Friday, October 25, 2013

Fwd: qotd: UnitedHealth’s Simon Stevens to head NHS England

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-------- Original Message --------
Subject: qotd: UnitedHealth's Simon Stevens to head NHS England
Date: Fri, 25 Oct 2013 11:35:01 -0700
From: Don McCanne <>
To: Quote-of-the-Day <>

October 24, 2013
UNISON responds to appointment of Simon Stevens as NHS chief executive

Responding to the announcement that the president of Global Health and
group executive vice-president at UnitedHealth, Simon Stevens, will take
on the role of chief executive of NHS England in April next year, UNISON
Head of Health Christina McAnea said:

"The NHS is facing its first serious crisis for the best part of the
decade, and it is critical that Simon Stevens respects and shares the
values of our NHS – universal healthcare that is free at the point of need.

"It is surprising that no one within the NHS has been found to take on
this position. We sincerely hope this is not a sign that the government
wants to import America-type values into the NHS and look at ways of
developing healthcare through an insurance model. If this is the
intention there will be massive opposition.

"Mr Stevens will have his work cut out for him right from the start. Far
from being protected from government cuts, the NHS is being starved of
the funds it needs. Thousands of jobs are under threat and accident and
emergency departments are creaking under the pressure of cuts,
privatisation and upheaval."

(UNISON is a UK trade union of public employees)

The Guardian
October 24, 2013
Simon Stevens, new head of NHS England, is in for a rude awakening
Under Labour, Stevens began the culture of competition in health. He
will now find out just how perverse this has become
By Polly Toynbee

As he sowed, so shall he reap. Simon Stevens will get his just deserts
as he takes up the reins of NHS England, only to find this horse has no
bridle or bit, galloping out of anyone's control. That was, of course,
precisely the explosive "creative destruction" Andrew Lansley intended.
Stevens returns from the biggest US health company to an NHS whose
current path he designed as Tony Blair's adviser. Now he must piece
together some coherence from the fragments of what Sarah Wollaston, MP
and GP, called "a grenade" tossed into the NHS.

As Lansley outlined his scheme in 2010, Stevens wrote a paean of praise
in the Financial Times. It reads as a touchingly optimistic vision,
where choice and competition in a perfect market deliver everything a
patient or GP could desire. When he sees what he's inherited, he may get
a rude awakening. But he shares the blame, claiming authorship: "What
makes the coalition's proposals so radical is not that they tear up
(our) earlier plan," but "move decisively towards fulfilling it – in a
way that Mr Blair was blocked from doing by internal opposition".

He lists the plan's glories: in "the new model NHS, patients are rightly
being promised that 'no decision will be made about me, without me'". No
sign yet of that. He praises "the severing of day-to-day political
control of the NHS", but now he'll find his own control severed. How
will he marry his vouchers for pregnant women with wildly unpopular
maternity closures? His hope that "patient power will become real, GP
commissioners will fire on all cylinders and hospitals will be liberated
to innovate" is a world away from today's NHS.

But his greatest regret may be his praise for "the decision to extend
competition law across the health sector and treat the NHS as a
regulated utility, with an economic regulator – Monitor". Faith in
competition fills his writings – but reality is biting back. Monitor,
engine of NHS competition, has only just understood its destructive
force: its chief executive, David Bennett, recently recoiled, saying
Monitor would be "mad" to enforce the Lansley competition rules leaving
commissioners to "spend all their time running competitive processes
because they're terrified they're going to get in trouble if they
don't". Too late now.

So far, 63% of contracts have been put out to tender by clinical
commissioning groups (CCGs), now run by just a few GPs. The 211 CCGs are
widely regarded as no match for the private sector in writing complex
contracts. Section 75 of the Health and Social Care Act forces them to
put all but a few services out or risk any putative bidder challenging
them in court. Bringing competition law into the NHS means no one can
control these unleashed forces.

Watch Stevens demand more changes to the law if he's to control the
unfolding chaos. Half of NHS trusts have announced a deficit for this
year – that's unprecedented – yet by 2017 the NHS must "save" £30bn. The
Care Quality Commission says one in four hospitals are a safety risk,
but their inspections aren't allowed to count numbers of staff: the NHS
has haemorrhaged 6,000 nurses since 2010. Many CCGs that control NHS
funds are chaotic, with services falling between gaps, no one paying for
them. Privatisation rushes on, at least £11bn so far, but private
providers escape the NHS duty of openness or freedom for whistleblowers.
Waiting times are rising, ambulance and A&E times growing, as the social
care crisis blocks NHS beds with winter approaching.

Stevens will find many perversities in the competition culturre. He said
top-down control was a disaster – but he may find fragmentation and lack
of strategic control far worse. Can he make his perfect market work – or
admit he might have been wrong?

Comment: The National Health Service in England currently exemplifies
the greatest problem with publicly-administered and publicly-financed
national health programs: They become subject to privatization efforts
whenever conservatives gain control of the government. Selecting
UnitedHealth's Simon Stevens as chief executive of NHS England surely
advances Conservative Prime Minister David Cameron's privatization scheme.

When do you suppose UnitedHealth will put in a bid to purchase the NHS?
It would be great for Cameron's budget, though the people would lose out.

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