American health insurance and digital technology companies are poised to take up near-monopoly positions running the NHS, once its fragmentation into up to 42 so-called Integrated Care Systems is cemented by proposed legislation that would take effect from April 2022.
That is, if Simon Stevens – former CEO of the Medicare business of the world’s largest health insurance company United Health and President of its Global Health division – has his way.
The quango NHS England/Improvement, headed up by Simon Stevens, recently advocated legislation to turn Integrated Care Systems into statutory corporate NHS bodies. This would complete the process of their takeover of the NHS, which has been going on for the last five years.
Cementing the American insurance and digital data companies’ dominance of key NHS planning and commissioning roles would be achieved by the abolition of NHS Clinical Commissioning Groups, with their strategic functions absorbed into the Integrated Care Systems.
Actuarial processes are already being introduced into NHS commissioning by American health insurance and digital technology companies eager to pursue the profits they will gain from access to the unique digitised treasure of over 70 years worth of a whole country’s personal medical data.
Why should we care?
The proposed legislation would seal the degradation of the NHS from a comprehensive, universal public service that’s based on meeting people’s medical needs (not on our ability to pay), into a state-funded business where access to health care is driven by actuarial considerations.
You can see where this is going – this so-called ‘managed care’ imported from the USA’s Medicare system is a way of cherry picking patients whose treatment offers the ‘best value for money’, and denying the rest of us access to treatment – or making it conditional on participation in behaviour change schemes, largely run by social enterprises or private companies.
There is much more to this sell-out. There are opportunities for corruption. The government’s response to the Covid19 pandemic has followed the Disaster Capitalism/Shock Doctrine template, with the corrupt and secretive handing out of £bns of public money to companies, often with financial and personal connections with the Conservative Party. This has been made possible by the emergency suspension of requirements to publicise contract opportunities so that companies are able to bid freely for them.
A similar process could easily result from the proposals in the Integrating Care Next Steps document to abolish the requirement for competitive tendering of contracts. Collaboration is a very nice buzz word, liberally scattered throughout NHS England/Improvement’s Integrating Care Next Steps document.