Tag: #privatisation

Increasing rationing in the NHS is incompatible with ‘halving the disability employment gap’

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NHS England has published an updated list of medical conditions for which you can no longer receive prescriptions for, as part of a wider cost-cutting exercise due to insufficient funding from central government.

Last year I wrote an article about the stealthy creep of rationing of treatments in the NHS, and how gatekeeping has become a watchword within our public services over the past seven years. It’s being driven by the government’s deep affection for neoliberal dogma, the drive for never-ending ‘efficiency savings’ and the Conservatives’ lean, mean austerity machine. Perish the thought that the public may actually need to use the public services that they have funded through their contributions to the Treasury, in good faith. 

One important point I didn’t raise in the article was about how the marketisation of the NHS has given rise to ‘perverse incentives’, which violate the very principles on which the national health service was founded. Neoliberal policies have shifted priorities to developing profitable ‘care markets’ making ‘efficiency’ savings and containing costs, rather than delivering universal health care.

In 2017, doctors raised concerns that vital medical treatments and operations are being increasingly rationed. The treatments affected include hip and knee replacements and cataract surgery to help restore sight as well as drugs for conditions such as severe forms of autoimmune related arthritis.

Such health care is normally given routinely under the NHS, but the British Medical Journal has found evidence it is being cut back, the data showed doctors are having to resort to special appeals to get their patients treated, and that the increasing restrictions were due to a lack of funding. 

The journal gathered evidence from clinical commissioning groups (CCGs) which showed the special requests are increasingly being used for vital non-emergency services, many of which prevent conditions from deteriorating and preserve mobility and vision, for example. 

Responses from 169 of the 209 clinical commissioning groups, which control local budgets, showed:

  • In 2013-14 there were just 49 requests made for hip and knee surgery, but by last year the figure had reached 899
  • Over the same period, the number of cataract appeals trebled to more than 1,000.
  • Overall the number of requests being made through the special cases route rose by 47% to 73,900
  • Just over half of all requests were approved.

Doctors now use a standardised scoring system to assess how much discomfort and lack of mobility a patient has for hip and knee replacements, for example. By increasing the bar at which a referral for an operation is made, the NHS is restricting the numbers of people getting treatment. This will invariably have an impact on the quality of people’s lives, and their degree of independence. 

These restrictions also apply to essential mental health care.

Doctors said the trend was a clear indicator that care was being rationed. For every case where an ‘exceptional argument’ has been made for treatment, there will be plenty more where patients will have gone without care and their doctor did not appealed.

Restricting access to mental health care, arthritis and cataract treatment is a false economy. Patients with these conditions are at risk of social isolation, depression, and the latter two conditions may lead to fall-related injuries and other complications. This cost-cutting approach means the NHS is reduced to little more than a crisis management service, rather than one that treats citizens to ensure they don’t reach a point of crisis in the first place, which is the best possible outcome. 

The administration of health service support impacts on people’s ability to work

The impacts of a profoundly punitive and inadequate social security system on the health of disabled people, and how the cuts have become a barrier to work has been well documented, and the enduring poverty and hardship disabled people are forced to live under. There has been rather less discussion about the impact of cuts to health care, treatment rationing and how this affects peoples’ working lives, however. With the NHS in crisis and waiting times for non-urgent treatments escalating, it’s difficult to see how timely interventions to help people back to work can possibly be delivered. 

One patient who has been caught up in the health care squeeze is Helen Cole, from west London. She was diagnosed with rheumatoid arthritis 11 years ago. This is an autoimmune condition that leads to very severe and disabling inflammatory arthritis and progressive joint damage. It doesn’t only affect the joints, however, as the illness can also affect major organs, such as the heart and lungs. It can cause osteoporosis and affect blood vessels, nerves, tendons and may even affect the hearing. Furthermore, during flare ups of inflammation, rheumatoid arthritis generally makes people feel very unwell.

Most rheumatologists agree that early treatment is essential to try and prevent the disease progressing rapidly.  Helen relies on an immune suppressing drug called rituximab, but it is not being routinely funded by her local health managers, so her doctor has to make a special request for it every six months. This has led to delays in her getting the drug and gaps in her treatment. Last time, she had to wait 10 weeks to get her next treatment. 

“I had a lot of pain in my joints and really big problems with fatigue. It can be really challenging day to day.”

She said she finds the whole process “stressful” and believes it “makes no sense”.

“The whole point of treating a disease like rheumatoid arthritis is to try to keep it under control at all times,” she added. 

Having timely and effective treatment which manages symptoms as effectively as possible can make a lot of difference to a person’s quality of life and independence, including being able to remain in work.  

Autoimmune conditions such as rheumatoid arthritis leave a progressive wake of damage that cannot be undone, which is why early treatment is essential. Patients are not always given treatments that are the most effective. The new generation of biologics –  such as rituximab –  are  very effective, but cost much more than older ‘disease modifying’ medications such as methotrexate, which is a chemotherapy that suppresses the immune system. Between 15 – 25% of people with rheumatoid arthritis respond positively to methotrexate. 

The new and expensive biologics, on the other hand, tend to be prescribed to those people whose disease is deemed ‘severe’, and who have not responded to methotrexate. But classification of ‘severe’ disease is an imprecise art and definitions are now invariably tied in with available funding. It means that people are waiting until their disease becomes aggressive, and damage to their joints has progressed before even being considered for a treatment that could have helped prevent the damage in the first place. In other words, NHS cuts are leading to disability, when it may have been prevented with effective treatments.

Stephen Cannon, of the Royal College of Surgeons, said local health managers were “unfairly and unnecessarily prolonging the time patients will spend in pain, possibly immobile and unable to carry out daily tasks or to work”.

The latest list of restrictions on prescriptions includes those for:

  • Acute Sore Throat 
  • Cold Sores
  • Conjunctivitis
  • Coughs and colds and nasal congestion
  • Cradle Cap (Seborrhoeic dermatitis – infants)
  • Haemorrhoids
  • Infant Colic
  • Mild Cystitis
  • Contact Dermatitis
  • Dandruff
  • Diarrhoea (Adults)
  • Dry Eyes/Sore tired Eyes
  • Earwax
  • Excessive sweating (Hyperhidrosis)
  • Head lice
  • Indigestion and Heartburn
  • Infrequent constipation
  • Infrequent Migraine
  • Insect bites and stings
  • Mild Acne
  • Mild Dry Skin/Sunburn
  • Mild to Moderate Hay fever/Allergic Rhinitis
  • Minor burns and scalds
  • Minor conditions associated with pain, discomfort and/fever. (e.g. aches and sprains, headache, period pain, back pain)
  • Mouth ulcers
  • Nappy Rash
  • Oral Thrush
  • Prevention of dental caries
  • Ringworm/Athletes foot
  • Teething/Mild toothache
  • Threadworms
  • Travel Sickness
  • Warts and Verrucae
  • Probiotics, vitamins and minerals are no longer available on prescription.

Although there are over-the-counter medications that people can buy for most of these conditions, those living on low incomes may not be able to afford the treatments. Effective pharmacy treatment for cystitis, for example, is around £25. If left untreated, cystitis can lead to kidney infection, which will require urgent treatment. Conjunctivitis is an eye infection that can be caused by bacteria, and this type most frequently needs an antibiotic ointment to prevent it from becoming more serious, because the eyes are very vulnerable to infection. Left untreated it can damage the eye and may cause blindness. 

There are exceptions to the restrictions, however. Circumstances where the product licence doesn’t allow the type of medication to be sold over the counter to certain groups of patients, for example. This may vary by medicine, but could include babies, children and/or women who are pregnant or breast-feeding. Community pharmacists will be aware of what these restrictions are and can advise patients accordingly. 

Patients with a minor condition suitable for self-care that has not responded sufficiently to treatment with an OTC (over the counter) product may also be prescribed treatment.

Patients where the clinician considers that the presenting symptom is due to a condition that would not be considered a minor ailment may also be prescribed medication for some of the above conditions. For example, chronic dry eyes many be one symptom of an underlying autoimmune condition, without effective treatment, it may cause progressive damage to the cornea as well as recurring bouts of conjunctivitis. Recurring mouth ulcers may be a symptom of a chronic condition, such as an autoimmune disease – for example lupus. 

In circumstances where the prescriber believes that in their clinical judgement exceptional circumstances exist that warrant deviation from the recommendation to self-care, they may prescribe medication for the above conditions.

Patients where the clinician considers that their ability to self-manage is compromised as a consequence of social, medical or mental health vulnerability to the extent that their health and/or wellbeing could be adversely affected if left to self-care may also warrant prescribed treatment for these conditions.

NHS England chief executive Simon Stevens, said: “To do the best for our patients and for taxpayers it’s vital the NHS uses its funding well.”

But that flies in the face of the ‘preventative approach’ that health secretary Matt Hancock has proposed recently.  For example, contact dermatitis may become infected if left untreated, especially if the person affected can’t isolate the cause. If one member of a family has head lice (and children pick them up very easily from nursery or school) and this isn’t treated promptly, the whole family is likely to catch them. Effective head lice treatment is costly and needs to be repeated. 

Threadworms are also highly contagious, and children pick them up very easily, as they are transmitted via microscopic eggs that can stick to clothing, towels, bedding, carpets and on unwashed hands. One study showed that up to 40% of children at primary school age will have threadworms. If access to prescribed treatment is restricted, children with embarrassing and very unpleasant, uncomfortable conditions like threadworms and head lice in poorer families may be left with the conditions longer, and may well pass on the parasites to others.

Deflection is when patients who are unable to get a GP appointment or adequate treatment seek treatment elsewhere – for example, an accident and emergency (A&E) department. The national GP patient survey asked patients who were unable to get a convenient appointment last time they called their GP what they did instead. It found that people end up going to an A&E department or a walk-in centre. Again, cost-cutting leads to further costs further down the line. 

Restricting treatments for those with mental health conditions and chronic illness means that these citizens are less likely to be able to work. This is at odds with the government’s pledge to ‘half the employment disability gap’.

GP’s are being ‘incentivised’ to reduce referrals to specialists

It was announced in April last year that General Practitioners across England will be able to “better manage” hospital referrals with a “digital traffic light system” developed by the Downing Street policy nudge wonks. This nudge is designed to target the ‘referral behaviours’ of GPs.

GPs are being offered cash payments as an ‘incentive’ to not refer patients to hospitals – including cancer patients – according to an investigation by Pulse, a website for GPs. 

Furthermore, a leaked letter sent by NHS to England to Clinical Commissioning Groups (CCGs) and seen by Pulse magazine last year, asks that all family doctors in England to seek approval from a medical panel for all non-urgent hospital referrals.  

A “clinical peer review of all referrals from general practice by September 2017”, will be required, the letter said. 

To ‘incentivise’ the scheme, the letter said that there will be “significant additional funding” for commissioners that establish peer-led policing schemes. It added that it could reduce hospital referral rates by up to by 30 per cent. NHS England said that they want to introduce the “peer review scheme” whereby GPs check the referrals of one another to ensure they are ‘appropriate’. However, experts warn this increasingly Kafkaesque layer of bureaucracy could lead to more problems and possible conflict with patients’ safety and standard of care. 

“Cash incentives based on how many referrals GPs make have no place in the NHS, and frankly, it is insulting to suggest otherwise,” said Professor Helen Stokes-Lampard, chair of the Royal College of GPs.

Of course, it’s important to take measures to ensure that GP referrals are appropriate and high-quality, but payments to reduce referrals would fly in the face of this, and erode the trust our patients have in us to do what is best for them and their health.” 

The NHS has been squeezed for increasingly drastic ‘efficiency savings’ in the past eight years. It’s absurd, however, that a huge amount of money is being spent on restricting access to healthcare, rather than on simply adequately funding healthcare provision.

Potential impact on social security assessments for people with chronic illness

Something else to consider is the potential impact this may have on people needing to claim social security disability support. The private company assessors hired by the government to determine eligibility for Employment and Support Allowance (ESA) and Personal Independence Payment (PIP) tend to regard people who haven’t been referred to a specialist as being less ill than those who have.

They also tend to take prescribed treatments into account when assessing the severity of illness, the needs of claimants and their eligibility for an award. Being let down by the NHS potentially has a knock-on effect which may leave some people in a situation where they can’t get either the health care or the financial support they need to live independently, increasing their vulnerability. 

There is no specific list of services to which individuals using the NHS are guaranteed access. Instead individuals have a number of legal rights that are set out in the NHS Constitution. These include the right to: receive most NHS services free of charge; receive certain treatments within a maximum waiting time; be treated in a safe and clean environment; have access to drugs and treatments recommended by the National Institute for Health and Care Excellence (NICE), if a doctor says it is appropriate. 

Like our social security system, the NHS should be there for all of us in our time of need, based on principles of inclusion, support and security for all, assuring us of our safety and dignity. However, chronic under funding, rationing and the increasing marketisation and ‘efficiency savings’ demanded by the government are incompatible with supporting citizens – especially those with multiple disadvantages – to live full, healthy and independent lives.

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Related

Tories propose nudge, big business AI initiative and ‘personal responsibility’ in place of adequate health care funding

Cash for Care: nudging doctors to ration healthcare provision

 


I don’t make any money from my work. If you like, you can help me by making a donation to help me continue to research and write informative, insightful and independent articles, and to provide support to others going through disability assessment, mandatory review and appeal.

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Labour party plans to end privatisation of public services

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Carillion was a British multinational facilities management and construction services company which liquidated in January 2018 | Daniel Sorabji/AFP via Getty Images

The current government has consistently failed to fix the serious problems created by its’ privatisation of public services, which has directly impacted on the lives of many citizens. Those needing the support of services have found them less accessible, conditional and often, rather than alleviating hardship and socioeconomic exclusion, the private sector, contracted in tandem with government policies, has contributed to actually increasing the vulnerability of marginalised social groups, exploiting them for profit.

Poorly conceived contracts have created cost increases that surpass the costs of in-house services, and the oversight of the contracts is poor, the government is vulnerable to corruption and profiteering. The scandal of G4S and Serco charging the Ministry of Justice for tagging offenders who were dead shows just the visible surface of how bad things can get.

G4S, for example, has left a wake of human rights abuses on a global scale, and we have to question how on earth such highly controversial companies manage to secure successive government contracts involving working with vulnerable populations. The Ministry of Justice is still spending millions on tagging offenders with G4S and Capita despite the tagging scandal because, despite all of the chatter about ‘market competition’, it has not actively welcomed in or competently procured new entrants in the market.

In the wake of the collapse of Carillion, a succession of scandals involving large British companies like G4S, Serco and others, and the zig-zagging share price of outsourcing giant Capita, now is the right time to rethink the UK government’s approach to the private provision of public services. 

Any government that claims it wants to ‘take on vested interests’ wherever they may be must look first at how it itself has created – and become dependent -on a select number of vested, incumbent private suppliers. In practice, when the government claim ‘efficiency’, that generally means lower wages and substantially reduced services. When they mention ‘economies of scale’, that generally translates as constructing the contracts in such a way as to leave only the largest companies eligible to bid for them.

When the government use the word ‘incentives’, for the profiteering companies, those are perverse incentives. And when they say ‘competition’,  the government is refering to a handful of companies barely compete with one another at all but instead operate as an unelected oligarchy – a shadow state.

A Labour government would end the outsourcing of public service contracts that involve close contact with vulnerable groups, because of ongoing, grave concerns that people are being put at risk by private contractors such as Atos and Capita. The party has drawn up the plan in response to what is described as a series of outsourcing disasters. 

This would mean addressing the controversial assessments for disability and illness related social security, NHS care, the treatment of people in detention centres and prisons, and failures over recruitment and substandard housing for Armed Forces personnel, bringing those services back ‘in house’. 

Under the Labour’s party’s plans, when an outsourced contract expires or is terminated, central or local government will be required to assess whether a service involves significant contact with ‘at risk’ groups, poses a threat to people’s human rights, or entails the use of ‘coercive powers’. People ‘at risk’ are defined as those who rely on state protection, be they prisoners, hospital patients or social security recipients. 

If the answer to these criteria is “yes”, then new statutory guidance would be used,  which will lessen the grip of the private sector over our public services. After years of privatisation, it’s become clear that perverse incentives – the profit motive and ‘efficiency’in particular – have led to very poor service delivery and caused distress and harm to many citizens who have needed to access support, such as social security or healthcare. Private firms have performed notoriously badly, most often prioritising private profit over meeting human needs, while costing the British public billions of pounds.

However, there may be exemptions to the Labour party’s new rule, where:

  • The contract does not fall under a statutory definition of ‘relevant contract’.
  • The value of the contract is below a certain threshold.
  • The contract is between local authorities (or between a local authority and another public authority).
  • The public authority can demonstrate that it has ‘good reason’ to override statutory guidance.

The Labour party has repeatedly criticised the outsourcing of assessments for Personal Independent Payments and for Employment and Support Allowance, saying that this has led to a complete breakdown in trust between disabled people, the assessors and DWP decision-makers. The Ministry of Justice was forced to take control of Birmingham prison from the contractor G4S, after inspections found that prisoners were regularly using drink, drugs and violence, and corridors were littered with cockroaches, blood and vomit last year. The plan comes after a series of high-profile outsourcing controversies.

Andrew Gwynne MP, Labour’s Shadow Communities and Local Government Secretary, said: “For too long the British public have paid the price for outsourcing.

“The Tories’ dogmatic commitment to markets at all costs has delivered sub-standard services at inflated prices. And when they fail, as they often do, it’s the taxpayer that picks up the bill.

“Labour is proposing a radical new settlement that gives people the power to end outsourcing and decide for themselves how best to deliver the services they need.

“For too long this county has been run by and in the interests of a small few who are all in it together.

“It’s time to shift the scales and bring democracy and accountability back to government, and put power in the hands of the many”.

The plan is most likely to be backed by unions, but may cause concern for some councils  under severe financial pressure after years of cuts to their funding.

The pledge is also part of a wider Labour strategy to return public services to public ownership. It reflects that Labour is serious about implementing major democratic changes to the economy, to make it more inclusive.

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The threats to public health care in the UK.

Outsourcing in the NHS is officially said to be about cutting costs and improving efficiency, but such reforms, have really helped create healthcare markets that simply promote inequality among patients and healthcare workers and erode the public nature of healthcare provision.

There is also a very obvious limiting factor to a ‘market’ in healthcare: those in most need of healthcare are least able to pay the ‘market price’ for it – the elderly, very young, people with mental illness and those who are chronicically il , many of whom are poor. So, for private healthcare to be profitable for more than just the wealthiest minority, it still requires public funding.  The government, however, have systematically refused to accept this, despite the empirical evidence that verifies the damage being done to the poorest and most vulnerable citizens.

 


I don’t make any money from my work. I am disabled because of an illness called lupus. If you want to, you can help me by making a donation to help me continue to research and write informative, insightful and independent articles, and to provide support to others going through disability assessment, mandatory review and appeal.

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Financial advisors and millionaires are preparing for a Labour government led by Corbyn

30 years of plutocracy have brought un-representative democracy

Back in 2013, I wrote an article, together with Richard Murphy, director of Tax Research UK, which was about a chilling proto-fascist document written by JP Morgan – it can be accessed here: The Euro Area Adjustment—About Half-Way There.

Firstly, the authors said that ‘financial measures’ are ‘necessary’ to ensure that major investment houses such as JP Morgan can continue to reap huge profits from their speculative activities in Europe.

Secondly, the authors maintain, it is necessary to impose ‘political reforms’ aimed at suppressing opposition to the massively unpopular austerity measures being imposed at the behest of the banks and financial sector. 

The authors write: “The political systems in the periphery were established in the aftermath of dictatorship, and were defined by that experience. Constitutions tend to show a strong socialist influence, reflecting the political strength that left-wing parties gained after the defeat of fascism [following world war 2].

“Political systems around the periphery typically display several of the following features: weak executives; weak central states relative to regions; constitutional protection of labour rights; consensus-building systems which foster political clientalism; and the right to protest if unwelcome changes are made to the political status quo. The shortcomings of this political legacy have been revealed by the [eurozone] crisis.”

Whatever the historical inaccuracies in their analysis, there can not be the slightest doubt that the authors of the JP Morgan report are arguing for governments to adopt authoritarianism to complete the process of social counterrevolution to austerity that is already well underway across Europe.

What JP Morgan is making very clear is that anything resembling ‘socialism’, representative ‘democracy’, collectivism, trade unionism or inclinations towards the left of the spectrum must be removed from political structure: localism must be replaced with strong, central authority; labour rights must be removed, consensus (democracy) and the right to protest must be curtailed.

In short, JP Morgan are calling for extremely authoritarian measures to suppress the working class and wipe out its social gains since the post-war settlement. This is the proto-fascism and reflects the unadulterated antisocial voice of  neoliberalism, which is incompatible with human rights, social liberalism and democracy.

JP Morgan are not a lone voice making such demands. In the UK, savage welfare cuts have driven some disabled individuals to fear for their lives. But the austerity programme also has a few winners. Cutting or eliminating publicly funded support programmes that support the poorest citizens, those who fall on hard times, has long been an ideological goal of Conservatives.

Doing so also generates a tidy windfall for the corporate class, as the ‘business friendly’ government services are privatised and savings from austerity pay for tax cuts for the wealthiest citizens. The liberalisation that the financial class demand – what bankers call deregulation – is the process that caused the financial crash.

Many of us have said over the last eight years that austerity is not an economic necessity or ‘in the national interest’ as was claimed in 2010, and it is more like a tool of ‘statecraft’ and radical socioeconomic re-engineering, driven entirely by ideology and not economic requirements. 

You can read my 2013 article here.

Now for more of the same

In a truly nauseating article in the Financial Times (FT) titled How to hedge your finances against a future Corbyn governmentfinancial ‘advisors’ are cowering in outraged ‘fear’ at the prospect of a Labour government. They are very worried that a few millionaires may face a capital gains tax rise, property taxes and other erosions to the generous privileges they have become accustomed to over the last few years.

Gosh, fancy that, having to contribute a fair amount of tax towards maintaining a country that the rich have taken so much from. Yet they don’t want to contribute anything to the society that has benefited them so much. 

I can really empathise with their ‘fears’. I mean, that’s almost as bad as having to join the foodbank queue because your wage doesn’t meet the cost of living, or even your most fundamental survival needs. I can see why they would be left cowering in fear behind their hoarded wealth. 

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This despicable class of people, who regard most of their fellow human beings as disposable commodities, have had their own way for far too long. They have institutionalised their power through law, media, and corrupt political rituals, and have become habituated to the status quo.

The FT says “They might be considered unlikely to vote for Jeremy Corbyn, but the rising popularity of the Labour leader is rapidly moving up the agenda in conversations between the UK’s wealthiest and their financial advisers. In the event that he came to power, what impact might future Labour policies have on their wealth? And secondly, what financial planning measures — if any — could be considered to mitigate these?

Well you could be less controlling and anally retentive. Less pathological about wealth defense. You just let go and stop hoarding obscene amounts of money. You could care about the suffering inflicted on others so that you can stash your cash offshore, leaving a black hole in the economy and our public services on the point of collapse, because of ever-circling vulture capitalist parasites like you.

George Bull of RSM, the accountancy firm, says: “these fears are well-founded, as Labour’s 2017 manifesto mentioned wealth taxes as one option for easing the care cost crunch.”

Oh, the sheer horror of it. I mean fancy having to give a shit for the people who have been brutally dispossessed by the state in order to fuel the accumulation of even more wealth for the already very very wealthy. How outrageous. 

The article goes on to say:  “Should a mis-step in the Brexit negotiations topple the existing administration, this could prompt a fresh election which many believe Mr Corbyn could win.”

Yes, and your very worst fear has been realised. The PM’s Brexit deal was rejected by 230 votes – the largest defeat for a sitting government in history. It takes a very special sort of skill to unite so many people against your proposals. Dis may.

Yet curiously, despite the vote of no confidence tabled by Corbyn, the BBC are claiming that the Pound rises after ‘meaningful’ Brexit vote and crashing defeat for the PM.

The BBC then claim the “vote opens up a range of outcomes, including no deal, a renegotiation of May’s deal, or a second referendum.” However, the BBC don’t mention the rather obvious other possibility – a General Election, which is more than a little short sighted of them.

Even if we assume that a no confidence motion may not force an election , it would be prudent to consider Wednesday’s vote as the start of a process. The shadow international trade secretary Barry Gardiner has suggested the PM could face a series of confidence votes in the coming weeks. In fact that is highly likely, since she does not command a majority and will struggle getting anything through parliament.

Apparently, sterling rose 0.05% to $1.287 after declines of more than 1% earlier in the day. The currency slumped 7% in 2018 reflecting uncertainty about the terms of the UK’s exit from the European Union. 

“A defeat has been broadly anticipated in markets since the agreement with the EU was closed in November 2018 and caused several members of the government to resign,” said Richard Falkenhall, senior FX strategist at SEB. The BBC says that “business groups said their members’ patience was wearing thin.”  

On Friday, hedge fund manager Crispin Odey, a major donor to the Brexit campaign, said he now expected the project to be abandoned altogether and that he is “positioning for the pound to strengthen.”

The real culture of entitlement

The very wealthiest are likely to find ways to circumvent increased taxes on those on the highest incomes. I guess rich  people don’t like  ‘progressive’ tax , well-funded and functioning and effective public services 

Bull continues: “There is no certainty as to what people might do.

“However, we hear far greater interest about lifetime tax planning — for example, gifts of assets to children being made sooner rather than later — so that parents’ asset values are reduced before a wealth tax or land value tax takes force.”

“The favourable inheritance tax status of defined contribution pensions, which can currently be passed tax free to heirs in some circumstances, is something many advisers fear the current government will scrap, let alone a Labour one. Higher-rate tax relief on pensions contributions is another obvious area of vulnerability, advisers say.”

Vulnerability? I guess that’s pretty relative. Ask those people targeted by austerity policies from 2010, which saw them lose their lifeline support while at the same time, the chancellor handed out £107,000 each per year to millionaires in the form of a tax cut. People have died because the government’s austerity policies. Get a grip.

My favourite part was this:  

“The Labour party has also signalled its intention to close various loopholes and tax breaks, as well as ending “the social scourge of tax avoidance”. It has signalled that it would make public the tax returns of those earning more than £1m a year and double the number of HMRC staff investigating wealthy tax avoiders.

“It might also increase the insurance premium tax on private healthcare. The rate of corporation tax would be restored to 26 per cent. In addition, a Labour government might tackle tax planning that takes advantage of the gap between income and corporate tax rates, such as the practice of holding investments within a company.

“One possibility is that the undistributed profits of “ close” companies— those controlled by five or fewer people — could be taxed as though they had been distributed to shareholders. 

“Labour has said it wants to see the public disclosure of trusts, which it describes as “a key vehicle for tax avoidance and illicit financial flows”. The industry says HMRC already has access to this information and making it public would put beneficiaries in a vulnerable position. 

“People avoiding tax by using trusts would fear “trial by media”.

“It would be a witch hunt. People might want to consider unwinding those structures.”

My heart bleeds. Like the ‘trial by media’ that unemployed and disabled people faced in the run up to the brutal and uncivilised cuts to the social security that the overwhelming majority of them had paid into via taxes? And all to justify a transfer of wealth from public funds to a few private bank accounts, a proportion of those being offshore.

The hysteria continued: “Labour’s plans to nationalise railways, water, energy and Royal Mail would take a toll on those segments of the market. And Mr Corbyn’s aim to intervene more heavily in areas such as energy could drag on the dividends paid by those companies and investment funds.”

But it would benefit the public. You know, the many, not the few.

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Job Curtis, a Henderson fund manager, says: “We are already beginning to see weakness in companies involved in passenger transport and water utilities. United Utilities — a water company covering the north west of England, has experienced a large share price fall in the last year partly because of the increased likelihood of a Labour government under Corbyn.”

“Sectors including utilities and energy companies are high dividend payers and whether it’s nationalisation or increased regulation and price caps, the outlook for higher and sustainably high dividend incomes looks under threat under a Corbyn government,” says Mr Stevenson. 

But many of us will be able to afford our utility bills.

Henry Pryor, an independent buying agent, whines the prospect of a Labour government is “frightening” for the owners of large, expensive assets. I think Henry should really try to expand his understanding of the word “frightening”.

I suggest he asks citizens for some insights, perhaps those with severe illness who are forced to claim disability support after a lifetime of working and paying social insurance via taxes, then he should go through mandatory review and the appeal process. That’s fear. Or perhaps he should spend a year on the streets, without the safety of his wealth and assets. 

 That said, perhaps the pitchforks really are coming…

Nick Hanauer is a rich guy, an unrepentant capitalist — and he has something to say to his fellow plutocrats: Growing inequality is about to push our societies into conditions resembling pre-revolutionary France.

 

You can sign the petition (here) to register your own no confidence in Theresa May’s government, and demand a general election. Only 557 more signatures are needed, as the response overnight has been overwhelming. 


 

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Rationing and resource gatekeeping in the NHS is the consequence of privatisation

People march through London to mark 70 years of the NHS

People march through London yesterday to mark 70 years of the NHS.

Gatekeeping has become a watchword within our public services over the past seven years. It’s being driven by the government’s deep affection for neoliberal dogma, the drive for never-ending ‘efficiency savings’ and the Conservatives’ lean, mean austerity machine. Perish the thought that the public may actually need to use the public services that they have funded through their contributions to the Treasury, in good faith. 

In the NHS, even the resource gatekeepers have gatekeepers, those receptionists standing sentry at the end of the telephone, and in general practices, who ration access to the GPs so assiduously we patients often get better before we’ve managed to arrange an appointment. Or ended up at an Accident and Emergency Department.

Only a service dedicated to keeping the public and service providers apart could have devised a system so utterly demeaning. It turns patients into supplicants and receptionists into bouncers who make decisions they are unlikely to be qualified to make, neither being roles to which any of us aspired.

Now, it has been decided that the NHS needs to scrap more medical procedures, including injections for back pain, surgery to help snorers and knee arthroscopies for arthritis, which form part of an initial list of 17 operations that will be discontinued completely or highly restricted by NHS England as many of these problems “get better without treatment.”

I can assure you that arthritis of the knee, or anywhere else for that matter, doesn’t tend to get better. Medical interventions can help patients with ‘managing’ the condition, however. 

Varicose vein surgery and tonsil removal also feature on the list of routine operations to be axed as part of NHS England’s drive to cease “outdated” and “ineffective” treatments.

The latest round of rationing is hoped to save £200m a year by reducing “risky” or “unnecessary” procedures. Patients are to be told they have a responsibility to the NHS not to request “useless treatment.”

However, complications from varicose veins, for example, include leg ulcers which require more costly specialist treatment to help them heal. 

Steve Powis, the medical director of NHS England, said: I’m confident there is more to be done”, adding that the list of 17 operations formed “the first stage” of rooting out futile treatments that are believed to cost taxpayers £2bn a year.

“We are also going to ask ‘Are there other procedures and treatments we should add to the list?’. Additions could include general anaesthetics for hip and shoulder dislocations and brain scans for patients with migraines.

Hip and shoulder dislocations are notoriously excruciating, as is the process of having the joint relocated, though the latter is short-lived. It’s particularly brutal to leave patients without pain relief, and especially children.

The reason why brain scans are often very important when people develop migraine symptoms is that they can determine whether the severe headaches are caused by something more serious, such as a subarachnoid haemorrhage (which happened to me) or a tumour (which happened to my mother). Sometimes ‘migraines’ are something else.
Powis added: “We have to spend taxpayers’ money wisely. Therefore, if we are spending money on procedures that are not effective, that is money we could spend on new treatments that are clinically effective and would provide benefits to patients. It’s absolutely correct that, in getting more efficient, one component of that is to make sure we are not undertaking unnecessary procedures.”

The rationing comes as the government prepares to raise taxes and ditch an increase to the personal income tax allowance to pay for NHS funding plans. According to proposals, £20.5bn of extra funding would be set aside for the health service by 2023. In a speech at the Royal Free hospital in London a fortnight ago, Theresa May said tax rises were inevitable.

However, there doesn’t seem to be any indication that this additional measure will ensure the public has value and adequate health care for their money. 

The prime minister said: “As a country, taxpayers will need to contribute a bit more.But we will do that in a fair and balanced way. And we want to listen to people about how we do that, and the chancellor will bring forward the full set of proposals before the spending review.”

Here are the 17 treatments NHS England may axe

Four procedures will only be offered at the request of a patient:

  • Snoring surgery
  • Dilation and curettage for heavy menstrual bleeding
  • Knee arthroscopies for osteoarthritis
  • Injections for non-specific back pain

A further 13 treatments will only be offered when certain conditions are met:

  • Breast reduction
  • Removal of benign skin lesions
  • Grommets for glue ear
  • Tonsillectomy
  • Haemorrhoid surgery
  • Hysterectomy for heavy menstrual bleeding
  • Removal of lesions on eyelids
  • Removal of bone spurs for shoulder pain
  • Carpal tunnel syndrome release
  • Dupuytren’s contracture release
  • Excision of small, non cancerous lumps on the wrist called ganglia
  • Trigger finger release
  • Varicose vein surgery

Some of these procedures do improve the quality of people’s lives. I’m wondering how this sits with the government’s drive to push people with disabilities and medical conditions into work.

Although it was announced recently that the NHS is to hire 300 employment coaches to find patients jobs to “keep them out of hospital.” It’s what the government probably calls the ‘two birds and one bullet’ approach.

A man with a birthday placard as thousands of people march to mark 70 years of the NHS

Yesterday, tens of thousands of people marched through London to mark the NHS’s 70th anniversary and demand an end to government cuts and further privatisation of the health service. Bearing placards reading “Cuts leave scars”, “For people not profit” and “Democracy or corporate power” demonstrators moved down Whitehall on Saturday afternoon to the chant of “Whose NHS? Our NHS”.

The protesters stopped outside Downing Street to demand Theresa May’s resignation en route to the stage where they were greeted by a choir singing “the NHS needs saving, don’t let them break it”. Shortly after, Jeremy Corbyn addressed the crowd – organisers said there were about 40,000 people present – demanding an end to privatisation, the closure of the internal market, for staff to no longer be subcontracted to private companies and for social care to be properly funded.

Corbyn said: “There have been huge attacks on our NHS over many years,” he said. “The Tories voted against the original legislation and have always sought to privatise it and continue an internal market.

“Paying money out to private health contractors, the profits of which could and sometimes do, end up in tax havens around the world.

“Think it through, you and I pay our taxes because we want a health service for everybody, I don’t pay my taxes for someone to rip off the public and squirrel the profits away.”

I absolutely agree. 

A brief history of the travailing NHS under Conservative governments

The government has failed to adequately fund the NHS since taking office as part of the coalition in 2010, and has overseen a decline in the once widely admired public health service, as a way to privatise it by stealth. 

The Tories have utilised a spin technique that carry Thatcher’s fingerprints – it’s called ‘don’t show your hand.’

Image result for nhs safe in our hands

Jeremy Hunt and the Conservatives insist the NHS is ‘safe in our hands’

Chris Riddell 16.08.09

The direction of travel was set 25 years ago by the NHS review announced by Margaret Thatcher on the BBC Panorama programme in January 1988. The Conservatives have a poor track record with the NHS. Thatcher ushered in the NHS internal market, the mechanism that introduced what many in the health service still revile: competition.

Health authorities ceased to run hospitals but instead “purchased” care from hospitals who had to compete with others to provide it and became independent, self-governing trusts. The stated aim was to ‘increase efficiency’ and ‘eliminate waste’ through competition. Yet by the time John Major was prime minister, we saw the crisis deepen, with the postcode lottery and patients parked on hospital trolleys in hospital corridors for hours on end, waiting to see a worn out, overworked doctor.  

In order to assess the impact of Thatcher’s legacy on healthcare, it’s essential to appreciate that NHS market reforms began on her watch. Even the apparently relatively minor step of outsourcing hospital cleaning services was to cast a dark shadow over hospital care decades later. Putting cleaning services out to competitive tender meant that the job of cleaning wards went to the lowest bidder – often to companies that used casual, untrained staff, supplied by job centres. The contrast between the high quality of surgical treatment and the dirtiness of wards became notorious. The level of hospital-acquired infections grew steadily, including those caused by  ‘superbugs’  including MRSA. 

A study published by the Health Service Journal laid the blame for the rise of antibiotic resistant infections on poor hygiene standards; finding hospitals full of rubbish, uncollected left-over food in canteens and dirty linen strewn over bedroom floors. The impact outsourcing has had on cleaning services has been a constant source of tension since those early reforms. While trade unions and medical professionals have consistently argued against it, business leaders have always rejected any connection between outsourcing, infection rates, and declining standards.

Public sector outsourcing is central to the present government’s ideological strategy, despite the evidence that is now stacked against it being genuinely ‘competitive’. Since 2010, the number of large contracts awarded has increased by over 47% with tens of thousands of workers in various sectors – health, defence and IT – being transferred to corporate employers like Serco, Capita and G4S. The UK’s public sector has become the largest outsourcing market in the world, accounting for around 80% of all public sector contracting in Europe. These multinationals are not particularly interested in competition; they’re interested in profit and being in a monopoly position where they can dominate the market. Despite the wake of scandals that follows these companies, growth in the public sector outsourcing market shows no signs of slowing and the government shows no signs of learning from these events. 

Thatcher wanted to introduce even more radical changes – such as a shift to an insurance based healthcare model, with ‘health stamps’ for the poor – but in a busy decade, it seems that her battles with trade unions and left-wing Labour councils took priority.

It was under Thatcher’s administration that the climate of austerity began within the NHS. 

Then there was the Black Report into health inequalities, published in 1980 after a failed attempt by the  Conservatives to block its publication, noted that health inequalities in the UK were linked to socio-economic factors such as income, housing and conditions of work. The government rejected the report’s findings and recommendations.

Conservatives published a policy book called Direct Democracy in 2005. It claimed that the NHS was “no longer relevant”, and a system was proposed whereby patients were funded “either through the tax system or by way of universal insurance, to purchase health care from the provider of their choice” – with the poor having their contributions “supplemented or paid for by the state”. The authors included the current health secretary Jeremy Hunt. 

Against a backdrop of austerity and public cuts, healthcare facilities are continuing to contract out their facilities management and clinical services. But, the practice remains deeply controversial and the consequences are becoming more visible. 

Thatcher’s competitive tendering was introduced for cleaning, catering and other ancillary non-medical services, and were extended by the Tories in the ’90s under the NHS and Community Care Act – the first piece of legislation to introduce an internal market into the provision of healthcare. This was followed by the Private Finance Initiative (PFIs) in 1992 under the Major government.  Lansley’s reforms – premised on ‘increasing the diversity of providers in the management of the NHS’ – represent only the culmination of this legacy.

A centrally funded health service has demonstrated its a major contribution to reducing health inequality, by permitting healthcare practitioners and policy makers to design services and deliver care based on need, not the profit incentive. An increasingly privatised NHS has simply led to rationing and inadequate healthcare.

The biggest single contribution to health inequality is social inequality, a problem that has deteriorated significantly in the wake of the Conservative agenda of combined economic austerity and welfare reform.

Image result for hands up NHS
Image courtesy of Robert Livingstone 

 

Related

The Coalition has deliberately financially trashed the NHS to justify its privatisation

Rogue company Unum’s profiteering hand in the government’s work, health and disability green paper

Private bill to introduce further charges to patients for healthcare services is due for second reading today

Labour challenge government about ‘shocking’ rise in coroner warnings over NHS patient deaths

 


I don’t make any money from my work. I am disabled and don’t have any paid employment. But you can contribute by making a donation and help me continue to research and write informative, insightful and independent articles, and to provide support to others. The smallest amount is much appreciated – thank you.

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The interdependence of the PR industry and neoliberal Conservative governments

The PR industry arose to promote and protect private interests in neoliberal economies

Public Relations (PR) and propaganda are key mechanisms by which power and influence are won (and lost). PR consultancies are also behind significant victories on behalf of big business, resulting in a tilted, biased market. PR emerged as a distinct discipline as a result of threats to the interests of business and government along with a ‘promotional culture’. 

Evidence indicates that PR arose rapidly in tandem with neoliberal policies. Those countries with the most marked privatisation and deregulation from the 1980s onwards – the US, the UK and Japan – had the largest PR industries. By contrast, countries such as France and Germany, which retained significant elements of consensus-based policies and state investment in industry, have much smaller PR industries. The global PR industry is dominated by a few big players, most of which are US or UK in origin and
ownership. 

Relative size of PR agencies in Europe, the US and Japan:

PR US Japan Eu

The expansion and power of Trans National Corporations (TNCs) relative to nation states has been a key spur to the development of communications conglomerates, which provide a full range of ‘promotional’ services and aspire to a global reach.  TNCs’ influence over the policy making process by entering an international market place has also led to a globalising of  the PR industry.

Multinational corporations, particularly in the US, and increasingly in the UK, look for global PR agencies who can operate adaptably and locally, wherever they are needed. 

The consensus in British politics was based on a compromise between organised labour and capital, which was founded on the post war 1945 settlement. This did secure real and significant democratic advances for ordinary citizens in the shape of the NHS, the welfare state, universal education, significant public ownership of utilities and heavy industry and, partly as a result, some amelioration of inequality in wealth distribution.

The end of the consensus in British politics during the New Right era ushered in more competitive politics in which traditions were displaced by a neoliberal tilt to the market in government policy. The crisis of the consensus shifted decisively with the 1979 election of Margaret Thatcher’s government which favoured the role and ‘right’ of employers to ‘manage’, with government rolling back state mediation.  

During the Thatcher era, changes in the communication strategies of the nationalised industries were crucial to the changed relationships between management and workers.  Controversial government actions and policies also led to a vast increase in PR spending by governments and by corporations in their attempts to influence government policy.

Fundamental to this is the relationship between PR, lobbying, and neoliberalism, (particularly the privatisation of national assets and the deregulation of business and service provision in state institutions). There are several parts to this relationship which are interrelated and in some respects, mutually reinforcing. These include:

Lobbying and preparation for deregulation,
• Spending on privatisation by government/nationalised industries,
• Spending by newly privatised companies,
• Spending on promotion by industries and professions following
deregulation,
• Increased spending on PR in the new business climate created by the
deregulation of the City. 

Conservative policies could not work without the PR industry and the PR industry would not have developed in the spectacular way it did without consecutive Conservative governments. The British privatisations of the 1980s were instrumental in the rapid  expansion of the PR industry. Once industries are privatised, PR, corporate identity consultants and advertising are needed to promote the private interests of the companies and as a part of their strategic armoury to create positive public images of them. By the 1990s, accountancy firms also routinely employed lobbying firms.

Lobbying increased deregulation which increased PR spending by encouraging financial institutions to market themselves, and by ‘selling’ the marketing. Nowadays there are no matters for business, government or private interest pressure groups that have not been first addressed by promotional professionals, which has made, in turn, further contribution to shaping economic-political life and profoundly reduced the quality of our democracy. 

PR consultancy and neoliberal ideology are intimately connected, the role of PR has facilitated an institutional corruption in British governance.

The rise of political branding and marketing, where the primary development involves the way political candidates, parties, government, lobbyists and groups have borrowed communication techniques from the private sector in the attempt to achieve
strategic objectives like gaining votes, driving public opinion or influencing legislation, is generally regarded to be an Americanisation of campaigning in the UK.

However, the identifiable practices like negative advertising, personalised politics, and high pre-election campaign expenditures are generally more about maintaining a neoliberal status quo, and these methods are a ‘whatever it takes’ approach that are subsequently exported in a pre-packaged box of persuasion techniques to other countries. Political identities are being constructed rather than given, policies are presented on showroom dummies, dressed up in techniques of persuasion. Yet there is evidence to suggest that overexposure to this kind of window dressing and made over political coverage has contributed towards widespread political alienation.

Image result for pr and democracy

The rise of political marketing with its techniques of ‘spin’, selling and persuasion may have somewhat undermined the credibility of political leaders and institutions,  with the elevation of style over content and image over substance, along with a concomitant  ‘brand and package’ pack mentality political journalism, ultimately leading to hardened public cynicism. We are after all, inhabiting a world dominated by PR operations that leave little place for objective reporting. Every message that the public receives is “sponsored” by someone trying to sell us something – be it a product, a service, a candidate, a government or a legislative act.

The content of the messages is calculated to generate superficial and shallow emotive responses rather than inspiring deliberative, rational and critical thinking. 

It wouldn’t be such a stretch to imagine that, in addition to the reductionist and glib sloganisation of politics, the normalised use of  emotive, negative and ‘attack’ Conservative political advertising may in fact demobilise the electorate, too.

The Conservatives in the ‘war room’ – a case study

The UK Policy Group is the UK branch of a notorious US political organisation – Definers Public Affairs – which has worked for Donald Trump’s administration and has aggressively targeted his critics. The company boasts: “What sets us apart is our focus on political-style research, war room media monitoring, political due diligence and rapid response communications.

“We help our clients navigate public affairs challenges, influence media narratives and make informed decisions to disrupt crowded markets.

“The global political, policy and corporate communications landscapes are evolving rapidly. Decision makers need high quality research to make informed decisions and need relevant content to drive the court of public opinion and provide context to shape decisions by policymakers.

“With affiliates in Washington, D.C., and Silicon Valley, UK Policy Group employs some of the best communicators, researchers and media analysts as part of our team.”

The Conservatives have outsourced their “research” to the UK Policy Group, privatising their dirt digging and smear campaigns. 

US lobbying firm Definers Public Affairs was founded by Mitt Romney’s 2012 presidential campaign manager, Matt Rhoades and former Republican National Committee research director Joe Pounder. Rhoades and Pounder are also directors of UK Policy Group.

Definers made headlines in December 2017 when it was paid US$120,000 in a no-bid contract by the United States Environmental Protection Agency (EPA) to build up dossiers of compromising information on “resistance figures”, opposed to the policy agenda of Scott Pruitt, and Donald Trump, the man who appointed him. Definers cancelled the contract in short order after its activities were exposed. 

UK Policy Group was originally called, and registered with Companies House as, ‘UK Rising’. Rhoades and Pounder are co-founders of America Rising, a political action committee (PAC), that specialises in helping [Republican] party candidates and Conservative groups find damaging information on political rivals. Both companies “craft convincing narratives and focused messaging”.

The expansion by Definers Public Affairs came at a time when US lobbying firms were eyeing UK expansion in anticipation of flood of Brexit-related work.

UK Policy Group’s website unambiguously states it works for ‘corporate clients’, however, not a single one of those running the company has a significant private sector background. In fact, each of the five individuals standing alongside Pounder and Rhoades is intimately connected with the Conservative Party.

Former government officials are advising this highly controversial company. The UK company’s vice president is Andrew Goodfellow, who was the Conservative Party’s director of policy and research. He specialised in ‘opposition’ research.

James Caldecourt was previously a Political Adviser in the Conservative Research Department, also specialising in ‘opposition’ research, and was part of George Osborne’s team while he served as Chancellor of the Exchequer 2010 — 2015. He has worked on several national election and referendum campaigns in political, policy and operational roles. Louis McMahon worked for two tears for two Conservative government ministers, and previously co-authored a criminal justice report for the Center for Social Justice think tank, founded by Conservative MP Iain Duncan Smith MP in 2004.

Ameet Gill, who was the former director of strategy Number 10 and founder of lobbying company Hanbury Strategy, is providing consultancy to the firm. Official documents reveal that David Cameron ’s former director of strategy, Gill, was given permission by parliamentary authorities to accept a contract advising the firm through his political strategy company Hanbury Strategy. Pelham Groom, a company director, was previously head of ‘media monitoring’ for the Conservative Party. Chris Brannigan, Theresa May’s former Director of Government Relations is also a member of the group’s advisory board. Rhiannon Glover is an analyst, formerly, the late duty press officer for the Conservative Party and researcher in the office of Nick Hurd.

The company is also partnered with Trygve Olson, of Viking Strategies, who advised the European People’s Party in the 2009 EU elections and worked as a consultant to the Republican Party in the US.

The company says: “We offer our clients an end-to-end system of research on issues and opponents, monitoring the news cycles, and shaping narratives via rapid rebuttal communications.

UKPG provides our clients with unparalleled campaign-style research as the foundation of driving informed decisions that allow them to shape public opinion, and impact outcomes.”

The company employs people to find damaging information on political rivals. Scrutinising the personal histories, online videos and posts of Labour Party candidates, the company collects dossiers of potential discrediting and smear material to be handed to the Conservative Party. It’s understood that the information is then handed to right-wing websites and newspapers to construct narratives and add a veneer of evidence to negative articles.

The company expansion by US-based company Definers Public Affairs came at a time when US lobbying firms were eyeing UK expansion “in anticipation of flood of Brexit-related work, using their capacity to influence the national news cycle’ and as a ‘master of opposition research”. 

Ian Lavery MP, Labour Party Chair, said: “I am disappointed but not surprised to hear that in an attempt to deflect from their total lack of direction and policy, the Tories are reduced to digging low and dragging British politics through the gutter, in the desperate hope that they may find some salacious morsel.

“This kind of base mudslinging has no place in British democratic debate, and deflects from the real issues facing people today. It is time that Theresa May stops spending money and effort on these tactics and focuses on policies to improve the lives of those who have suffered because of her government’s heartless policies.”

It may be argued that there are communications requirements of modern democracies. However, a representative democracy requires that political communication is dialogic – it flows in both directions between government and people. In fact that is a prerequisite. Instead we witness a manipulative neoliberal monologue from the current administration.

Neoliberal Conservative governments and the PR industry are very closely aligned, each profiting from the other. The condition of the spectacular growth of the PR and lobbying  industry was to facilitate and profit from the marked redistribution of wealth from the poorest citizens to the rich, establishing, elevating and securing the prioritisation of the private interests and power base of the 1% over and above – and at the expense of – public interests.

Image result for pr and democracy chomsky

 


 

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Private bill to introduce further charges to patients for healthcare services is due for second reading today

NHS charges

Christopher Chope, a Barrister and the Conservative MP for Christchurch, has proposed a private bill that would make provision for co-funding, and to extend the use of ‘co-payment’ – charges – throughout the National Health Service (NHS); and for “connected purposes.”

Though there are already some charges for health services such dental treatments, eye tests and prescriptions already, experts have warned that if the bill gains assent, it would open the floodgates to charging for a range of other services including GPs appointments and minor operations.

The National Health Service (Co-Funding and CoPayment) Bill would “make provision for co-funding and for the extension of co-payment for NHS services in England” and this will be the second reading of the bill.

MPs are set to debate the proposed bill today.

Recent changes to NHS prescribing guidelines has shown that the co-payment system is far from perfect. Controversial limits to the kind of conditions for which GPs can prescribe medication. Instead, patients will be given advice on what medications to buy from the pharmacy. 

Simon Stevens, Chief Executive of NHS England, said: “Across the NHS our aim is to: ‘Think like a patient, act like a taxpayer’. The NHS is probably the most efficient health service in the world, but we’re determined to keep pushing further. Every pound we save from cutting waste is another pound we can then invest in better A&E care, new cancer treatments and much better mental health services.” 

John O’Connell, Chief Executive of the TaxPayers’ Alliance approved the changes, adding that “It’s great news that NHS England will save a vast amount of taxpayers’ money by curbing prescriptions for basic items that are much cheaper to buy in the supermarket than they are to prescribe. Taxpayers should not be footing the bill for items like anti dandruff shampoo or athlete’s foot powder, so cutting out wasteful spending like this will mean that precious resources can be focused on frontline services. Patients too must remember that these items are not “free” – the money comes out of taxpayers’ pockets, so NHS England should be applauded for this move.”

However, someone should remind Stevens and O’Connell that everyone pays tax and national insurance. This kind of rationing is a steep and slippery slope to a health service that is no longer free at the point of delivery. 

However, NHS has always been free at the point of delivery – that’s one of the founding principles on which it was created. Millions of ordinary people rely on this principle. Under no circumstances must we permit the government to take us back to the time when had to sell their household belongings to see their doctor. Citizens in a civilised  and democratic society should not be penalised financially for being ill and needing NHS services.

Justin Madders MP, Labour’s Shadow Health Minister, said: “Once again we see the Tories’ true colours.

“At a time when the NHS is going through the biggest funding squeeze in its history and more than four million people are waiting for treatment, Tory MPs are proposing a two-tier system where those who can afford it get treated first.

“Labour’s first priority will be to give the NHS the funding it needs to protect an NHS free at the point of use for everyone who needs it.”

Chope has previously tabled a range of other controversial bills.

He was appointed as the Parliamentary Private Secretary to Peter Brooke, the Minister of State at the Treasury in 1986, before being promoted by Margaret Thatcher to serve in her government as the Parliamentary Under Secretary of State at the Department for the Environment later in the same year, where he was responsible for steering through the immensely unpopular “Community Charge” (best known as the Poll tax) legislation.

In June 2013 Chope was one of four MPs who camped outside Parliament in a move to facilitate parliamentary debate on what they called an “Alternative Queen’s Speech” – an attempt to show what a future Conservative government might deliver. 42 policies were listed including reintroduction of the death penalty and conscription, privatising the BBC, banning the burka in public places and preparation to leave the European Union. 

Chope helped to lead backbench support for the motion calling for a European Referendum. He has also been heavily involved in the use of private member’s bills to achieve this aim. Chope came under fire in January 2013 for referring to some staff in the House of Commons as “servants”. Parallels were drawn between this opinion and his views on the minimum wage – which he has called to be abolished.

On 28 November 2014 Chope, a private landlord, filibustered a Liberal Democrat bill with cross party support intended to make revenge evictions an offence.

In 2014 Chope along with six other Conservative Party MPs voted against the Equal Pay (Transparency) Bill which would require all companies with more than 250 employees to declare the gap in pay between the average male and average female salaries.

He came under criticism in late 2014 for repeatedly blocking a bill that would ban the use of wild animals in circus performances, justifying his actions by saying “The EU Membership Costs and Benefits bill should have been called by the clerk before the circuses bill, so I raised a point of order”.

You can read Chope’s latest controversial and draconian bill: The National Health Service (Co-Funding and Co-Payment) Bill here.

GP and NHS campaigner, Bob Gill, says:

Ever wondered why Government wanted to spend a fortune on the charging infrastructure for collecting relatively insignificant sums from illegal immigrants using the NHS?

Well that was the cover story. Reality is that charging was always intended to apply to everyone.

Here is the Bill to extend charging to all.”

Please tell your MPs to attend the debate and to argue and vote against it, whatever party they are.

Here is how to contact your MP.

Template emails are downloadable from the 999 Call for the NHS website.

Let’s not let the Conservatives get away with privatising our NHS by stealth.

Image result for MPs with a vested interest in NHS

 

Update

The bill did not get through the second reading, as it ran out of time. However,  the Conservatives have rescheduled the bill for another attempt, on Friday 15 June.

Related 

Rogue company Unum’s profiteering hand in the government’s work, health and disability green paper: work as a “health outcome”.

 


I don’t make any money from my work. I’m disabled through illness and on a very low income. But you can make a donation to help me continue to research and write free, informative, insightful and independent articles, and to provide support to others. The smallest amount is much appreciated – thank you.

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Grenfell, inequality and the Conservatives’ bonfire of red tape

Residents were trapped "screaming for their lives" as flames raged through a 27-storey tower block in Notting Hill in the early hours today

The Grenfell Tower fire reflects a colossal betrayal of working class people’s trust by the state. The Conservatives have emphasised “economic growth” at the expense of citizen’s welfare in their policies since taking office in 2010. This is a government that has rewarded the propertied class and punished the renting class (by inflicting policies such as the bedroom tax, and the welfare cap, for example). It’s a government that values and supports profiteering landlords, who have lobbied against essential safeguarding regulation, and one that has also imposed massive local authority budget cuts. 

It’s estimated that there are more than 700 tower blocks in London. These range from the brand new luxury apartments to the post-war council-owned buildings which were seen as a convenient cure to problems caused by the crumbling and unsanitary 19th Century slums.

Around 8% of Londoners now live in tower blocks. Some of the flats are bought for millions; others are relatively low-cost social housing, rented from a local council at a fraction of the private rate. Grenfell Tower itself was designed in 1967, building started in 1972 and finished in 1974.

Originally built as municipal housing as part of the slum clearances of the 1960s, it had 120 one and two-bedroom flats over 20 of its 24 storeys, and was renovated in 2016.

Grenfell House is in a neighbourhood ranked among the most deprived 10% in England.

The BBC’s Bethan Bell says

“Just two miles away – or four stops along the Circle/Hammersmith and City line – is 3 Merchant Square, a 21-storey tower that is part of a new development around Paddington Basin. The contemporary block was finished in 2016 and holds 60 apartments over 15 storeys.

It’s a different world. The penthouse apartment was sold for £7.5m. One-bedroom flats are at least £1m.

Surrounded by restaurants and bars, workers and residents can lounge on deckchairs on a newly-built floating park. Lunchtime yoga sessions are held and there’s a luxury fitness club.

There’s an enormous fountain and a bridge created by renowned designer Thomas Heatherwick, a nursery and winter garden.

But nice though these peripheries undoubtedly are, they don’t keep people safe from fire. For that, we must have a look at the specifications of the apartments in the tower. 

Once you get past the sales brochure description of 3 Merchant Square’s walnut cutlery drawer inserts and integral wine coolers, the adjustable mood lighting and heated bathroom walls, you come to the fire safety details: Every flat has not only ceiling mounted smoke detectors but sprinklers.

The International Fire Sprinkler Association (IFSA) says that automatic fire sprinkler systems are the single most effective fire protection measure available, and are able to make up for a wide range of other fire protection deficiencies.

There has never been a multiple loss of life from a fire developing in a building protected by a properly designed, installed and maintained fire sprinkler system. While fire sprinkler systems have been required in new high-rise residential buildings in England since 2007, it is not compulsory to retrofit them into existing buildings. So Grenfell Tower had none.”

It’s a tale of two cities.

The former chief fire officer Ronnie King, honorary secretary of the all-party parliamentary group on fire safety and rescue – which had recommended fitting sprinklers to buildings to save lives – has said the regulations “badly need updating” and “three successive ministers have not done it”.

“My own thinking is there was the red tape challenge and they don’t really want to put regulation on to businesses, adding a burden.

“It’s one of those that if you bring in a new regulation, you have got to give three up to get it.” 

This echoes my own comments yesterday

In 2012, David Cameron vowed to “cut back on the health and safety legislation “monster”, and to “kill off the health and safety culture for good.” The Conservatives’ Cutting Red Tape programme allows Business to tell Government how it can cut red tape and reduce bureaucratic barriers to growth and productivity within their sector.” The Tories boast these “big successes” in getting rid of “unnecessary bureaucracy”: 

  • Over 2,400 regulations scrapped through the Red Tape Challenge
  • Saving home builders and councils around £100m by reducing 100s of locally applied housing standards to 5 national standards
  • £90m annual savings to business from Defra reducing environmental guidance by over 80%
  • Businesses with good records have had fire safety inspections reduced from 6 hours to 45 minutes, allowing managers to quickly get back to their day job. 

Among others.  

Apparently, “Cutting Red Tape wants to work with business, for business.” I don’t see any balanced democratic representation and reflection of public needs. Back in 2015, business Secretary Vince Cable and Business and Enterprise Minister Matthew Hancock announced that “better enforcement of regulation” is saving business more than £40 million every year. What that phrase actually means is not “better enforcement” – it’s deregulation. The Tories are masters of Doublespeak. 

The Focus on Enforcement review programme, which asks companies to identify poor “enforcement practices” that “hold them back”, has benefited around one million businesses and boosted growth in 9 vital sectors of the economy from coastal developments to childcare. And building. 

This “builds on government action to scrap or reform regulatory rules which has saved firms some £10 billion over this parliament.” It has also undermined health and safety legislation, consideration of which has a direct impact on the welfare of public. Conservative ideology prioritises private profit over human needs. New Right neoliberalism is all about privatisation, fiscal austerity, deregulation, free trade, and a “small state” commitment entailing reductions in government spending in order to increase the role of the private sector in the economy and society.

The problem is that the government regards regulations as an inconvenience – as raising unnecessary obstacles to free market economics – business, growth, competition and “innovation”, while disregarding the fact that regulations actually serve important social objectives. 

The Conservatives have long argued that “red tape” impedes freedom and “damages productivity”. They have glibly assured us that the UK would be a better place with a lot of deregulation and fewer bureacratic “barriers” to business. The 2010-15 Tory Health and Safety “reforms” (that word is always a Conservative euphemism for cuts) have been motivated, for example, by a belief that: “good health and safety is important, but the burden of excessive health and safety rules and regulations on business had become too great and a damaging compensation culture was stifling innovation and growth. We want to protect people in the workplace while reducing the burden of unnecessary health and safety rules and regulations on businesses.”

The “red tape” that the Conservatives regard with such disdain consists of laws that provide essential public protections and rights that prioritise citizen’s lives. The freedoms being protected by this government are those of the rich to exploit the poor, of corporations to exploit employees and the public, of landlords to exploit their tenants and, to nick a sentence from George Monbiot, of industry to use the planet as its dustbin.

2012 report by the British Automatic Fire Sprinkler Association (BAFSA) concluded that fire sprinklers could be retrofitted with tenants in place at a cost of about £1,150 a flat. Since the 24-storey Grenfell Tower contained 120 flats, it would have worked out at £138,000. That’s significantly less than the £2.6m spent on the cosmetic cladding and replacement windows

Architect and fire expert Sam Webb said: “We are still wrapping post-war high-rise buildings in highly flammable materials and leaving them without sprinkler systems installed, then being surprised when they burn down.

I really don’t think the building industry understands how fire behaves in buildings and how dangerous it can be. The government’s mania for deregulation means our current safety standards just aren’t good enough.”

Some of these issues were raised in a report following a fatal fire at a tower block in 2009 in Camberwell, in which six people were killed.

The Secretary of State for Communities and Local Government, Sajid Javid, said his predecessor in the role had accepted the report’s recommendations and put them into action.

He said: “The coroner did not recommend new planning regulations. The coroner recommended a change in the guidance. There is a lot of information out there and it is right that it is independently looked at by a judge-led inquiry.” 

When asked whether the government would retrofit sprinkler systems to tower blocks, he said: “I don’t think we can immediately jump to the conclusion that sprinklers is the issue here. We will do whatever it takes.”

An associate pastor of Notting Hill Community Church, Danny Vance, says “the poor are constantly neglected” in the city.

He said: “The disparity between rich and poor in this city is disgusting. This would not have happened to the £5m flats around the corner” [from the Grenfell tower].

Theresa May has announced a £5 million emergency fund for the survivors of the Grenfell inferno, amid angry protests over the government’s lack of appropriate reaction to the tragedy, and what survivors see as the slow emergence of information with regard to loved ones and friends who are still missing.

It’s worth considering that the Conservatives consistently spend close to the £19m general election spending limit on their campaigns. In comparison with the funding offered to people and their families who have lost loved ones and friends, their homes, and all of their belongings, it highlights a problem with our democracy. It is one of political priority. Much more money is spent by the Conservatives on staying in power than it is on pressing social need, reflecting the somewhat corrupt priorities of this government. 

The Labour party have said that the £5 million isn’t enough. It really isn’t. 

Grenfell Tower stands as a dreadful symbol of the failings of austerity for which the Conservatives are culpable. It’s an emblem of the intentional Conservative attacks on our poorer citizens. Tory MPs have sneeringly  rejected housing regulation; they implemented cuts to councils responsible for retro-fitting fire suppressants; they disregarded the coroner’s instructions after the 2009 Lakanal House tragedy; and plan to opt out of EU safety regulations. Conservative Kensington and Chelsea council have regularly blocked its ears to tenants’ well-founded anxieties

For many, the blackened husk of Grenfell Tower is a terrible and tragic monument to inequality. It stands as an awful accusation. It should not be the case that society’s most disadvantaged citizens suffer most from the mistakes of the powerful. The state should protect and value citizens’ lives – each life has equal worth, it is equally precious – and not remain indifferent to people who complain that their home is potentially a death trap, neglecting their fundamental concerns and needs. We live in a society where our government values property rights over more fundamental human rights. It’s a democracy for property-owners, but not for tenants.

Danny Dorling has highlighted that black and minority ethnic people in social housing are disproportionately housed in flats, to the extent that most black children in London and Birmingham are housed above the sixth floor. This is not to do with a shortage of housing, but is a reflection of the fact that not only are ethnic minorities more likely to be working-class by wage and occupation, but they experience discrimination – tacitly or blatantly – when allocated housing. Jeremy Corbyn and other Labour MPs are absolutely right to call for the use of empty homes in Kensington to rehouse locally those made homeless, and experiencing such devastating losses, by the fire. 

We live in a society where it’s become normal and somehow acceptable that the privileged class can buy their safety, their security, rights and their legal representation, while many working class people and those citizens who are vulnerable have none of these. 

Grenfell Tower is a charred and bitter testament to how our poorest citizens are placed at risk because we live in a society that values unfettered private profiteering, no matter what the cost to ordinary people, and the superficial and appearance over what really matters – people’s lives. The deadly cladding was added as cheaply as possible to improve the view for others, while the sprinklers, working alarm and fire extinguishers that would have saved lives were omitted. 

Emergency services personnel on top of Grenfell Tower in west London after the fire 
Related

Grenfell is a horrific consequence of a Conservative ‘leaner and more efficient state’

The Conservatives are forced to end austerity because they face a turning tide and electoral extinction

London protests as they happened: Demonstrators demand justice for Grenfell victims after day of fury and sorrow

 


 

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