NHS & Wine: Simon Stevens----Sell then Sail?

As the sun sets in Atacama, Chile; it may well be setting for NHS England engineered by Simon Stevens.

©2015 Am Ang Zhang

Public health concerns mount as 'personal health budgets' imposed on 10,000 chronically ill patients

CAROLINE MOLLOY 13 March 2015

Patients across the country are to have their health funding rolled into their social care funding and be expected to manage both themselves. Is this empowerment, or something more sinister, health experts wonder?

NHS boss Stevens is a powerful figure in all of this. Since the 2012 Act dramatically reduced ministerial accountability for the NHS, the NHS CEO’s role has been super-charged, with politicians largely taking a back seat on new NHS announcements. Stevens - who advised Tony Blair on his pro-market NHS 'reforms' - has spent the last few years as Vice President of the European Division of US healthcare megalith, United Health before he was hired to take the NHS reins in 2014.

This week Stevens was ubiquitous on the airwaves, promoting his version of ‘integrated’ health and social care through a shift to ‘new provider models’ and to move care ‘away from hospital and closer to people’s homes’. Again, there are fears amongst experienced health campaigners that what is actually envisaged, beneath the jargon few journalists have seriously penetrated, is a loss of NHS hospitals and a shift towards greater private provision.

Even less noticed by the media, however, is Stevens’ enthusiastic push towards Personal Health Budgets, which are able to be spent on both NHS and non-NHS providers. He used his first speech as head of the NHS last year to announce that Personal Health Budgets would be available to anyone with a long term condition who requested one from April 2015.

Professor Scott-Samuel said: “Personal Health Budgets are being introduced at a time when rapid privatisation of the English NHS is taking place and where restrictions are being placed on people’s access to healthcare.

“As a result many see their introduction as a diversionary gimmick designed to help pave the way for the conversion of the NHS into the insurance-based system which may believe is the intention of the UK government.”

Time to get even with Stevens

JOHN LISTER 11 July 2014

New NHS boss Simon Stevens has revealed his true privatising colours with this week's announcement on personal health budgets - which would wreck England's NHS services and leave the field clear for big business.

We have been waiting to see whether - and how - new English NHS boss Simon Stevens would work round to furthering the private sector agenda he has brought with him from his sojourn at US insurance giant UnitedHealth – and now we know.

In a speech to the Local Government Association this week Stevens called for a major extension of combined health and social care personal budgets. The announcement opens up a whole range of opportunities for private insurers selling policies to cover top-up payments, and a host of cheapskate private service providers looking to cash in on a new £5 billion-plus market.

There is just one thing you could do to save some of us>>>>

Control Health Insurers! 

A reprint:

The Cockroach Catcher was privileged to be having dinner with his good friend.

He covered the bottle when he served his favourite red wine.

"See what you think."

"Fully of blackberry and long with good tannin that has softened. And Truffles too!"

"1996 and the tannin will keep it going for another 5 years."

"Of all the recent great wines that you have served and that included the second wines of Lafite and Margaux, this is the most impressive. Just like our NHS!"

"But now you have one of the most impressive guys running it."

"Selling it, you mean!"

"I did not want to upset you."

"So you know about Simon Stevens. Not just wines then."

"You need to know that Britain is responsible for producing all the great doctors in the old commonwealth. My cardiologist was trained there. Look at Singapore, Australia & New Zealand, generations of doctors were all trained in the UK and in turn the next generations.

Why do you think that UnitedHealth paid so much to get one of the top UK guys to add a new perspective?

UnitedHealth is based in Minnesota, home of the famous Mayo Clinic and Simon Stevens is married to an American and they have school age children. As you well know, it is not easy for Americans to adjust to British life."

"So you think he is not going to last that long?"

"He has a very natural excuse!"

"Family!"

"Lets see what Bloomberg say:"

BRITISH EXPERIENCE

UnitedHealth followed up on June 30 with another report for lawmakers pinpointing $332 billion in savings through better use of technology and administrative simplification. If enacted, those changes would potentially benefit UnitedHealth's Ingenix data-crunching unit. Ingenix, with annual revenue of $1.6 billion, is poised to establish a national digital clearinghouse to ensure the accuracy of medical payments and provide a centralized service for checking the credentials of physicians.

Stevens, an Oxford-educated executive vice-president at UnitedHealth, once served as an adviser to former British Prime Minister Tony Blair. In that capacity, Stevens tried to fine-tune the U.K.'s nationally run health system. Today he tells lawmakers that theU.S. need not follow Britain's example. Concessions already offered by the U.S. insurance industry—such as accepting all applicants, regardless of age or medical history—make a government-run competitor unnecessary, he argues. "We don't think reform should come crashing down because of [resistance to] a public plan," Stevens says. Many congressional Democrats have come to the same conclusion.

UnitedHealth has traveled an unlikely path to becoming a Washington powerhouse. Its last chairman and chief executive, William W. McGuire, cultivated a corporate profile as an industry insurgent little concerned with goings-on in the capital. From its Minnetonka(Minn.) headquarters, the company grew swiftly by acquisition. McGuire absorbed both rival carriers and companies that analyze data and write software. Diversification turned UnitedHealth into the largest U.S. health insurer in terms of revenue. In 2008 it reported operating profit of $5.3 billion on revenue of $81.2 billion. It employs more than 75,000 people. 

Stevens argues that while UnitedHealth will likely benefit financially from health reform, the company will also aid the cause of reducing costs. He cites what he says is its record of "bending the cost curve" for major employers. 

During a media presentation in May in Washington, Stevens said medical costs incurred by UnitedHealth's corporate clients were rising only 4% annually, less than the industry average of 6% to 8%. But that claim seemed to conflict with statements company executives made just a month earlier during a conference call with investors. On that quarterly earnings call, UnitedHealth CEO Hemsley conceded that medical costs on commercial plans would increase 8% this year. 

Asked about the discrepancy, Stevens says the lower figure he is using in Washington represents the experience of a subset of employer clients who fully deployed UnitedHealth's cost-saving techniques, including oversight of the chronically ill. "These employers stuck at it for several years," he says. "We are putting forward positive ideas based on our experience of what works."

"Wow!"

"So there is not reason for him to leave UnitedHealth! They love him. The best of British & of Oxford!"

"Perhaps he has not left UnitedHealth!"

"So perhaps a sort of UnitedNHS then!"

"Well despite what people say about Obamacare, even Stevens concede that:

.....the U.S. insurance industry—accepting all applicants, regardless of age or medical history—make a government-run competitor unnecessary, he argues.

"NHS as such was the most serious competitor to the Health Insurance Industry. It is serious because there is not even any co-pay!"

"And quality is the same as the actual specialist doctor on either side are the same."

"Only the coffee is better!"

"Whatever Stevens plan to do is not something most of us can begin to guess but my suspicion is that it would not be to anyone's liking..."

"Except the Health Insurance Industry."

"So, he will not follow the US example of insurance industry accepting all applicants, regardless of age or medical history."

"No way!"

"You see, UnitedHealth has decided to leave California because of that."

"Not profitable!"

"If Insurers need to cover everything in England, they would think twice and most likely do a California thing."

"And Stevens can go back to America then!"

"So what is the wine?"

"Big Sail Boat!"                                                              

"Big Sail Boat?"

That the logo might have helped to sell a wine is unthinkable if the wine is no good. Ch. Beychevelle was fortunate enough to have a boat on its label and the Chinese just embrace it now that Lynch Bages hit the roof and there are too many fake 1982 Lafites around.

When my friend stock up on his Beychevelle, it was he told me, just a third of the price right now.

"It will be the next Lynch Bages."

"That is why 50% has been sold to the Japanese!"

"Wow!"             

So will Simon sell or sail? Or sell then sail!

Forbes:

I recently learned that this month a class-action lawsuit has been filed against California United Behavioral Health (UBH), along with United Healthcare Insurance Company and US Behavioral Plan, alleging these companies improperly denied coverage for mental health care.

According to the class action lawsuit, United Behavioral Health violated California’s Mental Health Parity Act, which requires insurers to provide treatment for mental-health diagnosis according to “the same terms and conditions” applied to medical conditions. Specifically, the insurer is accused of denying and improperly limiting mental health coverage by conducting concurrent and prospective reviews of routine outpatient mental health treatments when no such reviews are conducted for routine outpatient treatments for other medical conditions. 

New York:

Pomerantz Law Firm has filed a Class Action Against UnitedHealth Group, Inc. 
for Violations of Federal and State Mental Health Parity Laws - UNH

NEW YORK, March 12, 2013 (GLOBENEWSWIRE) Pomerantz Grossman Hufford Dahlstrom & Gross LLP has filed a class action lawsuit against UnitedHealth Group Inc. (“UnitedHealth” or the “Company”)(NYSE: UNH) and various subsidiaries, including United Behavioral Health.  The class action was filed in the U.S. District Court, Southern District of New York, and docketed under 13 CV 1599, alleging violations of federal and state mental health parity laws and other related statutes. The action has been brought on behalf of three beneficiaries who are insured by health care plans issued or administered by United and whose coverage for mental health claims has been denied or curtailed. These plaintiffs seek to represent a nationwide class of similarly situated subscribers. In addition, the action was filed on behalf of the New York State Psychiatric Association, Inc. (“NYSPA”), a division of the American Psychiatric Association, seeking injunctive relief in a representational capacity on behalf of its members and their patients.

California regulators seek up to $9.9 billion in fines from PacifiCare

The health insurer violated state law nearly 1 million times from 2006 to 2008 after it was bought by UnitedHealth Group, the Department of Insurance says. The fine, if there is one, is likely to be much less than the maximum allowed.'

UNITED HEALTHCARE INSURANCE AGREES TO PAY U.S.
$3.5 MILLION TO SETTLE FRAUD CHARGES

WASHINGTON, D.C. - United Healthcare Insurance Company has agreed to pay the United States $3.5 million to settle allegations that the company defrauded the Medicare program, the Justice Department announced today.

The government alleges that beginning in or about 1996 and continuing through 2000, United Healthcare's telephone response unit knowingly mishandled certain phone inquiries received from Medicare beneficiaries and providers and then falsely reported its performance information to the Centers for Medicare and Medicaid Services (CMS) concerning the company's handling of those calls. CMS is the federal agency charged with administering the Medicare program.

From October 2, 1995 to October 1, 2000, United Healthcare acted under contract with CMS as a Durable Medical Equipment Regional Carrier. Under that contract, United Healthcare processed Medicare Part B claims for durable medical equipment submitted to it by Medicare beneficiaries, physicians, and other health care providers and suppliers located in the northeastern United States.

"This settlement demonstrates our continuing commitment to pursue vigorously allegations of fraud and abuse in Medicare," said Peter Keisler, Assistant Attorney General for the Department's Civil Division. "Medicare contractors, along with other health care providers, can and will be held accountable for their billing practices. This settlement demonstrates our unwavering pursuit of fraud and abuse."

The allegations of improper conduct were brought to the attention of the government by a former United Healthcare employee, who filed suit under seal in November 2001 under the qui tam or whistleblower provisions of the federal False Claims Act. The United States recently intervened in the whistleblower suit.

As a result of today’s settlement, the whistleblower will receive $647,500 of the settlement amount. United Healthcare did not admit any of the allegations in the complaint in connection with the settlement. Under the False Claims Act, private citizens can bring suit on behalf of the government and share in any awards that are obtained through that legal action.

###

UnitedHealth & Simon Stevens: Your NHS! Your Money!

Save the NHS: Control Health Insurers! 

NHS & Lesser Rhea: Extinction?

The NHS is teetering on the brink of privatisation. We must stand up for it

Caroline Lucas

Our much-loved service is in danger. Thousands of jobs have been axed, including more than 4,000 senior nurses. More than 50 of the 230 NHS walk-in centres have been closed and 66 A&E and maternity units have been shut or downgraded. On top of this, the future mandated by the 2012 act is one where all hospitals in England that we think of as NHS hospitals only have to be 51% NHS – and 49% non-NHS. Why would anyone pay if they could get exactly the same on the NHS? This is setting up a queue-jumping service for the better-off.

The private sector is circling – there is, after all, a very tempting prize to be picked off – an annual NHS budget of £120bn. Private health firms already pocket £18m a day – that’s £6bn in the last year – from the NHS budget. More than 170 GP surgeries are run by corporations. Today, if you call 999 it could be a private ambulance crew that comes to treat you. Based on the trends that these figures show, private firms are on course to net £9bn of the NHS contracts that are up for grabs. The direction of travel is plain to see.

The inescapable truth is that the private sector is camping out on the lawn of the NHS, cherry picking. Even Norman Tebbit pointed out the dangers of this, and wondered how young NHS surgeons would learn if the private sector had nicked all the easy stuff. This is a problem that is getting worse, but it is not new. Private hospitals’ share of NHS-funded patients grew rapidly between 2006 and 2011. By 2010-11 private companies performed 17% of hip replacements, 17% of hernia repairs and handled 8% of patients’ first attendances in relation to orthopaedics or trauma, such as a broken limb.

Now Darwin's Rhea:

©2015 Am Ang Zhang

An ostrich-like bird, the Darwin’s or Lesser Rhea (Rhea pennata pennata) is one of the most distinctive, fabled and endangered residents of Patagonian steppe grasslands. Two species of rhea, the Greater and Lesser, occupy overlapping ranges in Patagonia. Lesser rheas typically weigh 35-55 lbs and have spotted dun, brown, grey and white feathers. Rheas are sociable birds, typically living in groups of five to fifteen. Rheas do not fly, but thanks to their unusually large wings, which they spread behind their bodies while running from predators, they can sprint at speeds over 35 mph.

©2015 Am Ang Zhang

Rheas are omnivorous, eating everything from herbs, shrubs, seeds and roots to insects, grasshoppers, and small vertebrates such as lizards or frogs. Their main predators are pumas, foxes, and birds of prey. Mating season lasts from September to December. During this time, one male will mate with several females, all of which deposit their eggs in the male’s nest site. The males incubate the eggs for 40 days. When one chick hatches, it begins to call, which stimulates the others to hatch. The whole brood will hatch within a period of 1-2 days. Males are then in charge of rearing the chicks, which will remain in his care until May or June.

©2015 Am Ang Zhang

Rheas attracted Charles Darwin’s attention when he visited Patagonia during his voyages on the HMS Beagle. Darwin had seen many Greater Rheas, but had only heard tell from gauchos of the existence of a smaller Rhea in southern Patagonia. Puzzled by the existence of two related but different species—which challenged the then-accepted theory that every animal was created in a fixed form, perfectly adapted to its place and life—Darwin went on the hunt for the fabled Lesser Rhea. He searched for months before recognizing the bird upon his dinner plate. The gentleman-ecologist put his dinner bones back together to form the skeleton, and with the help of ornithologist John Gould he confirmed that he had finally found the Lesser Rhea. With further examination it was clear that the Greater and Lesser Rheas were indeed two distinct, yet surprisingly similar species. This discovery helped spark his theory that species could change and diverge over time, and no creature is permanently fixed in its current state of life.

Conservacion Patagonica

Nature Posts:

It’s a Bird, a Reptile, a Mammal: It’s Platypus

ECOLOGY: First Bees, Now Bats. 

Paraguay: Technology Meets Ecology 

Hong Kong: Humpback Whale

Tasmania: Whales & Dolphins-Mother & Baby

Toucan: Darwin & Infra-red Technology

Introducing Pre-school Kids to Nature

Hospital Consultants: Who needs them?

From:Saturday, October 18, 2014

In Bad Medicine, Dr No caused a heated debate about General Practice:

The Apothecary: You’re Fired

Today’s GPs tend to be shy of their trade roots, not to mention more than a little miffed at the general presumption that they are country cousins to the hospital’s specialists. And so, over recent decades, they have followed the classical route to professionalisation, or, as our friends in the sociology line call it, ‘occupational closure’: defining a unique core body of knowledge gained by training (the vocational training scheme for general practice), the establishment of entry qualifications and lists of accredited registered practitioners (the MRCGP, and the GMC’s GP Register and locally held ‘Performers Lists’) – prior to these developments, any doctor could work as a GP – and the setting up of a professional association – the Royal College of GPs. By these steps, a line in the medical sand has been drawn, demarcating general practitioners from other medical practitioners.

Dr No is not persuaded that an extra year (or two) of training will produce better GPs. Despite assertions to the contrary, general practice is not some form of medical rocket science; it is instead the agreeably specialised but none the less generic practice of medicine which simply does not need extended years of training. Bolting on more years of training will simply increase the divide between those who are fully qualified, and those as yet excluded. There will, if training is extended, be more GPs in training grades, and less in career grades. More seriously, the real learning – which starts with unsupervised practice – will be delayed.

Attempts to change our beloved NHS may indeed be met with the same failure experienced by some other well known brands, sometimes at great cost.

Perhaps politicians can learn from this: you can say all the bad things about the NHS and you can quote how badly we are doing but we still love our NHS for all its short comings.

Just look at the faith we have in our A&E departments to the point that Roy Lilly suggested:

Roy Lilley ‏@RoyLilley16h

@clarercgp @drjohnbye @DrGrumble inner city solution; close P'care and put GPs in A&E just like Detroit

There is even argument that GPs cannot do A&E work and A&E doctors cannot do GP work. What has gone wrong with medical training?

There is a very discrete attempt to change the name of A&E to ED.

Wow! Do people never learn from history?

No!!! NHS and A&E. Original please   

So if politicians have not been so interfering and allow us doctors, nurses and patients to make things work together we may indeed have a better NHS. All the analysis on the reform is clear about one thing: someone is going to make money and that means less money for actual health care.

I have maintained for some time that:

Most people in well paid jobs (including those at the GMC) have health insurance. GPs have traditionally been gatekeepers and asked for specialist help when needed. If we are honest about private insurance it is not about Primary Care, that most of us have quick access to; it is about Specialist Care, from IVF to Caesarian Section ( and there are no Nurse Specialists doing that yet), from Appendectomy to Colonic Cancer treatment (and Bare Foot doctors in the Mao era cannot do the latter either), from keyhole knee work for Cricketers to full hip-replacements, from Stents to Heart Transplants, from Anorexia Nervosa to Schizophrenia, from Trigeminal Neuralgia to Multifocal Glioma, from prostate cancer to kidney transplant and I could go on and on. China realised in 1986 you need well trained Specialists to do those. We do not seem to learn from the mistakes of others.

So do you really think that hospitals are not necessary, or not necessary for the average citizen of England. Soon they will be sold and it will be costly to buy them back.

What about medical training? If these hospitals are sold, who pays?

And watch out, someone, your parent, your spouse, your child and even your MP may need a Hospital Consultant one day. 

Soon rationing of health care will start. Only the view of flowers will be free!  Or at least of my photos:

©2013 Am Ang Zhang

©2013 Am Ang Zhang

©2013 Am Ang Zhang

Latest from Colin Leys

Decisions being made on the ground, however, suggest that the policy is being pushed ahead without public debate. In July NHS London explained its thinking on the reconfiguration of hospitals in the capital. Eight of London’s A&E units were to close. In their place ‘minor injury’ and ‘urgent care’ units would be opened, but located ‘away from hospitals to prevent people entering A&E unnecessarily’. Some of the eight targeted A&E departments have already been closed or are scheduled to close, and Lewisham’s would have been until Mr Hunt’s decision to close it was ruled unlawful. So it seems fair to suppose that concentrating A&E and maternity services – and the necessary depth of other supporting services – in a few very large hospitals, and in effect closing many of the rest, is one half of the model that NHS England are pursuing.

Also:

Quality premium will be paid to CCGs that achieve targets set by the board, including reducing avoidable emergency admissions, rolling out the friends and family test, reducing incidence of healthcare associated infections and reducing potential years of lives lost through amenable mortality.

A new game will start: Hospital Avoidance!!!

The part of Health Care  delivered by Hospital Consultants will be severely rationed. Many so called Foundation Trust Hospitals would be in severe financial difficulties as the new CCGs will be rationing Hospital based work from A & E to Stent procedures so that the FT Hospitals will be forced to make money from private work and mainly from overseas as most citizens are still paying for the collapse of the likes of RBS, Northern Rock & HBOS.

Just look at A & E, Urgent Care Centres are set up by the new CCGs to avoid paying hospitals and if you use OOH or A & E too often, you might by removed from their list. There will be other life style excuses to exclude even Type 2 Diabetes.

Waiting time may once again be used as an excuse for rationing and this may be because of the 49% private work load. Who knows, would many consultant still be with the State side of NHS? My dentist went totally private years ago and never looked back. Do we really have such short memories?

If you do not believe the plot, the tactics are already in place to separate Primary and Secondary Health Care: 

Care pathways
Case management
Demand management
Productivity
Clinical and financial alignment
Risk stratification

Inappropriate referrals
Referral protocols 

Rules-based medicine
Referral management systems 

Admission avoidance

Doctors will not be involved to avoid problems with the GMC!!!

Local Authorities: Failed with Iceland & now NHS!

Wow!!!

The Manchester experiment is not the way to integration

The divide between the NHS and social care divide is increasingly blamed for a crisis in A&E services, so-called “bed-blocking” and much suffering, waste and inefficiency. So it is hardly surprising that the Manchester experiment to transfer billions in NHS funding to the council has been met with widespread interest and support. This will mean that local authorities have control over health and social care budgets.

But what if instead of upping the game of the NHS – Britain’s most loved public service – this brave new idea merely drags it down it to the level of social care, the most devalued and misunderstood welfare service? This is a possibility that demands more rigorous attention.

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We need to look at the problems Manchester is trying to solve. First, by shifting funding from the NHS to the local authority, the aim is to meet the growing need for long-term support resulting from changing demographics. Older people and long-term conditions now make the major demands on our healthcare system. Second, by putting the local authority in charge, the goal is to shift from a hospital-based medical model, to a social approach that keeps people in the community and maintains well-being. Most of all, the aim is to put an end to the traditional health and social care divides that have been costly, wasteful and ineffective.

A reprint:

Lava spurts out of the site of a volcanic eruption at the Eyjafjallajökull volcano near the Eyjafjalla glacier in Iceland on March 27, 2010. (HALLDOR KOLBEINS/AFP/Getty Images)

We were stuck on the island of Mallorca for two full days during our recent holiday because of 'volcanic ash'. Iceland was of course in the news before the recent volcanic eruption.

The Met Office has been blamed for triggering the “unnecessary” six-day closure of British airspace which has cost airlines, passengers and the economy more than £1.5 billion.                          Telegraph

Iceland bank failure: which councils are affected?

Have we really learnt anything?

Pulse:

GPs to sit on local authorities as councils take on key commmissioning role

23 Jul 10

GPs will be forced to work closely alongside local authorities when the new era of GP-led commissioning begins to take place, the Government has revealed.

The details of the plans for GPs to take on commissioning responsibility, published this week in a White Paper consultation document, reveal GPs will be required to sit on new local council ‘health and wellbeing' boards.   

GP consortiums will work in partnership with local authorities to jointly plan and commission health and adult social care, public health and integrated care, with local authorities acting as the lead commissioner for certain services, such as older people’s care.

And local authorities will be given the power to block GP commissioning strategies if they do not agree with a consortium's plans, and refer disagreements to the Independent Reconfiguration Panel.

GPs will also have to cooperate with local councils and other agencies in relation to criminal justice.

Local authorities are set to play a much more prominent role in commissioning, the document states, and will be given ‘a new enhanced role’ in promoting public involvement in decisions about service priorities and changes to local services, and in responding to any public concerns about inadequate involvement.

‘Local government will have an enhanced responsibility for promoting partnership working and integrated delivery of public services across the NHS, social care, public health and other services. One way in which this could occur is through health and wellbeing boards which would include representatives from GP consortia.’

Iceland:

Iceland bank failure: which councils are affected?

The key points from this release are:

A total of £929.2 million was invested by English local authorities in Icelandic banks as at 31 December 2008. This amount was invested by 125 local authorities out of a total of 482 authorities.

39% of the investments were with Landsbanki islands hf, 29% were with Heritable Bank Ltd, 20% with Glitnir Banki hf and 12% with Kaupthing Singer & Friedlander Ltd.

96% of the investments were internally managed while the remaining 4% were externally managed. There were no externally managed funds invested with Heritable Bank Ltd

Within the total, £24.6 million was invested on behalf of other local authorities. All these investments were made on behalf of fire or police authorities.

Iceland bank failure: which councils are affected?

Should we exclude 125 Local Authorities?

Independent:

13 April 2010

Learning lessons: Is Britain interested?

The damning verdict of Iceland's so-called "truth commission" into its banking system is set to add to calls for a similar inquiry in Britain.

Even though the state injected an estimated £1.2 trillion into Britain's financial system, including the nationalisation of two banks (Bradford & Bingley and Northern Rock) and part-nationalisation of two others (Royal Bank of Scotland and Lloyds Banking Group), there has been nothing like the Icelandic report in the UK. Analysing what went wrong, and the roles played by the Government, the Financial Services Authority and the Bank of England, has largely been left to the institutions themselves or the Commons' Treasury Select Committee.

And while the latter has conducted lengthy hearings, it remains the case that British select committees do not have the clout of, say, US congressional committees. Despite the select committee's best intentions, membership is still in the gift of party whips and it cannot be considered truly independent in the way the Icelandic Commission or its US equivalents have proved themselves to be.

President Obama has, for example, created the Financial Crisis Inquiry Commission, charged with grilling hundreds of people from the investment community, large banks, the US mortgage industry, government agencies and academia. Then there was the devastating 2,200-page report into the collapse of the 158-year-old Lehman Brothers by US legal examiner Anton Valukas, which pulled no punches and embarrassed prestigious names on both sides of the Atlantic. There appears to be a desire to learn lessons across the Atlantic – and in the middle of the pond – that is lacking here.

Related:

Telegraph: Axe falls on NHS services