Simon Stevens, the new chief executive of NHS England, former President of global health at UnitedHealth, a large US health corporation, proposed the Five Year Forward View in October 2014.
Five Year Forward View is written in code, to give the impression that it is in favour of sustaining the NHS according to its founding principles and merely wants to make it more financially sustainable.
Closer scrutiny reveals a five year plan to impose “new care models” ( NCMs), inspired by the US health market. These would replace our current GP surgeries, District General Hospitals ( DGHs) and tertiary care.
The plan depends on a gigantic shift of clinical services out of DGHs and into large new out-of-hospital providers fashioned after American health maintenance organisations, such as Kaiser Permanente. The remaining hospital care would be divided between dumbed down smaller hospitals and networks of large specialised providers, often using ‘prime contracting.’ The closure of fully backed A&E departments would accelerate.
Five Year Forward View alleges that these NCMs, as well as much more ‘self- care’ by patients, would drastically reduce demand for hospital care and ramp up “efficiency”, such that it would be possible to save up to £30bn a year by 2020.
The plan is predicated on an attack on the national terms and conditions of the NHS public sector workforce, the downgrading of its training, and drastic reduction in numbers employed.
The aim is to cut staffing costs by; increased productivity up to 2-3% a year, meaning more patients per nurse; reduced skill-mix; local pay; 24/7 working with unsocial hours paid at reduced rates; staff required to work “across organisational and sector boundaries” (that is to be outsourced ), and have “flexibility to deliver new models of care, including the development of transitional roles’ ( meaning lower qualified staff taking on doctors and nurses roles ). There would be a huge increase in unpaid labour in the form of volunteers.
This plan is about destroying our NHS services and imposing NCMs, as attractive investments for multinational corporations, which are already circling like vultures to enter the healthcare market opened up by the Health and Social Care 2012.
The ” test bed ” for the NCMs is to be Greater Manchester under Chancellor George Osbornes 27.2.15 ‘ Devo Manc’ proposals. Greater Manchester is to be a “trailblazer for the objectives set out in the five year forward view”.