Sunday, November 13, 2011


Since the announcement of the Circle Health Hinchingbrooke NHS "deal" it seems that more comes out daily to show my warnings have been vindicated.

One local Tory biased propaganda weekly paper call me a scaremonger and fall just short of calling me a liar, but as they dine and meet with our local and "dodgy" MP, who has been berrated for his expenses claims and recently brought to book over share dealing and a possible conflict of interest with his government office.

I warned that this "deal" was Profits before Patients and today it is revealed just that they are not a social enterprise
One thing you will notice is the debts that Circle Health made a pre-tax loss last year of £44.3m and yet they claim to be able to pay off Hinchingbrooke's historic,government induced debt of £38m. This does sound dubious as with this years £10m losses in 10 months added then the prospect for this to fail are high

On top of this we find that Patient Care is to fall this was again, Highlighted by me and again I was brandished a scaremonger and all but a liar and yet again I will be vindicated.

The other issue is the motives of Circle and how they can manage to turn a profit, even a small one.
One of the largest liabilities for a Hospital is staff pay and lets be fair we are paying for highly skilled people here,from x-ray, blood testing,porters and the like right up through Nursing staff to Consultants. All are trained to high standards to provide there service to the patient.

Under the Circle "deal" all the staff are to be retained using the Retention of Employment model, which means they are seconded from the NHS to the new company while retaining their NHS employment status, terms and conditions.
However, I know what Circle are going to do, they are going to, through slick presentations, going to offer to staff the chance to opt out of the NHS ROE model and choose to TUPE to their Terms & Conditions with an offer of shares that will never be worth the paper they are written on.

The outcome for those who choose the TUPE route will be devastating as Circle will not bat an eyelid when it comes to culling staff as these poor souls will be cast to the wilderness without a care and yes the shares will be worth nothing.

Under the current management team, Hinchingbrooke makes a small surplus, enough to keep it in the black but not enough to eat into the Historic debt that was caused over the years by successive governments and their relentless top down reorganisations.
So, who will Circle make any more cash to really eat into the debt and as the architect of this dubious deal the non clinical "Dr" Dunn claims?....they wont.

Unless the PCT and the forthcoming CCG's favour Hinchingbrooke Hospital for treatment,(I hazard a guess DOH "guidance" will "encourage" this) and the upcoming health bill's "Bung Tariff" (higher than normal payment)used then they wont make any more surplus than they currently do.
If this happens, having more activity(patients through the door) and a higher tariff(payment for work) then this is unfair and again I said this would happen if/when Circle or anyone else was handed the Hinchingbrooke Management to make it work,or seen to work.

The only other means to save cash is for staff numbers, already cut to the bone, to be further reduced.
I know of managers who have already been "encouraged" to consider early retirement and the TUPE crowd as I have already explained will also be fair game for the Circle axeman.

I also wonder, not as so much as to who pays, but should something go wrong in the hospital that requires repair. I ask this as the back up generator at Hinchingbrooke is now a little suspect and was noticed during last Friday's power cut. We all know the NHS will have to pay for this to be repaired or replaced BUT how will Circle react to a failure like this and what procedures are in place for such an occurance?....

There will be more to follow on from this but remember......under the terms of the "deal".... Circle Health can get out of the contract at any time.....

My words to them is.... Get out now, while you can or you will regret it...

Friday, November 11, 2011

Remembrance Day

Today we remember our Troops that have given the ultimate sacrifice at 11:00 please spend a minute to remember them......

Sadly we need to apply the same to the NHS in England,as of yesterday...the ultimate treason took place.... RIP..
The Day After.....

Yesterday was very busy, I did a quick interview on the radio and said that I think the Circle Health "deal" will be a Flash in the Pan.

My reason....they won't make cash out of it under the Health & Social Care Bill structure, if it gets passed along with the huge NHS cuts that the CCG (commissioning groups that take over from the NHS Cambs PCT) face.

CCG's will ration Hospital referrals and our healthcare locally, way more than was forced upon the local Health Board in the 80's.

As the majority of patients know,especially the elderly ones, how their Health Care has been rationed over the last 30 years with us have 50% of national funding instead of being afforded the full funding other areas get and now we are going to get even less and with an expanding and ageing that fair?..NO
But then is this rotten government fair.....NO..and the 80's Government who reduced the health care funding was of the same ideology as today's

Pre 2006 Hunts PCT had a deal with Hinchingbrooke where the Hospital got paid under tariff, so more patients were referred and referred earlier.
The result being balanced books everywhere and Patients conditions were treated at an earlier stage and better outcomes achieved.

Post 2006 and Labour's top down creation of Cambs PCT and EoESHA things got tougher, especially because the Treatment centre was to handle referrals from a large area yet during the build the goal posts changed....and hence Hinchingbrooke's debt...likewise PBR was introduced too compounding the debt.
Post 2006 led to the SHA suggesting the hospital may close.....well that's history as we kept it open......however, the number of "interim" Chief executives of the local trusts came and went and took their £1000 + per day and nowt changed.

Cambs PCT as it was before renaming to NHS Cambridgehire, said that Hinchingbrooke would have 25% less activity and more will be done in the community.
They built Oak Tree Centre a Darzi type unit, where minor procedures could be done and grandstanded a £2m investment in community services.
I said that £2m was only enough to provide vehicles and phones and maybe offices but not services....and I was correct.
Over the past few years NHS Cambs was formed and Cambs Community Services formed and CCC is funded by PCT and Cambs County Council and this is where things get complicated.
Social care is allocated by the County council and Community Services has taken on that service with some former county employees now in community services and they are the Oak Tree Centre...the Darzi type unit where the treatment rooms (still with sinks and cupboards etc are used as meeting rooms and offices)and not providing healthcare.

It's all in a mess really but then things have got more stable where you visit your GP and he may or may not refer you to a hospital of your choice, in the main with the rubbish road network we choose Hinchingbrooke as it is close by.

Out of Hours care is another story and post Dr Ubani scandal,most go straight to Hinchingbrooke and bypass the GP route. This is being discouraged but the 2004 choices made post GP contract led to Private companies running OOH GP's and failed.

Is Circle the answer or retribution for keeping Hinchingbrooke open?

Circle is just payback for keeping the hospital open, and a political opportunity to get the Private Sector parasites into the NHS, nothing more.
When you see the local political structure and how it got to this then you have the answer to why Hinchingbrooke was a soft target.

In the post Marching and Save Hinchingbrooke fall out, the Hospital restructured and has made annual surplus's and the hospital has been refurbished too.
Everything has been done to make the Hospital run efficiently and Circle wont make anything like the changes they want to without sacking staff...

Magic Ali said yesterday they they want to reduce red tape etc....that is a DOH issue and about data collection, any clinical procedures have parameters that cannot be changed to prevent errors, although Addenbrookes the wonderful have made grave surgical errors recently.

Circle Health take over next February, in my last post I said January but there you go.....and how will they make money...they wont unless there is more activity (bodies through the door) I do know the intention is to run the Theatres 24/7 and I would hazard a guess many will be shipped from Circle's other units to keep throughput up.

Under the Health Bill, this is a failed and old model that is not sustainable.

Magic Ali is going to use Hinchingbrooke's Support services, for FREE,for his other units....sterile services, Blood Labs,Catering and X-ray to save cash at the other units and we pay for it.....

Only Transparency will show that this is not going to happen and his other business's will pay the going rates,but of course we know that we will never find out....but yes I insider who tweets,as well as staff members who send me anonymously information to share.

Circle will also be getting rid of middle managers, in fact I know of 3 who have been "encouraged" to retire early so that they then will not be replaced.
Circle have had their "pink and fluffy" orchestrated stunt filled staff meetings all this week, before the announcement yesterday and they only like sessions which do not question their motives.

Lastly, the contract is watertight in Circle's favour....they can get out whenever they want.... so that gives me and the community no faith in the deal which in fact isn't worth the paper it is written on