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A Nod’s as Good as a Wink…

Posted by Dr No on 28 January 2011

bung.jpgNot content with just nuking the NHS – so last year, my dear - it now appears that Lang-Ho and the Con-Doms – fresh from turning a blind eye to city bonuses – are lining up to offer their private healthcare pals an eye-watering billion dollar bung to ‘ease’ their entry into the post-NHS healthcare market.

The proposals – buried deep in last week’s Health and Social Care Bill Impact Assessment – have arisen because a management consultant (KPMG) report estimates that Lang-Ho’s non-NHS provider buddies are at a financial disadvantage compared to NHS providers:

A recent study of fair playing field distortions was able to quantify the impact of some of the distortions identified. The majority of the quantifiable distortions work in favour of NHS organisations; tax, capital and pensions distortions result in a private sector acute provider facing costs about £14 higher for every £100 of cost relative to an NHS acute provider.” (Para B55).

The Impact Assessment goes on to suggest a need (amongst other things) for :

A better understanding of how costs vary as a result of provider type and action to make the playing field fairer” (Para B59)

and then we have (under proposing/implementing recommended solutions):

Once the net distortion facing different provider types is better understood, the tariff methodology could be developed in such a way as to move towards a fairer playing field by setting different prices for different providers in order to recognise different levels of implicit subsidies.” (Para B108)

‘Action to make the playing field fairer’; ‘tariff…developed in such a way as to move towards a fairer playing field by setting different prices for different providers’ – strip out the management mumbo jumbo, and what we have here is a naked ambition to pay non-NHS providers - including multinational for profit providers - more to provide the same care, to ‘level the playing field’. Never have the playing fields of Eton been fairer - or richer...

£14 higher for every £100 may not sound very much, but given an overall NHS budget of £105 billion (2010-11), and some 5% of that (£5.25 billion) going to non-NHS providers – including multinational for profit providers – a £14-in-every-£100 (ie a 14%) uplift of that £5.25 billion works our at a cool £735 million. And since many of these multi-national private providers are US based, we might usefully quote the cost in dollars – a cool $1.17 billion at today’s exchange rate.

And so there we have it - a billion dollar bung set to go into non-NHS provider coffers. Nod or wink – that sure is some bung!


I don'tknow whether you read this in Saturdays Guardian and yesterdays Observer.

I would draw you attention to "But, unlike Labour, we won't pay the private sector more than the NHS. And we will establish a powerful regulator to enforce these rules."

I think the DoH is telling porkies! Perhaps someone should email The Guardian?

Anna :o]

Well it seems the hacks at the Guardian/Observer are embedded in the DoH, and tell us what they are told to tell us. It is the work of a few minutes to check out the DoH website and see what the Impact Assessments really have to say - but they chose not to do that..

I think there is a serious problem in that the mainstream media can't/wont understand what is going. The overwhelming weight of UK medical blogging activity is clearly against the plans. But often in the comments there will be those who accuse us of being deficit deniers/NHS dinosaurs etc etc. I suspect these 'no change is not an option' types are perhaps over-represented in the media. Some of them might even think the Con-Doms are doing the right thing - Heaven forbid!

The BBC's coverage of the announcement of the Health And Social Care bill was conspicuous by it's absence. Let's see how much coverage they give today's developments.

Well - I suggested the BBC wouldn't cover the HaSC Bill but they did - sort of. They had RoboNic on the case. A bit like a blind slug trying to work out where the lettuce is.

An interesting observation has come to light on Dr Jonathon Tomlinson's excellent abetternhs blog. His was the practice lucky enough to be visited by Lansley and the BBC for the Ten O'Clock News last night, on which Dr No commented above. It seems that Dr No's earlier suspicions that RoboNic - the BBC's political editor - is unable to hack medical stories because they are too complex may have basis in fact:

"When SoS Lansley came to visit my surgery yesterday with Nick Robinson from the BBC, the interesting discussions were stopped by Nick Robinson for being too ‘technical’. But evidence is technical. Political propaganda on the other hand is deceptively simple. So when Dr Deborah Colvin challenged his assertions that the UK health outcomes are way behind Europe and she quoted Professor John Appleby’s highly critical analysis of the data published in the BMJ, he quite literally, with a sweeping gesture, dismissed her concerns and Nick Robinson steered the conversation back to sound-bite stuff."

How convenient!

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