Onkar Sahota will get an early visit from CQC

20141118_231254Today the Daily Mail went over the top with its front page. The CQC’s risk based approach to doing assessments of GP’s surgeries seems sound and it is good they are being transparent and publishing the whole thing. The Daily Mail should have covered it more objectively.

I wasn’t impressed when I heard chairman of the BMA’s GP committee, Chaand Nagpaul, complaining on the BBC Today programme this morning that the data should have been kept secret. In the public services we have too many highly paid people keeping data out of sight. Believe me after 8 years of being a local councillor I have seen it too often. Nagpaul’s Twitter account is headed with the phrase “The NHS is a revered public service not a shopping mall.”

Reverence isn’t very 21st century. Transparency is.

The whole thing did make me ask though – how is Onkar Sahota’s business doing? Sahota is the sole shareholder of Healthcare 360 Limited which owns three GP’s practices. Privatisation isn’t a dirty word for Dr Sahota. One of Onkar Sahota’s practices is going to get a visit soon having been rated 1 (ie highest risk). None of the three practices got the lowest rating (6).

Greenford Avenue Family Health Practice

Rated 1 (most risky)

Potentially not identifying enough Chronic Obstructive Pulmonary Disease, not doing enough flu jabs, not nagging smokers enough and a poor result in their patient survey.

Somerset Family Practice

Rated 3 (risky)

Potentially not identifying enough Chronic Obstructive Pulmonary at a level that CQC consider to be an “elevated risk”. Only 29% of patients reporting that it is easy to get through to the surgery on the phone.

Hanwell Health Centre

Rated 5

Potentially not identifying enough Chronic Obstructive Pulmonary Disease and dementia.

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Labour’s union funded campaign denies its own NHS record

Labour NHS Campaign

Today Ealing’s Labour campaigners were bolstered by a group of young people who came out to talk about the NHS in Acton. They were taking part in a union funded campaign that essentially insists that the NHS must be run for the benefit of its staff and cannot change to meet the needs of the people who use it and pay for it.

The union paid for posters talk about “selling off our NHS, piece by piece”. First off you might ask where is it sensible to draw the line? Should we have NHS coal dug in NHS mines used to fire NHS steel furnaces to make steel to be rolled in NHS rolling mills and transported in NHS lorries to NHS scalpel factories? Most people don’t care how their health service is provided they just want to keep the cross-party post-war consensus that health services should be provided free at the point of use.

No doubt the unions would like to see the 35 year Private Finance Initiative (the clue is in the name) at nearby West Middlesex Hospital undone. The deal was done in January 2001. You can read all about it in a National Audit Office report. Of course it wasn’t done by David Cameron it was done by Labour’s own Alan Milburn when he was Secretary of State for Health when some of these young people were tiny children. The last Labour government went further than any other government, including the current one, in introducing privatisation into the NHS.

Did the Labour party explain to these fresh faced youngsters that the stringency that the NHS is operating under was already locked in in 2010 and written down on page 4:3 of Labour’s manifesto to give Labour cover to proceed? The so-called Nicholson Challenge was kicked off in 2009 by Andy Burnham when he was Health Secretary.

Labour Manifesto Nicholson Challenge - close up

Labour think if they keep denying their own record on the NHS they can fool voters as well as these young people.

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Typically Dr Sahota is only telling half of the story

Local GP and Labour politician Onkar Sahota has been writing on the LabourList blog. Typically Dr Sahota is only telling half of the story.

North West London’s Shaping a Healthier Future programme is merely the local roll out of Labour’s £20 billion Nicholson Challenge. Nicholson was kicked off in 2009 by Andy Burnham and aimed to take £20 billion of savings out of existing services to ensure that new services could be provided and new demand met in a post 2008 world. To give itself cover to proceed with this programme Labour included it on page 4:3 of their 2010 manifesto. Go and look. The Coalition had little choice but to continue with it.

Labour Manifesto Nicholson Challenge - close up

Shaping a Healthier Future follows from both Nicholson and Labour’s own Darzi Review. The programme would have happened in the same way if Labour had won in 2010 as the same decision makers would have been working to the same constraints. The reason Ealing hospital is under threat is because the West Middlesex is subject to a 35 year PFI deal signed under a Labour government. 35 years! Sahota fails to mention this key point. He wants to pay for a brand new PFI hospital and keep a tired old building going at the same time but refuses to say where the money will come from.

As Sahota rightly points out only two A&Es have closed not the four originally proposed. That is because Tory Secretary of State Jeremy Hunt demanded that they stay open. The only actor that has mitigated the North West London programme in any way is Jeremy Hunt. Not the courts. Not the Independent Reconfiguration Panel. And Labour refuses to make any promises of mitigation whatsoever.

We are all angry that London North West Hospitals trust has messed up its change programme failing to open its brand new A&E at Northwick Park in time for the closure programme. This is bureaucratic failure not government direction.

Sahota still refers to himself as a GP in spite of sullenly failing to be objective about health issues since he was elected. Poor show.

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The USA is so different

I was on holiday in the US with my family during the elections of 2012 this time two years ago. We saw Air Force One and its accompanying presidential motorcade as we flew out of Richmond, Virginia to Savannah, Georgia.

The most amazing thing we saw that holiday was this advert from John Barrow who was a Democrat for Georgia’s 12th congressional district until last night. He was running for re-election at the same time as the presidential election.

This morning I saw that he lost. Anyone who thinks that American politics is anything like ours needs to watch this!

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Does Sahota believe a word of it?

This morning local Labour assembly member for Ealing and Hillingdon, Onkar Sahota, retweeted this five point manifesto from a campaign group called People’s Vote for the NHS.

I am not sure who People’s Vote for the NHS are beyond an anonymous Facebook account that seems to be related to the NHS “Jarrow” march in August/September this year.

The core of these people are hard left unionist and SWP types who have no interest whatsoever in making sure that the 10% of GDP we spend on health in this country gets the best results for the most people. They do want to bring down the Coalition and make sure that the Conservatives do not get into power. They do want to make sure that the Labour party protects vested interests and ignores patient outcomes as in Stafford.

What is Labour’s policy and how does it compare with this pledge list?

REPEAL THE COALITION’S NHS REFORMS. STOP PRIVATISATION. NO TO TIPP

Labour will make a show of tweaking the NHS reforms but will do nothing substantial to change the purchaser/provider split that sits at the centre of them and which are entirely uncontroversial to all but a few on the extreme left who believe that the NHS can be directed by central control. Privatisation under the Coalition has been going on at a slower pace than it did under Labour but Andrew Burnham thinks this a good line so he will limit privatisation even if it means worse outcomes for patients. The TTIP bit seems to be Labour party policy even if the whole issue has been misunderstood and is probably a red herring. Sahota probably can endorse this first pledge but after this it gets hard.

END THE NHS FUNDING FREEZE

Labour was vague about this before the last election and it will remain vague. They didn’t make any firm promise to protect health spending in 2010 unlike the Conservatives who have delivered on this pledge. Labour did though put the £20 billion Nicholson Challenge on page 4:3 of their manifesto and it was built into the NHS’s planning before the election. More recently Labour seems to be offering £2.5 billion from a mansion tax which will not appear for at least 2 years. The £2.5 billion has to pay for a new social care service which will be a huge undertaking. It represents only just over 2% of total NHS spending and cannot plausibly go anywhere near covering wage pressure, a so-called GP “crisis”, a so-called A&E “crisis”, undoing Nicholson and cover social care.

Labour will not end the funding freeze. All they are promising is a very tiny amount of money to do something new. The Tories have promised to protect health spending which Labour still has not done unequivocally. Perhaps Sahota can tell us how much the NHS will get and when?

NO MORE CUTS AND CLOSURES TO NHS SERVICES

Sahota cannot possibly agree to this proposal. It is totally unaffordable nonsense and flies in the face of previous Labour health policy as laid down in the Darzi Review and the Nicholson Challenge. The only way that the NHS is going to have half a chance of meeting new demand within financial constraints is if there are massive changes to services. Sahota needs to spell out what he would do differently and how it would be paid for. He won’t because he hasn’t got the first idea.

FREE OUR HOSPITALS FROM THE PFI DEBT BURDEN

The rule of law and respect for commercial contracts are two of the main underpinnings of our economy. These contracts cannot be unmade without very expensively compensating the PFI operators, most of whom were given contracts by the Labour government. For instance, the reason that Ealing Hospital is losing out and that West Middlesex isn’t is that the Labour government signed a 35 year, yes 35 year, deal on it. Does Sahota, who has spent a whole career being a private supplier to the NHS, really think that that the NHS should rip up its PFI contracts breaking both UK and EU law? Or does he think they should be bought out? Where will the money come from? Is Sahota serious? Perhaps he can explain?

FAIR DEAL AND FAIR PAY FOR NHS STAFF

Labour is making no promises on pay and the most likely outcome is that there will have to be years of pay restraint in the NHS unless it can revolutionise its productivity. Perhaps Sahota can spell out how he thinks NHS pay will change under a Labour government?

It is strange to see an ostensibly mainstream Labour politician like Sahota endorsing this left-wing agenda which is miles away from official Labour party policy. Either he is totally off piste and naive or he doesn’t mind what lies he tells to get Labour back into power. Given that he is a very rich and successful doctor which one do you think is true?

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GPs want their cake and eat it

Dr-Maureen-Baker_cdp-20131009123916836Today sees the start of the Royal College of GP’s annual conference and is marked by a media blitz by their chairman Maureen Baker. Again and again Baker overstates her case.

Baker is seeking a 37.5% increase in resources for GPs. Sure we would all like someone to wave a magic wand and push a lot more cash at us. It is an outrageous demand.

The latest piece of evidence Baker is using is a bogus piece of research that suggests over 500 GPs practices will close as their doctors are over 60.

In making her case Baker undoes herself. Her own press release says: “the average retirement age of GPs is 59”. Wait a minute. Why are GPs retiring so early? Has she no self-awareness? Do the GPs really think they can opt out of working life, after such a long and expensive education largely paid for by the state, after such a short working life?

One of the things that really confuses me about the NHS is that GPs manage to remain as private contractors but also enjoy a state provided defined benefit pension scheme. I can only imagine that this pension is way too generous if doctors are checking out so early. In the interests of public debate and seeing that Baker raised the issue perhaps the RCGP could publish details of the GP’s pension scheme?

Of course local multi-millionaire GP Onkar Sahota is backing Baker’s campaign. If so few medical students want to go into general practice maybe Baker should send Sahota to medical schools to explain to young doctors how they too can make their fortunes out of being private operators within the NHS.

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Ealing Labour keeping up its big NHS lie

The local Labour party was keeping up its mendacious NHS campaign yesterday by staging the delivery of a letter to Secretary of State for Health, Jeremy Hunt. They haven’t published their letter and much more importantly they refuse to say what they would do if they were in charge.

The two A&E closures that come into force on 10th September will be a worry for people but I suspect that the NHS will navigate around them safely. It is after all the NHS’s own plan and they will have to pay the legal bills if things go wrong. The original plan was that four A&Es should close to bring the area into line with the Royal College of Emergency Medicine’s guidance that sustainable A&Es require a catchment area of 500,000. It is quite right that Conservative Secretary of State Jeremy Hunt ordered that Ealing and Charing Cross A&Es should remain in some form. For all the noise coming out of the local Labour crowd on this subject the only actor in this drama who has done anything for us is Hunt. The courts said the consultation was sound and turned down the council’s judicial review request. The Independent Reconfiguration Panel said that the whole programme was sound.

Bell, Sahota and the rest of the Labour crowd know they are being venal. They know that this programme is the local roll out of Labour’s own £20 billion Nicholson Challenge programme kicked off by Andy Burnham in 2009. They know it wouldn’t have been any different under a Labour government. This programme was on page 4:3 of their 2010 manifesto.

Indeed it might have been worse under Labour. Whatever you think of the Tories they have honoured their pledge to maintain NHS spending in real terms (as even Alistair Darling kept repeating in the recent Scottish debate). Labour made no such pledge and it is unlikely a Labour government would have been able to increase health spending.

Local Labour types have been painfully careful not to make any promises on the NHS. It is only 8 months to go before a general election when Labour might win power. Ed Balls has said there will be no new NHS cash from increased National Insurance or a new social care charge on death. The current programme will most likely roll on in its current form whatever government comes in in 2015. No government is going to find £20 billion (a year!) to undo Nicholson.

Local Labour politicians think they can blame their own policy on the Tories and get away with not making any promises of their own. Maybe they are right.

To repeat myself the only person who has done anything for Ealing so far is Jeremy Hunt who ordered that only two A&Es would close of 10th September not four. Labour sullenly refuses to make any promises.

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Bell overstates his case – big time

Yesterday the online version of the Gazette published the latest opinion piece from Labour council leader Julian Bell. He rightly points up the opporitunities facing Ealing but makes too much of the dreaded cuts. He says:

Over the last four years we have already cut our budgets by £87m and things have been tough.
To have to find another £96m of cuts over the next four years is near on impossible.

Bell’s claims about cuts are exaggerated to say the least. He says that: “we have already cut our budgets by £87m”. This is a very misleading statement and forward looking statements by Labour and the council officers can be discounted as being equally misleading.

The reality is that total spending by the core of Ealing council increased by about £10 million in cash terms in the 2010-2014 period of the last council. If the council hadn’t been packing away underspends into reserves or using them to pay for capital projects spending would probably have been maintained in real terms in the core of Ealing council.

I asked Question 41 at the end of the last financial year:

Please state the council’s revenue spending for the following financial years: 2009/10, 2010/11, 2011/12, 2012/13, 2013/14.

If figures for the last financial year are not available please use the latest forecast out turn figures. Please separate out education spending and housing benefit spending. Everything else can be lumped together unless there are other large items that distort the figures.

The council, typically, did not answer my question as straightforwardly as I might like, in a way that is easily comprehensible by the public. That is because they are embarrassed by the gulf between the story they have been telling and the truth.

Ealing Council Schools Expenditure

In the four year period education spending increased from £203.3 million to £259.7 million, a rise of £56.4 million or 28%. Generous indeed and well above inflation.

Ealing Council Housing Benefit Expenditure

In the four year period housing benefit spending increased from £236.8 million to £271.3 million, a rise of £34.5 million or 15%. Certainly a real increase after inflation.

The council received a totally new public health grant to take on responsibilities from the NHS. It was much more generous than they were expecting at £21.4 million and council officers are convinced they will be able to manage this money much more effectively than the NHS and make it go further.

Ealing Council Housing Expenditure

Spending on council housing rose from £65.1 million to £69.0 million, a modest rise of £3.9 million or 6%. Maybe a slight fall in real terms but more or less flat.

All other spend

Finally, we get the everything else column which is a net figure for the core of Ealing Council. In other words they have taken total spending and already subtracted that part of it which is covered by income from fees and charges so the actual spend is many £10 millions larger than this. They don’t want you to see the whole picture because it makes the “cuts” look rather more manageable.

As it happens £10 million of the “cuts” Bell talks about are increases in charges for everything from parking to paying for carers. So the bit you can’t see got £10 million larger but they are not admitting to it. No wonder they say local government finance is opaque.

The figure for “All other spend net of fees & charges” was level rising from £337.2 million in 2009/10 to £337.3 million in 2013/14. This is a real terms drop but it is not so bad due to the extra £10 million from increased charges which is hidden in this presentation of the sums.

This picture doesn’t even tell the whole story as the council packed money away into reserves by underspending over the last four years. If the council had wanted to maintain spending in real terms it could have done by not underspending. The modest real terms cut has only arisen because the council chose to underspend on the current account.

Overall the council has seen flat or growing spending in some areas and only suffered a real terms cut to its core because of underspends. Julian Bell, and the council officers who maintain the fiction of cuts, really should be ashamed of the way they misrepresent the facts.

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Slow progress on recycling – big spending on ads

Yesterday Labour’s Bassam Mahfouz was bigging up the Borough’s recycling last year – 44%. This is an improvement on the administration’s previous three years which showed only a very slow improvement in recycling rates after they doubled under the Conservatives.

Recycling rates

When the Concersavtives were in charge recycling doubled from 19% to 38% in four years. Under Labour the rate of increase has been much, much slower. Recycling rose from 38% to 44% in the last four years.

Mahfouz refers to “inventive communications”. He maybe should have said “expensive communications”. The council has spent £300,000 talking about recycling over the last year. Most of it was spent in the run up to the local elections – ten times what Labour was allowed to spend on leaflets during the election campaign.

Labour keeps changing its mind on the idea of achieving 50% recycling of household waste in the Borough.

At a council meeting on 16th December 2008 Cllr Mahfouz proposed that the council went for a target of recycling 50% of domestic refuse by 2010. This was easy to say in opposition.

At a cabinet meeting on 17th December Labour proposed to spend £700,000 to achieve a target of 50% by 2020 – backed by a massive advertising campaign that just happened to coincide with a local election. £300,000 of this cash was spent on advertising.

You might think that Labour would stick with this target having pledged £700,000 of public funds to get this idea across. But, only a month later, on 20th January the Ealing Labour party launched a pledge card that talked about 50% by 2018.

The benefit of Labour’s latest target is that it does coincide with the electoral cycle. Within days of the end of March 2018 we will know whether the council has achieved the target.

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Attlee in perspective

Attlee graphic corrected

Yesterday morning, to mark the anniversary of the post-war Labour government, a man called Matthew Ward published this “infographic”. He calls himself “Historian, edutainer & broadcaster”. He clearly is a Labour supporter. He clearly is no historian. Three of the claims on this infographic are bogus. Four of them are rather weak.

Let’s go through them.

Yes, the Attlee government “created the NHS”, if by that you mean nationalising the existing health infrastructure. The Atlee government built no new hospitals. It wasn’t until the sixties that the NHS commissioned new hospitals. The Labour government merely took existing local authority and charity hospitals into public ownership. The Conservative model put forward in their 1944 white paper was based on local authorities taking the lead – probably a more sustainable model and certainly a more accountable one. A free at the point of use national health service was settled Conservative policy by the end of the war – Labour rammed through a centralised model ignoring the 1944 model agreed by the wartime coalition and widely discussed in the country.

Did he build the welfare state? The modern welfare state took 200 years to build. Liberals, Tories and socialists all played their roles. A key component was Lloyd George’s National Insurance Act 1911. Vast progress on welfare was made by Tory hero Lord Shaftsbury in the 19th century. Yes, the Attlee government pushed forward the ideas of the coalition government as enunciated by Beveridge. To claim the welfare state for Attlee and Labour is way too much. See my next point for instance.

It is utter nonsense to say Atlee introduced child benefit. In those days it was called Child Allowance and it was introduced by the 1945 Conservative caretaker administration. The legislation passed on 16th June 1945, the operational date being set for August 1946, to be implemented by whichever party was then in power. The legislation was put forward by Leslie Hore-Belisha, a Conservative minister, of Belisha beacon fame. Atlee came to power on 26th July 1945. Sure he didn’t stop Child Allowance but the course was already set. At the very best, poor history from Mr Ward.

Legislation on womens’ property rights dates back to 1870. The idea that Atlee’s government played a large role won’t fly. The Married Women (Restraint upon Anticipation) Act 1949 was a fairly minor and technical addition to the law which removed a legal protection for married women which had become redundant. Putting this on a list of Attlee’s achievements does rather make you think it needs padding.

It is freaking outrageous to claim that Atlee “introduced free secondary education as a right”. This was put in place in the famous 1944 Education Act. Pushed through by Tory hero RA Butler. Ward is talking nonsense here.

The UN claim is preposterous too. The UN Charter was adopted unanimously on 25th June 1945. Again before Atlee came to power on 26th July 1945.

Given that the wartime coalition had already promised Indian self-rule the granting of Indian independence doesn’t seem like a great leap. Implemented by socialist hero Lord Mountbatten (not). I admire the patriots who fought for Indian independence. The idea that any post-war British government could have denied them is laughable.

Bought public services back into public ownership – this seems to be some kind of approbation for nationalisation. Yes, he nationalised the railways. The majority of the Attlee nationalisations were rolled back from the eighties and are unlikely to be ever repeated. Let’s give Attlee those two.

UK Unemployment

Achieved full employment? The war achieved full employment, a state that continued into the 1970s. The graph is clear.

Atlee’s record was nationalise like crazy. Most of it has been rolled back and very few serious people argue we should go back. His enduring achievement is the NHS which was the settled consensus of the time and clearly the child of the wartime coalition led by Conservative Winston Churchill.

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