Not a European Private Healthcare Bill - Allyson Pollock's Response

Over the past couple of days I have had more hits than I usually have in a month. Or two months. Or more. But that would be giving too much away about my only-just double figure traffic..

Anyway, I've decided to post up a link to Allyson Pollock's department and their response to this bill. The short version is that they think it's a load of privateering, dangerous bull****t. The longer, more elegant version can be found here. Many thanks to the department and Dr James Lancaster for enabling the link.

Not a European Private Healthcare Bill- the Crossborder Healthcare Bill

All my fellow bloggers are blogging about Europe tonight and I’m feeling slightly left out, so I’ve decided to write a post which I had put on the back burner for sometime. It’s regarding a rather obscurely named bill going through the European Parliament just now called ‘The Cross Border Healthcare Bill’ . Don’t be fooled by its fuzzy name. It is the most insidious, ill-thought out, dangerous bill since the NHS Improvement Plan, which left the NHS almost completely exposed to the private market. This bill is going to do much the same, but on a Europe wide scale and it is going to open a European battleground for health.

So what’s it about? Well, its basic premise is this; European citizens should be able to go to any country in the EU to receive medical treatment. If there is a waiting list in one country, then a patient should be able to travel to another to receive the treatment required.The member state that the patient comes from will fund the patient up to what it would cost in their own country; if it costs more, then the patient will fund the difference. This is an extension of ‘the four freedoms’; freedom of movement of goods, services, capital and persons. On the face of it, it looks like a good idea. It’s not.

Each country in the EU has its own social insurance system. The NHS in Britain is pretty monolithic, despite the government’s best attempts to break it down, but it is a health system that has relatively few variations in it and the burden of funding comes from central taxation and social insurance. This is not the case in other European countries. They vary far more in organisational structure, and a significant amount of the funding is employer based. The most popular structure is the Bismarkian system, which as the name suggests, originates in Germany. The Bismarkian system usually consists of several not-for-profit health organisations based round occupations; for example, there are farmers’ health unions, miners health unions and so on. They are funded by employers and the government also gives them money, but the burden is split between government and employer. Many of these not-for-profit organisations are in trouble just now, because of the rising costs of healthcare and also rising unemployment. In Germany Angela Merkel applied the blunderbuss approach to raising funding for healthcare; she raised the rate of VAT and she also allowed people to ‘opt out’ of health unions and buy cheaper private healthcare. The latter proved to be a very expensive mistake, as those who paid a higher contribution to the healthcare opted out and left the health unions struggling even more.

So what has all this got to do with this bill? Well, what this bill would allow these unions to do, is to take patients from other countries and charge the bill to the patient’s member state instead of to its own union. If it skimped on a few essentials, it could make a good profit on it. It would also allow them to tout for business in other European countries. In short, you would be turning a not-for-profit organisation into a private healthcare business. For struggling health unions at the moment, it must look irresistable.

What would it mean for us here? Well, we’ve got a waiting list. We could send off patients to cheaper countries in the EU to get treatment and pay less for them. Never mind that some poor Romanian isn’t going to get his operation because a rich Brit has turned up instead; in the EU all citizens are equal and therefore a patient that actually comes from the member state does not get preferred. And we could take patients from other countries and get them to cough up their own cash for treatment. This bill is going to involve the setting of tariffs and therefore the establishing of a private market in health by default.

It doesn’t stop there. Another of the proposals is the recognition of prescriptions issued in other countries. Now, the bill is rather vague on what this means. Does it mean that a prescription written, say in France will be valid here simply for medicines approved for prescription by NICE? Does it mean that it will be valid also for medicines that are not available on prescription here, and if so, who’s going to pay for them? The French, the NHS or the patient? I suspect it will be the patient.

Finally (and please don’t groan) no evil masterplan would be complete without a supercomputer. Yep, just when you thought the SH had been put into IT by ‘Connecting for Health’ along comes yet another super duper IT plan, but this time it’s going to be Europe wide. The EU are planning to set up a European IT system for the transfer of patient records, medical data and ‘e-health services‘, whatever the hell that might be. Microsoft are already bidding for the contract. You know, I thought that Doctor Who was being simplistic, when the goodies only had to find the master Dalek to kill off all of them, and that some baddie would work out that you shouldn’t connect them all to a central system. It seems that Dr Who was simply prophetic. How many times do these systems have to crash and how much money do we have to spend, before governments realise that big single servers do-not-work? Not to mention the implications for patient confidentiality. But hey, if you’re going to have a private European market, it makes sense to have European access to patient information so that you can pitch your services more effectively to the market, eh?

What is galling about this bill is how it denies all along that it is about undermining health social insurance systems. It is about freeing up the internal market, it will let private healthcare in, it will turn your prescribing into a cocked hat, it will build another big computerised Black Hole of Calcutta for all our money to disappear into, but it is absolutely, categorically, emphatically not about a European private health care market and absolutely not about letting in all those American health care companies take over not-for-profit organisations and allowing them to work cross border in Europe. No sir.

When I was about ten, my sister was given a Kermit frog as a Christmas present.
‘So are you going to call it Kermit then?’ I asked.
‘No’ my sister replied.
‘But it is Kermit.’
‘Well, I’m calling it Not-Kermit,’ my sister replied and went off. She grew up to become a lawyer.

There’s an awful lot of Not-Kermit about this Not-a-European-Private-Healthcare-Bill..

Keep Calm and Carry On ? A Torrid Night at the Polls.

Well, it was a night to remember.

A higher than expected turnout, plenty of spoiled papers,six counts, a request for a recount and a win by 63 votes. Where was the centre of the action? Coatbridge North and Glenboig council by-election of course.

The evening started off fairly innocently. It was largely expected that Labour would romp home in the first round, and even although the turnout was 29% (about 6% higher than expected) noone thought it would get very far. As the papers piled up in Peter Sullivan's box,(Lab), people were already reaching for cups of tea, fags and other refreshments. But at the end of the first count, Sullivan was on 1529, Stubbs (SNP) was on 1276 and yours truly was on 557.

At this point Gavin Whitefield the electoral officer brought over the spoiled and doubtful papers. Some had put an X instead of a 1. Others had put two or three Xs and these were rejected. Then we were shown one that had a '7' written beside Labour and no other mark. We had been told in advance that any number apart from 1 in a box on its own would not be accepted.
'That's a squiggly 1,' said one of the labour supporters hopefully.
'It's a 7!' the rest of us chorused.
Gavin Whitefield rejected it. 'It's a measure of Labour's position with its voters; number 7,' said one of the SNP supporters.
Next paper, 7. Next paper 7. Next paper 7. All rejected. What was going on? Then a paper cropped up with a 5 beside my name, and another with a 4 beside the Green candidate. The penny dropped. Some people were counting the number of boxes down that their candidate was, and writing it in. So I was fifth on the paper order and got a 5, and Sullivan was seventh on the paper order and therefore got 7 beside his name. In all, something like 30 Labour votes were lost to this. Peter Sullivan looked on gloomily, no doubt reflecting that as a maths teacher, he had taught his constituents to count boxes, but not how to use a preference vote.
Onto the deliberately spoiled papers. There were a number of messages on these, some ruder than others, but the agreed favourite was the one that said, 'I could run the country better myself!'
They probably could as well. Gordon, watch out. Someone wants your job..

Second round. Fraser Coats from the SSP was eliminated, and his second preferences transferred. 1 to Hugh Banford; 2 to Stubbs; 8 to myself; 11 to Keane (Greens);13 to Sullivan. 4 were also transferred to the Conservatives. Are there closet Conservatives amongst the Socialists that were letting their inner Tory out, or was it a very clever tactical vote? We'll never know.

Third round. The Green candidate Keane got eliminated and I won the most second preferences off him with 39 votes. I felt a slight pang of guilt, having driven round to the count (just two minutes walk away) and having shopped at Tesco that week and forgotten my life-long bags as usual. Still, I was campaigning against a school being built on a dump and a landfill that wasn't properly sealed, so I reckoned it balanced out.

Fourth round. Hugh Banford, the other independent got eliminated and 218 votes were up for grabs. Stubbs got 50, I got 31 and Sullivan got only 19.

Fifth round. Things were getting serious. Burgess the Conservative was eliminated and Stubbs took 89 votes. Labour surprisingly managed 38 votes at this point. I took 95 votes and my total vote was therefore 730; 18% of the total vote.

Sixth round. Very tense. I was eliminated and my vote divided between SNP and Labour. Stubbs took 250 votes and Labour took 144. This took the vote to; SNP 1696 and Labour 1759. Only 63 votes in it and neither had reached the allocation of 2058. What was going to happen now?

The SNP asked for a recount. Gavin Whitefield refused, because it had been agreed that full recounts could only be requested after each round. As this had not been requested at any stage, he could only permit a bundle count. The two boxes were emptied and the counters flicked through the piles at speed as things grew tenser and tenser. Finally it was confirmed. Labour had won by 63 votes. The relief from the red corner was palpable.

So who were the winners and who were the losers in this? It was a good night for the independents like myself, because we turned the ward into a marginal and made the big boys scrap for it. It was also a good night for the SNP even although they lost. It was a bad night for Labour, who did not expect things to go the whole way in this count. Hopefully it will make them rethink their current policy on St Ambrose and Kilgarth, which has severely hacked off the local people here.

But the biggest winners? The stewards. The count went on until 1.30am which meant they got double time on their pay.

Guys, you owe me and Hugh a pint..