#NHSwhitepaper Thread:

Contrary to some of the headlines, the reforms are NOT the
‘end of privatisation’

(Will explain below)

The white paper wants to reverse legislation that mandated competitive tendering, which meant every contract had to be put out ‘to the market’....

1/
Which was a nuisance
Created unnecessary beurocracy And wasted a lot of money

This legislation was brought in under Cameron’s coalition government

(Against the advice of the unions, health think tanks, royal colleges...basically everyone)

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The suggested move away from forced competition

And towards integration is very positive

As I explained in @tortoise #publicinquiry

The barriers between services, created by the imposed ‘market’, hindered the H&C system’s ability to have an effective coordinated response

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However, there are serious concerns re transparency and accountability

There is a lack of coherence and gaping holes in this #NHSwhitepaper on some key crisis areas that require urgent action

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As I mentioned, This is NOT an end to privatisation

Under these reforms there is NO duty on the government to provide key services

Foundation trusts are still able to receive 49% of their income from outside the NHS

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Moreover, these proposed ICS boards, which will hold significant power

And importantly hold the budget for all acute and community services, can have private companies as members

And private companies can also be contracted to provide services

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Unfortunately, this white paper ignores the Health and Social Care Committee “strong recommendation”
to rule out non-statutory providers (i.e. private companies) from holding the ICP contracts

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ACCOUNTABILITY & TRANSPARENCY

As I wrote last year, over the pandemic

Over 10 billion worth of contracts have been awarded by government to companies without competition, often to companies with links to the cabinet
@thefabians https://fabians.org.uk/catalogue-of-errors
Within the NHS, the current open tendering process is at least a check against corruption

The lack of detail or transparency in the white paper on how contracts will be given

Means we risk the corruption and cronyism we’ve seen during the pandemic becoming the new norm

9/
SOCIAL CARE

Excess deaths of care home residents AND care workers is the shameful outcome of a dysfunctional system

Pre covid, over 1 mil elderly had unmet care needs (now likely to be higher)

Quite Astonishing, reforming social care is not 1st priority of this government
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Furthermore, without reform, trying to “integrate” the NHS (free at the point of need)
And social care (means tested and partly privatised) simply wont work

And could handicap the urgently needed reform of the care sector

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PRIORITIES

Structural reforms to our NHS is definitely needed
(those who follow my blog know I have been whinging about this for years)

As it underlies many of the core issues in the health system

And my inner policy geek welcomes the attention to this

HOWEVER.........

12/
Over 4.5 million people are waiting for treatment

With 200,000 people waiting more than a year

(150x higher than in 2019)

I have seen first hand the devastating impact of this

People are suffering, their conditions deteriorating,
at risk of permanent disability

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The failure to deal with the immediate crisis, of capacity & waiting times

And the lack of a comprehensive workforce strategy

Has dumbfounded many

Concerns government planning the renovations before putting the fire out!!

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Finally, our exceptionally high death rates cannot simply be attributed to government mistakes

We are the sick man of Europe

With widening health inequality

Significant proportion of the population living with health problems, at lower age than other european countries

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Reducing health inequalities needs more than lip service

If we’re serious about reducing inequalities, this needs to be imbedded & prioritised in every part of government

Simply ‘asking the NHS to address this’ is not good enough & WONT work, it requires a cross govt agenda
17/
How we deliver and value health and care in this country desperately needs a rethink

To summarise, this is simply not good enough

END

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