BITS AND PIECES – Published Articles





OUR NHS? (October 2015)






Staff, patients and even its Trust chair are up in arms at NHS England’s plans to cut Brompton Hospital’s Congenital Heart Disease (CHD) unit, the largest and one of the best in the country. This will make its paediatric intensive care unit unsustainable. Thousands of children with complex respiratory diseases will be affected by the loss of this leading national service provided by the Brompton. It will also see the loss of the Brompton’s world leading adult congenital heart research centre.

NHS England’s reason is that the Hospital doesn’t provide additional paediatric services required under its new standards. Brompton argues that these have been satisfactorily provided over many years by the Brompton’s nearby neighbour Chelsea & Westminster Hospital working closely with them.

Cardiac specialist and Royal Society President Professor B Sethia says that the NHS England proposals are “based on imprecise or no evidence and disregard the excellent outcomes delivered by Royal Brompton Hospital in both adult and paediatric cardiac patients”. At a March 7th public consultation NHS England’s heart disease director Professor Huon Gray admitted that there was “no scientific evidence” to back NHS England’s plan.

Other hospitals will have to reallocate hard-pressed funds needed elsewhere in order to cater for the 14,000 patients affected by the loss of Brompton’s CHD unit. This robbing-Peter-to-pay-Paul pressure on hospitals furthers NHS England’s plans to reduce hospitals’ in-house public provisioning and public usage, including beds and A & E units, which are to be more than halved. Faced with long waiting times for treatment patients deemed as non-urgent are being offered more readily accessible private sector services. Whether these are obtained via the NHS or out of an individual’s own pocket it is the public who foots the bill for NHS services being replaced by more costly privately-provided ones.

The private sector isn’t just being given space by government-driven NHS cuts to provide its services at added cost to the public. Top, expensive US business consultants like McKinsey are also heavily involved in drawing up NHS England’s plans, including the cuts. The plans are hugely costly for the taxpayer (estimated costs of North West London’s plans alone are over £1 billion). Furthermore, private sector interests like McKinsey and Optum, a subsidiary of US healthcare/health insurance giant United Health, have been brought into the actual commissioning of services for the NHS. They are substantially responsible for spending taxpayers’ money that benefits expensive private sector providers. United Health and subsidiaries of it are currently facing a multi-million dollar lawsuit for defrauding the US healthcare system.

The transfer of responsibility for our public healthcare from a wholly publicly-owned and run NHS to a US-modelled public/private, business-oriented enterprise is already creating a US-style 2-tier system, a readily accessible one for those who can afford it and a less accessible, rationed one for those who can’t afford it. The CEO of NHS England who is overseeing all this is Simon Stevens, former CEO of global strategy for United Health, for whom he lobbied to get Obamacare watered down.




A new app offers 24/7 medical advice ‘in the palm of your hand…so you can talk to a GP when it suits you and your family, wherever you are in the world.’. The Babylon app allows patients to skip queues to see a GP by allowing them to pay for medical care seven days a week. Supporters argue that the app, which has been described as working liking a ‘taxi booking service’, will take pressure off busy GP surgeries and A&E departments. Doctaly is another new online ‘booking service’ who similarly arrange same-day appointments with NHS GPs charging for this private provision of their services. Babylon and Doctaly are part of a wave of hi-tech, DIY medical care initiatives being pushed by NHS England.

But according to the National Health Action Party (NHA) the devil is in the detail of the exclusion clauses contained in the agreements patients sign up to with these whizzo private GP providers. “Once embarked on a private route everything that follows – tests, treatment – is private too. Lots of people seem to see it as NHS queue jumping to see the GP. Not so. It’s the gateway to private healthcare,” says the NHA. Doctaly charges people between £39 and £49 for a 15-minute GP appointment during office hours and the cost rises to £69 for appointments out of hours, such as before 9am and after 6pm.. Doctaly does not employ its GPs directly but takes a cut of their fee for their Doctaly “pay to see GP” appointments. Patients then pay for subsequent treatments they receive.

Patients choosing and booking an appointment through Doctaly’s website are asked to confirm they aren’t registered at the GP practice they choose. The BMA General Practitioners Committee’s deputy chair Richard Vautrey says that “the risk is a more fragmented service and patients having remote consultations with doctors they don’t know and who won’t have full access to their NHS medical record.” It also prises patients away from the their underfunded, overstretched GPs and into the hands of private competitors, rather than providing the proper public funding their GPs need for their NHS services. 650 GP surgeries have already been closed, merged or taken over since 2010 and the Royal College of General Practitioners warns that up to a further 600 surgeries face closure by 2020.

NHA’s Dr Louise Irvine is concerned that some GPs may be “tempted to fill the holes in their funding – which is at an all-time low right now – by taking on this (Doctaly) additional work.” Dr Jackie Applebee, chair of Tower Hamlets Local Medical Committee, says that the Doctaly scheme could “further destabilise general practice…This sort of service is the slippery slope towards privatisation of the NHS. It introduces the principle of topping up NHS services with purchased services if one has the disposable income. If the more affluent begin to do this in significant numbers it is only a small step to an insurance-based health service.”

That’s because, by attracting more and more of the public to privately provided services and to private health insurance schemes to cover their costs, this will undermine the argument for universal taxation to fund the NHS’ provision of universal, quality healthcare for all regardless of income, a founding NHS principle. Like in the US we’ll develop a 2-tier healthcare system – a more expensive, accessible private one for the better off and a cheaper, less accessible public one for the worse off – leading many to putting their homes at risk to pay for their healthcare. Private healthcare is now the biggest cause of personal bankruptcy in the US. ‘Don’t Get Sick In America!’ will become ‘Don’t Get Sick In England!’.

In 1977 Thatcher pin-up Nicholas Ridley declared to the Conservatives’ Economic Reconstruction Group “Denationalisation should not be attempted by frontal attack, but by a policy of preparation for return to the private sector by stealth. We should fragment the industries as far as possible; and set up the units as separate profit centres.” The deliberate underfunding of the NHS and GP services – by 2020 the cuts will amount to £40 billion – along with their ‘reconfiguring’ using private ‘booking services’ like the Babylon app and Doctaly, is central to the breaking up of what was once the cheapest and most cost-effective public healthcare system in the developed world. NHS England’s current Sustainability & Transformation Plans (STPs) for ‘reconfiguring’ a broken NHS are intended to put it back together again with the private sector pervasively embedded within it. This is the climax of over 30 years of Ridley’s envisaged NHS privatisation by stealth under both Tory and Labour administrations.




Hammersmith & Fulham Clinical Commissioning Group (CCG) called it a ‘public engagement’. But their October 3rd event at St Paul’s Church, Hammersmith proved to be more military than matrimonial in connotation. Angry Save Our NHS campaigners overrode the CCG’s agenda with repeated demands for information on NHS England’s Sustainability & Transformation Plans (STP). The STPs update NHS England’s 5-Year Forward View blueprint for restructuring the NHS and reducing its deficits. They involve major cuts, a drastic reconfiguration of health provision and making patients and their communities increasingly responsible for their own healthcare. The plans are seen by campaigners as the coup de grace in the dismantling of the NHS and handing over its profitable parts in marketable entities to the private sector.

In West London alone this would mean the axing of Charing Cross and Ealing Hospitals’ A & E departments, the loss of over 500 beds at Charing Cross, the sell-off of buildings and land for luxury flats development and its conversion to a modest clinic. A ‘gold rush’ for planned asset sell-offs at St Mary’s Paddington is anticipated. But much of NHS England’s plans remain shrouded in obfuscation and uncertainty.

Councils, along with CCGs and hospital trusts like North West London’s Imperial NHS Trust, have been made responsible for enacting the plans. But LBH&F and Ealing Councils are refusing to collaborate with the STP cuts. So far they’re the only two councils in England to do so. The councils’ refusal follows their commissioning of Michael Mansfield QC’s damning report on the 5-Year Plans for NW London. These demand the cut of a projected £1.3 billion deficit by 2020, the largest cut of any NHS ‘footprint’ in England, and the creation of a £55 million surplus, City-speak for making a business attractive to bidders. The STPs are being rushed through to complete this massive turnaround in only 4 years, without any clear assessment of the risks involved, who will be responsible for what, or plans for funding of services, critics say. That the NW London plans are costing the taxpayer £1.3 billion to implement, much of it for business consultants like US behemoth McKinsey, doesn’t enhance their standing. Meanwhile, by withholding adequate funding, the Government continues to fragment and weaken the NHS as a public service, with chronically overstretched A & E services, a beds crisis accentuated by the privatisation of hospital wards and care homes, and lengthy waiting lists.

The STPs do contain some reasonable sounding proposals for modernising the NHS – the use of new technologies, service rationalisations and efficiency savings. But as a well-established local GP says; “All this could be done by the (non-privatised) NHS”. Like many GPs he sees privatisation, with all its financial incentivisation and division of doctors, staff, services and units into competitive entities, as detrimental to his patients’ interests. How can patients trust doctors who are being forced to work as business people driven by market imperatives? Human relationships and collaboration between medical practitioners, GPs and their patients have always been key to the NHS’ exceptional public esteem. “Competition has no place in public healthcare. And the idea of asking for a credit card is repugnant”, the local GP states.

Privately provided services, with shareholder dividends, costly bank loans, large add-on ‘management’ fees and high executives’ rewards, are also a lot more expensive than publicly funded ones, as the saddling of the NHS with over £80 billion in repayments on private sector hospital investments (PFIs) of £11.6 billion has proved. International studies show that the admin costs of private sector marketing – tendering, consultants, lawyers, billing, accountants, auditors – double, even triple, public sector admin costs. NHS admin has soared since privatisation. The £200 million costs of ‘health tourism’ pale in comparison to the estimated £5-10 billion or more that privatisation is costing taxpayers every year. That’s where waste really lies.

How our healthcare costs will be met, if not by inexpensive State investment and modest tax increases on the best off, is also obfuscated. At a Parliamentary Health Enquiry in May Health Secretary Jeremy Hunt invoked the USA’s private health insurance-based model. Apart from being the most expensive in the world this privatised system is notorious for putting corporate profits before patients’ needs. Those that are seen as risky – smokers, drinkers, the ageing, those with a medical or mental history – face hefty premiums or can be denied insurance cover. Claims by ‘customers’ who they do accept can be whittled down to leave patients footing outstanding bills. Unsurprisngly healthcare costs are the leading cause of personal bankruptcy in the US.

When confronted by local Save Our Hospitals campaigners at Imperial Trust’s AGM on September 14th Board Chairman Sir Richard Sykes, GlaxoSmithKline’s former chair, invoked European models of public healthcare. But none of these systems, with combinations of health insurance and patients’ payments, are as cost-effective as our old tax-funded and publicly provided NHS, as international studies have shown. Where once our nationalised NHS was a world leader a recent OECD report placed the now part-privatised NHS 28th out of 30 for healthcare resources, with fewer doctors, nurses, beds and medical scanners than most wealthy countries. We have only 2.7 beds per 1000 compared to 6.3 in France, 8.2 in Germany and 13.3 in Japan.

Hammersmith & Fulham CCG abandoned its event’s scheduled round-table confabs with local residents on executing the plans as campaigners tore into the lack of proper public consultation and the STP’s lack of a clear strategy or business plan. “You have a responsibility to defend the health of local residents!” said one local campaigner. “We have a responsibility to work within our budget” responded the CCG’s supremo Clare Parker. The budget has indeed been imposed on them by NHS England. Its CEO Simon Stevens, a former senior executive of US private healthcare and insurance giant United Health, is seen by campaigners as the Government’s hatchet man. He has the same Nuremberg defence as the CCGs – ultimate responsibility for public spending lies with the politicians. And the Government appears bent on privatising as much of the NHS as it can by 2020.

In 1977 Thatcher pin-up Nicholas Ridley declared to the Conservatives’ Economic Reconstruction Group “Denationalisation should not be attempted by frontal attack, but by a policy of preparation for return to the private sector by stealth. We should first pass fresh legislation to destroy the public sector monopolies. We might also need to take power to sell assets. Secondly, we should fragment the industries as far as possible; and set up the units as separate profit centres.” The STPs are bringing to a head over 30 years of this stealthy NHS privatisation under both Labour and Tory administrations. “Only the public can save the NHS” says East End GP and NHS campaigner Dr Youssef El-Gingihy. That’s you, dear reader.



‘Infrastructure’ is a polite word for services that we the public own or once owned – hospitals, schools, railways, utilities. Last year I spoke to a Big Beast of the debt markets. He’d started an infrastructure financing company, the kind that feeds off the publicly-owned assets and services handed over to the private sector by successive UK governments. I wanted an insider’s perspective on the crippling costs of the Private Finance Initiative (PFI) hospital projects that have landed the taxpayer with debt repayment costs of £80 billion on private sector investments in the NHS of only £11.6 billion.

For the private investor/financier this is a lot more lucrative than investing in the stockmarket and it’s low-risk given the consistent demand for healthcare. But for the taxpayer the PFI debt repayments are far higher than for State financing of the NHS. Tory and Labour governments wanted ‘experts’, the Big Beast explained confidently; “It’s the old story that if a government drives a business it will drive it into bankruptcy. Governments don’t know how to run projects.” As for the taxpayer? “You’re stuck with it. You can’t get out of it. That’s the beauty of the capitalist system! There’s always somebody on the right side of the trade and somebody on the wrong side!” he concluded brightly.

The PFIs are just part of the government’s ongoing dismantling of the NHS and the surrendering of its profitable services and assets to private companies such as Virgin, Serco and US giant United Health who hide behind the NHS logo. Valuable NHS buildings and land are being sold off to property developers, often as a result of the exorbitant costs of paying for new hospitals built under PFI.

But privatised services cost the NHS and taxpayer far more than when provided by our publicly-owned and publicly-run NHS. That’s because public health systems don’t seek profits. They don’t need to pay dividends to shareholders. They don’t have the management fees that private companies charge. And they don’t have the added costs of private sector borrowings. The State can finance at lower interest rates, even at near zero rates if they deploy ‘quantitative easing’, the money-printing scheme with which they’ve bailed out the bust banks.

A public NHS also doesn’t have the huge marketing and contract administration costs using extra lawyers, accountants, consultants and management that privatisation incurs. A conservative estimate puts these at £4.5 billion annually and rising. The Shaping A Healthier Future (SaHF) plans for ‘reshaping’ our local health and care services involve mega business consultants like US corporate squid McKinsey who are being used to oversee NHS privatisation. The costs of the SaHF plans have escalated from £112 million in 2012 to £1 billion, including spiralling consultancy and management fees, according to the recently published Mansfield Commission report on NW London healthcare. Just cutting costs like these, not NHS services, would go a long way to cover the shortfall between government underfunding and the needs of the NHS over the next 5 years. Our local hospitals would not need the SaHF cuts in staff, beds and services, the A & E closures, the selling-off of their buildings and the desertion of doctors, nurses and GPs from a public service whose vocational work we rely on and cherish.

NHS services – including A & E, maternity and provision for children and the elderly – have been deliberately underfunded since 2010. The comprehensive care we’ve had continues to be cut back. The huge commercial costs and the chaos caused by the ongoing NHS fragmentation are the direct result of privatisation and a stark refutation of the Big Beast’s claims of the free market’s superior efficiency. This is endangering the quality and safety of our public healthcare. NHS privatisation isn’t just bad for our pockets. It’s bad for our health.

It’s also bad for other services, assets and amenities which we value for their benefits to our society and communities across the social spectrum – the BBC, schools, social housing, libraries, public spaces. These are actually our services and our assets. We the public own them. And they’re being handed over to the private sector without a proper mandate from us, even when there is clear support for their public ownership – polls repeatedly show that most of us want to keep our NHS.

That’s why protesters and campaign groups need to band together to oppose the onslaught of the privatisers with their schemes for the NHS, the Paddington Pole/Shard 2, Chelsea Crossrail and public housing. Central & West London Action/CAWLA ( is a Chelsea and Fulham 38 Degrees Group initiative providing a non-party forum for combined public actions on key local issues.

38 Degrees HQ say that the NHS is their members’ major issue. Campaigners are rallying to the NHS Reinstatement Bill ( which provides the legislation needed to remove the costs and waste of privatisation and to restore the NHS as a publicly-funded and publicly-run NHS. Green MP Caroline Lucas has presented it to Parliament with the cross-party support of 76 MPs. The growing number of objectors to unfettered privatisation can sign the 38 Degrees petition Support The NHS Reinstatement Bill To Bring Back Our NHS. They can pressure their MPs to support the Bill and to act on other issues which matter to them. They can take their resistance to the streets, council chambers, privatisers HQ’s and mayoral hustings. The Skyline Campaign’s recent success in obstructing the Paddington Pole/Shard 2 plans shows that people power can have an effect. Don’t just seethe. Do something!



OUR NHS? by John Furse

Hidden behind its trusted logo ‘our’ NHS is becoming ‘their’ NHS, its services increasingly outsourced to private sector providers. And at a far greater cost to the NHS than if it remained its own provider. Because private providers incur hefty additional legal and management fees, profit margin requirements and private finance costing 50% more than State funding. Is it surprising that NHS costs as a percentage of GDP have doubled since the first major privatisation legislation in 1990?

‘NHS Detectives’ ( is a 999 Call For The NHS website for the public to pool their discoveries about who their local service providers really are – Healthcare & Transport Services, G4S, x9 Services, Serco, ISS, CFS Group, Care UK, BUPA, InHealth, Bain Capital, Virgin et al. These private companies already provide blood, agency nurses, scanning and diagnostic services, ambulances, disabled transport, portering, cleaning, catering, hospital buildings, post-operative beds and care homes. And the list grows.

Imperial College Healthcare NHS Trust – a mash-up of Charing X, Hammersmith, Queen Charlotte’s & Chelsea, St Mary’s and Western Eye hospitals – has Sir Richard Brook Sykes as non-executive chairman. A prominent biochemist his cv includes chairmanships of GlaxoSmithKline and currently three biotech/health tech companies.

He’s also chair of think-tank Reform who want total public spending cut along with taxes so that individuals can provide for their own healthcare needs and obtain high quality services more ‘efficiently’. Paying for your GP visits is one of their wheezes.

This doubtless chimes well with big hitters like United Healthcare, the USA’s largest health insurance and services provider, lining up for the rich pickings to be had from the marketisation of the NHS, the fourth largest business in the world. And with Simon Stevens, United Health’s former head of global health, now CEO of NHS England.

As NHS funding is bled away by costly private providers NHS services become overstretched, wrung-out staff quit and waiting lists mount. The privateers’ hope is that we will seek expensive private health insurance. A US-style insurance-based health service is what leading health and social policy expert Professor Allyson Pollock sees being prepared for us. “We’re facing the Americanisation of our public services,” she says. And we all know the ‘Don’t Get Sick In America’ mantra.

The Imperial Trust has other non-executive private sector notables on its board – Jeremy Isaacs, founder of hedge fund JRJ with an arm in tax haven Jersey. His cv includes spells as a Goldman Sachs director and a Lehman’s overseas CEO until 2008, Lehman’s annus implodius. Rothschild executive vice chairman Dr Andreas Raffelm and Sarika Patel, partner in Zeus Capital, an investment bank heavily into infrastructure and real estate, are also Imperial Trust board members.

Patel has held ‘key roles’ at accountancy giant Grant Thornton. Such accountancy behemoths are the ‘fixers’ between corporate and investment big hitters and their targets. Imperial has a biggie in Sir Gerald Acher, a senior partner at mega auditors KPMG.

Chelsea & Westminster Hospital NHS Foundation Trust’s non-executive chair is Sir Thomas Hughes-Hallett, a former banker who promotes the line that “The NHS can’t afford to treat us all for free. It’s time we paid for our care”. Begging the obvious question that if we could bail out his lot why not the NHS?

His vice-chair is Sir John Baker, whose cv includes leading the UK electricity privatisation programme before becoming CEO of privatised National Power plc. Chelsea & Westminster Trust non-executive director is Jeremy Jensen, director of Aaronite Partners, specialists at ‘restructuring’ distressed businesses. He’s also director of MPG Hospital Holdings who own, operate and lease UK hospitals. Adding her mergers and acquisitions expertise is former BP exec Eliza Hermann.

The US-based Commonwealth Fund recently found NHS performance to be at the top of their league tables despite chronic underfunding (the US came bottom). And a publicly funded and serviced NHS is far cheaper than a privatised one. Bank bailouts and Quantitative Easings (QE) have been a revelation – governments can actually print billions without causing rampant inflation or the collapse of their currencies.

Whether through QE, taxes and/or bonds our government could in fact fully fund the NHS, particularly with interest rates set to remain at historic lows. It’s also an investment that produces tens of thousands of jobs, healthy workers and consumers old and young with spending power to stimulate the economy.

But the NHS, like most of our politicians, has been infected by 30 years of a free-market ideology whose true workings have been exposed by the 2008 Banking Crash and its aftermath. The boards of our local hospitals overseeing the turning over of NHS assets and services to the private sector are symptomatic of that infection.




“Unless there is a change of government, the NHS in England will be completely destroyed by 2020.”                          Lord David Owen, March 2014

The closure of Hammersmith Hospital’s A&E department and plans to sell off over half of Charing Cross Hospital are local manifestations of the Government’s privatisation drive. Using the debt crisis as cover, it’s deploying austerity to deprive the NHS of resources for coping with our increasing longevity and health needs; and to transfer the rich pickings from these vital social assets to the ‘free’ market.

A new free market wheeze called the Transatlantic Trade and Investment Partnership (TTIP) may now become an additional threat to the NHS and other State-owned assets as it could facilitate their sell-off to private overseas companies, or to overseas State-owned giants like France’s EDF, now owner of our old LEB. Selling a profitable State entity to a foreign twin? You know it makes sense.

War on Want (WoW) says that the TTIP is being negotiated in great secrecy between the EU and the USA. Its motive is to de-regulate pesky market barriers like labour rights, food safety, environmental and toxic chemical regulations; and increase international corporate profitability.

TTIP could allow corporations to sue governments before secretive arbitration panels which bypass domestic courts and override the will of parliaments. It could stop privatised State assets like the NHS from ever being taken back into State-ownership. Unless, presumably, they are beacons of the free market’s failure like the Big Banks; then the public can pick up the privateers’ trillion-dollar bad debts and keep their leading backers’ investments ‘solvent’. That’s the Big Society for you, pulling together, working together. All “in the national interest” of course.

With stock market and property values bloated by Quantitative Easing (QE) ‘printed’ money, the threat of an even greater financial crisis than 2008, which the burgeoning debt mountain could again precipitate, is forcing the authorities to turn off the QE tap. So making and selling things (that problematic enterprise demoted over the last 30 years in favour of a consumer-led, property-based, debt-fuelled juggernaut) has an added urgency.

But how to achieve the surge in growth needed to keep the whole debt-burdened shebang afloat? Debt interest is costly; it inhibits consumer spending and investment in the productive sector. As ever, for the free market fundamentalists, this means a minimum of meddling government, restrictive regulation or demanding labour. Hello TTIP.

WOW points to the powers that TTIP-type provisions have already given major corporations to sue governments pursuing public interest policies. French giant Veolia is suing the Egyptian State because its National Wage Council tried to keep private and public employees’ wages inflation-linked. Tobacco king Philip Morris is suing the Australian government over its anti-smoking legislation.

Anti-TTIP protesters in Brussels were recently water cannoned and the UK is taking up the baton thanks to internet campaign organisations like 38 Degrees. But the problem remains for opposition to the free marketeers to gather ‘critical mass’. Could the global debt issue be a focal point for this?

Couldn’t we do what its creditors did with a debt-laden Germany in 1953? They agreed to write off some 50% of Germany’s debt. In 2011 The Boston Consulting Group (BCG), a top global business consultancy, suggested a $20 trillion dollar write-off of “unsustainable” developed world debt as a resolution to the debt nemesis. It is our debt overhang that’s preventing the levels of growth needed for economic recovery. And BCG suggested a one-off tax of almost 30% on the best-off to recapitalise the banks and insurance companies so they could fund the needed surge in investment and growth.

Now there’s a Big Society idea: the hit to be taken by the free market’s leading beneficiaries. Not such a blow for the 1% who apparently own almost half the world’s liquid wealth in cash, stocks, bonds; and the 85 people who have as much money as the poorest 3.5 billion. Why shouldn’t they carry the burden, rather than the public and our essential services like the NHS and welfare? I asked a former Big Bank debt department boss how long the technicalities of a global debt write-off could take. “With computers,” he said, “about 10 weeks…”. So why is this idea not being widely raised?

John Furse is a filmmaker. His latest project deals with the global debt crisis and the issue of debt forgiveness ( the debt ditch the rich).

For more information see War On Want and the 38 Degrees TTIP campaign



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