Sunday, February 16, 2014

NHS Privatised? Never! Never! Never!

The NHS will never be totally privatised.

That won't be any good for the privateers. Who would then remove the PIPs? Who would look after private hospital errors for 7 or more years. Where is dialysis going to go as it is not covered. And even a private patient flown in from the Middle East....

No! No! No!

That is not how it works. NHS must stay public, then the privateers can charge whatever for whenever.

NHS111, no problem. OOH. Charge the NHS!

The old NHS without the internal market avoided much of the problems associated with cross charging. Now, allowing competition leads to a new level of gaming. 

When will they ever learn? 

But, no, they knew! One day they may pretend and cry.

Remember the Barracuda? Good parasites do not kill their hard working hosts!!! Nor do predators kill the whole species. Keep some alive!!! Milk them forever!!!


The inspiration 

Giant Barracuda (Sphyraena barracuda) ©2003 Am Ang Zhang 

As the US insurers found out, Government money is the best money to make and that is really tax payer’s money. The new NHS will be the private sector’s main source of income, as only 90,000 in the UK are covered by private insurance and often they are offered cash incentives to use the NHS.

It is therefore essential for the private health care companies that the NHS is around, at least in name, so that they can make money by providing a “better value and more competitive” service to the NHS!

Some parts of the NHS will have to remain too, as it is necessary for the private sector to dump the un-profitable patients: the chronic and the long term mentally ill, for example. (Right now, 25% of NHS psychiatric patients are treated by the private sector.  But why? Even in psychiatry, there are cherries to be picked.)

Finally, in order to keep the mortality figures low at competing private hospitals, they need to be able to rush some of their patients off to NHS hospitals at the critical moments!

In any case, they do not do dialysis and intensive care, do they?

"You know, we had it good. Quite good and nobody knew!"

From a previous post: 

No it is under the guise of COMPETITION.

It is allowing Any Qualified Provider (privateer if you must know) to cream off. But it is not as simple as that. Recent PIP private clinics not only refused to remove the implants but went into administration to avoid paying compensation. There is as yet not legislation to guarantee NHS patients. Even travellers seem better protected.

In health care, DEATH is irreversible.

The NHS has been by and large highly efficient as it has avoided the pitfall of internal market system until recent years.

The crazy bonus system, internal market and Pavlovian style reward system skewed the efficient NHS to breaking point.

A once fairly integrated health care system where many doctors and nurses contributed free extra hours became a scandal ridden system where OOH fight not to see patients and not let A & E see them either. Or else OOH are run by so few doctors that patients suffered or died.

But it could be worse as the new AQPs do not seem to be liable:

The Guardian: Harmoni OOH


The family of a young woman is suing the country's biggest out-of-hours GP provider and one of its nurses, whose failures meant her fatal condition was not diagnosed, because neither will accept liability in a test case over legal responsibility in a privatised NHS.

Clare Secker, 19, died of bronchopneumonia in December 2008 after a nurse working for the privately-run telephone service told her parents to give her paracetamol and fluids.

Earlier this year the nurse admitted through her lawyers that she had been "in breach of her duty by failing to arrange for [Secker] to be seen by a doctor". If the young mother, who died when her son Tyler was less than a year old, had been prescribed antibiotics she would have recovered fully.

Despite this neither the firm, which was part of the Harmoni out-of-hours service until it was bought by Care UK in November 2012, nor the nurse has offered compensation to the family.

The nurse claims she does not need to pay out as her employment contract specifically states that the company had insurance in place "to indemnify … for any claim arising from any wrongful act committed by … any employee while carrying out their contractual obligations". But Harmoni says its insurance excludes responsibility for negligence by nurses.

With the Health and Social Care Act 2012 leading to more NHS contracts going to private providers, lawyers are concerned that the fragmented system will lead to a loss of accountability.

"It cannot be right that patients no longer know who is actually providing their care, or for those who are harmed to have the additional stress of providers trying to dodge responsibility by pointing to a clause in a contract or insurance policy. Until something disastrous happens we, the public, think we are still within the safety net of the NHS and increasingly that's just not the case. There is little transparency or protection, it seems to me."

Hospitals now fight other hospitals and the failed ones will be handed over to privateers. Some of these have the highest mortality rates. I am surprised that they are not sold  off for just a single pound.

The more failed hospitals, the better for the government. Once they washed their hands off, it is not their problem. If the privately run hospital failed, they change CEO, change ownership and continue. 

The GMC has been quiet about them as they have with the Breast Implant ones and many other plastic surgery private hospitals. 

Yet, right now the NHS picked up the mess of the PIP implants. The private companies pocketed the money. Lots of money.                                                                                                   

Please don't cry!!!
© Am Ang Zhang 2012

Lith Style Photographic work.

Thursday, February 13, 2014

Shadow Elite & NHS : Money! Money! Money!


Andrew  Lansley
The former Health Secretary Andrew Lansley blocked an attempt to hold a Parliamentary debate into the influence of an NHS lobbyist who he has admitted to knowing “over many years”.
Today The Independent revealed that NHS bosses allowed a lobbying company run by John Murray to write a draft report which could help shape future health policy.
But attempts to get the report’s origins debated in Parliament were blocked by Mr Lansley, who is now Leader of the House of Commons and in charge of scheduling legislation and debates.
The issue was raised by the Liberal Democrat MP Tessa Munt last month.
But Mr Lansley rejected her request replying: “I know John Murray, I know him over many years to be, in personal terms, someone very expert in relation to specialised healthcare issues. The responsibility lies I think with NHS England and it is their job to exercise a dispassionate and impartial approach to the making of policy.”


Jeremy Hunt:

So there’s Jeremy newly installed as Health Secretary after just seven short years as an MP. This is a summary of his meteoric rise:

He made a fortune at the taxpayers’ expense as monopoly supplier to a notorious quango where, by happy coincidence, his cousin sat on the Board. He became MP for SW Surrey where, by happy coincidence, his cousin had been MP previously. He became Minister in charge of Media & Culture where, by happy coincidence, he wound up steering his pals at Newscorp in the right direction. And he became Health Secretary partly because, by happy coincidence, his cousin is a lobbyist for the private health sector.

Virginia Bottomley: Secretary of State for Health 1992-95   now with BUPA. Cousin  of  Jeremy Hunt.


David Miliband



Like his mentors Tony Blair and Peter Mandelson, Mr Miliband is one of that unappetising breed of modern politician that has chosen to profiteer out of public service. It is a pity that the BBC did not ask him whether his sudden decision to abandon his constituents was not informed by a desire to keep his huge earnings out of the public eye.
During his short, undistinguished career, Mr Miliband has done grave damage to British politics. He is part of the new governing elite which is sucking the heart out of our representative democracy while enriching itself in the process. He may be mourned in the BBC and in north London, but the rest of us are entitled to form a more realistic view. David Miliband has belittled our politics and he will not be missed.
Money? Really?
The House of Commons register reveals that he has earned an incredible sum – nearly £1 million – from outside interests since losing the party leadership to his brother, including £125,000 for 15 days’ work as a director of Sunderland, a constituency-based football club owned by a super-rich businessman with interests in private equity. Approximately £60,000 has come his way from the UAE, a gulf state with an unappetising human rights record, and another hefty chunk from St James’s Place, a company that advises very rich people how to invest their money.
It looks as though these people are everywhere! The Shadow Elite.

Are you ready to read it? 

Why?

It is scary!!!

"The new breed of players," writes Wedel, "who operate at the nexus of official and private power, cannot only co-opt public policy agendas, crafting policy with their own purposes in mind. They test the time-honored principles of both the canons of accountability of the modern state and the codes of competition of the free market. In so doing, they reorganize relations between bureaucracy and business to their advantage, and challenge the walls erected to separate them. As these walls erode, players are better able to use official power and resources without public oversight."
"That's a spot-on description of what happened with health care -- as well as a spot-on description of the totally-lacking-in-transparency bailout of the financial system. Remember how the bailout was supposed to take care of not just Wall Street but Main Street? Well, the former ended up with record profits and bonuses while the latter is looking at double-digit unemployment -- and millions of foreclosures and bankruptcies -- for the rest of the year."

Perhaps the decade!
                                            Janinie R. Wedel is an anthropologist.


"We Are Wall Street" that circulated this spring, directed at Main Street America

: "We eat what we kill, and when the only thing left to eat is on your dinner plates, we'll eat that."


The 21st century power brokers -- less stable, less visible, more peripatetic, and more global in reach than their elite forebears -- are potentially more insidious and dangerous to democracy. Their manoeuvrings are largely beyond the reach of traditional monitors. Unlike the rest of us, these players are virtually immune to accountability to voters or government or corporate overseers, because the full range of their activities and their true agendas are more difficult to detect.                                      
 Janinie R. Wedel




Looks like they are here and targeting our much loved NHS.
       




“Interestingly, former health ministers have done particularly well. The ex-health secretary Patricia Hewitt earns more than £100,000 as a consultant for Alliance Boots and Cinven, a private equity group that bought 25 private hospitals from Bupa. After leaving the department, her predecessor, Alan Milburn, worked for Bridgepoint Capital, which successfully bid for NHS contracts, and now boasts a striking portfolio of jobs with private health companies.”

Alan Milburn

Following his resignation as Secretary of State for Health (to spend more time with his family, his partner is a hospital doctor), Milburn took a post for £30,000 a year as an advisor to Bridgepoint Capital, a venture capital firm heavily involved in financing private health care firms moving into the NHS, including Alliance Medical, Match Group, Medica and the Robinia Care Group. He has been Member of Advisory Board of Pepsico since April 2007. Wikipedia

 Alan Milburn now also holds a place on the board of PepsiCo as an advisor.        Wikipedia


Patricia Hewitt

In January 2008, it was announced that Hewitt had been appointed "special consultant" to the world's largest chemists, Alliance Boots. Such an appointment was controversial given Hewitt's former role as Health Minister, resulting in objections to her appointment by members of a Parliamentary committee. Hewitt will also become the "special adviser" to private equity company Cinven, which paid £1.4 billion for Bupa's UK hospitals.


In March 2008, it was announced that Hewitt will join the BT Group board as a non-executive director.[40] She joined the group on 24 March 2008. In July 2009, Patricia Hewitt joined the UK India Business Council as its Chair.



In May 2009 The Daily Telegraph reported that Hewitt claimed £920 in legal fees when she moved out of a flat in her constituency, stayed in hotels and then rented another flat inLeicester. Claimed for furniture including £194 for blinds delivered to her London home. In June 2009 Hewitt announced that she will be stepping down from the House of Commons. She said she was leaving the Commons for personal reasons as she wanted to spend more time with her family.   Wikipedia
David Bennett is the current head of Monitor (a sort of health FSA!) He is not a medical doctor.
David was a Director at McKinsey & Co. In his 18 years with McKinsey he served a wide range of companies in most industry sectors, but with a particular focus on regulated, technology-intensive industries.

Health:
Ex-Blair: Patricia Hewitt: now with Cinven (Bupa Hospitals)


NHS & Monitor: Eggs & Enron.

FSA:
Iceland:
Councils blamed over Iceland savings





Wednesday, February 12, 2014

Chicago: Hello Winter!






All photos © Am Ang Zhang 2014
Book:


“You can’t get fired for hiring McKinsey & Company.”


It often goes unmentioned, but McKinsey has indeed offered some of the worst advice in the annals of business. Enron? Check. Time Warner’s merger with AOL? Check. General Motors’s poor strategy against the Japanese automakers? Check. It told AT&T in 1980 that it expected the market for cellphones in the United States in 2000 would amount to only 900,000 subscribers. It turned out to be 109 million. The list goes on.

A thought-provoking new book called “The Firm: The Story of McKinsey and Its Secret Influence on American Business,” which comes out next Tuesday, offers a fascinating look behind the company’s success.

The book, by Duff McDonald, chronicles McKinsey’s rise but also raises an important question about it that is applicable to the entire netherworld of consultants, advisers and other corporate hangers-on: “Are they worth it or not?”

The answer amounts to hundreds of billions of dollars annually. Indeed, the army of advisers whispering into the ear of Verizon and Vodafone (its C.E.O. is a former McKinsey partner) over the weekend for their work on the $130 billion deal stand to make over $200 million alone. And, perhaps most important, they don’t have to give the money back if the deal turns sour.


Mr. McDonald’s book explores the remarkable and intriguing disconnect between the advice McKinsey offers and the ultimate results.


Book:


“You can’t get fired for hiring McKinsey & Company.”


It often goes unmentioned, but McKinsey has indeed offered some of the worst advice in the annals of business. Enron? Check. Time Warner’s merger with AOL? Check. General Motors’s poor strategy against the Japanese automakers? Check. It told AT&T in 1980 that it expected the market for cellphones in the United States in 2000 would amount to only 900,000 subscribers. It turned out to be 109 million. The  
Book:
Central Park: Hello Autumn!




Thursday, February 6, 2014

NHS & McKinsey: A Doctor in a Trojan Horse!


As I sort through thousands of photos of my recent stay in Finland: I marvelled at how a country recovered so quickly from Russia & Nazi & provided its citizens with good free health care & child care. The State is still responsible for alcohol sale apart from beer. so the government kept the tax and profits. Not Supermarkets nor Wine Merchants. 


© 2012 Am Ang Zhang

It would seem to me that it was some genius or else some very smart plotters that worked out the scheme (or was it scam) to destroy our NHS of old. The NHS was not without its faults but just recently some Qatari took his private plane to check into a Private Hospital in London. But very quickly he was transferred to an NHS Hospital! No, not a Circle run one. People still have faith in our NHS Hospitals despite Mid Staffordshire or Baby P.

No!No!No! When you are really ill, you want real hospitals. Because by then you do not care about decor, cappuccino or Michelin Star meals. They know that the fabric might be old, but the medicine served is good.

So how can these Management Consultants succeed in the sell off of something as lovely as the Finnish Scenery. 

Simple: History! History! History!

Trojan Horse.

When Iceland banks failed, it was with the collusion of its regulators.

In the film, the Inside Job:

Not too long ago in Iceland, those working for the banking regulator may find themselves employed by the bank that they were “regulating” during one of their visits. We all know what happened to Iceland.

Some very smart people there indeed. Governments never seem to learn as our banks failed too, so did those in the US & Ireland and other countries.




There is much talk of the role of the regulator Monitor in safeguarding our health care. It was the genius thinking this is a way to fool us into thinking : ALL IS WELL.



Perhaps we should look at our most famous regulator: FSA. (Financial Services Authority).



The FSA was dragged into the news recently as its first head Sir Howard Davies, resigned as director of London School of Economics for eight years over "a mistake". The "mistake" was to advise the LSE's council to accept £1.5m research funding from a foundation controlled by Colonel Muammar Gaddafi's son, Saif.                                 More>>>>>>>>>



So, were there any other "mistakes" when he was head of FSA?



Independent:

17 July 2008
The Financial Services Authority will be dealt yet another hefty blow to its credibility today, as the Parliamentary Ombudsman, Ann Abraham, reverses her decision of five years ago and accuses it of maladministration for its role in the collapse of Equitable Life eight years ago.

"The case of Equitable Life, which echoes earlier cases such as Vehicle & General in the 1970s and shares some similarities with the current example of Northern Rock, illustrates the need for absolute clarity as to what can and cannot be expected from financial regulation and the development of shared understandings as to the limits to the protection that such regulation offers to investors both before and after problems arise, as they inevitably will," said Ms Abraham.

"Key, however, is that those responsible for undertaking financial regulation should act in a way that is compatible with the duties and powers which Parliament has conferred on them. Those responsible for the prudential regulation of Equitable Life failed to do so throughout the period covered in my report."
Sir Howard Davies was previously employed by McKinsey and Company and was Special Advisor to the Chancellor of the Exchequer.

I was reading a book by Philip Delves Broughton on Harvard Business School (HBS): Ahead of the Curve.

He may not be the first to observe that HBS loves Marines, Mormons and McKinseyKim Clark  must indeed be the most famous sons of The Church of Latter Day Saints and PDB’s article in The Sunday Times: “Harvard’s masters of the apocalypse” may indeed be aptly titled.

He opened with:


If his fellow Harvard MBAs are all so clever, how come so many are now in disgrace?

From Royal Bank of Scotland to Merrill Lynch, from HBOS to Lehman Brothers, the Masters of Disaster have their fingerprints on every recent financial fiasco.

We MBAs are haunted by the thought that the tag really stands for:
Mediocre But Arrogant, Mighty Big Attitude, Me Before Anyone and Management By Accident.

For today’s purposes, perhaps it should be Masters of the Business Apocalypse.
On RBS (Royal Bank of Scotland)
When I was a student at Harvard Business School, between 2004 and 2006, I recall a distinguished professor of organisational behaviour, Joel Podolny, telling us proudly of his work with Fred Goodwin at RBS. At the time, RBS looked like a corporate supermodel and Podolny was keen to trumpet his role in its transformation. A Harvard Business School case study of the firm entitled The Royal Bank of Scotland: Masters of Integration, written in 2003, began with a quote from the man we now know as Fred the Shred or the World’s Worst Banker: “Hard work, focus, discipline and concentrating on what our customers need. It’s quite a simple formula really, but we’ve just been very, very consistent with it.”
Harvard Business School alumni include Stan O’Neal and John Thain, the last two heads of Merrill Lynch, plus Andy Hornby, former chief executive of HBOS, who graduated top of his class. And then of course, there’s George W Bush, Hank Paulson, the former US Treasury secretary, and Christopher Cox, the former chairman of the Securities and Exchange Commission (SEC), a remarkable trinity who more than fulfilled the mission of their alma mater: “To educate leaders who make a difference in the world.”




Trojan Horse: The Guardian


A global consultancy firm seeking to profit out of the fallout from the shake-up to the NHS is being paid £250,000 a year by the government for advice on the transition towards health secretary Andrew Lansley's vision of the service.

The American firm, McKinsey Inc, with estimated revenues of £4.1bn a year, has been advising the Department of Health on how best to manage the radical changes since March. McKinsey is also one of a group of private consultants that have united to provide paid-for advice to GPs as they prepare for life after the reforms.
Family doctors need help from private companies because of the government's decision to abolish primary care trusts as part of their controversial changes to the health service, a move criticised as a step towards privatisation.

The head of Monitor (a sort of health FSA!) is Dr Bennett. 

Monitor: Recent exchanges in Parliament

Q 195 Jeremy Lefroy (Stafford) (Con):  I have a couple of questions about the role of Monitor. The first is about the Mid Staffordshire trust into which the Francis inquiry is looking at the moment. It seems to me as the local Member of Parliament that Monitor approved the foundation trust status without going into sufficient detail as to the status of that trust, particularly the quality of care at the time. What assurances can you give us that Monitor’s approval of foundation trusts will be more rigorous in the future than it was in the case of Mid Staffordshire? 

David Bennett: Yes. I was not around at the time, but looking at the evidence, the trust was approved at a time when it was not delivering appropriate care to its patients, and that was wrong. Monitor has done three core things in the light of that, all based on an external review of what happened and why, and therefore what lessons can be learned. First, it has set a clear quality bar. That did not exist before—there was no clear definition of what was an adequate level of safe care for any trust to be providing to be authorised. In conjunction with the CQC and the Department of Health, there is now a clear definition of what the quality bar should be. 
Q 196 Jeremy Lefroy:  Sorry, are we saying that there was not a clear quality bar for approval of foundation trusts up till now? 
David Bennett: There has been for a while, but not at the time of Mid Staffordshire. 


Dr Bennett was a Director at McKinsey & Co. In his 18 years with McKinsey he served a wide range of companies in most industry sectors, but with a particular focus on regulated, technology-intensive industries.
Average citizen might think, he is a doctor regulating Health Care, it must be OK then. Well, he is not a Medical Doctor. Do you think the genius would put a doctor in the Trojan horse? 
There were more:



© 2012 Am Ang Zhang

ISTC

Q 203 Mr Barron:  I was on the Health Committee during the previous Parliament, when it looked into the independent sector treatment centre programme. I had conversations with more than one company running the programme that said they felt threatened by the pensions implications, with the work force working in the independent sector while keeping the NHS rewards such as pensions. I call them distortions, but most of us have one. By implication, what does that mean? 
David Bennett: I think again of Sonia’s point. There are lots of considerations. Yes, pensions are an issue, but as someone said there is an issue around the complexity of the cases that we have dealt with. 
Q 204 Mr Barron:  I accept that. ISTCs were contracted for cases that were not likely to go wrong in surgery, because there was no back-up in the hospitals or institutions if someone needed to go into ITU, and so on. I understand that exactly. 

Sue Slipman: The only thing I would add is that it is clearly the public sector that is carrying the responsibility for the education and training of people across the system as a whole. There are balances here in those imbalances, and we would certainly be pressurising Monitor very hard to take them into account. 
The Chair:  I think that they accept that. 

Trust!
Emily Thornberry:  I am tempted to press you further, David, given the profound implications of what you said in relation to work force pensions. We are about to pass this legislation and you are saying, “Take it on trust, as it will all be sorted out.” But we are talking about millions of people’s pensions here, and it is difficult not to push you at this stage. 

Worse than that, you said in an incomplete answer earlier that there were other obvious distortions and advantages that the NHS had over the private sector. I wonder whether you could list anything else, on top of pensions, that you might think might of? 
David Bennett: I said that obvious distortions are creating advantage within the NHS. I was also saying that there are other distortions in the market, and Sue has just pointed out two of them. At the moment, it is the public sector that has to pay for R and D, and it is the public sector that pays for training. That places the public sector at a disadvantage. That needs to be taken into account. 
Q 208 Emily Thornberry:  Do you have any others? 
David Bennett: I do not have a comprehensive list.        More>>>>>>>>>>


Book:


“You can’t get fired for hiring McKinsey & Company.”


It often goes unmentioned, but McKinsey has indeed offered some of the worst advice in the annals of business. Enron? Check. Time Warner’s merger with AOL? Check. General Motors’s poor strategy against the Japanese automakers? Check. It told AT&T in 1980 that it expected the market for cellphones in the United States in 2000 would amount to only 900,000 subscribers. It turned out to be 109 million. The list goes on.


A thought-provoking new book called “The Firm: The Story of McKinsey and Its Secret Influence on American Business,” which comes out next Tuesday, offers a fascinating look behind the company’s success.

The book, by Duff McDonald, chronicles McKinsey’s rise but also raises an important question about it that is applicable to the entire netherworld of consultants, advisers and other corporate hangers-on: “Are they worth it or not?”

The answer amounts to hundreds of billions of dollars annually. Indeed, the army of advisers whispering into the ear of Verizon and Vodafone (its C.E.O. is a former McKinsey partner) over the weekend for their work on the $130 billion deal stand to make over $200 million alone. And, perhaps most important, they don’t have to give the money back if the deal turns sour.


Mr. McDonald’s book explores the remarkable and intriguing disconnect between the advice McKinsey offers and the ultimate results.






Related:

NHS & Market Forces: Uncomfortable Readings!!!