A huge privatisation is underway that will put US health insurance company United Health in a position to bid for contracts to provide NHS clinical services, at the same time as it advises clinical commissioning groups on what clinical services to plan and buy.

NHS England – increasingly looking like a Trojan Horse for United Health (the previous employer of the NHS England CEO, Simon Stevens) – is pushing one of the biggest NHS privatisations to date, worth £3bn-£5bn.

Set up in 2013 to do most of the commissioning work for the newly-created local clinical commissioning groups, Commissioning Support Units are short-term NHS organisations, due to be privatised by 2016. This massive privatisation is now underway.

Under this privatisation,  Clinical Commissioning Groups will have to buy commissioning support from an approved supplier on NHS England’s lead provider framework.

The trouble is, most of the NHS England – approved suppliers are either American private health companies, lobbyists for American private health companies, or global management consultancy companies that make their living advising private health companies.

This means that clinical commissioning groups that decide what NHS services we, the public, get, will be “supported” in their decisions by profiteering companies, which have vested interests in pushing our clinical commissioning groups into handing over our NHS to private health companies, mainly American ones.

This chart shows NHS England’s “Leader Provider Framework” for Lot 1 commissioning support services. The red boxes are all United Health/Optum.

Nolan standards for integrity in public life have gone down the plughole

This approved suppliers list was drawn up by NHS England’s Commissioning Support Industry Group (CSIG). The CSIG was chaired and funded by United Health, with a membership of the ‘usual suspect’ management consultancy companies that have already carved up NHS regulation, and planning for service transformation, between them.

As the diagram shows, the list of approved suppliers gives pride of place to United Health, aka Optum – the previous employer of NHS CEO, Simon Stevens.

United Health/Optum has a big role in the supply chains of 6 of the 9 Lead Providers. The management consultancy companies represented on the CSIG also do pretty well, with generous places in 7 of the 9 supply chains.

The supply chain companies also include commercial lobbying firms working for private healthcare clients seeking to make money out of the NHS.

For instance Hanover, part of the United Health/Optum supply chain, is United Health’s lobbying agency. Spinwatch reports that other Hanover clients include:

• Hospital Corporation of America (a huge private hospital operator that had to pay $1.7bn in US fraud settlements in 2003) has a few ‘joint ventures’ with the NHS, but wants more.
• US pharmaceutical lobby group, the American Pharmaceutical Group.
• Alliance Medical, which paid ‘cash-for-access’ Tory MP Malcolm Rifkind to sit on its board and recently won an £80 million contract to run cancer scans across England (although a rival NHS  bid was £7 million cheaper).

When a clinical commissioning group pays Hanover to for commissioning support, whose interests is Hanover going to serve? The interests of the public who need and are entitled to NHS services, where all the money goes into patient care not corporate profits? Or the interests of its corporate paymasters, Hospital Corporation of America, the American Pharmaceutical Group and Alliance Medical?

On top of this obvious violation of the Nolan standards for integrity in public life, an additional conflict of interest is that United Health – aka Optum – is itself also angling for contracts to provide NHS clinical services, as well as for contracts to advise commissioners on what clinical services to plan and buy.

Optum was one of the leading bidders for the scandal-ridden £1.2bn contract to privatise cancer and end-of-life services in Staffordshire.  It also bid for a £1bn community services contract in Cambridgeshire.

It’s no wonder that, according to a 12/11/2015 report by David Williams in the Health Service Journal, most clinical commissioning groups have not bought commissioning support services from NHS England’s approved list of private providers. So NHS England has had to push back its commissioning support privatisation schedule, while warning of legal challenges and costs to Clinical Commissioning Groups that don’t do as they’re told.

Calderdale CCG is on schedule with privatised commissioning support procurement

NHS England has decided to close down the existing Yorkshire and Humber Commissioning Support Unit on 31st March 2016.

Health Investor reports that 23 Yorkshire and Humberside CCGs have contracted the eMBED private consortium to provide commissioning support services for four years with the option to extend for a fifth year. The contract is worth approximately £18m/year. The eMED consortium consists of health information business Dr Foster, advisory firm Mouchel Consulting, accountancy firm BDO and consultancy Engine.

Calderdale CCG spends £1.6m/year on commissioning support. It plans to provide most commissioning support services in-house, and only buy in Business Intelligence. The approved suppliers for Business Intelligence come under Lot 1 of NHS England’s Commissioning Support Lead Provider Framework. (See the chart above.)

Calderdale Clinical Commissioning Group told its June 2015 Governing Body that NHS England was ok with their plans and they were due to award the Business Intelligence contract on 27th August 2015. Update: A Freedom of Information reply states that:

• Calderdale CCG has an in-house Business Intelligence Team made up of one manager and two analysts
• It also buys in business intelligence services from EMBED. The total contract value is is £392,120 over 4 years.
• Dr Foster provides their risk stratification/population health system

Dr Foster became a joint venture with the Department of Health in a £12m secret deal criticised by the National Audit Office in a 2006 report.

Completing NHS England’s stealth handover of the NHS to American private health companies

The Commissioning Support privatisation is happening at the same time that NHS England’s boss (formerly employed by American private health insurance company United Health), is pushing Clinical Commissioning Groups to set up new “care models” that replicate United Health’s and other American private health insurance company models.

Like the Multi-speciality Community Provider (MCP) Upper Calder Valley Vanguard scheme  that is fast-tracking the Care Closer to Home scheme.

The cost cutting aim is to keep frail elderly and chronically ill patients out of hospital, and so make it ok to close at least one of the Halifax and Huddersfield A&Es, cut acute hospital beds and centralise all acute and emergency care in one hospital.

The Care Closer to Home scheme is a significant change to our NHS and as such has to go to public consultation. But the CCG is bashing ahead with the Vanguard regardless, without public consultation.

The Multi-Speciality Community Provider (MCP) model that the Vanguard is setting up replicates United Health’s MCP model almost exactly.

The new care models and associated “modern workforce” NHS staffing cuts and changes are key to NHS England’s 5 Year Forward View, and this is being fast tracked with the handful of Vanguard schemes that NHS has paid CCGs to set up.

These changes are timed to coincide with the privatisation of commissioning support, so that clinical commissioning groups will have the firm hand of private American private health insurers and their cronies on the tiller, directing the introduction of their very own care models into our NHS.

More information here

Credit:
The fox and hens header graphic is republished from Our Wisconsin Our Wildlife blog, with thanks

Updated 12 December 2015 with news of the eMED consortium contract with 23 Yorkshire and Humberside CCGs