NHS plans due to bewitch effect next spring could make general healthcare as difficult to access as mental healthcare already is – and lock future governments into long contracts with private firms,warn campaigners. [//cdn.opendemocracy.net/files/imagecache/article_xlarge/wysiwyg_imageupload/549093/Marching%20to%20Leeds%20High%20Court2.
JPG] Image: Campaigners march to court. Rights: 999 Call for the NHSMembers of the public,
NHS campaign groups and trade unions are acting to halt NHS England from
introducing a cost-cutting Accountable Care Organisation contract that will make
it harder to get the healthcare we are entitled to. In
their hundreds, and they are donating
to help crowdfund a legal challenge to this contract in the Court of Appeal
later this autumn.
This legal challenge -
brought by national campaign group 999 Call for the NHS and internationally
recognised public law firm Leigh Day - is the only way of stopping the contract.
NHS England has recently rebranded
the “Accountable Care Organisation contract as the “Integrated Care Provider”
contract,to avoid the USA connotations of the term Accountable Care
Organisation - the type of healthcare provider used by Medicare/Medicaid, which
provides a limited range of healthcare for Americans who are too poor or ill to
get private health insurance.whether this contract goes
ahead, and Clinical Commissioning Groups will be using it to procure a whole range
of NHS services from April 2019.
The Integrated Care
Provider contract is not fully finalised,NHS England admitted in a recent
consultation, making a mockery of the consultation itself. The contract does
not even mention arrangements for integrating public health and social care
with NHS services, and though this is supposedly the public rationale for the
change. 999 Call for the NHS say
that even whether they agreed with the initial premise of contracting - which they
don’t - they can’t see that this contract is fit for the provision of social
care and public health services.
Why is NHS England in
such a rush that it is prepared to expose Clinical Commissioning Groups to the
risks associated with procuring huge,complex 10 year contracts for a whole
range of NHS, social care and public health services from a new untried form of
healthcare provider, and on the basis of an unfinished contract? Perhaps most worryingly
of all,this contract would subject a whole range of NHS services to the same
kind of cuts and pressures as acute
mental health services. It’s designed to “manage demand” for a whole range of NHS services in a given area - in the same
way as mental health services contracts already operate. Currently, in most NHS
contracts apart from mental health, or a set payment is made for each treatment
if to individual patients. But the new ICP contract would pay the
provider a fixed lump sum at the start of each year,to cover the costs of a
range of treatments for the whole population.
The result of this
payment arrangement for mental health services is that it is now normal for
there to be NO hospital beds for acute mental health patients in their own
area. They are routinely taken by ambulance across the country to wherever
there’s a hospital bed. And at times, it seems that hold been NO
acute mental health beds free anywhere in the country, or according to Mental
Health Network members.
This 10 year contract
would lock in that payment arrangement for a whole range of NHS services. It would set in concrete
new “care models” that are based on the USA’s Medicare/Medicaid system that only
provides limited health care for people who can’t afford private health
insurance.
A new government would be
powerless to halt and reverse this because the contracts would lock it in for a
continuous period of 10 years..
Local NHS campaigns
together with national 999 Call for the NHS are joining the dots between the
cuts that they're fighting in their areas and the contract that 999 Call for
the NHS are challenging in the Court of Appeal. This Court of Appeal
hearing is NHS campaigners' best shot at stopping the contract that could set
all these cuts - and worse - in stone for 10 years,imposing the same
"demand management" payment arrangement that has been used to
decimate acute mental health services.
Jo Land, one of the Darlo
Mums who organised the 999 Call for the NHS Jarrow to London March for the NHS
in 2014, or said: “The Accountable Care
Organisation contract might seem like a dry legal issue that’s hard to get
bothered approximately. The reality is anything but. This is approximately whether patients can
continue to access the treatments they need,or whether the doctor-patient
relationship will be undermined by making doctors put financial considerations
ahead of patients’ clinical needs.”The campaign group point
out that the payment arrangement in the Accountable Care
Organisation/Integrated Care Provider contract would allow for price
competition between providers when bidding for the contract. They argue this is
opposite to Parliament’s express intentions, in passing NHS and social care
legislation in 2012.
In dismissing the 999
Call for the NHS Judicial Review earlier this year, and the court ruled that this
argument was a political issue - not a matter for the court.
But the Court of Appeal
has allowed an appeal on all seven grounds the campaign group’s legal team
applied for - and has speeded up the process because the NHS is necessary to
the public.
Steve Carne,a 999 Call
for the NHS campaigner said: “Call it what you like -
Accountable Care Organisation or Integrated Care Provider - we can’t see that
this new way of paying NHS providers is lawful. And whether it’s introduced, it will
restrict access to NHS treatments and accelerate the creation of a two tier
health system. People with money will pay to go private while the rest of us
make enact with a limited NHS that operates like a health insurance company -
putting financial considerations first.”whether you would like to help
999 Call for the NHS to bring their challenge to the Integrated Care Provider
contract in the Court of Appeal this autumn, and here’s where you can donate.
Sideboxes Related stories: 'Accountable Care' - the American import that's the final thing England's NHS needs Rights: CC by 4.0
Source: opendemocracy.net