebuild the William Sutton Estate social housing estate in Chelsea with 144 fewer low-rent homes. Affinity Sutton wants to replace some of them with more than 100 luxury apartments expected to sell for millions.

Izzard has thrown his weight behind the opponents of the plans which have divided residents amid claims of “social cleansing”. When the Guardian joined him to meet tenants, some of whom face eviction, he showed little patience with the landlord’s representatives.

“Just on the vibe everything you are saying is wrong,” he told Lisa Louis, a spokeswoman for Affinity Sutton. “All your responses are wrong. You’re doing a PR frontage, you’re going on and on. It doesn’t make any sense.”

Louis tried to explain: “One of the things we are really struggling with is there is no government funding for social housing. We are working on providing the minimum private housing that we absolutely have to, to be able to re-provide the social housing. Otherwise it could not happen at all.”

Izzard, was having none of it: “That’s not fact. That’s your facts. That’s how you feel it is.”

The transformation of the estate in one of the richest areas of London is part of what Izzard describes as a new “moneyocracy” dividing society. As an Ed Miliband loyalist who has cleared his diary to campaign in next month’s general election campaign, he believes the plans highlight growing division in society – a key theme as he steps up his bid for a career in British politics.

“The separation of the rich and the poor … does feel like it is happening here and it can be stopped with the right legislation and encouragement for people to keep social housing and not squeeze people out on low incomes,” he told the Guardian. “We will lose our vibrancy. The city is going to be emptying out and lots of houses will be empty.”

Affinity Sutton strongly denies allegations of profiteering and social cleansing and has attacked “celebrities that are passing comment, [who] appear to have spoken only to opponents of the scheme”. But Izzard is undeterred.

A lot of what he thinks is going wrong with inequality in cities like London is summed up for him in the stonework of the Sutton estate mansion blocks. They were built in 1913 according to the last will and testament of William Sutton who set up a trust to provide “model dwellings and houses for use and occupation by the poor”. The word “trust” has at some point been hacked off the stonework leaving a blank between “Sutton” and “dwellings”. It is a metaphor for a wider pattern that worries Izzard.

“If you look at the super-rich in America, in the UK and around the world, that is a dangerous thing: the separation of people who have learned to make a tonne of money and everyone else struggling around,” he said. “If people don’t have parents who can help you’ve got no chance. Social housing is the lifeblood of London, London will be losing its lifeblood. Social cleansing should not be happening in 2015 and it looks like Affinity Sutton are trying to do social cleansing.”

Again, Affinity Sutton, has hit back. This week it posted a rebuttal of the opposition’s campaign’s claims.

“The main objectors are in fact not our tenants and we are concerned that they are causing distress through a campaign of deliberate misinformation and speculation,” a spokesman said. “We reject outright the allegation that redevelopment of the scheme is motivated by creating large profits.”

Izzard plans to run as London mayor or for parliament in 2020, putting “into hibernation” a comedy career that he loves. While Brand’s iconoclastic politics, urging people not to vote and to abandon conventional party politics, emerge naturally from his subversive comedy, the spirit of Izzard’s surreal improvisations are harder to find in his pursuit of a conventional political career.

Asked what matters most to him in the coming election, he replies with Labour’s core message: “I suppose it is that the financial recovery is for the few and not the many and we need to get it working for the many.”

Asked for another, he sighs and produces another core message: the National Health Service.

He describes himself as a “radical centrist”. Miliband is “doing fine” and polls showing some people consider him weird are “just nonsense” and “Tory spinning”. Brand’s anti-voting position is plain wrong, he said.

“We have to make decisions,” he said. “Politicians are needed and we want to get it as open as possible … We need voting otherwise you have one person running the country and you get into kings and dictators saying ‘I’ll just be here for ever’. I don’t think Russell is saying that, but I don’t see how anything gets done without voting. Russell is coming from a positive heart point of view but I disagree on how he’s going about getting it done.”

Izzard reckons more comedians are poised to make the leap to political leadership. He references Al Franken, the former Saturday Night Live performer, who became a US senator in 2009, and Beppe Grillo, the Italian comedian whose Five Star movement became the largest party in Italy’s chamber of deputies in 2013.

“It’s weird that comedians haven’t gone in [to politics] before,” he said. “But comedy is an attack weapon. If your upfront message is attack all you are doing is tearing things down. I am quite positive on humanity, politics, people, life, building things. If you use comedy straight in there it doesn’t work. If you look at Senator Al Franken, he came from a comedy background. It can be done. I think more people will come in from that world in the future. Talking is our job. Comedians at least have articulation.”

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