This autumn sees the opening of the Trafford Care Co-ordination Centre. All GP referrals in Trafford and it seems social care as well, will be sent to this new centre. Sounds great you may say…it certainly seems that way in the corporate video you can watch here
According to Trafford CCG (Clinical Commissioning Group- made up of local GPs) the first phase is the provision and management of population health with a focus on efficiency. Nigel Guest chair of the CCG claiming that “obviously its better for the healthcare economy” .
Trafford CCG – has gone into ‘partnership’ with private company CSC . They are keen to point out that THIS IS NOT OUTSOURCING ! – the second phase will also see CSC co-creating new care pathways!
Imagine for a moment that we are moving to a US style Health Maintenance Organisation such as those operated by Kaiser Permanente and United Health, who are already operating services for the NHS. CSC are well placed to take advantage of a privatised healthcare system, with market-ready products such as the CSC Payer 360.
The new devolved Health and Social Care landscape would not be recognisable as the NHS at all, but one in which doctors are incentivised to not treat you. In this system referral centres would play a vital role in performance managing GPs (sorry you will have to cut your referrals by 10% or no bonus for you), administering the growing number of private contracts, deciding care pathways and ultimately denying care.
In Simon Stevens’ (NHS England’s chief executive and previously of the United Health Group Inc.) Five Year Forward plan there are 17,000 beds to close, this is equivalent to another 34 district hospitals. While people hear that the NHS is being privatised – there is still a comforting notion that it will still somehow be our NHS – just run by different people- so not too much to really worry about- but don’t forget that the Health and Social Care Act has removed the government’s duty to provide you with healthcare.
We are going to see a major contraction of NHS services to drive us to take up private health insurance, accelerated by the introduction of personal health budgets and top up insurance. We are already seeing the medical profession being incentivised to deny care more and more and this will be the defining change, striking at the very heart of our relationship with our doctors. Driving down referrals ie denying care gets dressed up as efficiency savings by a referral system which pits GP against Consultant. You may of noticed relentless calls for billing structures to be introduced via the charging of foreign nationals, charging for missed appointments, charging immigrants, charging drunks in A and E etc together with a rise in adverts for health insurance.
Though many GPs don’t yet realise it there will be a lot fewer of them, as they are replaced by tele-health and cheaper physician associates housed in large health hubs. The majority may get sold out by the few who sit on the board either blindly or willingly. Clinical decisions may be made by fewer less skilled medics at rationing board level.
General Practice as we know it is being destroyed as today’s Pulse shows . They have been set up to take the flak and get the ball rolling. We will see CCGs phased out to be replaced with Joint Commissioning Boards through the new devolved council structures, an increase in outsourcing and the introduction of Care.data. The foxes will have control.
The Trafford Care Co-ordination Centre will also be able replace many of the functions of the Commissioning Support Unit (due for privatisation in 2016). It looks set to not only act as a commissioning/ referral board , but to performance manage GPs and to administer the growing number of private provider contracts.
What we might be left with may not resemble the NHS at all, but something along the lines of an American insurance style HMO, be they called HMOs, AMOs, or now as we have in Tameside ICOs, what they won’t be is a National Health Service.
The only clear way to reverse this is the NHS Reinstatement Bill, presented to Parliament by Caroline Lucas MP with cross party support in July 2015. The second reading of the bill will take place in March 2016. You can help by spreading the word to all your friends and asking your MP to support the bill.