Profit-driven firms have been winning far more NHS contracts than ministers admit and privatisation has increased significantly under the coalition government, the latest evidence shows.
Two new sets of figures, detailing who is being awarded contracts to provide NHS clinical services, both challenge the government’s claim that only 6% of the service’s budget goes to private firms.
Contracts monitored by the NHS Support Federation campaign group show that private firms won £3.54bn of £9.628bn worth of deals awarded in England last year – a win rate of 36.8%.
And responses from GP-led clinical commissioning groups (CCGs) to a Labour freedom of information request reveal that private firms have been winning 40% of contracts CCGs have put out to tender, worth a total of £2.3bn, only slightly fewer than the 41% awarded to NHS bodies.
Labour also claim that NHS patients have had to endure longer waits for treatment as NHS hospitals have increasingly maximised their income from private patients, the number of which has gone up by as much as 58% since 2010. The NHS will end up as “a two-tier service”, with those paying privately being prioritised over other patients, unless action is taken to reverse the trend, the party claims.
Andy Burnham, the shadow health secretary, said the figures it had collated “demolish [David] Cameron’s claim that there’s only been a modest increase in privatisation on his watch. The truth is there has been a sharp increase and the public has never been asked whether they want the NHS to go in this direction.”
Labour will on Saturday try to again use health to its advantage in the election campaign by pledging to reinstate the 2% limit of total income that NHS hospitals can earn by treating patients privately.
Ministers claim that the proportion of the NHS’s £100bn-plus budget going to private firms has risen from 4% under the previous Labour government to 6% during the coalition’s time in office.
This month, the health secretary, Jeremy Hunt, accused Labour of trying to “scare people about privatisation that isn’t happening”.
But Labour’s research found that of 5,071 contracts awarded by CCGs 2,098 (41%) went to NHS bodies and 2,024 (40%) went to private healthcare firms, such as Care UK. The GP-led groups took control of £69.2bn of NHS funding in 2013.
“David Cameron and Jeremy Hunt have not been honest with working people about the scale and pace of privatisation on their watch. They’ve tried to play it down but these figures show they simply cannot be trusted with the NHS,” said Burnham. “It is shocking to see private companies winning just as many contracts as the NHS, and some with links to the Tory Party too.”
In 2009-10, Labour’s last year in power, 129 NHS foundation trust hospitals earned £224m in total from private patient income (PPI). By 2013-14 that had grown to 142 trusts sharing £389m between them.
The coalition lifted the cap on how much trusts could earn from PPI from 2% to 49% as part of its unpopular shakeup of the English NHS under the Health and Social Care Act 2012.
The £3.5bn worth of contracts won by private firms is five times the £681m the NHS Support Federation identified the year before. It also represents a huge increase on the £205m of contracts awarded in 2010-11, the coalition’s first year.
Of 13 contracts awarded last year that were worth at least £100m, six went to private firms, another five to private consortiums and just two to NHS providers bidding on their own. For example, Virgin Care got a £280m deal to coordinate care for long-term illness and care of elderly people in East Staffordshire.
“The public need clear sight of what’s happening to the NHS ahead of 7 May. The government cannot go on denying NHS privatisation. If we stay on the same path the NHS will become dominated by big business and there is a real danger that it will not survive,” said Paul Evans, director of the NHS Support Federation, which is funded by individuals, charities and unions.
“This is proof positive of a steep escalation in the private sector’s hold over the NHS. The mammoth NHS reforms opened up the NHS to the market and business. There is no current limit on how far their involvement can go,” he added.
The Tories rejected Labour’s claims about growing privatisation and dismissed returning the private patient cap to 2%.
A spokesman said: “This is a gimmick from Labour. Official figures show that outsourcing accounts for just 6p in each NHS pound, and private patient income is actually falling as a proportion of hospital budgets.
“By fixating on privatisation that independent experts and [NHS England boss] Simon Stevens say is a myth, Labour betray patients because the real debate should be good care against poor and on their watch, terrible events at Mid Staffs went ignored for four years.”
Source – The Guardian, 24 April 2015
This article was written by Karen McVeigh, for The Guardian on Sunday 14th December 2014
The Department for Work and Pensions has been urged by mental health and disability charities to publish its secret investigations into suicides that may have some link to benefit changes, following revelations that it has carried out internal reviews into 60 such cases.
A Freedom of Information request by the Disability News Service has revealed that the DWP has carried out “60 peer reviews following the death of a customer” since February 2012. A peer review is triggered when suicide or alleged suicide is “associated with a DWP activity”, according to its internal guidance.
Despite growing concern over the way benefits are administered in relation to vulnerable individuals, and amid a number of reports of related deaths, the department told the Guardian it had no plans to publish the reviews.
Disabled People Against the Cuts said that, because of the way the reviews were carried out, the DWP figure was likely to be the “tip of the iceberg”.
Tom Pollard, the policy and campaigns manager at Mind, told the Guardian the figures were a concern. He stressed that suicide was a complex problem but added:
“It would be helpful for organisations to see what things could be going wrong in the benefit system that could lead to these tragic situations.”
Sue Bott, director of policy and services at Disability Rights UK, said DWP reviews should be transparent.
“There have been allegations and anecdotal evidence for a while that the benefits regime has tipped people over the edge. It should be looked into in a transparent way,”
“This is not just about the nature of the decision taken as to whether it was right or wrong. It’s also about the process and there is a lot of concern about the way benefits are administered.”
The DWP’s latest figures show that sanctions to punish disabled ESA claimants had risen by 470% in 18 months, from 1,096 in December 2012 to 5,132 in June 2014.
According to DWP figures released as the result of an FoI request, 62% of adverse ESA sanction decisions in the first three months of 2014 were made against people with mental or behavioural problems (9,851 out of 15,955).
The calls for transparency from the DWP come after a number of reports of the deaths and suicides of vulnerable individuals after adverse benefit decisions.
David Clapson, 59, a former soldier and type-1 diabetic, died in July after his benefit was cut. Clapson had no food in his stomach, £3.44 in the bank and no money on his electricity card, leaving him unable to operate his fridge where he kept insulin.
MPs are to look into his death after a petition written by Gill Thompson, his sister, gathered more than 200,000 signatures.
Thompson, told the Guardian:
“All I’ve ever asked for is lessons to be learned. I can’t bring him back but we should know what is going on. There are certain people who shouldn’t be sanctioned. People with terminal cancer, waiting for heart operations, people with diabetes. Before they sanctioned my brother, they knew his disability. He was waiting to hear from a job, he had been on work placement. He was claiming the bare minimum.”
Christine Norman, a nurse whose disabled sister, Jacqueline Harris, took her own life in November 2013 after her benefits were cut, said:
“It’s too late for my sister. Everything is stacked against you. If you’ve got a great education, if you have great health, you’re OK. But if you haven’t, you have to fight against the odds. The government want you to work. The ones they pick are the ones that are vulnerable and ill.”
An inquest found last month that Harris, 53, of Bristol, who was partially sighted, took her own life after months of constant pain and following a “fit for work” ruling that replaced her incapacity benefit with jobseeker’s allowance. Staff at a jobcentre Harris was told to attend had to call an ambulance after she blacked out in pain.
Disabled People Against Cuts said that, because the DWP’s reviews only relate to suicides or alleged suicides and were triggered by regional managers within the benefit system, the number of deaths was likely to be far higher than the 60 cases that reached review.
Anita Bellows, of Disabled People Against Cuts, said:
“The triage for advising whether a peer review is to be carried out is done by regional managers at seven regional centres, who may not have an interest in putting them forward. Also, the guidance for peer review is focused on suicide, which does not cover people like David Clapson.”
She called on the DWP to open a proper investigation into the deaths, and include evidence from medical experts.
“These should be public documents” she said. “They are also only focused on the process. There are no medical experts on it.”
The DWP said it was unable to disclose the names of individuals under review because of provisions of the Social Security Administration Act.
However, the Mental Welfare Commission of Scotland, a Scottish government-funded watchdog, published its comprehensive review of the suicide of a claimant known only as Ms DE this year. The MWCS concluded that the WCA process and the subsequent denial of ESA was at least a “major factor in her decision to take her own life”. It concluded that the work capability assessment process was flawed and needed to be more sensitive to mental health issues.
Colin McKay, chief executive of the Mental Welfare Commission of Scotland, said he was disappointed with the DWP response to the report on Ms DE, who died on 31 December 2011.
“Certainly, nothing in what they said gave us confidence that if another Ms DE was claiming benefit, the outcome would be any different,” he said. “If the number of deaths are 60, that’s a lot. You would expect any organisation experiencing deaths as the potential consequences of their actions would be seriously considering whether they needed to do anything differently.”
This year a whistleblower tasked with getting claimants out of the ESA sickness benefit told the Guardian that some of her clients were homeless, many had extreme mental health problems – including paranoid schizophrenia, bipolar disorder and autism – and some were “starving” and extremely depressed after having benefits stopped. “Almost every day one of my clients mentioned feelings of suicide to me” she said.
Mind released research on Thursday that found that people with mental illness were having their benefit cut more than those with other illnesses. It also found 83% of those with mental health problems surveyed said their self-esteem had worsened, and 76% said they felt less able to work as a result of DWP back-to-work schemes.
The DWP said: “We take these matters extremely seriously, which is why we carry out peer reviews in certain cases to establish whether anything should have been done differently. However, a peer review in itself does not automatically mean the department was at fault.
“Since its introduction in 2008 there have been four independent reviews of the work capability assessment and we have made significant improvements to make it better, fairer and more accurate.”
Source – Welfare Weekly, 14 Dec 201
More than 60% of adverse Employment and Support Allowance (ESA) sanctions decisions made during the first three months of 2014 were against people with mental health issues or behavioral problems, new figures show.
Figures released by the Department for Work and Pensions (DWP) in response to a Freedom of Information Request, show that 9,851 adverse benefit sanctions decisions were made against ESA claimants with mental or behavioural disorders between January to March 2014.
This compares to:
- 508 adverse sanctions decisions against ESA claimants with diseases of the circulatory or respiratory system.
- 1,598 against those with diseases of the musculoskeletal system and connective tissue.
- 571 against people with diseases of the nervous system.
- 714 against people with injuries, poisoning and certain other consequences of external causes.
- 2,727 against those with other health conditions or disabilities.
A DWP official said benefit sanctions are used to encourage people to “engage with the support being offered by Jobcentres, by making it clearer to claimants what they are expected to do in return for their benefits”.
However, charities and medical experts say people with mental health issues, learning problems and behavioral disorders often struggle to understand what is required of them in return for their benefits. Following strict requirements can prove to be more difficult for these groups of people, without additional support and guidance.
Commenting on similar figures from November 2013, Tom Pollard, Policy and Campaigns Manager at the mental health charity Mind, said:
“We’re very concerned that an increasing number of people on ESA are having their benefits stopped, despite the fact that there are now fewer people in the WRAG (Work Related Activity Group).
“We know that around half of people in the WRAG need support because they have mental health problems, but over 60 per cent of sanctions are imposed on this group.”
“It is unjustifiable that people with mental health problems are being disproportionately affected by this increasingly punitive system. This confirms our fears that people are being pressured to undertake activities that are inappropriate for them and are not having their mental health properly taken into account.”
“As a result people often become more anxious and unwell and this makes a return to work less likely. We urgently need to see people with mental health problems placed on a scheme which recognises and helps them overcome the challenges they face in finding and keeping a job.”
In total, there were 15,995 adverse ESA sanctions decisions between January to March 2014.
A cross-party report published earlier this week said the harsh use of punitive benefit sanctions is leading to rising numbers of people turning to food banks.
Commenting in response to the report, Salman Shaheen of Left Unity said:
“Sanctions mean that tiny mistakes can see people’s benefits stopped. Often people are given unclear instructions. Sometimes the rules suddenly change or appointments are moved. One slip-up and they join the ranks of the hungry.
“Every crackdown on benefits pushes more people into the food bank queues. Abolishing sanctions is the simple answer: no one should ever be left with no income to live on.
“We also need to raise benefits from their current poverty level. And it is vital to tackle in-work poverty by ending zero-hours contracts and raising the minimum wage to £10 an hour.”
Source – Welfare Weekly, 10 Dec 2014
So desperate are the DWP to hush up the names of charities using workfare that they have been reduced to using a blog post titled “Chris Grayling is a lying bastard” to prove how horrible everyone is being to them because of their forced work schemes.
The post was part of the evidence provided by the DWP at yesterday’s tribunal brought to appeal the Information Commissioner’s Office’s (ICO) decision that charities using workfare should be named. This followed a Freedom of Information request made two years ago asking for the names of organisations who are accepting workfare placements on the Mandatory Work Activity scheme.
The DWP have pleaded that if this information was made available then workfare will collapse such is the awesome power of Boycott Workfare. Reams of evidence has been produced by the department, largely taken from the media and Boycott Workfare’s website, which they claim shows…
View original post 181 more words
This article was written by Rowena Mason, political correspondent, for The Guardian on Monday 5th May 2014
Jobseekers face losing their benefits for three months or more if they refuse to take zero-hours contract roles, a letter from a Conservative minister has revealed.
For the first time, benefit claimants are at risk of sanctions if they do not apply for and accept certain zero-hours jobs under the new universal credit system, despite fears that such contracts are increasingly tying workers into insecure and low paid employment.
More than one in 10 employers are using such contracts, which are most likely to be offered to women, young people and people over 65. The figure rises to almost half of all employers in the tourism, catering and food sector.
Currently, people claiming jobseekers’ allowance are not required to apply for zero-hours contract vacancies and they do not face penalties for turning them down.
However, the change in policy under universal credit was revealed in a letter from Esther McVey, an employment minister, to Labour MP Sheila Gilmore, who had raised the issue of sanctions with her.
The senior Tory confirmed that, under the new system, JobCentre “coaches” would be able to “mandate to zero-hours contracts”, although they would have discretion about considering whether a role was suitable.
> Oh well, that’s all right then. We can rest assured that the fact that they’re chasing targets and bonuses wont affect their judgement as to whether a role is suitable.
Quite obviously, if a job doesn’t guarantee a weekly income, its suitable to very few people indeed – mainly people who don’t eat or have bills to pay presumably…
Separately, a response to a freedom of information request to the Department for Work and Pensions (DWP) published on its website reveals: “We expect claimants to do all they reasonably can to look for and move into paid work. If a claimant turns down a particular vacancy (including zero-hours contract jobs) a sanction may be applied, but we will look into the circumstances of the case and consider whether they had a good reason.”
Higher level sanctions – imposed if a jobseeker refuses to take a position without good reason or leaves a position voluntarily – will lead to a loss of benefits for 13 weeks on the first occasion, 26 weeks on the second occasion and 156 weeks on the third occasion.
Asked about the issue by the Guardian, the DWP said jobseekers would not be required to take a zero-hours contract that tied them in exclusively to work for a single employer. The government is already consulting on whether to ban this type of contract altogether.
The change has been made possible because universal credit will automatically adjust the level of benefits someone receives depending on the number of hours they work. This means claimants should not face periods without the correct benefits when their earnings fluctuate or they change job.
> Universal Credit still does not work. It may never work, judging by its progress so far. Why would anyone trust it to “simplify” the system ?
However, critics raised concerns that the new policy will force people into uncertain employment and restrict the ability of claimants to seek better work while still placing a burden on many to increase their hours.
Sheila Gilmore said she was concerned about the situation because JobCentre decision makers already do not appear to be exercising enough discretion before applying sanctions under the old regime.
“While I don’t object to the principle of either universal credit or zero-hours contracts, I am concerned about this policy change,” she said.
“I also fear that if people are required to take jobs with zero-hours contracts, they could be prevented from taking training courses or applying for other jobs that might lead to more stable and sustainable employment in the long term.”
> Oh, I see. She’s not against the principle of either universal credit or zero-hours contracts, just that it might prevent someone taking part (for which read : being made to take part under threat of sanctions) some other pointless “training” course. Labour – the people’s friend…
Andy Sawford, a shadow minister who has pushed for reforms of the contracts with his zero-hours bill in parliament, also expressed concern about the change, as universal credit will require many people on low hours to try to increase their work. Those below a “conditionality earnings threshold” – normally 35 hours at the minimum wage – may be asked to “carry out relevant actions” to raise their earnings, or again face sanctions.
“How can you commit to training, undertake a proper job search or agree to participate in interviews when you are on a zero-hours contract and may be required to work at any time?” Sawford said.
“Requiring people to take zero-hour jobs is a big change from the past. It will create further insecurity for many of the lowest paid people.”
Labour has promised to crack down on abuses of zero-hours contracts, with leader Ed Miliband saying their use has reached “epidemic” proportions in some industries. He wants to see workers with irregular shifts and pay getting a contract with fixed hours if they have worked regularly for the same employer for a year.
The TUC has also expressed worry that they are “no longer confined to the fringe of the job market”.
A spokesman for the DWP said: “As now, if there’s a good reason someone can’t just take a particular job they won’t be sanctioned. But it is right that people do everything they can to find work and that we support them to build up their working hours and earnings. The average zero-hours contract provides 25 hours of work a week – and can lead to long-term opportunities.
“Universal credit payments will adjust automatically depending on the hours a person works to ensure that people whose hours may change are financially supported and do not face the hassle and bureaucracy of switching their benefit claims.”
> We don’t believe you…
Source – Welfare News Service 06 May 2014
I’m indebted to A6er, who seems to have found an answer to a question left hanging in Jobseeker’s Agreement Fun & Games – part 4.
In a letter to my Jobcentre’s manager I asked :
Independent advisers. Should I feel it necessery, I assume there would be no objection to my having an independent legal adviser accompany me to any Jobseekers Agreement negotiations. I would be grateful if you could confirm this.
Their reply :
Jobcentre interview are discussions between the claimant and their Personal Adviser. The interviews are usually completed unaccompanied and legal advisers would not normally be present a these negotiations. However, please note if you have any concerns during you interviews that you can suspend the interview if you wish to seek independent legal advice and we will make another appointment to continue the review at a later date.
A bit ambiguous, you might think. They’re not actually saying you cant, they do seem to be saying “we dont want you to”.
However, A6er has located an up-to-date Freedom of Information request and reply from the DWP on the whatdotheyknow.com site.
View the full document at : https://www.whatdotheyknow.com/request/196795/response/486014/attach/html/3/Response%20634.pdf.html
The highlights, as they apply to this case –
DWP Central Freedom of Information Team
e-mail: [email address].
Our Ref: 634
24 February 2014
Dear F. Walker,
Thank you for your Freedom of Information request which we received on 10 February 2014.
I’d like to know what the rules on taking support to jobcentre appointments, in particular signing on are.
I suffer from anxiety and my doctor has given me a note saying I suffer from anxiety and should have someone at all jobcentre appointments.
My advisor was unhappy with this and I would like to know if I am allowed support or not.
Claimants accessing Department for Work and Pensions (DWP) benefits and services can have someone to accompany them to act on their behalf.
DWP will treat the person acting on behalf of the claimant with the same customer standards
as the claimant.
> That’s a bit harsh, isn’t it ? Judging by the sort of customer standards this claimant has witnessed…
The person acting on behalf of the claimant is expected to maintain the same
behaviour standards as the claimant and treat our staff with courtesy.
Claimants can have a variety of people accompany them such as Representatives,
Appointees, Corporate acting bodies or Personal acting bodies.
Guidance for staff includes the information provided below:
A customer representative is any person or organisation acting on behalf of or making
enquiries for the customer. The representative could be helping a customer in several ways,
including progress chasing, helping them make a claim, seeking an explanation of entitlement
and how it has been decided, representing them with a reconsideration or appeal, or helping
them manage their finances. This can be at any stage of the customer’s business with DWP.
Representatives may include:
advice or welfare rights organisations
professionals such as social workers, community nurses or doctors
DWP Central FoI Team
There is quite a lot more than you can – and should – review at the link above, but this extract proves that yes, you can have a representive with you, and the inclusion of advice or welfare rights organisations would seem to fit the category of independent legal adviser.
So – was I lied to by the Jobcentre, or do they just not know their own rules?
And which of those options do you think is worse ?