Government backs down on some retesting for sickness benefits

Government backdown won’t apply to all but is an opening

The Work Capability Assessment (WCA) is highly damaging to those of us who have to go through it. Despite this, both main parties have consistently denied that there is any problem, and claimed that the WCA is necessary to weed out scroungers. That might be about to change.

Firstly, Labour announced at their conference that they would scrap the WCA altogether. This doesn’t mean much right now since they are not in power, but it is a major turnaround for a party that introduced the WCA in the first place and has refused to even oppose most benefit cuts in the last few years. Jeremy Corbyn called the WCA degrading. Debbie Abrahams acknowledged that it makes people feel worthless and dehumanised.

It’s not all good, since they still refuse to oppose benefit sanctions, and used the same old language about work being the goal for everyone, but it is a start.

Secondly, Damian Green, Tory Secretary of Work and Pensions, has told the media that the government will stop repeatedly retesting people who aren’t going to improve.

“If someone has a disease which can only get worse then it doesn’t make sense to ask them to turn up for repeated appointments. If their condition is not going to improve, it is not right to ask them to be tested time after time. So we will stop it.”

This is a huge reversal of policy. Continuous retesting was always the point of Employment Support Allowance (ESA) although there have never been enough resources to apply that to everyone.

Many people are celebrating this. However, there are big questions as the government haven’t specified any details. I’m not sure they even know yet. Reports imply that the exemption from retesting will apply to people with specific illnesses that are known to only deteriorate. If that is the case, then many people who have illnesses that are just as bad as those on the list but are not recognised as such, will miss out. So will people who have not yet been diagnosed, and that can mean people who are sick for years – or decades – before they find out the cause.

The more logical policy would be to apply this exemption to everyone who is in the Support Group, since this category is meant to contain people who have no prospect of improvement. In practice the Support Group doesn’t work like that, and people who will never improve are frequently placed in the Work Related Activity Group instead, thanks to DWP efforts to deny them support in order to keep costs down. If the exemption were to apply to the Support Group only then it would still be unfair to all those improperly placed in the WRAG.

Whether the Government decides who qualifies based on diagnosis, or based on support group, it will still be unfair. However, I do see this announcement as a big win. A Tory government minister said “constant reassessment is pointless” and “does increase their stress and anxiety levels” “causes financial insecurity” to describe repeated work capability assessments. That is a huge admission for the Tories, or even for Labour.

We can use this. We can attack the inconsistencies in the government’s argument. We can point out that the Work Capability Assessment is damaging to everyone. We can show that their descriptions apply to Personal Independence Payments too, even though they’ve spent six years attacking PIP’s predecessor, DLA as “abandoning” people so as to justify welfare reform and repeated reassessments. This isn’t an unqualified victory and won’t necessarily improve things for that many people (perhaps including myself) but this is a major event in the struggle against welfare cuts of the last few years.

All About Trans: Avoiding Responsibility

The All About Trans project looks at creative ways to encourage greater understanding between trans* people and media professionals to support better, more sensitive representation in the UK media.

The project offers the trans* community a platform to speak out against the prejudice they may experience and promotes engagement between the wide diversity of trans* voices and the media.” – http://www.allabouttrans.org.uk/about/

Over the last two months one of the people who works with All About Trans and has a reasonable media profile has been making comedy videos where he plays a woman in an ill-fitting wig with facial hair. He has ignored criticism that it mocks trans women regardless of his intentions. When it was pointed out to All About Trans that this made him unsuitable to represent trans people they said:

I understand that All About Trans sees itself as merely a link between transgender people and media. Leaving aside that this isn’t quite true – the project has been cited by name in various media outlets and in the quote above refers to offering a platform – making connections like this is not and cannot be neutral. There is discretion and choice involved.

It doesn’t matter if All About Trans want to represent trans people or not. It doesn’t matter if we want them to represent trans people or not. The fact is, to the writers and presenters, and to the general public that see what is written and broadcast, both All About Trans and the people that they select are there representing trans people.

All About Trans puts forward a certain set of people to comment in the media. That selection is a choice they have made. When one of the people they have put forward has repeatedly made comedy based on prejudice against trans women, All About Trans have promoted a transmisogynist as representing trans people. In failing to condemn the material that hurts trans women, All About Trans have tacitly condoned it.

All About Trans cannot abdicate responsibility here. They are in a position of representing trans people regardless of whether they intended to or not, and the choices they make about who to promote matter. The actions of those representatives matter. If a person’s actions work against the group they are representing, they are no longer suitable to represent that group, and continuing to put them forward is therefore a statement about their actions. All About Trans have done good work in the past but in their response to this situation they are letting us all down.  If the people running All About Trans do not think that the comedy in question is a promoting misogyny and transmisogyny then they should say so, so that we at least know where we stand.

PIP 20 metre rule consultation back in court

This time last year we took the Department of Work and Pensions to a judicial review to decide if they properly consulted about cutting help for people who can only walk a few metres.

The original consultation did not make clear the plan to cut the qualifying maximum distance from 50 metres to 20.  In quite strong language for a judge, the court noted that the consultation was  “Mind-bogglingly opaque”, “At best ambivalent”, and “Convoluted, inherently unclear, ambiguous and confusing.  No construction allows for full coherence.”

Nevertheless, the court found – very narrowly – in favour of the government and said that the second consultation, started after this judicial review was in motion, was enough to make things right.

This week we are back in court to appeal that decision. We argue that the second consultation could never have changed the decision that had already been made. The hearing will take place in the Royal Courts of Justice in London from 10:30 on the 14th and 15th of July. The judgement will follow a few days later.

It is frustrating that this case is about whether the consultation on PIP was fair rather than about the cut itself, but the courts cannot decide on government policy. As part of their defence the DWP pointed out that they are fully aware of the impact of their policy, and are removing DLA from “individuals with genuine health conditions and disabilities and genuine need” and “removing or reducing that benefit may affect their daily lives.” The DWP did do a consultation on their policy though, and that consultation wasn’t fair, so that is what we are fighting.

 

Electric Wheelchair in the back of a car
My Motability car, which I stand to lose if denied the high rate mobility component of PIP

 

Background information

As part of the Welfare Reform Act 2012 the government replaced Disability Allowance with Personal Independence Payments. Their main reason for the change was to introduce repeated frequent testing to see if claimants have miraculously healed. They also changed the maximum distance that you can walk and still qualify for help towards regaining your mobility. Under DLA the cutoff was recognised to be 50 metres. Under PIP it has been slashed to just 20 metres. This means that if someone can walk more than 20 but less than 50 metres (subject to a few caveats) then they will no longer get the highest amount for the mobility component of PIP. Assuming the person still qualifies for the lower rate of mobility, this is a cut of £35.65 per week. But worse than that, the higher rate mobility component is a gateway to all sorts of help including the right to lease a car or wheelchair through the Motability scheme. As a result of this cut more than a hundred people are losing their car every week, and many thousands more will follow when they are reassessed for PIP. Losing independent transport means losing independence and access to services.

A prominent example of this came just last month when Teenage Paralympian Kayleigh Haggo was denied the higher rate for mobility and lost her car. Kayleigh got her car back after the decision was overturned a few weeks later but this illustrates the problem that we are facing.

UPDATE
The hearing took place and seemed quite positive however the judgement will follow at a later date, probably October.

Previously on this blog:

PIP judicial review: Court rules against us but vindicates our case

Two weeks until PIP Judicial Review – 20 metre limit in the dock

Replacement of disability living allowance headline news for hours

Why I am suing the government

“Lots of folk can’t afford a car”

Please vote, even if you only spoil your ballot

I understand completely why lots of people refuse to vote – that has often been how I have thought too over the last few years. There is a catalogue of reasons: the main parties are all the same, they are all in the pay of big business, the smaller parties and independents don’t stand a chance, the party system is broken, no one represents your views, there’s no option for none of the above, voting doesn’t change anything… and the list goes on.

https://twitter.com/auntysarah/status/329737539881664513

If you just can’t bring yourself to vote for any of the candidates, I urge you to spoil your ballot instead. You can even have fun with it, draw a picture or write something witty. Just don’t take a photo while you’re in the voting booth because that is illegal. (So as to protect against any compulsion about who you vote for.) It is true that spoiling your ballot won’t directly lead to change but I believe it would at least counter the idea that people don’t vote out of apathy and they just don’t care about politics. I think it’s worth spoiling your ballot paper just so that the politicians and journalists can’t keep saying that no one cares what happens.

That said, I will be voting this time. Part of the reason for this is that elections for the European Parliament use proportional representation and so the less popular parties can still get an MEP. This does of course mean that far-right parties may also get an MEP.

Obviously the far-right BNP, UKIP and nationalists are not even in the running as far as I’m concerned, nor the right-wing or  neoliberal parties like Conservatives, Labour or LibDems. There are parties that I could vote for though, and maybe you can too. You could consider the Green Party, the Pirate Party (who are in some ways similar to the Greens) and the National Health Action Party who are standing up for the NHS. Of those I only have the Green Party as a choice so they’ll get my vote this time. There are smaller more local parties in some areas too so check who they are and what they promise before you go to vote.

If you don’t want to go and vote on Thursday I’ll understand why. I don’t think voting should be compulsory and I don’t think refusing to vote is an insult to anyone’s ancestors. But if you don’t want to vote for any of the options available I’d be very pleased if you would spoil your ballot instead.

Fascism in the UK

The Home Office a few weeks ago: “There will be no hiding place”.

https://twitter.com/ukhomeoffice/status/352408433506533377

The Home Office last week: “GO HOME OR FACE ARREST”

 

Racist Van

Border Agency in London today: Papers please.

https://twitter.com/mattkelcher/status/362128773195382784

https://twitter.com/mattkelcher/status/362163037291040769

A tale set three years ago:

https://twitter.com/SandiaElectrica/status/362241861089378307

So I was sitting on the bus going through E & C, and it got stopped by transport police (they always stop it in poorer neighbourhoods)

The Police officer gets on and starts asking everyone for their tickets or oyster cards – so far, so usual

But there is a big van parked up on the pavement by the bus stop and instead of issuing fines they start asking for ID’s, for ‘Papers’

‘Papers’ is not a term normally used in that context. My Oyster was in the bottom of my bag somewhere, so as I struggled to find it….

…the officer then asked me for my ‘papers’ and then in Spanish ‘papeles’ – I already knew what was happening but this was the clincher

I’d been racially profiled as Latin American (which I am) & the phrase ‘sin papeles’ – ‘without papers/illegal’ was what he meant

Looked up from my bag (I’d just found my UK passport in there – I was born here) and said ‘What?!! You’re racially profiling me aren’t you?’

‘This is my BRITISH passport. I was born here. Here is my Oyster card too. I want your ID number, I’m going to make a complaint’…

The dude looked me in the eye, went a strange grey shade, turned his heel and got off the bus..

I was late going somewhere so I didn’t have time to chase after him but as I looked out of the bus window…

..I saw the people they’d already taken off the bus for not having their tickets/oysters being loaded into the parked van

Black & Brown faces stared back at me with expressions of hopelessness – I felt sick, but what could I do?

This didn’t happen last week, month or even year. This was nearly 3 years ago

I’ve spoken to others and they say it’s often in the early mornings when the many foreign workers who clean our offices are going to work

This ISN’T new but it does seem to me to be becoming more blatant. Today in Kensal Green they didn’t even pretend it was abt smth else

In the end I didn’t report the officer – in a neighbourhood where the police racially profile us everyday, who was going to listen?

We are not paranoid, we’re not ‘playing the race card’, we do not have a ‘chip on our shoulder(s)’ – this is real & it’s only getting worse

(Copied from tweets by @SandiaElectrica)

The Guardian, November 2011: UK Border Agency officials ‘illegally targeting’ bus passengers

I suggest you aquaint yourself with the Warning signs of fascism.

Ed Miliband’s Speech and Social Security Reform

Ed Miliband made a speech today setting out how Labour will cut spending on Social Security. He said “Controlling social security spending and putting decent values at the heart of the system are not conflicting priorities.” Many of the ideas he set out in the speech seem positive but his language suggested that Labour still have some of the mainstream rhetoric at heart. He said that the system does need reform, and I won’t disagree with that, but I differ slightly as to how.

So the four building blocks of a One Nation social security system are: work, rewarding work, investing for the future not paying for failure, and recognising contribution.

For the rewarding work part, Miliband noted that work does not pay enough to live on and that welfare fills that gap, and I applaud his commitment to promote a living wage and to change the law to prevent loopholes that allow reduced wages.

When it comes to investing for the future not paying for failure he said that housing benefit costs are high because there are not enough homes and said that building homes would be a priority, although he did not say who would pay for those homes or mention a rent cap. Nevertheless I applaud the commitment to building homes.

However, I disagree with what he said about recognising contribution. He said that  “people’s faith in social security has been shaken” because “it appears that some people get something for nothing and other people get nothing for something“. The example given was that someone who became unemployed after forty years would receive the same help as someone who became unemployed after two years. I think this is a very poor example given that he was talking about National Insurance, because it is that nature of an insurance system that some people pay in more than others but that everyone gets the same help when they need it. A driver who had a car accident after ten years of driving would not get a better payout than a driver who crashed in their first week. The actual issue which needs addressing here is that Job Seeker’s Allowance is not enough to live on whether a person has worked two years or forty and in fact in the UK our unemployment benefits are much lower as a proportion of income than in many other countries.

It is when Miliband turns to the subject of work that we find some of that scrounger rhetoric still present. Tell-tale phrases such as:

Which leaves hundreds of thousands of people in long-term idleness.

the denial of responsibility by those who could work and don’t do so.

Now just as there is a minority who should be working and don’t want to, there is a majority who are desperate for work and can’t find it.

“Idleness” is a loaded word when Miliband could have referred to unemployment. At least in the last statement he said that it is a minority that does not want to work, but I believe he should have gone further and pointed out just how tiny that minority is rather than fuel the myth. Maybe as Sue Marsh says Labour are improving when it comes to scrounger rhetoric, but they are still using the language of the Tories and the tabloid papers and they have some way to go.

Labour’s big idea to tackle unemployment is a compulsory jobs guarantee. I like the idea of a guaranteed job after a year or two of unemployment. I am not so happy with the emphasis on the compulsory part, which again plays to the scrounger rhetoric. Under Labour’s plan the government would pay for 25 hours a week at minimum wage while the employer would pay for 10 hours of training. There would be a tax on banker’s bonuses which Labour say would fully fund the scheme. I think as solutions to unemployment go, this isn’t a terrible idea, although I have to ask what happens when the funding for these jobs ends. And I am concerned that if the system is not flexible then people may be forced into inappropriate jobs which may not accommodate their circumstances or abilities. I hope that some safeguards to prevent that are written in to the compulsion.

I am more concerned about the plan for parents. Miliband said that since children of 3 and 4 years old get 15 hours a week in nursery education, parents must use that time “to undertake some preparations to help them get ready to go back to work. Attending regular interviews in the Job Centre, undertaking training, finding out what opportunities exist. To be clear, under this policy there would be no requirement to go back to work until their youngest child is 5.

In other words, parents must spend several hours a week for two years going in to the Job Centre to attend pointless interviews which presumably will be farmed out to the likes of A4E, where they will continually re-jig their CV and attend training which may or may not be relevant to work they can get months or years later. This, apparently, is to encourage the ethic of work, because he seems to believe the scrounger rhetoric that says otherwise those parents will never want to return to work.

Disabled people got a mention in the speech too. Unfortunately Miliband reinforced his commitment to the Work Capability Assessment. He did at least concede that the WCA is not working, saying:

But when over 40% of people win their appeals, it tells you the system isn’t working as it should. And too often people’s experience of the tests is degrading. So this test needs to change. It needs reform so that it can really distinguish between different situations. Disabled people who cannot work. Disabled people who need help to get into work. And people who can work without support.

The test should also be properly focused on helping to identify the real skills of each disabled person and the opportunities they could take up. I meet so many disabled people desperate to work but who say that the demand that they work is not accompanied by the support they need. So these tests should be connected to a Work Programme that itself is tested on its ability to get disabled people jobs that work for them.

Miliband did not say how exactly he would change the assessment so that it can accurately distinguish between people who can or can’t work or need help, and I doubt he knows. He didn’t say how he would stop the assessment being degrading. He also made no mention at all of the severe stress caused by continuous reassessment and health implications of that.

The benefit cap, too, got Miliband’s support. He said:

“In 2011, there were 10 cases where £100,000 a year was spent on housing benefit for individual families. That’s 10 too many. And it is one of the reasons why Labour has said we would support a cap on overall benefits. As Ed Balls said on Monday, an independent body should advise government on how best to design this cap to avoid it pushing people into homelssness and costing more.”

Possibly the most stupid policy announced was an overall cap on social security spending for three years. The effort to reduce the spend on social security by attacking unemployment and high rents is great, but there is no predicting how the economy will actually do to the total cost and setting an absolute budget means that should too many people need help then some will go without or everyone will have to get less. That will result in poverty, homelessness and starvation either way.

I don’t want to criticise these ideas without providing an alternative. I want to suggest some ideas of my own which would take into account some things that I think we need to recognise: That capitalism will not focus work where we have need, such as healthcare, social care and building. That even after creating more jobs we cannot go back to full employment because new technology, efficiency savings, automation and outsourcing mean that we will never again need as many workers as we once did. That there are very few people who can work but do not want to, but there are many who want better working conditions or better wages who have a very weak bargaining position. That the benefits system is inefficient, full of errors, and places a huge strain on those subject to it.

Allowing for those facts, then, I would suggest:

  • Build new social housing by investing in housing associations and cap rents to create secure and cheap homes not subject to inflation through private profit.
  • Invest heavily in healthcare and social care to create jobs in areas where we need the services.
  • Introduce a Universal Basic Income (Citizen’s Income) that will provide enough to live on to every single citizen.

I think that housing associations are a much better way to invest in housing than any scheme to encourage private industry to build them. Housing associations become self-financing and take that initial investment to continue creating more homes which are cheap and secure. Rent caps would reign in private landlords who are profiteering from inflated rents, and would also prevent rents from rising in response to universal basic income. Investing in the NHS and social care would both create jobs and improve our healthcare and quality of life to the benefit of all rather than subsidising jobs within private industry for the profit of a few investors.

Universal Basic Income is, I admit, a much more distant proposition because it’s too revolutionary for many people. The concept is this: that every citizen would receive an income sufficient to live on, regardless of means, without asking anything of them in return. They would not be not required to look for work, or to volunteer for a charity, or to do community service, or anything else. It would be unconditional. It would replace the tax allowance on wages because although an employee would pay tax on all income, they would still have their universal basic income. It would replace pensions, Job Seeker’s Allowance and Employment Support Allowance (Incapacity Benefit) as well as most other benefits, in one stroke removing means testing, the work capability assessment, and the stress and stigma of the current system.

Water cannon, CS gas bullets – government intimidating the public

man blinded by water cannon

In the last few days there have been a number of news stories about how the police intend to respond to riots this summer. It seems that the Home Office and the Metropolitan Police are suddenly convinced that there are going to be riots, and they plan to respond quite harshly.

The Express announced on the 5th of May with a headling of “Water cannons on standby for summer riots” that the Home Office and the Met Police were holding talks about allowing the police to buy water cannon “in case disorder arises from protests planned for London before the G8 summit in Northern Ireland.”

Then on the 9th and 10th of May The Independent and The Telegraph published a story about the Home Office testing a “Discriminating Irritant Projectile” – a cartridge that is fired from a baton gun instead of “rubber bullets” that sprays CS gas or tear gas when it hits. This is the kind of weapon that we have seen being used against people in awful footage from repressive regimes like Egypt.

The BBC has reported that “An entire prison block at Maghaberry jail in Northern Ireland has been set aside to house protesters convicted of disorder at the G8 summit.” In the same article the NI justice minister told the BBC that they were also changing the law to allow people to be tried in places other than the usual court rooms so as to speed up dealing with people arrested at the summit.

Riot policePreparing for potential protests at the G8 summit does seem sensible, but the scale of this preparation is questionable. The acquisition of water cannon and new CS gas bullets by the Met is a whole new step in the war on the public. Combined with the massive jump in the use of Tasers by police (and non-firearms police at that) this is a very nasty shift against the safety of the public and against the right to protest. What jumps out to me about all these stories is that police and government have sought out the press to make a point of talking about the measures.

It is hard to tell what the intention of the government is by talking about all of this in public. It is likely that the intention is to intimidate people into staying away from the G8 summit and other protests. I wonder though, if by talking about riots as a certainty they want to provoke a protest so that they can brutally suppress it.

The announcement about preparations of jail cells and extra court capacity seems like an act of intimidation towards those people who intend to peacefully protest at the G8 summit – perhaps they are worried that a whole new segment of society will be protesting for the Enough Food For Everyone campaign. The announcements of water cannon and other measures with specific mention of protests in London preceding the G8 summit are even worse. Whatever they are scared of, these announcements are likely to put people off from exercising their right to protest, just as previous police violence has prevented thousands of people from protesting against welfare cuts and NHS privatisation over the last two years. I think that talk of these measures in the right-wing press like The Express and The Telegraph is designed to both intimidate potential protesters and to scare the readers of those papers into voting the Tories in again at the next election as “the party of law and order”. It’s a tried and tested formula for the Tories – when in doubt get violent towards the downtrodden and tell the scared electorate that you will protect them.

 

If it’s not a bedroom tax then it’s not a spare room subsidy policy either

This is a clip from the Six O’Clock News on Radio 4 today. It is about a woman who killed herself and left a note blaming the government cuts to her housing benefit.

[audio http://latentexistence.me.uk/media/20130512-Radio_4-Spare_Room_Subisdy.mp3]

I suppose I should be grateful that the BBC are reporting this story at all, because most people who get their news from the BBC would hardly know that cuts to welfare are even happening. However, I am furious about this story because of the way they phrased the report. Here’s how they referred to the cuts:

“her benefits were being cut as a result of the coalition’s spare room subsidy policy.

…she was facing financial difficulty because of what critics have called the bedroom tax”

This is repetition of government propaganda. True, the cut is not called the bedroom tax. Nor is it the removal of a spare room subsidy, because there never was any such thing, merely people receiving enough housing benefit to cover their rent in the available social housing. The official name of this cut in the legislation is the under-occupancy penalty. Because that’s what it is – a penalty for having a spare room, even if you had no choice about the number of rooms in the home you were allocated or if you need that room for medical equipment or numerous other reasons. It was never, ever a subsidy in the first place to remove. “Removal of the spare room subsidy” was a name given to the cut by a panicking government because people were calling it a bedroom tax and that was too close to the truth.

That the BBC repeated the official government line and referred to a spare room subsidy when reporting a suicide is a serious problem. Of course I don’t believe the BBC is unbiased any more; if anything the BBC follow a pro-government line no matter who is in power. But if the BBC won’t call it a bedroom tax then they shouldn’t call it a spare room subsidy either. They should use the official name of under-occupancy penalty, but they won’t because the word penalty is too revealing about this government’s actions when they are still claiming that this is not about money and that they are protecting the most vulnerable.

 

Vile Product of MP’s Expenses

Vile product of MP's expenses

George Osborne was seen yesterday getting into his Chauffeur-driven 32mpg luxury Land Rover Discovery 4, paid for by taxpayer’s money, in a parking space reserved for those with genuine need. The feckless chancellor had stopped for lunch at McDonalds, preferring to waste our money on food with little nutritional value rather than cook a healthy meal for himself to eat with his staff around a table.

Someone we grabbed off the street said:

“Osborne is responsible for this abuse of help for disabled people and these are crimes that have shocked the nation. The tabloids are responsible for sentencing, but I think there is a question for government and for society about MP’s expenses and the taxpayers who pay for MP’s expenses, subsidising lifestyles like that. I think that debate needs to be had.”

Last year Osborne had boarded a train with a standard class ticket and sat in first class, insisting that he couldn’t possibly sit with the common people no matter what kind of ticket his servants had paid for.

This wholesale rip-off of the British people by MPs, as typified by Osborne, must stop, and this blogger calls for all MPs to be flogged.

 

The destruction of the NHS

1948 pamphlet explaining the new NHS
A 1948 pamphlet explaining the new NHS

Download the full 1948 NHS pamphlet [PDF]

Today the Health and Social Care Act comes into force. One of the things it does is split the NHS up and put the parts out to tender to the lowest bidder. This video is an interview with Dr Lucy Reynolds who is a research fellow at London School of Hygiene and Tropical Medicine and she explains exactly how this works and what it means for the NHS.

I have reproduced some of the transcript here. Read the full transcript at The BMJ: The future of the NHS—irreversible privatisation?

Lucy Reynolds: We’re not going to have a big bang privatisation for the NHS. We’re going to have a very quiet one.

What has happened is that all of the rules that control health financing have been gradually changed since the New Labour times. Overall, we now have the NHS reorganised in such a way that it can be relaunched as a mixed market, so not just the public health sector service, but also a healthcare industry. The rules are structured in such a way that there will be a gradual transition between those two groups. The public sector will shrink away, and the private sector will grow.

But because there will never be an announcement in parliament that the NHS is privatised, and because the private providers will be allowed to use the NHS logo for anything that they are getting NHS funding for, it is very likely that the general public will not be aware that the private sector has in fact come in and taken over whatever bits of the NHS it finds profitable until probably service provision gets fairly bad.

—–

it sounds like a good idea to have diversity and options and these kinds of things, and that would be fine if it weren’t for the fact that the rules of the market are thoroughly stacked. We know for certain that organising [healthcare] as a public sector service is the cheapest and most effective way of providing healthcare. And that is broadly because the market model does not fit healthcare. The market model includes assumptions that both parties are in possession of all information about the subject of the transaction. In markets where the consumer has to rely upon the supplier for guidance, what you get isn’t a market that clears down to a minimum price and is efficient. What you get is soaraway inflation and abuse within that market.

—–

If you pay doctors only when they do work, then they over-treat people. If you make sure that medical facilities have no way of making any money other than by selling things, then they become salesmen, not advisers and advocates for the public. And actually in the world we have one of the very best public services, and compared to other developed countries it’s also one of the most cost effective

—–

The health service is being restructured on to an insurance compatible footing, and the CCGs are technically state-owned insurance schemes. So they are going to be taking on around 80% of the NHS budget and they are going to be parcelling it out to providers. They have been told that they are going to have a lot of autonomy in that and that they will be able to represent the interests of their patients in the matter.

That bit doesn’t appear to be able to be delivered when we have these regulations in place because what the regulations say is that commissioners will put out contracts according to competition law, and they will decide according to competition law. If anybody that didn’t get the contract feels that they don’t like the decision and that it could be faulted on failure to comply with competition law, they are permitted to complain to the sector regulator, Monitor, which is required to enforce competition law. So once everything gets put through the market, the CCGs won’t actually have any autonomy in the matter.

—–

It’s not suddenly going to turn into a privatised service on 1 April. What happens on 1 April is a bunch of legal and operational changes that affect the way that the NHS functions internally. In general this reform is a health financing reform. So we’re finishing the transition away from the original form of funding of the NHS and moving into a market system which is going to be full-on market.

The Telegraph – NHS reforms: From today the Coalition has put the NHS up for grabs

NHS Choices: NHS history

BBC Archive – Birth of the National Health Service | The early history of the NHS