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Private hospitals profit in crisis

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The NHS has done a deal with private hospitals to use almost all their capacity during the coronavirus epidemic.

Despite NHS England’s claim that there will be no profiteering, it seems likely the taxpayer will be hit for the full cost of all private sector beds used. This means a very expensive bailout for private hospitals whose usual business would otherwise be badly affected by Covid-19.

Private health facilities should belong to the NHS in the first place. Most private hospitals, in my experience, contribute nothing whatsoever to training medical and dental staff or any other essential members of healthcare teams.

Their consultant medical staff are generally not salaried by the private hospital. Instead they either bring private patients with them from the NHS or have private patients allocated to them by the hospital, which pays a fixed fee for the elective—planned, non-urgent—procedure.

Private hospitals contribute nothing to out of hours or emergency care, to treating trauma, acute strokes, heart attacks, pneumonias, psychoses and so on. Private hospitals do not offer emergency diagnostics or emergency in-patient treatment.

Even where a well insured person demands to be taken to a private hospital, the ambulance will always take them to an NHS hospital.

Most private hospitals do not offer critical care. They may have ventilators and high dependency beds, especially so if they offer elective cardiothoracic surgery, but if someone suffers complications and requires critical care then almost universally the patient’s consultant will want them transferred to an NHS critical care bed.

Private hospitals are almost all only in the business of providing elective care. Given the government’s Covid-19 advice and guidance, all elective care should by now be cancelled, so private hospitals shouldn’t currently be earning any money and will have significant spare capacity.

The NHS will most likely use private sector beds for recovery and recuperation and to look after rehab patients (who might not get any rehab). It will try and move so called “bed blockers” from front line hospitals. That is patients awaiting community care assessments, packages of care or placements in rehab, continuing care or nursing home care accommodation.

This will help to reduce pressures when NHS capacity is reached—as was already happening in most hospitals several times a week as evidenced by the long trolley waits in A&E departments for emergency inpatient care.

In other words the private sector will provide care and maintenance for a group of very low-cost patients.

The government has been very coy about the cost per inpatient bed day that they have agreed with the private sector. It will, in all likelihood, match the average cost of an acute NHS hospital inpatient bed day.

But costs in the private sector are far lower than those of the NHS. Private sector hospitals directly employ fewer staff—wages in the private sector are about 20 percent of turnover, in the NHS they are 70 percent.

The private sector specialises in uncomplicated surgical procedures with short recovery periods. It will provide only a staff grade non specialist doctor, no consultant led care, no specialty or sub-specialty care, no diagnostics, no rehab and no out-of-hours specialist care.

If things don’t work out, they will simply call an ambulance and return the patient to the NHS. Anyway, it will probably have recruited its staff from the NHS which trained them.

A small number of private hospitals might agree to take Covid-19 patients, but it is very unlikely that they will take critically ill patients.

Government funding will, I suspect, be used to diagnose and treat urgent but straightforward NHS cases during the crisis, or to catch up with waiting lists after the crisis rather than investing in NHS capacity.

I don’t generally comment about the private health care sector. It is used by the super-rich, people whose employers buy health insurance for staff, rather than pay corporation tax to fund the NHS, and by individuals driven to despair by the failings of a grossly underfunded health service to deliver them the treatment they need.

I have no confidence in private health care management or its standards of care.

It is parasitic on the NHS and should be brought into public ownership now.

Sweeping powers puts France under the boot

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France is in Covid-19 lockdown with strong decrees enforced by heavy state power. Nearly everyone accepts that there has to be an end to most social interaction. But it’s being done in a harsh and class-based manner.

The first fine for violating the rules over confinement or being outside without reason is €135. This is increased to €1,500 in the event of a repeat offence within 15 days. In the case of four violations within 30 days, the offence will be punishable by a fine of €3,700 and a maximum of six months in prison.

Greece wages war on refugees for EU

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On 3 March EU commissioner Ursula von der Leyen went to Evros on the Greek-Turkish border in order to congratulate Greek prime minister Kyriakos Mitsotakis on his murderous policy against refugees.

She also pledged €700 million (£635 million) to continue his work, stating that Greece has become “Europe’s shield”.

Meanwhile, Greek foreign minister Nikos Dendias’ request for an urgent EU leaders’ summit on the “refugees crisis” was met on 18 March when they held a conference call.

However, the issues discussed were Covid-19 and the resulting economic crisis.

Johnson’s U-turn

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Who could have foreseen the extraordinary events of March when the Covid-19 crisis led the Tories to shred every orthodox belief of the past 45 years?

Boris Johnson has been forced to subsidise the wages of millions of workers while throwing more money at business than during the 2008 bank bailout.

Business has been paramount in his calculations. But Johnson has been running to catch up with the reality of infection and deaths.

Election spells the end of Ireland’s old order

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The reverberations of the dramatic Irish General Election continue as we go to press. Sinn Fein’s astonishing electoral insurgency has put a serious dent in the old order of Fine Gael/Fianna Fail, which had prevailed for nearly a century.

Not only did Sinn Fein win more of the popular vote than any other party, its leader Mary Lou MacDonald topped an impressive election campaign by winning more votes for Taoiseach (prime minister) than either the incumbent Leo Varadkar of Fine Gael or Micheal Martin of Fianna Fail.

Rishi Rich takes top job as chancellor

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Boris Johnson has just installed the richest man in the House of Commons, Rishi Sunak, as Chancellor of the Exchequer in his “people’s government”. The fact that Sunak is a disgusting sycophant, only appointed because he was prepared to demonstrate absolute commitment to the realisation of Johnson’s greatness, and who would do what he was told, should not disguise this fact. Indeed, a willingness to publicly humiliate and demean oneself before Johnson is now an essential requirement of being a Tory minister.

Cocky Johnson faces dilemmas

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Britain finally left the EU at 11pm on 31 January, signalling the ease with which Boris Johnson can now get his way in parliament following the Tories’ big election win.

Johnson was thwarted in his attempt to secure a special Big Ben bong to mark the occasion. However, his government has big ambitions. Johnson wants to shift the political landscape of Britain.

He sees being hard on immigration and law and order as key, leavened with gestures towards “rebalancing” London and the regions.

Billionaire super-yacht owner dies

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Sultan Qaboos bin Said of Oman, according to the British establishment one of the finest, wisest, kindest men in the world, has died. Flags were flown at half-mast on public buildings and the prime minister, Prince Charles and the Chief of the Defence Staff flew out to offer their heartfelt condolences.

According to Boris Johnson’s official statement, Qaboos was “exceptionally wise…the father of the nation who sought to improve the lives of the Omani people”.

Labour leadership contest is not the key

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The current battle to lead the Labour Party stands in sharp contrast to the leadership contests in 2015 and 2016 when Jeremy Corbyn’s candidature electrified the campaigns.

Corbyn was both the most left wing Labour leader in history and the most popular with the party membership, which swelled to more than 500,000, making Labour the biggest political party in Europe at a time when Labour-type parties elsewhere in Europe are in crisis.

His victory in 2016 came despite two-thirds of the shadow cabinet resigning in an effort to bring him down.

Democratic race sees Sanders surge

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There is a real possibility of Donald Trump being re-elected in November. Trump has made much of the mini revival of the US economy, while the attempt to impeach him will have done little to hurt his chances. In fact it is likely to fire up his base by allowing him to continue to pose as anti-establishment.

So the imposing figure of Trump, bigot-in-chief, looms large over all the candidates in the race for the Democratic nomination for its presidential candidate in November.

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