Tag Archives: UK news

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.

guardian.co.uk © Guardian News & Media Limited 2010

Published via the Guardian News Feed plugin for WordPress.

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.”

guardian.co.uk © Guardian News & Media Limited 2010

Published via the Guardian News Feed plugin for WordPress.

Don’t blame the intelligence agencies for jihadism

I can’t really relate to anything thats going on with what’s called radical Islam. Any more than I  could relate to any other fundamental religious group. Its just so far  beyond my way of thinking about other human beings, that I simply can’t get a handle on it all. 

The key thing seems to to be that someone quite ordinary turns a corner and steps over a line. Someone likely to have easily exploitable human weakness that can be molded in to a suitable image and form to do the work of others whilst believing that its of their own free will.  


Powered by Guardian.co.ukThis article titled “Don’t blame the intelligence agencies for jihadism” was written by Matthew d’Ancona, for The Guardian on Sunday 1st March 2015 19.28 UTC

We have refined our collective critique of Big Brother with the precision of picky consumers rather than principled citizens. Most of the time we don’t want BB around and complain of his intrusions, real or imagined. But when things go wrong – when a young Londoner suddenly becomes a global figurehead of murderous Islamism, for instance – we resent the state even more. To put it plainly: the only thing we object to more strenuously than MI5 taking action is MI5 failing to do so.

This is the paradox that has been evident once again since the naming of “Jihadi John” as Mohammed Emwazi. It is a commonplace to argue that the intelligence agencies in the country are powerful (and power-hungry) to an extent that threatens the fibre of democratic society. Yet good old doublethink enables such a claim to coexist with the charge that the security service was somehow responsible for Emwazi’s actions by its sins of commission (trying to recruit him) and omission (letting him “slip the net” and flee to Syria).

Over the weekend politicians rushed towards the controversy, megaphones in hand. David Davis, a big beast whose talents would have been better deployed as part of the coalition, made the baffling claim in these pages that the spooks settle for a “disruption and management” strategy when they and their colleagues in the police and CPS should be pursuing and prosecuting Islamic extremists.

Would that such a simple choice were available. The problem facing any intelligence agency is precisely that the evidence required to mount a prosecution is so often lacking. It follows that a suite of counterterrorist powers must be made available to such agencies by parliament and, quite rightly, subjected to regular review and structures of accountability. But what powers, applied where, and with what degree of severity?

The coalition is at present split over the ban on extremist speakers at universities. Vince Cable, who is responsible for higher education, wants only explicit incitement to terrorism to be prohibited in the guidelines; Theresa May seeks a broader definition. Both cabinet ministers, please note, are potential leaders of their respective parties: with only 66 days to go before the general election, everything they say, or allow to be known, is entangled with these ambitions.

David Cameron’s government, of course, has already replaced Labour’s control orders with Tpims – terrorism prevention and investigation measures – which have proved to be only a couple of notches up from useless. To date, two militants have escaped this weak system and absconded to Somalia.

Yvette Cooper, the shadow home secretary, was quite right to argue on The Andrew Marr Show that the power of relocation, which removed the terror suspect from his geographic network, should be restored. But what will parliament actually do when it considers the question, almost certainly after the election? And will there be a stable government to lead opinion at Westminster?

To delve into such questions, one must remember that politicians, like generals, are usually fighting the last war. In the long years of opposition, many Tories came to regard the counterterrorist measures proposed by Tony Blair and Gordon Brown as a subcategory of New Labour authoritarianism rather than a legitimate response to the post-9/11 threat. The Conservative party postured as “hard-nosed defenders of freedom”, which is up there with “predistribution” in the annals of political nonsense. For decades the Tories had been the party of security and law and order. Yet faced with Big Blair and Even Bigger Brown, many of them embraced a retro-libertarianism that owed more to Magna Carta than Shami Chakrabarti.

This surge of “Runnymede Conservatism” reached its apogee in Davis’s resignation as MP for Haltemprice and Howden in 2008, in protest at Brown’s plan to extend the limit for pre-charge detention of terror suspects to 42 days. This strand of contemporary Toryism also helped to cement the coalition. As the Cameron-Clegg programme for government put it: “The [coalition] believes that the British state has become too authoritarian, and that over the past decade it has abused and eroded fundamental human freedoms and historic civil liberties.”

The pieties of 2010 have been eroded by the experience of office. As home secretary, May has found herself thwarted by loopholes – notably when she sought to deport Abu Qatada – rather than reining in the supposedly tyrannous state created by New Labour. To understand the Conservative urge to renegotiate Britain’s position in Europe and the status of the European Convention on Human Rights look no further than ministers’ exasperation over the pursuit of terror suspects and the limitations imposed by Brussels and Strasbourg.

The intelligence agencies themselves are constrained by a legal web, and rightly so. No less inevitably, they have limited resources.

There is a weekly meeting at MI5 at which senior officers discuss which “persons of interest” are to be monitored intensively, round the clock. There are several thousand such people – Emwazi was one – but only a few can be subjected to round-the-clock surveillance. How could it be otherwise?

When we speak of suspects “slipping the net”, we imply counterterrorist agencies can intercept every such jihadi on his way to commit violence, every such plot to spill blood at home or abroad. Given the odds, it is frankly remarkable any are stopped at all.

It cannot be stated too often: contemporary jihadis are not like the IRA, or the UDA or Eta. They exploit what the greatest guide to the post-9/11 world, Philip Bobbitt, calls the “unique vulnerabilities of globalised, network market states” and a “connectivity that allows a cascading series of vulnerabilities to be exploited”.

Today’s Islamist militants do not operate within a cellular hierarchy, but more closely resemble local holders of a global franchise. They are self-starters, morphing capriciously from one role to another (the Madrid bombers were essentially book-keepers who became suddenly ambitious). Mohammad Sidique Khan, the presumed leader of the 7/7 plot, had indeed come to MI5’s attention a year earlier, in Operation Crevice. Yet, in 2004, he was still a relatively peripheral figure.

What made Emwazi become what he has become, able to do what he has done? What we call “radicalisation” – the walk from one side of the flaming bridge to the other – often occurs in a very short space of time, for reasons that resist pat psychological speculation: to know the reasons why would be to decode the secrets of the soul. Against such mysteries it is not the power of the state that is truly frightening, but its weakness.

guardian.co.uk © Guardian News & Media Limited 2010

Published via the Guardian News Feed plugin for WordPress.