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July 2016 saw the very quiet publication of two key documents charting the route to the privatisation of the NHS in England. Firstly, from\u00a0NHS England, came Strengthening Financial Performance and Accountability in 2016-17<\/a><\/em>. This is the latest set of instructions on the implementation of NHS chief executive Simon Stevens’s\u00a0Five Year Forward View<\/a> <\/em>(5YFV).<\/p>\n The 5YFV is increasingly coming to resemble one of Stalin’s Five Year Plans from the 1950s. As the new guidance makes clear, Stevens’s latest collectivisation strategy, the Sustainability and Transformation Plans<\/a> (STPs), is being rigidly imposed across England.<\/p>\n My alternative title for the guidance document would be “Policing the government’s privatisation plans.” Having constructed, with help from the Treasury, a universal set of NHS trust financial deficits based on arbitrarily imposed cash limits<\/a>, NHS England is now using those deficits to legitimise impossibly tight controls on hospital trusts, clinical commissioning groups (CCGs), and other NHS agencies to ensure they conform to central proposals for cuts and mergers between NHS institutions.<\/p>\n At the same time, private sector and insurance friendly “new models of care\u201d are being imposed in community settings, further undermining NHS hospitals<\/a>. The ultimate intended outcomes of this massive, dictatorial reorganisation process are privatisation, co-payments, charges, and insurance funded care.<\/p>\n These intentions are made clearer in a second policy paper, similarly released during the parliamentary recess when it is least likely to be noticed:\u00a0the NHS Improvement Business Plan 2016\/17<\/a><\/em>. The plan states that providers will be required \u201cto transform services in line with the 5YFV and this will include making use of new care models and innovative organisational forms.\u201d A priority for 2016\/17 is \u201cto facilitate independent sector providers to form NHS partnerships.\u201d<\/p>\n We are told that: \u201cWe intend to bring together the most promising potential areas for formal collaboration\u00a0between NHS\u00a0Improvement,\u00a0providers, independent sector partners, NHS England, and\u00a0other key stakeholders into a\u00a0new work\u00a0programme.\u00a0The key elements of this\u00a0programme\u00a0in the first instance\u00a0will\u00a0examine\u00a0the opportunities in the areas of: In other words, before the end of the 2016-17 financial year, we will see the new Conservative government start to impose the large scale privatisation of clinical services, foreshadowed in the Health and Social Care Act 2012<\/a>. In the event of any doubts regarding the obligatory nature\u00a0of these policies, the NHS England\u00a0report referred to earlier\u00a0makes it clear that \u201cspecial measures\u201d (central takeover of local management) will be imposed if agencies fail to balance the books or deviate in any way from the government’s plans.<\/p>\n In this context, it’s ironic to recall all the fluffy political spin about \u201cputting GPs in the driving seat\u201d when CCGs were launched in 2012. By contrast, we are now told by NHS England that CCGs that\u00a0fail to follow Stevens’s diktat will be disbanded and\/or forced to become US style accountable care organisations<\/a> (ACOs). This is with the aim of promoting mergers, cuts, and closures in the publicly provided NHS and introducing community based “integrated packages of care,”<\/a>\u00a0which are readily amenable to private sector provision and insurance funding\u2014as occurs in the US ACOs on which this particular “new model of care” is based.<\/p>\n It is no coincidence that the House of Lords is currently\u00a0calling for evidence to be submitted to its new select committee on the long term sustainability of the NHS<\/a>.<\/p>\n This inquiry, supported by government ministers, is likely to make recommendations that will legitimise the aims of Stevens’s five year plan, including the “inevitability” of top-ups, co-payments, charges, and of the short term personal health budgets<\/a> and longer term health insurance system that would be required to fund them. This toxic combination of an increasingly insurance based and increasingly privately provided health service will signal the final dismantling of what was once our National Health Service in England\u2014a horrific and destructive act, which we now know to have been first proposed by Prime Minister Theresa May’s predecessor Margaret Thatcher in 1982<\/a>.<\/p>\n Alex Scott-Samuel<\/em><\/strong>\u00a0is a senior public health academic and joint chair of the Politics of Health Group.\u00a0<\/em><\/p>\n Competing interests:<\/strong>\u00a0I have been a member of the Labour Party since 1978.<\/p>\n","protected":false},"excerpt":{"rendered":" July 2016 saw the very quiet publication of two key documents charting the route to the privatisation of the NHS in England. Firstly, from\u00a0NHS England, came Strengthening Financial Performance and Accountability in 2016-17. This is the latest set of instructions on the implementation of NHS chief executive Simon Stevens’s\u00a0Five Year Forward View (5YFV). The 5YFV […]<\/p>\n
\n–\u00a0mainstreaming\u00a0clinical capacity for elective, outpatient, and diagnostic care;
\n–\u00a0joint ventures and\/or\u00a0outsourcing of new, novel, or restructured clinical
\nservices;
\n– joint ventures and novel financing for facilities and\/or technology;
\n– independent sector\u00a0management models\u00a0to support\u00a0capability\u00a0and leadership\u00a0challenges.\u201d<\/p>\n