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The NHS privatisation US trade deal discussion really glosses over how much the NHS is already privatised behind the scenes. And how much free at point of use is already being undermined within public provision via up front charging and surcharges.
A lot of community health provision has been hived off from the NHS and is now subcontracted to 'social enterprises'. Employees moved from NHS go on TUPE but will be excluded from collective bargaining (I think?). 100k people work for these now.

nhsconfed.org/resources/2019…
The massive one is PFI, where hospitals were built against 20-30 year exorbitant loans and contracts. Saddling now economically siloed
NHS trusts with massive debts.

independent.co.uk/news/long_read…
Overseas NHS patients are subject to a stricter and stricter regime of upfront charging. And even NHS staff now pay a 'surcharge' alongside visa fees to access the NHS themselves (essentially public insurance but only for immigrants).
Both the upfront charging and the surcharge prefigure a more generalised charging regime - the infrastructure to check if you've paid will be much the same.
Then apart from the privatisation of clinical staff via social enterprises, nursing agencies are of course private. And then maintenance and cleaning services have been outsourced to private companies for years.
Privatisation can be a pretext for attacking pay and conditions, creating a multi tier workforce, and raising prices, but these can also been done within nationalised orgs as well. Or the weird hybrid model that the NHS currently is.
This stuff is not exactly secret but it is really not talked about. And unless you read the headed paper on a vaccination reminder carefully you're almost always dealing with 'the NHS' even if the person you're talking to doesn't technically work for it any more.
Another new one that's deliberately complex and obscure is Integrated Care Providers, which allows all health services in an area to be provided by a single private company.
nhsfunding.info/accountable-ca…
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libcom dot org
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Today is the 105th anniversary of the SPD voting for war credits in the reichstag at the start of WWI. There's still a lot to learn from that event to understand how we got to where we are today. Black and white photo of the Reichstag
"Those who had worked for and wholly believed in the ability of organized labor to stand against war now saw the major social democratic parties of Germany, France, and England rush to the defense of their fatherlands." - Rosa Luxemburg

libcom.org/library/crisis…
Liebknecht was the only SPD deputy who didn't vote in favour of war credits. Less than five years later he was murdered by the proto-fascist Freikorps, under the control of SPD minister Gustav Noske.

Read 15 tweets
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libcom dot org
@libcomorg
The Tory manifesto contains a clause that they're going to confiscate the property and vehicles of Roma and traveller communities. We will tackle unauthorised traveller camps. We will give the police new powers to arrest and seize the property and vehicles of trespassers.
They already made a change in 2016 that meant anyone from a GRT community who stayed static for three months could no longer define themselves as such and to enable councils to reduce the number of legal sites.

vice.com/en_uk/article/…
George Monbiot, who we have our own various disagreements with, wrote up Priti Patel's consultation paper before the manifesto launch.

theguardian.com/commentisfree/…
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libcom dot org
@libcomorg
Morales cancelled a contract with a German company just a week ago. But this was a project supported by the Bolivian government that was arranged in June under Morales. There very well may be a lithium rush now, but it's not helping anyone to misrepresent what happened.
Some more background from yesterday. As both a narrative and an actual thing, 'lithium wars' could dominate the next couple of decades or more, so splitting this out into its own thread.

There were ongoing protests against the plant - locals not trying to shut it down, but wanting a higher dividend payment. Morales claimed the protests were stoked by the right wing ahead of the election (this is from October 8th).
apnews.com/e9a563ddf79643…
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Dr Sonia Adesara
@SoniaAdesara
We’ve made a video 🎬

No spin lines
No empty slogans

Just the FACTS

From #nhs workers of what we’ve seen happen to #ourNHS over the past few years

The #ToriesTrackRecord speaks for itself

Please share
#FactsNotSpin #NHScrisis

Thread ⬇️
1️⃣ FUNDING

These promises of “extra spending” we hear every year never materialise

The reality: An NHS underfunded by by 30% since 2010

That’s 30 BILLION / year short

The recent ‘cash injection’ promised by the Tories, is STILL under what the 4% needed to stop further decline
2️⃣STAFFING

Dangerous staffing shortages across the NHS

40,000 nurses
10,000 Hospital DRs
7000 GPs

For years the govt have been warned about the worsening shortages

Their response:

Visa caps
Nursing bursary cut
Training budgets cut
Imposing unfair contracts on Junior DRs
Read 7 tweets
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Gower Initiative for Modern Money Studies
@GowerInitiative
Please read & act on this long but incredibly important #NHS thread...

Gimms founding member and longtime dedicated public service campaigner at @ThePublicMatter Deborah Harrington, who when asked 'How much of the NHS has already been privatised?'

Answered -
Pretty much all of it.

While all eyes are on companies like Virgin thinking they are the threat the NHS itself has been broken up into over 500 ‘provider bodies’ which are a mix of the arms’ length public interest companies, private and voluntary sectors. 1/
The ‘NHS’ Foundation Trusts are companies which run subsidiary companies and compete with one another for contracts and sub-contract to the private sector for ‘extra capacity’. 2/
Read 19 tweets
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Nigel Edwards
@nedwards_1
We hosted a confidential roundtable for experts & leaders working on the #NHS and #Brexit this week at @NuffieldTrust, thinking about how to monitor the impact of no deal and the hovering uncertainty around it. So many big issues - and some are still discussed alarmingly little!
Medical devices face a bizarre no deal landscape. DHSC say they'll need to get their products signed off by EU based agencies gov.uk/guidance/regul…. But we heard these bodies are snowed under with implementing the new EU Regulation - can they really take on so much more work?
The doubt around medicine approvals, manufacturing approvals, and so much more is making the UK a much less attractive place to invest for pharma and life sciences. Many firms are already moving supply chains and shifting key people to 🇪🇺
Read 7 tweets
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Kate Andrews
@KateAndrs
The claim that the #NHS could be 'sold off' in a US/UK trade deal is ridiculous - a political storm in a tea cup.

But the storm has moved into #PMQs today. So here we go - 3 reasons why this is about political posturing and nothing else (thread).
1) Shock, horror: American companies can already bid, and win, NHS contracts. American companies own NHS hospitals (@GuidoFawkes thread below). People may not like this, but let’s stop treating it like breaking news.
2) As @jameskirkup highlights, US is not really interested in providing NHS services. Makes sense - it’s a monopoly provider. It wants more access to drugs market, which could translate into more available drugs and treatments in the UK.
Read 6 tweets
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Scottish Government
@scotgov
The draft #Brexit deal will make Scotland poorer, according to @scotgov analysis.

Scotland's interests are best protected by staying in the EU or, failing that, the European Single Market and Customs Union.

Here's a thread setting out our position on the proposed deal. ⬇️
The proposed deal ends free movement of people, and yet all of the population increase needed to grow our economy over the next 25 years will come from migration.

EU nationals provide vital support to help us meet the need for workers in key sectors such as research and care.
The impact on the NHS in Scotland is particularly concerning.

Ending free movement of people will make it harder for skilled and experienced health professionals from EU 27 countries to work in our #NHS, where they fill vacancies in hard to recruit specialisms and regions.
Read 8 tweets

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