Category Archives: NHS

Spending Review: Caveat Emptor- Buyer Beware

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George-Osborne1

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Today the Chancellor, George Osborne, launched the autumn spending review.

From the statement you might guess that he has climbed down over welfare spending cuts by abolishing his plan to cut tax credits, climbed down over big cuts to police budgets and acted to save the mental health budget and save the NHS from further cuts. All terribly good news along with more money for defence equipment, the security services, already announced.

But if you look at the figures he still planning  the same  huge level of cuts  but apparently with no pain.

For a start we are going to have no changes to the tax credits – yet there is going to be a change to the new universal credit which will replace a whole series of benefits. So the government will still be cutting the welfare bill by £12 billion. No details yet but it will be sneaked through when the figures are announced much later, hitting another group. And he is proposing to sell 20 per cent of the Department of work and Pensions estate- selling off  Jobcentres and benefit offices.

The NHS is getting more money but will have to make £22 billion of efficiency savings and provide a 7 day a week service. How? No details.

The police may not get their budget cut but the budget is not protected against inflation which is expected to start rising – so there is a hidden cuts inside this announcement.

And  the government claimed it had protected the science budget – but within hours engineers were announcing that a major demonstration project into carbon capture – which could save some coal fired power stations from closure – had been cancelled.

And both the extra money for defence and spending by HM Revenue and Customs – on equipment and tackling tax evasion- is going to be financed by axing thousands of civilian jobs in defence and closing down almost all local tax offices.

And while there is a £600m fund for mental health inside the NHS many voluntary organisations looking after the mentally ill and handicapped will be hit by the huge cut in local government funding.

There is more privatisation on the way – the rest of air traffic control, ordnance Survey and the Land Registry.

So what looks like a series of good announcements are often little more than smoke and mirrors. And in this budget it will depend more than most on the small print hidden in government announcements. Journalists are often fooled into first believing the initial message only to find it starts to unravel over the next few weeks when the policy bites. This is a Caveat Emptor Spending Review- buyer beware.

 

Closed today: The rehab hospital that should be at the cutting edge of NHS care

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Gossoms End Community hospital, Berkhamsted : Closed today

Gossoms End Community hospital, Berkhamsted : Closed today

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When my wife Margaret was struck down by a stroke on holiday and  lost her mobility one of the  redeeming features was that after her initial care in Truro she was transferred at our GP’s insistence to Gossoms End Community Hospital in our home town, Berkhamsted.

As a result of her stay there and later at the now closed  Holywell rehab unit at St Albans Hospital she has progressed in two years from help to get out of bed and living in a wheelchair through to the first stage of slow independent walking without any aids.

That is in no small part to the loving care at Gossoms End which led me to write a blog two years ago praising the work there.

At the time I said :

“What is particularly good is that some one has properly planned this facility so that stroke victims and people recovering from serious injuries can get proper physiotherapy and nursing care in a decent environment. The hospital unlike Watford, the main accident and emergency hospital for West Herts, is under no pressure to throw people out at the earliest opportunity. The cost of running it is much less than using a ward in acute hospital.

But the real key is that this is a nurse and physiotherapy led unit – with a weekly visit from a consultant and a doctor on call. The result is that the driving force  behind the care is to find the most suitable  rehab treatment for the individual patient.”

Alas that is no more. The unit closed  today because the Herts Community Health Trust  which runs it has overspent on agency staff because they can’t get full-time staff. It has faced criticism over staffing levels at other hospitals. Staff have been transferred elsewhere.

If you read the latest board minutes you see a trust that is struggling to provide services across Hertfordshire It is short of staff in key areas, facing an emergency financial crisis and failing in its ambition to become an independent foundation trust. Indeed it can only achieve the latter as far as I can see by slashing services so it can become profitable. Most of the key issues at the board meeting have a red or amber tag – meaning they are facing a disaster unless they slash costs in four weeks by closing down every possible service.

This local example to my mind illustrates the lie by our national politicians particularly by Jeremy Hunt, the health  secretary – about the state of the NHS. They trip out figures boasting about how much extra money there is. They haven’t a clue about integrated planning. They don’t know  and  don’t care how one policy – high house prices in Hertfordshire probably contributes to difficulties in recruiting staff -impacts on another. They are incapable of joining anything up – silo politicians.

In the meantime they talk about  so-called government policy ” care in the community” or ” no care in the community” as I prefer to call it. This is just an excuse to close down facilities and dump the sick ,ill, disabled and the insane on their families knowing that taxpayers don’t have to pay out. And if they haven’t any family, well, they will probably fall over and die and that will be a saving on the pensions bill.

To my mind closure of such facilities is short sighted. It means they only half rehabilitate people, failing to draw out their full potential and not wishing to acknowledge that new medical research shows that stroke victims  continue to improve for a much longer period than people thought. We are lucky that we can still afford to pay for Margaret to have private physiotherapy. I notice the lack in improvements among those who can’t.

I realise we have been lucky but I fear for anybody who has the misfortune to have a stroke in Hertfordshire today. Don’t expect the board members of Hertfordshire Community Health trust to do much about it.

Pathetic: The Child Sex Abuse Inquiry’s slow response to stopping vital documents being destroyed

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New Zealand dame Justice Lowell Goddard : tardy action over documents pic credit: http://www.teara.govt.nz/

New Zealand dame Justice Lowell Goddard : tardy action over documents pic credit: http://www.teara.govt.nz/

It was revealed yesterday by the Goddard Inquiry into Child Sexual Abuse that it has only just got round to writing letters to the Cabinet Secretary, police, NHS, religious leaders and local government asking them not to destroy documents which could hinder their investigations.

The fine words from Lowell Goddard  requesting this and lists of categories  which must not be destroyed can be seen here. No one can complain about the scope of the letters. It is just that they should have been written months ago.

The home secretary,Theresa May made it clear months ago when questioned by MPs that she expected this to be done. But obviously those in charge preferred to take a more leisurely approach and spent the time trying to recruit at least 20 more lawyers instead.

Any sensible person  would have made sure that the letters went out immediately the first panel was set up. It should have been the first act of the secretariat to safeguard documents to prevent them going into shredders to save Whitehall and town hall storage costs. And I am told that at least two members of the old panel requested this be done at early meetings.

In this inquiry this is particularly important. Investigations by Exaro have already discovered that vital documents in inquiries go missing. And the inquiry by Peter Wanless  and Richard Whittam failed to discover key documents including the dossier sent by the late Geoffrey Dickens MP on paedophiles to the late  Leon Brittan, the home secretary. And that raised questions about the retention of documents as long ago as November last year.

So it is particularly galling to see how long it has taken the inquiry to act. There is a lot of stake here – VIP paedophiles will be desperate not to be found out and want to cover their tracks. By taking such a long time in such a high profile inquiry they have been given every opportunity to do that by this delay.

NHS: Investigation into historic unexpected deaths of elderly patients at Gosport War Memorial Hospital

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Entrance to Gosport War Memorial Hospital Picture credit:BBC

Entrance to Gosport War Memorial Hospital Picture credit:BBC

Today I have been appointed to serve on an independent panel to review all the documentary evidence into historic unexpected deaths of elderly patients at Gosport War Memorial Hospital in Hampshire.

The panel will be chaired by Bishop James Jones, the former Bishop of Liverpool,  who chaired the Hillsborough Inquiry into the deaths of  Liverpool football fans.

The inquiry will try to obtain all the facts behind the deaths of patients at this hospital stretching back for a large number of years.

The aim is to address the concerns of families who lost loved ones and are very unhappy about the way they were treated by the authorities.

While the investigation is under way for the next three years I have been asked to keep a vow of silence about its findings until they are made public.

This is because my prime duty is to the families who believe they have been seriously let down and I intend to devote my energies as an investigative journalist to get as near to the truth as possible.

So you will find nothing on this blog about the investigation. Any journalist hoping for leaks on information this inquiry is uncovering is also going to be very disappointed. There will be an official website outlining the scope and nature of the investigation and who sits on the panel. The link is    gosportpanel.independent.gov.uk

But the only people who should know the findings in advance will be the families themselves.

Ever play bingo, go to the pub,do shopping: no patient transport for you

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Campaigners for better patient transport at transportforall assembly in London on October 7 pic credit: Christa Holka

Campaigners for better patient transport at transportforall assembly in London on October 7 pic credit: Christa Holka

A damning report, Sick of Waiting  by the transportforall, the excellent body campaigning for disabled people to have proper access to transport across the capital, reveals what everybody thought but nobody knew: disabled people have a lousy patient transport service in London.

As I report in this week’s Tribune magazine a survey of 200 disabled patients found that 37 per cent had missed an appointment due to failures by patient transport and almost half had arrived late for appointments over the past two years. Nearly all of this, as the report shows, was provided by newly privatised services.

A staggering 90 per cent had never been told that they could be eligible for financial help to get to hospital under the Healthcare Travel Costs Scheme while more than half were never told about patient transport when they booked an appointment.

But the health trust that really took the biscuit was Hillingdon Hospital Trust.Not only did they provide one of the worst personal examples of being ultra unhelpful – but they revealed that they had a questionnaire to weed out those they did not want to provide patient transport.

The personal case involved Robin who had previously been taken to hospital by a brother and Hillingdon expected this to continue. But the brother had moved to Spain. And guess what, Hillingdon expected him to come back and take her ( no doubt quoting cheap flights by easyjet – I made that latter point up!)

But the most extraordinary example was the disclosure through a freedom of information request was a questionnaire used by Hillingdon to assess whether people should get patient transport in the first place.

This included the questions ” Do you go shopping?” and “do you ever (my emphasis) go to the pub/cinema/ bingo? ”

I put this to the press office of Hillingdon and they replied: “The Trust does not discriminate against any of its patients. On occasion – for example where someone is very clearly able-bodied – the hospital’s transport team will ask people how they usually get around.

“This is to see if they are capable of getting to and from hospital without using patient transport as we want to ensure this valuable resource is available for those that really need it. This is in line with guidance from the Department of Health.”

I then sent back their own response to the FOI which listed the questionnaire they gave to ALL patients requiring transport. And the press office admitted they didn’t even know about it when they replied disclaiming the story.

They promised the transport manager would respond. And then they found he had taken leave of absence. So might I if a pesky journo was asking embarrassing questions about a dodgy practice.

Perhaps Hillingdon is overrun with bingo playing, binge drinking, shopaholics all demanding hospital appointments, but I very much doubt it.

Of course not all trusts were as bad as Hillingdon. The report praised Guys and St Thomas’s NHS Foundation Trust for its excellently managed patient transport service and the Royal Marsden came out well.

But far too many didn’t and some of the stories of the way disabled people were treated were callous and heart breaking.

Transportforall is laying down a new patients charter, demanding minimum standards, minimum waiting times and real transparency about the services provided by the private  and public sectors. Nor is this confined to London. The report cites problems in Kent, Manchester,Dorset, Devon, Cornwall, Coventry, Somerset, Lincolnshire, Derbyshire, Leeds and Suffolk..

It is time this issue went right up the political agenda. As the report says:” a national solution is needed”.

What about it, Jeremy Hunt and Andy Burnham?

 

 

 

Grant Shapps Tories defend the man who gave Jimmy Savile the keys to Broadmoor

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While  Tory chairman Grant Shapps presides over the party conference in Birmingham – attacking Tory defector to UKIP Mark Reckless- an extraordinary event is going on in his own constituency, Welwyn Hatfield in Hertfordshire.

John Dean, the leader of the Tory Welwyn Hatfield council and a prominent member of his constituency party is on record defending Alan Franey, his deputy leader of the authority – better known now as the former general manager of Broadmoor who gave Jimmy Savile free range in the facility. Franey had known Savile for 20 years.

Political Scrapbook which broke the story on the net have given me permission to reproduce the tale disclosed originally by the Welwyn Hatfield Times but surprisingly not put on the internet.

Mr Franey is definitely a big cheese in the Tories with a Cabinet job controlling the authority’s spending and a close relationship with Hertfordshire police. It beggars belief that nothing has been done about this given the disclosures following Savile’s exposure as a paedophile  – and I am told he  will survive the no confidence motion  tabled by Labour because of the huge majority the Tories enjoy on the council.

This is Political Scrapbook’s report:

A political ally of Tory chairman Grant Shapps is under pressure to resign over allegations linking him to the Jimmy Savile abuse scandal.  The relationship between Savile and Alan Franey — now the deputy leader of Shapps’ local council and a police and crime panel member — was the subject of harsh scrutiny by an official NHS investigation.

The Welwyn Hatfield Times reports that Cllr Franey will now face a no confidence vote from colleagues on Monday.

With paedophile Savile enjoying unfettered access to Broadmoor Hospital in the 1980s,a running partner, Cllr Franey, was appointed as the general manager of the facility in 1988 — apparently at the insistence of Savile. Witnesses told investigators about closeness between the pair, with Franey asking for “the godfather” when he regularly rang Stoke Mandeville hospital to speak with the TV presenter.

Franey — who strongly denies any wrongdoing and claims he has been made a “scapegoat”, is mentioned no less than 86 times in the official report into the Broadmoor abuse.

According to the report, Savile was fond of invoking his relationship with Franey and other “people in high places” in conversation with hospital staff.  Interviewees also told the inquiry that Franey was “seen as having authorised” Savile’s “unrestricted access to secure and clinical areas of the hospital”.

One health executive told investigators that Franey had told him Savile had “a little secret … a liking for young girls, the younger the better”, a claim strongly denied by Cllr Franey, who also denies that any complaints about Savile reached him.

The report raises allegations about Franey’s personal conduct, such as concurrent affairs with female staff, which may have given Savile and others leverage over the health chief. Again, Franey denies the claims:

“Widespread stories about [Cllr Franey’s] personal conduct circulated within the hospital and outside it, damaging his stature and credibility and hampering his ability to lead improvement”

The report then cites a particular incident in which a nurse was sacked for having “had a sexual relationship with a female patient”:

“she lodged an industrial tribunal case, at which she threatened to make public embarrassing revelations about the hospital’s management. Documents from the time show that this was believed to include allegations about Franey’s personal conduct, involving herself and other members of staff.

But investigators couldn’t find anyone who could explain why the nurse withdrew her claim, suggesting that “an irregular payment” may have been made and noting that the nurse“was, like Savile, a close associate of Franey’s”.

 

Coming Soon: The privatised sick note service that will email you back to work

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In two months time the traditional doctor’s note excusing you from work will start to cease being valid if you are still sick after four weeks.

Just before Parliament went into the summer recess welfare reform minister, Lord Freud, announced that a US multinational company,Maximus, which also operates in Canada and Saudi Arabia will take over running the new Health and Work Service for England and Wales.

My report in this week’s Tribune  reveals that up to one million people will be affected by the change which appears to be aimed to save the government money.

Maximus runs call centres, occupational health programmes, child support and job seekers programmes abroad and in the United Kingdom.

The programme is to be rolled out from November to next May aims to save up to £165 million a year by getting people back to work faster as part of Lord Freud’s welfare reforms.

The Scottish government  has declined to contract out the work to the private firm and will keep the assessment programme as part of the public service.

More worryingly it appears that the private company which will make the decision will not see anyone – and create a Return to Work programme  via  a call centre telephone interview and a decision by email.

The package is supposed to be agreed between the sick person and the private company and sent to both the individual and their employer. Failure to co-operate with the service will mean the individual will lose their sick pay.

Lord Freud is quoted in a DWP press release emphasising how the scheme will improve economic productivity and get people back to work faster.

He says:”Providing support where it’s needed most will help to reduce the length of time employees take off sick which, in turn, will cut sick pay costs, improve economic output and reduce the chances of people falling out of work and having to claim benefits. “

After the cruel and nasty system that forced disabled people  to find work or lose benefits run by the French company, ATOS, I have a suspicion that this new system could push the sick back to work before they are ready.

While ATOS did this by personal interviews and tests, Maximus look like putting the sick back to work without examining them to see they are fit and well. No doubt the government will see it as another way to tackle the workshy. But even employers’ advisers are sceptical about this. This new development needs watching.

About time too! Inspectors to up their game on private ambulance companies

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England’s private ambulance services need some tough discipline as companies – from bus firms like Arriva to parking firms like NSL ( formerly National Car Parks) rush to make profits providing patient transport.

 A report I have written for Tribune magazine this week reveals that already 50 per cent of patient journeys to care homes and hospitals are provided by the private sector and they are already eyeing up taking over 999 ambulance services, Such is the pace of privatisation under the Conservative-Liberal Democrat coalition.

The standards provided by some of the companies – as earlier blogs, including one from personal; experience reveal,- is little short of  cruel and appalling. I will be returning in future blogs to expose other bad  firms who show little care for elderly and disabled people except to swell their bosses’s salaries.

However there is some good news. The Care Quality Commission –  whose job it is to monitor hospitals, care homes and ambulance services – is planning to up its game. It is reviewing its entire inspection  system of both private and public ambulance services – for both patient transport and emergency responses.

 The  decision is contained in a report from the CQC  which reveals that  Sir Michael Richards, chief hospitals inspector, has decided that this rather neglected side of the business deserves revamping. The report also discloses – as the CQC is the main registration for ambulance services  that already 50 per cent of patient transport journeys are carried out by private firms.

 Sir Michael ought to have done this sooner – he should know from, some of his own CQC inspections that some private firms were failing in the most basic way – like not bothering to check the criminal records of staff carrying vulnerable patients or whether they had proper training.

He is making big promises He says:  “Over the next three years we will develop a ratings system for most providers of health and social care.

“Our ratings will develop to become the single, authoritative assessment of the quality and safety provided by an organisation. They will be primarily based on the judgements of our inspectors about whether services are safe, effective, caring, responsive to people’s needs and well-led, but will also take into account all the information we hold about a service and the findings of others.”

Fine words, he better keep them. Unions like Unite and Unison are already warning about the deterioration of services and some of the people who have contacted me on this website have related appalling experiences. The only private firm that contacted me wanted the information  I reported about a bad inspection of their company  by the CGC removed from the internet. It shows you where they are coming from. Vigilance of these firms is going to be essential.

 

 

 

 

 

 

Exclusive: How the French are squabbling over the spoils they can make by privatising and removing jobs from Britain

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Steria, the French IT company favoured by Whitehall and the NHS

Steria, the French IT company favoured by Whitehall and the NHS

An extraordinary battle is under way across the Channel between three big French IT companies who have a massive interest in British government contracts over the privatisation of Whitehall, town halls and the NHS including removing jobs from Britain to India.
Atos,hated by the disabled in Britain for its harsh policy in implementing Iain Duncan Smith’s policy of getting the disabled back to work, has made a hostile bid to take over Steria, the company chosen by the government to privatise NHS and Whitehall jobs and remove some to India.
Steria is trying to merge with Sopra, another French IT company,in a ” sweetheart deal ” to make big profits by combining new technology with removing jobs from Europe to India.
Steria is furious with Atos for what it calls ” disturbing ” its talks with Sopra. But Atos has left its lucrative offer on the table to tempt Steria shareholders
All this is revealed in a small report from the Paris reporters on the influential Bloomberg website over Easter.
For Atos the deal is simple. It a double whammy – they make money from Iain Duncan Smith’s privatisation of benefit medical tests and more money by offshoring jobs from Britain to India.
For the disabled not such good news, they are forced back into the job market say in Sheffield just at the point when jobs are being moved to India by the same company.
The deal merging Steria and Sopra is equally as good. the game is given away in a press release on Sopra’s website which reveals that it will create a three million Euro company, which could rapidly grow to four million Euros by economies of scale, more jobs shifted from Europe to India and a big jump in profit margins.
It says:”Sopra brings the power of its organisation in France, the strength of
its banking, human resources and real estate products and its effective application management model.
For its part, Steria brings its international reach (Europe and Asia) with a strong
positioning in the United Kingdom.”
“Industrial-scale production capacity would be significantly reinforced with an array of offshore and nearshore service centres representing a workforce of approximately 8,000 people,including over 6,000 in India.”
The company would be 35,000 strong with 8000 jobs in India and other offshore sites.
It also adds that “Steria would be able to leverage Sopra’s offshore capacity in India for its French clients.”
These include the Department of Work and Pensions, the Department of Environment, Food and Rural Affairs and the NHS. Soon,no doubt to be joined by the Home Office and Ministry for Justice.
It predicts profit margins – currently 6.8 per cent for Sopra in the UK will soon top 10 per cent.
For ministers like Francis Maude, Jeremy Hunt and Iain Duncan Smith, this must be bliss – the French squabbling over the best way to make loads of money from their privatisation programmes. It is a global capitalist’s wet dream with even the prospect of a few non exec directorships for retiring Tory politicians when they leave office.
For the disabled, civil servants and those who believe in and want good local services with a public service ethos, it probably can’t be worse. How long before a disabled claimant denied benefit by Atos is told there is a good company vacancy in Pune, India so go and get the job.

Revealed: How Francis Maude and Chris Grayling are actively working to remove jobs from Britain to some risky terrorist destinations

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Francis Maude: Actively encouraging off shoring Whitehall jobs

Francis Maude: Actively encouraging off shoring Whitehall jobs

David Cameron and George Osborne have been boasting how many new jobs their new economic recovery has created.

What they haven’t told you is that their Cabinet colleagues are actively working to strip Britain of existing jobs and replace them with new cheap skate jobs overseas, including some countries which have high risks of riots and terrorist attacks. And further the new jobs will mean the transfer of personal data on staff, possibly police and criminal records and the transfer of patient details from GP to GP to a foreign country.

I have written about this in Tribune magazine this weekend. But the two ministers are being very crafty – they are leaving it to a private company to sack the former civil servants and  transfer your records  and appointing a man who can hold both a Whitehall job and a private sector post at the same time to hand the companies the power to do it.

 

Peter Swann: the man enabling Steria to outsource jobs to his own company's high risk terrorist destination

Peter Swann: the man enabling Steria to outsource jobs to his own company’s high risk terrorist destination

The man is Peter Swann – or Peter S as he likes to hide under his Linked In entry unless you know him well. His entry shows he is currently Director of Crown Oversight at the Cabinet Office under Francis Maude and his job description according to his own Linked In Entry is “transforming the delivery of Civil Service back office functions to over 500,000 staff across the UK and in all Government Departments.”

 His other simultaneous job is  executive director of Aon Risk Solutions which in his words is famous for ” relocating corporate Head Office functions and aligning this strategy to Aon’s captive offshore arrangement and existing outsourcing contractual arrangements.”

 To put it simply he is an outsourcing and off shore fanatic whose company has had a 43 per cent rise in dividends this year. Incidently  his firm provides a Terrorist Tracking Tool and up to date world guide on the dangers of strikes, riots and terrorist attacks in dodgy foreign countries. Download the map here.

So it should be no surprise that within a year a French firm, Steria, have now taken over all the back room jobs for the Department of Work and Pensions, the Department of Environment, Food and Rural Affairs and the Environment Agency and is now looking at bidding for the Home Office and the Ministry of Justice. Again the move is subtle, Whitehall has created a new UK company to do it, 75 per cent owned by the French. It came one year after the Department of Health ensured that Steria also took a majority holding in a NHS data  company providing the ” invisible information” through NHS Shared Business Services, including patient information to GPs and clinical recall services.

And now Steria is arranging that jobs currently in Newport, Cardiff, Sheffield and Leeds are destined to be replaced by ones abroad and staff in Newcastle, Blackpool,Peterborough and York are facing the sack. An analysis of Steria’s accounts – which they are required to disclose under EU law- reveals that they make the most money out of their British operations – but their biggest off shore operation is in India with lesser ones in Morocco and Poland. They also derive 39 per cent of their income from the public sector,

 So what will be Sheffield’s loss could well be Pune and Chennai in India’s gain. And here’s the irony  Peter Swann’s company, Aon, rates India as a high risk country for riots, commotion and terrorism, while Sheffield is low risk. It is also amazing that to save money our justice secretary, Chris Grayling, and Cabinet Office minister, Francis Maude, are quite happy for Steria to do what they like with our personal data. I bet they don’t take such risks with their own personal security. Perhaps both of them should be removed to exile in Pune.