Sunday, January 25, 2015

Greece! Greece! Greece!

Two older posts:

Greece: Where are you heading?

Hot News:
European leaders and financial markets braced for Greece exit from euro!!!

Greece Can No Longer Delay Euro Zone Exit

© Am Ang Zhang 2011


© Am Ang Zhang 2011
I returned from Greece after a lovely cruise. Greece has been hit by more financial problems and it was clear that market forces caused much hardship to its ordinary citizens! One taxi driver told me that Greece will never pay back the EU. He may well be right.

A Chinese Story:

The Yangtze River is rising. Man is on the roof. A traditional pigskin boat rowed along: let me get you off.
“No, Buddha will protect.”
Man is now knee-high in water. Naval boat came along: old man, let’s get you off.
“No, Buddha will protect.”
Man is now up to his neck in water. Rescue helicopter came along: let’s winch you off, stubborn old man.
“No, Buddha will protect.”
Man died and saw Buddha. “Why didn’t you come when I needed you most?”
I did, I sent pigskin boat, Naval boat and even my best helicopter, but you refused!

The Greeks have their own Gods, but perhaps they should try Buddha.

So first the Gods sent in Antigone:
So Antigone had a part in this tragedy too. That's ­Antigone Loudiadis of Goldman Sachs, who ­arranged a complex ­currency swap deal that helped Greece to conceal the scale of its debt, in what the Financial Times delicately calls "an optical illusion", as the country snuck into the eurozone. 
Then God showed how it could be done in Argentina: defy the I.M.F.
When the Argentine economy collapsed in December 2001, doomsday predictions abounded. Unless it adopted orthodox economic policies and quickly cut a deal with its foreign creditors, hyperinflation would surely follow, the peso would become worthless, investment and foreign reserves would vanish and any prospect of growth would be strangled.
But three years after Argentina declared a record debt default of more than $100 billion, the largest in history, the apocalypse has not arrived. Instead, the economy has grown by 8 percent for two consecutive years, exports have zoomed, the currency is stable, investors are gradually returning and unemployment has eased from record highs - all without a debt settlement or the standard measures required by the International Monetary Fund for its approval.

He even took out the head of I.M.F. just to be on the safe side.
Then came Iceland:
Unlike other disaster economies around the European periphery – economies that are trying to rehabilitate themselves through austerity and deflation — Iceland built up so much debt and found itself in such dire straits that orthodoxy was out of the question. Instead, Iceland devalued its currency massively and imposed capital controls.

And a strange thing has happened: although Iceland is generally considered to have experienced the worst financial crisis in history, its punishment has actually been substantially less than that of other nations.

But no, the Greeks have not learned anything. 
This was written last year:
Germany will agree to some form of eurozone bailout. However, it will only support the minimum needed to ­placate the gods, and only with the most astringent, Creon-like conditions being imposed on Greece. It is an ­important but ultimately secondary question whether this help comes in the form of bilateral loans, loans from the European Investment Bank, purchases of Greek government debt, EU ­spending transfers, jointly issued eurobonds or any of the other mechanisms ­suggested. EU leaders will deny that this is a bailout and everyone will know that it is a bailout.                                                           Guardian.
The Greeks will do well to go back to their own Gods and not the I.M.F.

Are the bells tolling for Greece?©2011 Am An Zhang

The Guardian  Greece: what happens next?

Michael Lewis: The Big Short

NHS: Business Model? Spare Us Please!!!

The Next Europe: Left-over Euro & Deutschmark

 Dominique Faget/Agence France-Presse — Getty Images

Historian Hans-Joachim Voth gives the euro only another five years unless the euro zone is transformed into a full transfer union with massive redistribution. The continent is too culturally different to warrant a single currency, he says, adding that it would be best ifGermany and other stronger economies left the euro zone.

SPIEGEL: Professor Voth, how much longer do you think the euro will survive?

Voth: Five years. The euro can't survive in its current form. We could, of course, make a full-fledged transfer union out of the euro-zone countries, complete with euro bonds and massive fiscal redistribution. In that case, we would have a different euro than the one that was originally conceived and promised to German voters. In the end, if the heads of state and government don't want that, it's likely that the euro will have to be dissolved.

SPIEGEL: You give the euro another five years -- what will Europe look like then, in your opinion?

Voth: I can imagine a world where there will a left-over euro: with FranceItaly, the Mediterranean countries, perhaps Belgium as well. Apart from that the old Deutschmark zone will return, comprising GermanyAustria and the Netherlands, perhaps Denmark as well, perhapsFinland, which have no problems conducting the same monetary policy as Germany. We had a similar system during the European Exchange Rate Mechanism ERM. That was the optimal system, and then we gave it up for the euro.                                        Der Spiegel

See also Money Week

Der Spiegel:

  • The Ticking Euro Bomb: What Options Are Left for the Common Currency? - SPIEGEL ONLINE - 
  • Contagion!!! Dexia Rescue: Belgium Nationalizes Troubled Bank - SPIEGEL ONLINE - 
  • Berlin, Paris Deny Rift Rumors: EU Postpones Summit on Debt Crisis - SPIEGEL ONLINE - 
  • The Financial Crisis Returns: Europe's Attention Shifts to Its Ailing Banks - SPIEGEL ONLINE - 

Related Posts:

Wednesday, January 21, 2015

Religion & Medicine: Pork & GBM!

 © Am Ang Zhang 2015   

A short while back I blogged about GBM and how an innovative treatment may have helped. Being a doctor Dr Anderson noted this:
My wife, Carmen Alicia, called a local friend, also a cardiologist, who sent us to a nearby hospital; there, an MRI exam revealed a small spot on my brain. The neurologist felt it needed to be biopsied to obtain a tissue diagnosis. I immediately returned to Virginia and went to several specialists, who suggested further testing before I decided to have an invasive brain biopsy. I also had a blood test for cysticercosis, an infection that results from eating undercooked pork contaminated with Tenia solium. This common parasite produces cysts all over the body, including the brain. It is the most common reason for seizures in many countries, particularly in India, where children with seizures are first treated for this disease even before other studies are done. My blood test was strongly positive. I started a course of oral medicine to treat it. The test reassured me.
My later research showed that there may indeed be some association of Tenia and GBM. 

Neurocysticercosis (NC) is the most frequent and widespread human parasitic infection of the central nervous system (CNS). Glioblastoma multiforme (GBM) is a neoplasm of CNS in elderly population and may have a similar clinical and radiologic presentation as of NC. The coexistence of NC and neoplastic intracranial lesion in an individual is a very rare entity. The incidence of NC among intracranial space occupying lesions is reported to be 1.2-2.5%.[1–4] Though cerebral cysticercosis may be associated with glioma,[5] but this rare coexistence of NC and brain tumors puts into question a causal relationship between the 2 diseases. Here we report a case in which glioma and cysticercosis appeared concomitantly, with continuing progression of low grade Glioma to high grade Glioma (GBM, WHO grade IV).

So some religious dogma might actually be good for ones health. 

But watch out, even if you do not eat pork:

Neurocysticercosis in an Orthodox Jewish Community in New York City

All the patients and their families adhered to Orthodox Jewish dietary laws, which forbid the eating of pork. Moreover, T. solium taeniasis due to the ingestion of contaminated pork is extremely unlikely in the United States. Cysticerci were detected in only 3 of more than 83 million hogs examined after slaughter under federal inspection in 1990.
The most likely sources of infection in the patients described in this report were women living and working in the patients' homes who had recently emigrated from Latin American countries where T. solium infection is endemic.

In 2003 the world was in the grip of a new plague that challenged our knowledge of medicine to its limit.

         For the first time, doctors and nurses who were normally in the forefront of the fight against diseases were fighting for survival from SARS (Severe Acute Respiratory Syndrome), a new and dangerously contagious disease.  The alarm was first raised by its first victim, Carlo Urbani.  He was an Italian physician employed by the World Health Organisation (WHO) and based in HanoiVietnam and he gave the disease its current name. It was as if this newly mutated virus knew what it was on about. Get the doctors as they would be the first who could deal with you. Urbani died. So did some of the medical staff that attended the first few patients.

         Doctors often thought that they would be immune, a God given right I suppose.  Not so this time! The virus obviously knew what it was doing.

SARS, Freedom & Knowledge     

A doctor friend had just been diagnosed with GBM (glioblastoma multiforme) grade IV. My hospital librarian had the same tumour and told me that the hospital neurosurgeon got it too. Another close friend who is an ENT surgeon has just been diagnosed with NPC (Nasopharyngeal Carcinoma).

Looks like doctors are no longer as immune as we like to believe and that goes for those that worked closely with doctors like our beloved librarian.                                                                

Then I read an account by a doctor of his GBM.

He is a cardiologist for thirty five years, (so not a neurosurgeon then) but with the diagnosis his research unravelled one of the possible reasons for "catching" GBM.

Why did this tumor happen to me? I never smoked and had had no brain injuries, and there is no history of such tumors in my family. As a cardiologist, I had implanted close to 400 pacemakers in my life and during the procedure was exposed to ionizing radiation (X-rays). In the early days we used portable X-ray machines and gave ourselves some protection by using thin lead gowns. Nowadays, heavy lead gowns are worn, and doctors and technicians protect their thyroid and eyes with shields and glasses. We also use heavy sheets of radiation-protective glass that hang from the ceiling.

At some point in my research, I was surprised by an article by a Johns Hopkins-trained cardiologist who now practices in Israel. He had collected data on 23 invasive radiologists and cardiologists who had developed tumors, of which 17 were GBMs on the left side of the brain. I wrote to the author, who told me that he had learned of several more such cases since his article was published, and he added mine to his file."


" I had a glioblastoma multiforme (commonly called a GBM) grade IV. This is the most malignant brain tumor; no grade II or III exist. A glioblastoma is what killed Sen. Edward M. Kennedy (D-Mass.) in 2009. While rare, it is the most common of the brain tumors. The prognosis is dismal; on average, patients survive only 14 months after diagnosis even with chemotherapy and radiation. After five years, only 5 percent of patients are still alive."

So depressing.

But wait: The Zapping!

" The Preston Robert Tisch Brain Cancer Center at Duke University has the largest experience on the East Coast with my sort of tumor, so I went there for further consultation and treatment.

As doctors there examined me, it was obvious that my tumor had already grown again; in fact, it had quadrupled in size since my initial chemo and radiation. I was offered several treatments and experimental protocols, one of which involved implanting a modified polio virus into my brain. (This had been very successful in treating GBMs in mice.) Duke researchers had been working on this for 10 years and had just received permission from the FDA to treat 10 patients, but for only one a month."

The procedure:

"I was given the Salk polio vaccine to prevent a systemic polio infection.

At Duke, my skull was opened under local anesthesia and I had the viral infusion dripped through a small catheter directly into the tumor in my brain for six hours."

The result:

"I returned to Duke a month after the infusion, and though an MRI showed some expected swelling, the more significant fact was that the tumor had stopped growing. I have gone back to Duke every two months since then, and the tumor, initially the size of a grape, is now a scar, the size of a small pea. It’s been two years since the initial biopsy and radiation, and one year since the experimental polio viral treatment, and I have no evidence of recurrence nor tumor regrowth.

According to a presentation about the research that the Duke doctors gave last May, the results so far are promising: “The first patient enrolled in our study (treated in May 2012) had her symptoms improve rapidly upon virus infusion (she is now symptom-free), had a response in MRI scans, is in excellent health, and continues in school 9 months after the return of her brain tumor was diagnosed. Four patients enrolled in our trial remain alive, and we have observed similarly encouraging responses in other patients. One patient died six months following ... infusion, due to tumor regrowth.” They added: “Remarkably, there have been no toxic side effects ... whatsoever, even at the highest possible dose.”

That has been true for me. I feel as fit as I was three years ago, before the first symptoms of the glioblastoma made their appearance. I remain only on an anti-seizure medication."

Laoshan China

 © Am Ang Zhang 2011    

Thirty years ago, I saw mountains as mountains, and waters as waters.

When I arrived at a more intimate knowledge, I came to the point
where I saw that mountains are not mountains, 
and waters are not waters. 

Thirty years on,
I see mountains once again as mountains, and waters once again as waters.
 Adapted from Ching-yuan (1067-1120)

Friday, January 16, 2015

The Old World: High End Photography & Wine!

Revisiting the Old World!

It is no secret that I have many hobbies and two of them are photography and wine.

Salzburg in Cibachrome©2008 Am Ang Zhang/ Bauhinia Press

The photo of Salzburg was taken with a Hasselblad CF film camera with a 150mm lens at dusk.

This week in the run up to the New York Marathon I had the opportunity to be at one of the biggest photo show in the world: PDN PHOTO EXPO  and saw at first hand the new Hasselblad Camera: H4D, a mind boggling 60 Mpixel camera. What was perhaps a bit sad was that it was not a square 60 X 60 sensor but a 36 x 48 sensor and anyone with rudimentary mathematics will realise that it is the combination of two 36 x 24 sensor which is now used by NikonCanon and Leica in their high end products. Not that long ago we were even told that for digital cameras, there was no need for 36 x 24 sensors as 24 x 18 sensors were perfectly adequate.  When will they produce a Hasselblad sensor of 60 X 60?  I wonder.

Still, the Hasselblad H4D is staggering by any standard, and at very little change for $40,000, it should be.  Purists will feel sad that it may be a Hasselblad in name but it is Fuji with Imacon that developed the camera and the digital scanning technology.

I was also fortunate enough to be at Sherry-Lehmann for the book signing of The Heart of Bordeaux and their wine tasting. The book was more a beautiful coffee table book in time for Christmas, but the tasting was spectacular. It was a grand tasting of the wines of Graves Chateau, the subject matter of the book,  and those of Haut-Brion in particular.

After tasting around the hall starting with the “lesser” wines (for want of a better word as some of the wines were very drinkable), we all drifted to the “top” table. The whiteLaville-Haut-Brion 2006 was one of the best whites I have tasted in recent times.  It is just amazing what could be done with the right combination of Sauvignon and Semillon grapes.  They told me that this white could stay in the cellar for the next 10, 20 or even 30 years!  Then there were of course both La Mission-Haut-Brion 2006 and Haut-Brion 2006 in its distinctive bottle.

I whispered to myself: why did I like La Mission better?  Haut-Brion is first growth, and La Mission is not even classified.  Someone heard me and said, “ Just look at the price: Haut-Brion, $399.95, La Mission, $735.”

Afterwards I read on their website: 2006 is one of the greatest vintages of La Mission Haut-Brion.   It is difficult to say what Haut-Brion will be like in the years to come, but for now La Mission 2006 is much bigger and richer in every way imaginable.

La Mission Haut-Brion is just across the street from Haut-Brion and yet it is so different. That is why top French wines are so interesting.
It was a bonus to meet with Hugh Johnson who wrote the preface of the book.  Amongst other things, I just had to talk to him about Royal Tokaji. The story of this Hungarian wine is a legend in the modern history of wine and of individualism. The famous wines of the region were nearly destroyed during the communist era when mass production of poorer quality wines was the order of the day. George Orwell may well be wrong as the pigs did not recognise what was good. It took some smart footwork and of course a broad knowledge of different wines for Hugh Johnson to rescue this unique desert wine.

Hugh said that they were preparing for a 20th anniversary of the re-establishment of the wines. In his own words: “Tokaji is a wine that would make angels sing out loud in praise”.

Indeed! For now, a drop more of La Mission Haut-Brion.
Wine Posts:
-->Hairy Crabs & Wines 

Can it be that it was all so simple then
Or has time rewritten every line
If we had the chance to do it all again
Tell me - Would we? Could we?
                                                                      The Way We Were


Wednesday, January 14, 2015

There are two futures: NHS future now!

As the sun sets and it was clear that we have lost the first privatised NHS hospital :
©2014 Am Ang Zhang

CAROLINE MOLLOY 14 January 2015

Hinchingbrooke - the flagship of NHS privatisation - was given the CQC’s worst ever rating for ‘caring’. Both safety and leadership were also bottom of the heap.  Circle’s cleverly branded ‘mutual’ model, far from ‘liberating’ NHS professionals’ to make grassroots-led improvements, had in fact replicated some of the worst hierarchical, bullying practices to be found in the NHS. And it had lost the caring and expertise that are the NHS’s strengths, principally as a result of poor leadership and financially-driven staff cuts to satisfy investors.
But does that mean privatisation is dead?
No. Too many have staked their careers - and their fortunes - on it, for them to back off that easily.
No-one who understands the NHS has ever really expected the private sector to make profits from running full service hospitals with A&E departments.
Just as opponents to the Health & Social Care Act pointed out, what the private sector really want to do is cherry pick, taking the government money to run all the predictable and easy stuff - starving the rest of the NHS of funds as a result.
But the government had to pretend otherwise, to get through the Health & Social Care Act, and Ali Parsa's hyperactive hyperbole was very useful during those turbulent months.
“Forget the cherries - give us the potatoes” Ali Parsa told the Times in November 2011 on winning the contract. That years’ business plan set outgrand visions of Circle taking over 20 or more hospitals across the country. Parsa even told Newsnight "We would love to run a major teaching hospital".
But Parsa left at the end of 2012 for pastures new - his PR job done. And with the Act secured, and former Vice President of US healthcare giant United Health, Simon Stevens, now at the helm of the NHS, private health companies see better profits (and less brand damage) than openly taking over full service hospitals, as Circle’s statement on Friday hinted:
If doctors running local Clinical Commissioning Groups won’t hand over the NHS cash, there’s various ways decisions are being quietly wrenched away from them, from ‘commissioning support’ and ‘personal budgets’ to ‘chain hospital networks’, ‘Kaiser-style integration’ and ‘prime contractor’ models.
All of this will help companies like Circle sort the cherries from the potatoes.
And if the tariffs paid for many treatments are currently too low to squeeze a profit from, well, it's only a waiting game till the cherry picking undermines the NHS to the point the private sector providers can start flexing their muscles and demanding more money.
It's already starting.
In nearby Bedfordshire, Circle recently won a huge ‘integrated’ ‘prime contractor’ contract for all musculo-skeletal services in the area - and promptly tried to sub-contract the undesirable bits back to the NHS on Circle’s own terms. As the local NHS hospital told the BBC, “Our concern is that if we don't have the planned work coming through, then with the way the NHS is financed, we don't know whether we will have sufficient money to provide the emergency service.” Recent reports suggest Bedford Hospital is now in severe financial difficulties.

A little further afield in Nottingham, Circle runs the largest Independent Sector Treatment Centre in Europe, having pulled off an eyebrow-raising deal to force the NHS to pay it £42 million to buy its clinic in the hospital grounds, then lease it back to it. Circle then continued to expand, recently successfully bidding to take over the hospital’s routine NHS dermatology services - to thedisgust of the doctors who left rather than be transferred to Circle. Now, the local NHS hospital is closing its acute dermatology services too, because it can’t afford to provide only the more expensive dermatology services Circle doesn’t want. Patients will be forced to travel ever further afield for anything more complicated or less profitable.  

Hinchingbrooke, As it failed I am putting out my future blog again:
The future is now!!

“There are two futures, 
the future of desire and the future of fate, 
and man's reason has never learnt to separate them.”

 J. D. Bernal, Professor of Physics, Birkbeck College, London, FRS ( 1901—1971)

Scenario 1: Grandpa, why didn’t you save the NHS when you were Prime Minister?

But, why, we had enough money; you do not need the money like some third world leader?

But why did you let the private firms get in. All the papers and bloggers were warning you?

I know you did buy the hospitals back, but at what cost.

Hindsight? It is not hindsight, everybody was saying it.

Scenario 2: Grandpa, you were great. You listen to your own advisers from King’s Fund, and the bloggers and you stopped privateers taking over any health care.

No, the privateers only want to sell the land, float the hospitals and make money and leave. Many are not from here.

We had enough money and you do not need a job from them when you are not Prime Minister.

Lets enjoy the sunset.

©2010 Am Ang Zhang

LONDON -(Dow Jones)- Circle Holdings PLC, an employee co-owned healthcare provider, said Wednesday it plans to float on AIM June 9.
-Circle is 50.1% owned by the Company and 49.9% owned by the Circle Partnership which is 100% beneficially owned by Circle's clinicians and employees.
-Circle's objective is to redefine secondary healthcare delivery in theU.K..

Circle’s CEO, ex-Goldman Sachs banker Ali Parsadoust set out his view that the NHS is “an unsustainable industry” that costs too much to run. “In his view, Britain has world class retailers, telecoms and financial services firms, as these sectors have been opened to competition over the past few decades,”


The collapse of national retailer Focus DIY has sparked a fresh wave of attacks on private equity firms as details emerged of a decade of deal-making and financial engineering in which buyout specialists shared payouts of nearly £1bn.

An analysis by the Observer has found that one private equity firm, Duke Street Capital, which made an initial investment of £68m in 1998, took £700m out of Focus after presiding over a series of capital and debt restructurings that turned the small Midlands-based chain into a DIY giant with sales of £1.5bn. Apax, its investment partner, which put in £120m, pocketed £183m when the Wickes chain was carved out in a £950m deal that ultimately left the remnants of the chain struggling.


BT’s pension trustees are going to court to find out if there really is a crown guarantee covering a large portion of the company’s £40 billion pension fund.
They’re asking: if the company goes bust, will the government (and the RBS-owning U.K. taxpayer knows what that means) step in to plug any gap in funding for the thousands of pensioners who were in the scheme in 1984 when Margaret Thatcher was waving her privatization wand.

Financial Services Firm:
Goldman Sachs:
Goldman Sachs has been fined £17.5 million by the FSA for not letting it know that Fabrice Tourre, a trader who moved to Londonfrom New York in 2008, was being investigated by the U.S. Securities and Exchange Commission.
Goldman is a bad, bad boy. But if you think the firm is the only to be blamed in this game, think again.
On the Goldman side, what else can we expect from the firm that has already admitted making a bigger mistake in the same case? To refresh the memory, the firm agreed to pay $500 million in July to settle SEC civil charges that it duped clients by selling mortgage securities that were secretly designed by a hedge-fund firm to cash in on the housing market’s collapse. The firm didn’t admit to, or deny the charges, but it acknowledged it made a “mistake” by not disclosing to investors the role of the hedge fund, Paulson & Co.

Ali Parsadoust was with Goldman Sachs.

Backed by some of the City's most powerful hedge fund tycoons and run by former Goldman Sachs vice-president Ali Parsadoust, Circle was selected in November as the first private company to run an NHS hospital. But with losses of over £27.4m, according to accounts filed at Companies House last year, Circle recently lost two lucrative contracts with the NHS worth £27m, representing more than 42% of its £63m turnover.

Looks like some clever Financial manouvres!!!

Best money is government money: our money!

Caring for vulnerable older people is a statutory obligation under the 1948 National Assistance Act and is exercised on a means-tested basis through local authorities. The National Health Service and Community Care Act 1990 allowed councils to farm out care to any willing provider.
The big companies moved in, including Southern Cross, buying up small care companies or building new homes. As they grew, private equity firms started to show an interest, among them the US firm Blackstone Capital Partners. Investors, when they look at a home full of older people, see a stream of guaranteed income, most of it from local authorities and underpinned by the 1948 legal requirement to provide care. Since the elderly population is rising, investing in care looked like a one-way bet for long-term profit.
Money can be made by separating the income flows from the actual business of care and packaging them as saleable investment instruments – securitisation. Blackstone took control of Southern Cross in 2004 from another private equity firm, West Private Equity. Significantly, that year it also bought NHP (Nursing Home Properties), whose business included leasing care homes to providers (Southern Cross was its biggest tenant) and turning the resulting rental income into high-yield bonds to be sold to investors.
Blackstone floated Southern Cross on the stock market, selling up in 2007. It also sold NHP to an investment fund, Three Delta, with controversial upward-only rental agreements with Southern Cross. This has left Southern Cross with an annual rent bill of around £240m.

Latest: Southern Cross

From one of your own advisers: Prof Chris Ham
Parliament debate: Public Bill Committee
Chris Ham"May I add something briefly? The big question is not whether GP commissioners need expert advice or patient input or other sources of information. The big problem that we have had over the past 20 years, in successive attempts to apply market principles in the NHS, has been the fundamental weakness of commissioning, whether done by managers or GPs, and whether it has been fundholding or total purchasing."                             

“………The barriers include government policies that risk further fragmenting care rather than supporting closer integration. Particularly important in this respect are NHS Foundation Trusts based on acute hospitals only, the system of payment by results that rewards additional hospital activity, and practice based commissioning that, in the wrong hands, could accentuate instead of reduce divisions between primary and secondary care.”

"The fault, dear Brutus, is not in our stars,

But in ourselves."

Julius Caesar (I, ii, 140-141)

Hinchingbrooke, this is their timeline of how the hospital was put up for tender:
July 2007 – Department of Health gives the Strategic Health Authority approval to examine different options, including franchises.
July 2009 – Department of Health approves the business case for an open competitive tender for a franchise.
October 2009 – Open competitive tender announced and 11 organisations submit bids, six are selected to move to the next stage. Of those six, only one was NHS-only: Addenbrooke’s in Cambridge. Circle say there was no mention of a preferred provider at any point in the tender.
February 2010 -
 Addenbrooke’s pull out of the bidding process.
March 2010 – Shortlist for the franchise announced: Serco, Ramsay and Circle. Serco’s bid did include a partnership with Peterborough NHS Trust.(May 2010 – General Election in which Labour leaves office)August 2010: shortlist narrowed to the final two: Serco and Circle.
November 2010 – Circle announced as preferred bidder.
November 2011 – Contract signed with Circle, which began work in February 2012.

Mayo Clinic: Health Care is not a Commodity!!!

NHS 1978: Hope, Faith & Supermarket