Whistleblower says Britain's biggest out-of-hours private care provider Harmoni routinely jeopardises safety to cut costs

KJ, Chris and Fee have a brilliant idea...

SOURCE DAILY MAIL: One nurse for 250,000 patients: whistleblower reveals nurses are replacing GPs to cover entire counties
The revelations about Britain's biggest out-of-hours private care provider Harmoni come from a whistleblower GP. Harmoni makes £100million a year from NHS contracts. The GP has made a number of other startling allegations about how Harmoni is routinely jeopardising safety to cut costs. They include:
Terminally-ill cancer patients made to wait eight hours for a doctor to visit them at home and administer pain relief; Foreign doctors with a poor grasp of English being used to plug gaps in the rota; Locum doctors flying in on easyJet from Europe, or driving from elsewhere in Britain, to work back-to-back shifts round-the-clock without sleep.

OUR RELATED STORIES:

House of Lords refuses to block bill forcing NHS to tender services, and taking away their right to reject dodgy providers

Nurses caught neglecting patients? They're only following the national trend

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Rip-off News round-up. Our pick of the last week's media (Thu 16th May)

Cameron threatens to prosecute oil bosses for fixing the price of petrol
BP and Shell’s London HQs have been raided for evidence by the European Commission. They are investigating claims that prices were rigged for more than a decade. It could have had a "huge impact" on the price of petrol at the pumps "potentially harming final consumers". Four months ago the UK’s Office of Fair Trading (OFT) ruled out an investigation into petrol price fixing after finding "very limited evidence." TELEGRAPH
(Oh no, not another EU initiative that tells us what to do. We Brits do things differently! Errr... we do nothing.)

Iain Duncan Smith caught exaggerating benefit cap figures

The Work and Pensions Secretary said that his new benefit cap was having "the desired impact" because 8,000 people who would have faced a benefit cut had been incentivised to get jobs. But the UK Statistics Authority, the statistics watchdog, said his figures were simply "unsupported by the official statistics published by the department". For the third time in just six months, the head of the UK Statistics Authority has written to ministers to warn them about their misuse of statistics. BBC NEWS

(However, their sister regulator, the UK Lies Damn Lies Authority, once again gave IDS its full support...)

100 of UK's richest people concealing billions in offshore tax havens
An unprecedented global investigation is now under way as HM Revenue and Customs acts on a 400-gigabyte cache of leaked data. George Osborne, the chancellor, warned the alleged tax evaders and a further 200 accountants and advisers accused of helping them cheat the taxman: "The message is simple: if you evade tax, we're coming after you." HMRC declined to name any of the individuals, advisers or companies it is investigating. GUARDIAN
(“...And why should we? A quick look at the list of Tory party donors should tell you all you need to know,” said HMRC...)

One nurse for 250,000 patients: whistleblower reveals nurses are replacing GPs to cover entire counties 
The revelations about Britain's biggest out-of-hours private care provider Harmoni come from a whistleblower GP. Harmoni makes £100million a year from NHS contracts. The GP has made a number of other startling allegations about how Harmoni is routinely jeopardising safety to cut costs. They include:  

• Terminally-ill cancer patients made to wait eight hours for a doctor to visit them at home and administer pain relief 
• Foreign doctors with a poor grasp of English being used to plug gaps in the rota
• Locum doctors flying in on easyJet from Europe, or driving from elsewhere in Britain, to work back-to-back shifts round-the-clock without sleep 

DAILY MAIL
(How about Easy Group cuts out the middle man and launches its own “no-frills” out-of-hours private care provider. Call it easyNHS?... easyGP?... easyMoney!!!)

SSE boss says he is 'ashamed' over mis-selling

In April, energy firm SSE was fined £10.5m and ordered to compensate customers who were lied to, switched to SSE, and ended up paying more. But Chief Executive Ian Marchant insisted that examples of his staff lying were “few and far between” and that “a more common thing that was happening was misunderstanding – either deliberate or accidental”. BBC NEWS

(...And the latest addition to the Oxford Dictionary? A “Marchant” - a deliberate misunderstanding, otherwise known as a lie.)

Ban on pensions middlemen whose rip-off fees wipe out retirement saving

Rip-off charges levied by middlemen consultants that can wipe out large portions of pension savings will be banned from auto-enrolment schemes, as part of a two-pronged attack on pension charges. New rules mean employers must auto-enrol 11m workers onto pensions in the coming years. The ban however is not retrospective and will only be effective on schemes which are set up from today. But supporters of the fee said if employers cannot pass on the cost of the advice to their staff, they won’t bother to seek advice and end up choosing the wrong workplace pension provider. DAILY MAIL

Co-op Bank bosses face clawback of bonuses

The news follows the six-notch downgrade by Moody’s of the Co-op Bank’s credit rating, which was relegated to junk status after its failed takeover of Britannia Building Society in 2009, and a deal to buy 632 branches from Lloyds Banking Group collapsed this year. The Co-op’s directors are understood to be looking at what action they can take against managers, including former Co-op Bank boss Neville Richardson. He left the in 2011 with a package worth £4.6m, including a £1.4m payment for “loss of office”, as well as £1.39m in “compensation” for leaving. TELEGRAPH

Government cuts threaten gender equality gains

Some of the most vulnerable women in society – including single mothers, those who are disabled or from minority ethnic groups – are bearing the brunt of government policies. The findings come in a report by an umbrella organisation of 42 women's and human rights groups, including Women's Aid and the Fawcett Society. The report says all but the richest women are doing worse than in 2008, and that further spending cuts will worsen things further. Latest polls suggest support for the Conservatives among women is 15 points behind Labour, while it is roughly neck and neck among men. GUARDIAN

UK's top companies condemned for prolific use of tax havens

• Only two FTSE 100 companies have no subsidiaries in tax havens
• Big four banks and Tesco among biggest users

The UK's 100 biggest public companies are running more than 8,000 subsidiaries or joint ventures in onshore and offshore tax havens. Cameron and Osborne have promised the UK will lead a global clamp down on tax dodging. But 1,685 of those tax haven subsidiaries are in UK Crown dependencies such as Jersey, or overseas territories such as the British Virgin Islands (BVI), Bermuda and Gibraltar. GUARDIAN

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UK Uncut exposes Goldman Sachs’ £20m tax dodge deal with HMRC, struck “to save Government embarrassment”

Cameron interrogates Her Majesty's Revenue and Customs...

SOURCE INDEPENDENT: £20m 'Sweetheart' tax dodge deal between HMRC and Goldman Sachs was struck to save Government embarrassment, court hears
The deal has become the subject of a legal challenge by UK Uncut, the tax pressure group. The deal allowed Goldmans to escape paying between £6m and £20m in interest on tax owed to the Exchequer. HMRC apparently feared that Goldmans would pull out of George Osborne’s new tax monitoring agreement unless it was let off the tax. UK Uncut wants the High Court to declare the deal unlawful, but even if it does so, the deal cannot be overturned and Goldmans will not be obliged to pay the money. The court saw incriminating emails by Dave Hartnett, who was the top ranking civil servant at HMRC at the time.

OUR RELATED STORIES:

In numbers (+ a cool animation): Global tax evasion and money laundering

Is Corporation Tax being cut to make us more competitive? Or is there another reason?

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Liebrary: The truth according to the Office of National Statistics (ONS) behind the Public and Private Sector pay differential

The government gets regularly rapped by its own statistics body, the UK Statistics Authority, for making up stuff to support government policies. In May 2013 the Secretary of State for Works and Pensions, Iain Duncan-Smith, was put on the naughty step for fibbing about the number of people enthused into getting a job as a justification for his draconian policy of cutting benefits. 

Duncan-Smith's claim that the statistics "clearly demonstrates that the cap is having the desired impact" was quickly shot down by the UK Statistics Authority. The Authority declared the statistic "explicitly states that the figures are 'not intended to show the additional numbers entering work'". The decrease in claimants was actually due to policy changes that reduced the number being counted. Andrew Dilnot, Chairman of the UK Statistics Authority, wrote:

"We have concluded that the statement attributed to the Secretary of State for Work and Pensions that ‘Already we’ve seen 8,000 people who would have been affected by the cap move into jobs. This clearly demonstrates that the cap is having the desired impact’, is unsupported by the official statistics published by the Department on 15 April.

The release Ad-hoc statistics on JobCentre Plus activity, from which the 8,000 figure appears to be drawn, explicitly states that the figures are ‘not intended to show the additional numbers entering work as a direct result of the contact’. The release Ad-hoc statistics on households identified points out a number of policy changes that occurred between the publication of the 56,000 and 40,000 numbers, as well as caseload changes ‘due to normal caseload churn, reducing those potentially in scope for the cap’."

Politicians rarely allow truth to get in the way of policy. 
Another statistic that is grotesquely misused is the average pay in the Public and the Private Sectors. The two great heists being perpetrated on us ripped-off Britons in the name of 'austerity' are changes to pensions and the outsourcing of public services. Of these two, the greater is the outsourcing of public services:

• One reason the private sector can cut costs is it cuts the pay of all except top executives. (Remember, these services employ and pay ordinary people like us).
• Another reason the private sector can cut costs is it cuts the scope and quality of what the service formerly provided. . (Remember, these services serve ordinary people like us who can't afford directly to buy private health, education, legal services etc.).
• The objective of the service ceases to be to serve the public, and becomes to serve the shareholders. (Remember, on the basis that 'he who pays the piper calls the tune', the privatised service will think twice before criticising the governments that pay them).

Recent governments, Tory and Labour, have used the true fact that the average salary in the public sector is higher than that in the private sector to justify the privatisation of public services. In November 2012 the Office of National Statistics produced a report and video politely debunking government claims that public sector staff are overpaid, providing statistical reasons for the overall higher average pay. We summarise the main points below:

a) Public sector jobs have a higher proportion of higher skill jobs. Just as in the private sector, higher skilled jobs attract higher pay.
:

b) Public sector workers tend to be older. Just as in the private sector experienced staff tend to be paid more.

c) In both private and public sectors, those who work in larger organisations are paid considerably more (24.9% more) than those in smaller organisations. 94% of the public sector but only 49% of the private sector fall into the category of 'larger organisation'.

c) The group of people who are actually "overpaid" compared to the private sector are not the 'fat cats' but the poorest group. The lower paid groups are paid better in the Public Sector, while the higher paid groups are paid less.

The higher pay of the few is funded by the lower pay of the many:

Privatisation may mean costs are lower in the short term. However, in practical terms this means:

• Lower pay and services for the public who are employed and who are served. 
• Higher private sector profits, to fund pay and dividends for company executives and shareholders. 
• Lower taxes for those who pay tax. Rather than being taxed to maintain public sector services, they use the money they save to go private.

The greatest loss of all is the most powerful force protecting the interests of ordinary Britons: all those other ordinary Britons working in the public service watching the interests of us ordinary Britons. They may not be driven by heroism, but they are also not driven by profit.

That ONS video:

Read More

£80bn for Help to Buy 'bubble' could push house prices up by 30%... How about building some houses!

KJ and a banker discuss...

SOURCE TELEGRAPH: Help to Buy 'bubble' could push house prices up by 30%
The Government’s "reckless" Help to Buy scheme uses taxpayer money to provide a loan of up to 20% of the value of a new build property, provided the borrower can raise a 5% deposit. But it risks creating a new housing bubble and could push the average UK house price up by 30% to £300,000 by the end of 2015, a leading economic think-tank has warned. “Help to Buy is a reckless scheme that uses public money to incentivise the banks to lend precisely to those individuals who, absent the scheme, would not and should not be offered credit," said Fathom Consulting, set up by former Bank of England economists.

OUR RELATES STORIES:

Build more affordable homes, reverse the property bubble, and we'll save billions

Stop Britain’s biggest rip-offs, and no budget cuts or tax rises are required

Read More

Rip-off News round-up. Our pick of the last week's media (Thu 9th May)

“Shrinkflation”: Food products are getting smaller while the price you pay stays the same

Manufacturers and retailers are increasingly sneaking in new reduced sizes while describing them as special offers or re-launches. One shopper said: ‘It feels like being lied to. Why act in a deceptive manner unless it is to make more money out of us?’ The shrinking has happened over the past few years, with many customers being none the wiser. 

• Bakery chain Greggs cut the meat content of its Steak Bake pie by 15% while keeping the price at £1.35.
• Walkers crisps contents have fallen by 6% from 34.5g to 32.5g, but the price remains the same.
• A Mars bar has shrunk 2.5g to 58g.

Tell-tale signs are “special deals” which are just a cover for shrinking goods. They even have the nerve to make boasts like “less fat” when it is due to them offering less everything.’ Shredded Wheat Superfruity used to be sold for £2.68, so Sainsbury’s put it on £2 special offer before returning it to £2.68 but with less content. A spokesman for PepsiCo, which owns Walkers, said: ‘We have faced rising commodity prices and raw ingredients costs. Where possible we absorb costs but we have had to make slight reductions to the weight of some crisp products.’ Laura Sandys, Tory MP for South Thanet, says: ‘It’s wrong that consumers are forced to absorb inflation without knowing about it. The Government is looking at the issue.’ DAILY MAIL

("…we certainly are. So we can pull the same trick. Pay, pension and benefits freezes force those on lower incomes to absorb inflation more than anyone, but sadly they know all about it!" said our government insider…)

£20m 'Sweetheart' tax dodge deal between HMRC and Goldman Sachs was struck to save Government embarrassment, court hears

The deal has become the subject of a legal challenge by UK Uncut, the tax pressure group. The deal allowed Goldmans to escape paying between £6m and £20m in interest on tax owed to the Exchequer. HMRC apparently feared that Goldmans would pull out of George Osborne’s new tax monitoring agreement unless it was let off the tax. UK Uncut wants the High Court to declare the deal unlawful, but even if it does so, the deal cannot be overturned and Goldmans will not be obliged to pay the money. The court saw incriminating emails by Dave Hartnett, who was the top ranking civil servant at HMRC at the time. INDEPENDENT
(“So… it always pays to dodge tax. Even if we get caught, we get to keep the interest on the cash we’ve stashed. And get to blackmail George Osborne while we’re at it!” said our Goldmans insider…)

One in four UK children will be living in poverty by 2020, says thinktank

The IFS says tax and benefit reforms introduced since April 2010 account for most of the projected rise in numbers. Another 600,000 children may fall into relative poverty during this parliament, with this figure rising by more than 1 million by 2020, the IFS says. The jump will result in Britain missing binding targets to reduce child poverty by 2020: the target was to reduce it to one in 10, or fewer, of all children, or about 1.3 million. A government spokesman replied: "...We want to take a new approach by tackling the root causes of poverty including worklessness, educational failure and family breakdown.” GUARDIAN
(“Ummmm… and all our tax and benefit reforms introduced since April 2010,” the government spokesman added. Not.)

Is ScottishPower the next to be fined for mis-selling and repeatedly misleading customers?

SSE has already been fined £10.5m for repeatedly misleading customers. The other two firms being investigated by Ofgem are Eon and npower. All the investigations relate to past mis-selling: in SSE’s case it concerned hundreds of thousands of customers mis-sold contracts between 2009 and 2012. Angela Knight, boss of the industry’s trade body Energy UK, said that the industry faced an issue of trust when dealing with the public, and that companies that made mistakes should own up promptly. DAILY MAIL
(…And Angela Knight knows all about trust and owning up promptly. Her last job was the head of the British Bankers Association from 2007 to 2012…)

Help to Buy 'bubble' could push house prices up by 30%

The Government’s "reckless" Help to Buy scheme uses taxpayer money to provide a loan of up to 20% of the value of a new build property, provided the borrower can raise a 5% deposit. But it risks creating a new housing bubble and could push the average UK house price up by 30% to £300,000 by the end of 2015, a leading economic think-tank has warned. “Help to Buy is a reckless scheme that uses public money to incentivise the banks to lend precisely to those individuals who, absent the scheme, would not and should not be offered credit," said Fathom Consulting, set up by former Bank of England economists. TELEGRAPH
(Hmmm… lending vast sums to people who can’t pay it back. Where have we heard that before?…)

One in five families rely on loans and savings to meet grocery costs

The worst-affected group was households earning less than £21,000 a year and squeezed 30 to 49-year-olds, many of whom had children. 31% of people surveyed by Which? cut back spending on essentials last month, and they were most likely to be women aged between 30 to 49 years old. Which? Said: “Our tracker shows that many households are stretched to their financial breaking point, with rising food prices one of the top worries for squeezed consumers.” 68% of people across the survey described the state of the economy as poor, although 9% said it is good. DAILY MAIL
(…and 100% of payday lenders said it is bloody fantastic!)

£410m pension crackdown on foreign spouses will be 'bureaucratic nightmare'

A new law will close the loophole that allows 220,000 spouses who live abroad to receive UK state pensions. Steve Webb, the pensions minister, said that every year £410m is spent on spouses living outside the UK, some of whom are foreign citizens who have “never set foot in Britain at all”. The pensions can be worth £3,500 a year for the entire length of a person’s retirement. But experts say administering the new system will be a "bureaucratic nightmare" that could cost as much as it saves. TELEGRAPH

Read More

Should the wealthy elderly return their benefits, or the super-rich and corporates return their £70bn+ dodged taxes?

Cameron and Iain Duncan Smith do the sums...

SOURCE BBC NEWS: Iain Duncan Smith urges wealthy elderly to 'hand back' benefits

Wealthy elderly people who do not need benefits to help with fuel bills, TV licences or free travel should give the money to his department, said the work and pensions secretary Iain Duncan Smith. He said he would "encourage" people who do not need such financial support "to hand it back".

OUR RELATED STORIES:

In numbers (+ a cool animation): Global tax evasion and money laundering

The Top 5 tax loopholes, and the "no brainer" £125m Gift Aid dodge

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House of Lords refuses to block bill forcing NHS to tender services, and taking away their right to reject dodgy providers

The local elections in May 2013 reminded many Tories that their time at the trough maybe shorter than they had thought. Like children stuffing themselves in an unguarded sweet shop they will have two things on their minds:


1) How to stay in the sweet shop as long as possible, stifling their rustling and their chuckles hoping no-one will hear them.

2) How to take as many sugary delights with them when they are eventually ejected.

The sugary delights in question being the lucrative transfer of public services to the private sector. It is not that the time for privatisation and outsourcing is getting short. Labour governments of recent years were hardly any less enthusiastic under the cover of PFI (Private Finance Initiatives). It is just a question of which political party has its hands on the ladle when the deals are doled out.

With further privatisations and outsourcing likely to be fast-tracked - including the sale of Royal Mail and the sale of government stakes in the banks RBS and Lloyds, as well as various outsourcing contracts - we take a closer look at a little reported skirmish in Parliament in April 2013.

A debate was held in the House of Lords on the 24th April 2013, where peers voted to accept legislation making it a legal requirement for the NHS to contract with private sector suppliers of any odour (or should that be ordure). In particular, it removes the right of the NHS commissioning body to refuse to deal with a company because of its dodgy background:

Here are extracts from the clarification document (extracts highlighted in yellow and red) produce by the Department of Health with annotations by us:

The pre-amble to the Department of Health document states:

These notes relate to the Regulations made under sections 75 to 77 of the Health and Social Care Act 2012. They have been prepared by the Department of Health in order to assist the reader of the Regulations and help inform any debate. These notes should be read in conjunction with the Regulations themselves. Where a regulation does not seem to require any explanation or comment, none is given. 
The specific sections are these:
http://www.legislation.gov.uk/ukpga/2012/7/section/75/enacted
http://www.legislation.gov.uk/ukpga/2012/7/section/76/enacted
http://www.legislation.gov.uk/ukpga/2012/7/section/77/enacted

It goes on to say that those commissioning services from the private sector must:

3(2)..treat providers equally and in a non-discriminatory way, including by not treating a provider, or type of provider, more favourably than any other provider, in particular on the basis of ownership. 

Now we know from his time as Culture Secretary that the current Health Secretary, Jeremy Hunt, has particularly liberal views in terms of the type of owners he is pleased to deal with.


4 (3) A contract notice must include— 
(a) a description of the services required to be provided, and 
(b) the criteria against which any bids for the contract will be evaluated. 

Can't complain about that. Except the "criteria against which any bids for the contract will be evaluated" creates an open door for dodgy providers prepared to be creative in their promises as demonstrated in the following clauses:


5 (1) A relevant body may award a new contract for the provision of health care services for the purposes of the NHS to a single provider without advertising an intention to seek offers from providers in relation to that contract where the relevant body is satisfied that the services to which the contract relates are capable of being provided only by that provider.

So, it is left to the commissioners' discretion whether to award a contract to a favoured provider without advertising it for other potential providers to tender.


5 (3) For the purposes of paragraph (1), a relevant body is not to be treated as having awarded a new contract— 
(a) where the rights and liabilities under a contract have been transferred to the relevant body from the Secretary of State, a Strategic Health Authority or a Primary Care Trust; or 
(b) where there is a change in the terms and conditions of a contract as a result of— 
(i) a change in the terms and conditions drafted by 
the Board under regulation 17 of the 2012 Regulations (terms and conditions to be drafted by the Board for inclusion in commissioning contracts), or 
(ii) new terms and conditions drafted by the Board under that regulation. 

Apparently contracts can be awarded under an open tender and then the terms & conditions can be changed without re-opening the tender. Now, we wonder if that is open to abuse? 


6(1) A relevant body must not award a contract for the provision of health care services for the purposes of the NHS where conflicts, or potential conflicts, between the interests involved in commissioning such services and the interests involved in providing them affect, or appear to affect, the integrity of the award of that contract.

The document helpfully clarifies:

An interest referred to in paragraph (1) includes an interest of— 
(a) a member of the relevant body, 
(b) a member of its governing body, 
(c) a member of its committees or sub-committees or committees or sub-committees of its governing body, or 
(d) an employee.

So the interests of sundry friends and their friends and relatives and partners and ancestors' next door neighbours are not mentioned here.

And here is why publishing the 'criteria' for selection at the outset opens a barn sized door for those who would bend their promises to fit into the criteria, knowing that the terms&conditions can be changed later (as per 5(3) above). No matter how pongy the provider or its owners may be the commissioning body is forbidden to turn its nose up:

7(3) When taking a decision referred to in paragraph (2)(a), a relevant body may not refuse to include a provider on a list where that provider meets the criteria established by the relevant body for the purposes of that decision


7(4) When taking a decision referred to in paragraph (2)(b), a relevant body may not refuse to include a provider on a list where that provider meets the criteria established by the relevant body for the purposes of that decision

7(5) When taking a decision referred to in paragraph (2)(c), a relevant body may not refuse to enter into a framework agreement with a provider that meets the criteria established by the relevant body for the purposes of that decision

In short:

• All contracts must be put out to tender, except when the commissioners want to give the contract to a specific supplier in which case they don't need to put it out to tender after all.
• Contract terms can be changed after the contract is awarded, without regarding it as a 'new contract' with the scrutiny that would require.
• Conflicts of interest are tightly defined as members and employees of the commissioning bodies. The interests of chums and chums of chums are overlooked.
• Commissioners are specifically not allowed to reject suppliers who claim to be able to meet the "criteria established by the relevant body for the purposes of that decision". So no consideration is allowed to be made of the supplier's reputation and past history, and political affiliations. 

A proposal was moved in the Lords to block this law. The proposal was defeated: the results on the right show how the parties voted. 

One can't blame the Tories for backing this law. It is in their nature just as it is in the nature of a scorpion to sting. However it is more difficult to understand the support of the Liberal Democrats whose votes would have blocked this change in procurement regulations. Regulations that the British Medical Association oppose.

We assume removing the right to refuse to deal with dodgy companies, as legislated above, will become the template for future outsourcing and privatisations.

Read More

House of Lords refuses to block bill forcing NHS to tender services, and taking away their right to reject dodgy providers

The local elections in May 2013 reminded many Tories that their time at the trough maybe shorter than they had thought. Like children stuffing themselves in an unguarded sweet shop they will have two things on their minds:


1) How to stay in the sweet shop as long as possible, stifling their rustling and their chuckles hoping no-one will hear them.

2) How to take as many sugary delights with them when they are eventually ejected.

The sugary delights in question being the lucrative transfer of public services to the private sector. It is not that the time for privatisation and outsourcing is getting short. Labour governments of recent years were hardly any less enthusiastic under the cover of PFI (Private Finance Initiatives). It is just a question of which political party has its hands on the ladle when the deals are doled out.

With further privatisations and outsourcing likely to be fast-tracked - including the sale of Royal Mail and the sale of government stakes in the banks RBS and Lloyds, as well as various outsourcing contracts - we take a closer look at a little reported skirmish in Parliament in April 2013.

A debate was held in the House of Lords on the 24th April 2013, where peers voted to accept legislation making it a legal requirement for the NHS to contract with private sector suppliers of any odour (or should that be ordure). In particular, it removes the right of the NHS commissioning body to refuse to deal with a company because of its dodgy background:

Here are extracts from the clarification document (extracts highlighted in yellow and red) produce by the Department of Health with annotations by us:

The pre-amble to the Department of Health document states:

These notes relate to the Regulations made under sections 75 to 77 of the Health and Social Care Act 2012. They have been prepared by the Department of Health in order to assist the reader of the Regulations and help inform any debate. These notes should be read in conjunction with the Regulations themselves. Where a regulation does not seem to require any explanation or comment, none is given. 
The specific sections are these:
http://www.legislation.gov.uk/ukpga/2012/7/section/75/enacted
http://www.legislation.gov.uk/ukpga/2012/7/section/76/enacted
http://www.legislation.gov.uk/ukpga/2012/7/section/77/enacted

It goes on to say that those commissioning services from the private sector must:

3(2)..treat providers equally and in a non-discriminatory way, including by not treating a provider, or type of provider, more favourably than any other provider, in particular on the basis of ownership. 

Now we know from his time as Culture Secretary that the current Health Secretary, Jeremy Hunt, has particularly liberal views in terms of the type of owners he is pleased to deal with.


4 (3) A contract notice must include— 
(a) a description of the services required to be provided, and 
(b) the criteria against which any bids for the contract will be evaluated. 

Can't complain about that. Except the "criteria against which any bids for the contract will be evaluated" creates an open door for dodgy providers prepared to be creative in their promises as demonstrated in the following clauses:


5 (1) A relevant body may award a new contract for the provision of health care services for the purposes of the NHS to a single provider without advertising an intention to seek offers from providers in relation to that contract where the relevant body is satisfied that the services to which the contract relates are capable of being provided only by that provider.

So, it is left to the commissioners' discretion whether to award a contract to a favoured provider without advertising it for other potential providers to tender.


5 (3) For the purposes of paragraph (1), a relevant body is not to be treated as having awarded a new contract— 
(a) where the rights and liabilities under a contract have been transferred to the relevant body from the Secretary of State, a Strategic Health Authority or a Primary Care Trust; or 
(b) where there is a change in the terms and conditions of a contract as a result of— 
(i) a change in the terms and conditions drafted by 
the Board under regulation 17 of the 2012 Regulations (terms and conditions to be drafted by the Board for inclusion in commissioning contracts), or 
(ii) new terms and conditions drafted by the Board under that regulation. 

Apparently contracts can be awarded under an open tender and then the terms & conditions can be changed without re-opening the tender. Now, we wonder if that is open to abuse? 


6(1) A relevant body must not award a contract for the provision of health care services for the purposes of the NHS where conflicts, or potential conflicts, between the interests involved in commissioning such services and the interests involved in providing them affect, or appear to affect, the integrity of the award of that contract.

The document helpfully clarifies:

An interest referred to in paragraph (1) includes an interest of— 
(a) a member of the relevant body, 
(b) a member of its governing body, 
(c) a member of its committees or sub-committees or committees or sub-committees of its governing body, or 
(d) an employee.

So the interests of sundry friends and their friends and relatives and partners and ancestors' next door neighbours are not mentioned here.

And here is why publishing the 'criteria' for selection at the outset opens a barn sized door for those who would bend their promises to fit into the criteria, knowing that the terms&conditions can be changed later (as per 5(3) above). No matter how pongy the provider or its owners may be the commissioning body is not forbidden to turn its nose up:

7(3) When taking a decision referred to in paragraph (2)(a), a relevant body may not refuse to include a provider on a list where that provider meets the criteria established by the relevant body for the purposes of that decision


7(4) When taking a decision referred to in paragraph (2)(b), a relevant body may not refuse to include a provider on a list where that provider meets the criteria established by the relevant body for the purposes of that decision

7(5) When taking a decision referred to in paragraph (2)(c), a relevant body may not refuse to enter into a framework agreement with a provider that meets the criteria established by the relevant body for the purposes of that decision

In short:

• All contracts must be put out to tender, except when the commissioners want to give the contract to a specific supplier in which case they don't need to put it out to tender after all.
• Contract terms can be changed after the contract is awarded, without regarding it as a 'new contract' with the scrutiny that would require.
• Conflicts of interest are tightly defined as members and employees of the commissioning bodies. The interests of chums and chums of chums are overlooked.
• Commissioners are specifically not allowed to reject suppliers who claim to be able to meet the "criteria established by the relevant body for the purposes of that decision". So no consideration is allowed to be made of the supplier's reputation and past history, and political affiliations. 

A proposal was moved in the Lords to block this law. The proposal was defeated: the results on the right show how the parties voted. 

One can't blame the Tories for backing this law. It is in their nature just as it is in the nature of a scorpion to sting. However it is more difficult to understand the support of the Liberal Democrats whose votes would have blocked this change in procurement regulations. Regulations that the British Medical Association oppose.

We assume removing the right to refuse to deal with dodgy companies, as legislated above, will become the template for future outsourcing and privatisations.

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Rip-off News round-up. Our pick of the last week's media (Thu 3rd May)

“Big 4” accountancy firms use knowledge gained from staff seconded to Treasury to help clients avoid taxes
In one example, KPMG advised on the development of "patent box" rules, and then issued marketing brochures titled "Patent box: what's in it for you."  Deloitte, Ernst & Young, KPMG and PricewaterhouseCoopers have provided the government with expert accountants – free of charge - to help draw up tax laws. But the firms went on to advise multinationals and individuals on how to exploit loopholes in legislation they helped to write. GUARDIAN

("Yes, free of charge... Well, there is a small charge... Between £35bn and £70bn+ of taxes dodged by our clients!" said our Big 4 insider.)

Warning from headteachers as parents dig deep to fund boom in private tutors
Parents on modest incomes and families from ethnic minorities are behind a massive boom in Britain's multimillion-pound tutoring market. Hundreds of thousands of children – some as young as two – now receive private tuition at a cost of between £7 and £60 an hour. Parents say the extra study gives their children confidence and helps them secure top grades. But headteachers are warning that the tutoring market is beginning to spiral out of control and is "trading on insecurity". GUARDIAN
(…So… degrade a public service - education - and a whole new private sector is born! The system works!!)

More women turn to credit cards and loans to make up for their lack of income
A survey by credit report company Callcredit found that 72% of women have applied for some form of credit in the last 18 months, compared to just 28%. Worryingly, the main reason women did so was to make up for shortfalls in their income. The research also found that women are now far more likely to apply for credit to cover household goods than men, as well as being more likely to resort to the desperate measure of taking out an exorbitant payday loan. European Commission studies found that across the continent women earn on average 16.2% less than men. DAILY MAIL

Iain Duncan Smith urges wealthy elderly to 'hand back' benefits
Wealthy elderly people who do not need benefits to help with fuel bills, TV licences or free travel should give the money to his department, said the work and pensions secretary Iain Duncan Smith. He said he would "encourage" people who do not need such financial support "to hand it back". BBC NEWS
(Meanwhile, extremely wealthy people who do not need 'loopholes' to help with their 'tax', 'moral compass' and 'vast wealth' should give the money to the Conservative Party, if they haven’t done so already...)

Google and its auditor Ernst & Young ordered back to parliament to answer tax questions
Google's European boss told parliament's public accounts committee last November that his sales team was based in tax-sheltered Dublin and that the job of UK staff was simply to market Google. But evidence from Google's own website, interviews with clients and former staff, and staff profiles on the internet, shows that some sales staff are based in London. If so, Google's UK tax bill could increase significantly. Google's own corporate website advertises London-based jobs whose duties include "negotiating deals", closing "strategic and revenue deals" and achieving "quarterly sales quotas". Google responded: "As we have said many times, we comply with all the tax rules in the UK and in every other country in which we operate." Google’s motto is “Don’t do evil”. GUARDIAN
(Google added: "And as we have said many times, we comply with all the rules of evil as found in the Kingdom of Hell, and in every other moral vacuum in which we operate.")

Moody’s S&P settle lawsuits accusing them of hiding risky subprime investments

The lawsuits from King County in Washington state and Abu Dhabi Commercial Bank claimed that the ratings agencies and Morgan Stanley hid the risk of investing in a fund that purchased bonds backed by subprime mortgages. The collapse of such "subprime" funds triggered the global financial crisis. The cases were settled without any admission of liability or wrongdoing, which means that no one will be prosecuted. WASHINGTON POST
(…which is handy, as US jails are already rammed full of low income people who defaulted on their subprime mortgages…)

Estate agents obliged to reveal property problems, rather than keep quiet
The days of estate agents singing a property’s praises without mentioning its drawbacks are over. At least, that’s what the Office of Fair Trading has ruled. In the past, it was up to the buyer to ask the questions. The seller or agent did not have to volunteer every detail about a property — their only obligation was to give truthful answers. Now the onus is on the agent to be frank and disclose any information that could affect a decision — not only to purchase but even view in the first place. Matters that must be disclosed include: nearby motorways, flightpaths, night clubs and schools; crime; failed sales and the causes thereof. Also, photos must accurately reflect the state of the property. DAILY MAIL

Austerity kills, economists warn
Austerity is causing soaring suicide rates, rising HIV infections and even a malaria outbreak. In a new book, The Body Economic: Why Austerity Kills, the authors show how different strategies to deal with economic shocks affect health. Examples include Sweden, which used public spending to cope with its recession in the 1990s: the number of suicides fell despite a large rise in unemployment. In Greece, however, HIV infection has risen by over 200% since 2011 as prevention budgets have been cut, and intravenous drug use has grown amid 50% youth unemployment. Greece also experienced its first malaria outbreak in decades after budget cuts to mosquito-spraying, the authors say. GUARDIAN

Commission sales are abolished on some financial policies
The new policy will apply to the sale of investments such as pensions, annuities and unit trusts, but not to some mortgages and insurance policies. Commission-driven sales were at the heart of the huge mis-selling scandals of the past few decades, affecting the sale of endowment policies, personal pensions and most recently payment protection insurance (PPI). Even apart from those scandals, the FSA estimated in 2010 that mis-selling in general was costing consumers about half a billion pounds a year. A recent survey for the FSA found that 17% of adults currently take advice from a professional financial adviser and another 32% would consider doing so. But a third of the respondents thought, wrongly, that the advice was free. BBC NEWS
(…Errr... because a hundred per cent of salespeople told them it was?...)

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