The whole notion of Integrated Care Providers – formerly called Accountable Care Organisations – should be scrapped.
The privatisation aspect of Integrated Care Providers is not their sole problem. We oppose them because of their explicit ‘demand management’ rationale and the fact that they would cement the import into the NHS of the USA’s Medicare/Medicaid care models and workforce practices. These new care models are the result of successive governments’ policies and programmes – starting under the New Labour government and culminating in the 5 Year Forward View that Simon Stevens introduced in 2014. The new care models are based on cutting and centralising acute and emergency hospitals, turning District General Hospitals into planned care clinics or satellite urgent care hospitals where patients can be stabilised before being sent on to major trauma/Emergency Department hospitals, and setting up out-of-hospital services in large scale primary care practices based on GP lists of 30-70K patients. All these structural changes are underpinned by the introduction of tightly controlled criteria for patients’ access to NHS treatments. Criteria that are based on financial considerations, not patients’ clinical need. The result is to restrict patients’ access to NHS treatments and to undermine doctors’ professional competences and the doctor-patient relationship. GPs will be largely replaced by lower-skilled grades of associate staff who will make diagnoses and treatment decisions largely on the basis of computer clinical decision models. This fundamentally undermines the core NHS principle that it is a comprehensive service where all patients can access treatment on the basis of clinical need. Integrated Care Providers are not just about traditional NHS cuts, closures and privatisation – their introduction is about the stealth transformation of the NHS into the Medicare sector of the larger UK “health economy”, with the NHS as a provider of last resort for people who are too poor or ill to get private health insurance cover. The rollout of new Accountable Care models would be damaging EVEN IF they were delivered by statutory NHS organisations. This is why we can see no point in legislating for Integrated Care Providers. Turning them into statutory bodies would not solve the problems they would create. Read the full article here https://calderdaleandkirklees999callforthenhs.wordpress.com/2018/10/25/scrap-accountable-care-and-restore-the-nhs-and-social-care/
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Sussex Defend the NHS Archives
February 2023
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