ANALYSIS: New Treasury figures betray the Lansley hospital starvation strategy

Slog accused him, now PESA figures condemn him

Regular Sloggers will be aware of this site’s conviction that pushing yet more money at the primary care sector of the NHS, and reducing hospital funds still further, was an obvious ploy by Andrew Lansley to make it almost inevitable that hospitals would become insolvent – and could then be sold at a knockdown price to private providers eager to get their hands on cutting-edge hardware.

The new PESA figures released last week have been closely examined by some in the MSM, and found unremarkable aside from George Osborne’s policy of ‘underspending’ becoming more noticeable. But the nhs underspend tells an important story of its own. For while the gp side of things has mopped up every penny, the hospital expenditure (much of it capital investment) has been underspent by £1.72 billion.

That is three times the underspend of any other Ministry, and four times more than the average. Anyone who has used nhs hospital services this year and last could give you chapter and verse on how underfunded the service so obviously is…as well as the wasteful ‘pennypinching’ approach to many therapies that winds up costing more in the end because of late diagnosis.

Yet a health service with hospital Trust margins under pressure throughout Britain mainaged to underspend the budget.

In the two years since his ‘election’ in May 2010, David Cameron has yet to keep his promise to spend more in real terms on the NHS each year. Dissembling and perfidy are par for the course in government these days, but this is a particularly brazen example of it. As I posted at the start of May, the Lansley refrain would be, “starve the hospitals of funds, and then wring your hands and say look, they’re broke – we have to sell them”. Last June 27th, South London Healthcare went into administration. Eleven days earlier, The Slog asserted:

‘Two years into his mealy-mouthed plan to simply suck all the NHS’s hospital money out and then sell that infrastructure off, Andrew Lansley is on the verge of letting every Hank, Richard and Henri bid to take over larger group-practice primary care. Give it another year, and almost every Foundation Trust hospital-service provider will be in financial trouble…at which point the private sector will get what it wants – the massive taxpayer investment in hitech equipment and buildings – in a fire sale.’

Like so many issues in 2012, most people are only half-awake to what’s going on: and with Olympic media-mania moving into sixth gear, these kinds of things just slip through quietly on the nod.

Only later (uusually too late) does the Left hold pointless mass demonstrations to demand a stop to something that’s already happened. Here is a golden opportunity with cast-iron figures going to waste.

Could it be, one wonders, that the Hard Left would rather have the ugly scenes and the fights than an effective way to block this sort of privatisation?

26 thoughts on “ANALYSIS: New Treasury figures betray the Lansley hospital starvation strategy

  1. I don’t disagree with Lansley’s reforms from an organisational point of view. But (and it’s a big BUT) I do not believe the expertise exists in PCA to manage the bulk of NHS funds. IME many GPs are dubious at being good GPs let alone at being good administrators or managers of large sums of taxpayers’ money. And it will open the door to GPs having the power to decide what treatment a patient is given, which may be influenced by cost issues etc.

    • @BT GPs already have the power to decide what treatment a patient is given (it’s their job). But I know what you mean- I have failed twice to persuade my GP to refer me for surgery in centres of excellence outside PCT area because of funding issues. The only alternative was to go private. And anyone over 80 is already subject to cost-benefit analysis (though it might well be denied). It will only get worse.
      As to administration, I gather managers from the former PCTs and suchlike are being shoed in. Quelle surprise. So much for economy.

      • @aflatoxin: Yeah…to clarify what I wrote, at the moment a GP decides on how to treat you mainly with regard to his/her level of medical assessment skills and competence. Perhaps also some PCT financial guidelines too (eg the age discrimination issue you mention which I fully believe). But I’m sure when GPs get control of large amounts of NHS funding, money & cost will take a higher priority in decision making. But as it is now, it’ll be difficult for a patient to find solid evidence.

  2. If only they could invent a cure for loss of faith.

    Solve that particular afflication and once again politicians will enjoy our trust, even the NHS kind.

  3. Oh if ONLY the Tories could possibly get such a plan past the inventors of the NHS, the Liberals. We could sell the whole steaming pile of shite to the French for big bucks and then change to an entirely private hospital based system paid for by employers, just like back in the old days before the employers realised they could make the taxpayers pay for it if they went along with Bevan’s crackpot “free at the point of you already having paid for it through taxation” scheme. The sheeple only too readily fell for that scam.

    • JS
      You really are a complete dork, my friend. There was nothing crackpot about Bevan. Entirely private hospital based system? I am in the top 10% of wealth in this country, and I can’t afford it.
      Ring nursey up, and ask her to double your dose.

      • ‘I am in the top 10% of wealth in this country, and I can’t afford it’.
        Well you are obviously not as rich as you are pretending if you can’t afford it. But as you are busy telling us you are so rich you can obviously back up your Socialist beliefs by paying more tax – to keep Bevan’s daft idea alive. HMG will gladly accept your ‘donation’. Please send it to HMRC Accounts Office, Shipley, West Yorkshire, BD98 8AA.

      • IMOO, having a private system that one can tap, that then gets one back into the state system that one has poured £ into for donkey’s years, at a level where help is willingly given, (‘cos its needed) has to be worth considering.
        Otherwise we are all dead far too soon, even if we are contributors….but don’t get recognition/treatment….until its too late. Just a thought, from a very £ poor but ‘life rich’ person…….
        Wealth comes in many layers.

      • Mainly in reply to Andy:
        If you are in need of £20k worth of major surgery, say a major cardiac event, then you will pretty soon realise that even those that consider themselves upper middle class are really not in the least bit wealthy in terms of what covers their worst scenario needs.

        Do you really know what wage level, well managed, is needed to put you in the top 10% of wealth at retirement? On the same lines, what percentile of wealth do you believe can make one independent of state at the current time? What percentile of wealth do you believe will make one independent in your picture of the future?

      • Latest figures I’ve seen shows a take home income of just under £600 a week to put you into the top decile.

        Not exactly a footballers wage packet, if anything it serves to highlight the extent of low income in the UK and how right Private Frazer was with his prophecies.

    • I am sure David Cameron will keep his promise to spend more in real terms on the NHS each year once the profit centres are in place to benefit from it.

      lol Indeed you are nearer speaking the truth than you may think!

  4. Not a peep from the left -too busy cosying back up to the war criminal Blair.
    Not a peep from the media – too busy distracting us with the corporate shitfest that is the Olympics.

    People get the government they deserve.

  5. Your words do ring true in every way John. The NHS IS PRIVATITISING as we speak. The CEO in Glasgow are incorporating ‘ideas’ from staff about change. The corporate psycologists are seeling it as thus: to give people independance at home ( get them out of hospital to hell of they can cope or have family members to look after them) To involve as many in our profession in the very core of health care: Prevention ( spend billions on little services that become signposters to other services who sign post…. argh you get the point!) Main message in many leaflets all telling us to stop drinking booze-stop smoking-eat five a day to die a healthy death! Etc…
    Meeting criteria for input ( tick box health care, do you qualify for a specialist or can a laster plast save surgery). Diversity and inclusion ( Money will always be avaliable for evaluations to assess whether ‘minorities’ ( who and what are minorities are we not all Brittish?) are being given access to our erm.. just to check anyway that um thingy….EU directives are being followed ( fat cat administrators who employ educated people to do their job for them to decide if what sht they are talking is being listened to). Oh I could go on … It was very interesting to see a documentary ;ast week at a friends home about my pet subject: Suicide. I have long been telling thtat the Government ( all colours) who are making it compulsory for all staff in public services( and corporate ‘charities’ to do Suicide prevention training – due to the expected rise in such deaths as a result of Government policies on welfare /housing etc. The documentary pointed out my claim that you have to meet a ‘criteria’ and suicide is not a problem. The hell it isn’t – we need evaluation to find out how many minorities die from racial abuse so we can then roll it out to main stream population. the buzz words for getting budget money is * diversity* Inclusion* and *global warming*.

  6. Lansley was right with his reforms – he might have played his hand better and been more tactical in bring in his reforms. The fact is the NHS is an out of date model based as it is around large district hospitals.

    The NHS is a badly run monopoly so if you believe in liberty it ought to be broken up and that means a much larger private sector needs to be fostered. And that has been the problem since the creation of this silly thing.

    • Public or Privately funded you may not get what you paid for! and do you really beleive a whole bunch of ‘new cluesd up’ people are going to be running these Community services?- hell no Same ole’ same ole’ in different Uniforms ! Managers in abundance- staff being over worked and under paid. Ofcourse You are going to provide a whole functional report on how to achieve all this…No? ah didn’t think so you are just doing that ole- lets say somehting-anything- cos I CAN brigade. The system needs a rethink, a culture change but you’re not going to get it because those who decide will lose their jobs and pensions and that ‘aint gonna happen on their shift’!

      • All this ‘isn’t the NHS wonderful’ crap makes you want to juke, and JW ought to know better. The way Bevan set up the NHS in 1948 was a disaster, from beginning to end. And now it is somesort of sacred cow that you can’t touch. So ask yourself a simple question: why does the State need to own every damn Hospital ? Do you expect the State to own every cabbage field ?

    • Andy
      OK, fine – I agree. But what aout the 93% of shafted souls in Britain who can’t afford even a day’s stay in a private hospital?

  7. In Britain the private sector works so amazingly well, see G4S, as one of inumerable examples for how the private sector does things. The rest of our dynamic wealth creating industry is a joke and should spread the fear of death through the population but as long as the plebs have their flat screen TVs and abundant reality TV, sport and soaps to distract them nothing will change. The establishment will crush any dissent, as seen when the under classes rioted recently. This is how a fine and proud people that brought civilisation Newton, Darwin, Shakespeare, Mill, Hume and so many more great thinkers and innovators, descend into an abject bunch of losers.

  8. Granted the healthcare issue is complicated,(free,hence unlimited demand etc.) but surely it is like Boris having to demand from the Treasury an emergency grant for central London primary schools of £300 million .Why? Immigration.If GDP is still 4-5 percent beneath it’s Brown boom level,but demand for the NHS has been drastically increased by an expanded population,say 4-5 million since 1997,the outcome is Lansley cash starvation,which would apply under the other lot,who famously departed on the ‘sorry,the money has run out’.The NHS and the railways in India have a lot in common.

  9. fundamentally though…..the nhs is about 50% of the whole of the public sector spend and its a public sector that (im assuming) has to be reduced…….that alone says to me that there has to be some wholesale structural changes……..
    is there currently too much waste and inefficiency, beaurocracy etc? no doubt about it
    Have we extended the scope of nhs into areas that were never envisioned at its outset? Yes
    is the government and NHS between them largely incapable of implementing detailed measures to make the right level of savings? it seems so
    On the basis of the above, Lansleys structural changes are justified

    On another level completely……
    Are we basically an unhealthy nation with unrealistic life / treatment expectancies? i believe so
    Have we become unhealthy in part because of over dependence on expectancies of nhs despite its actual shortfalls? i believe so

    Something has to give…..

  10. To the Andy’s of this world,

    Do remember that, that ‘goddess’ of ‘capitalism/individualism’ one Ann(e?) Rand ended up depending on Medicare/Mediaid.

    Examine your own life and that of your parents and family and, I would be surprised if your family is not in debt to the NHS (that costs the UK c.10% of our GDP compared to the US where they spend c. 17% of their GDP and yet c.47 million are without basic health insurance).

    Even a sentient amoeba like Alien would conclude the the UK’s NHS principle of ‘free at point of delivery’ is worth retaining and fighting for.

    Reflect 90% of NHS benefits/costs accrue, on average, in the last 6 months of one’s life.

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