As Skwawkbox has exposed at length, Health Secretary Wes Streeting and his boss Keir Starmer have fully committed to the ‘integrated care’ programme for the NHS. The programme is an infuriating copy of US ‘Accountable Care Organisations’ (ACO), that means closed hospitals and rationed treatment – and incentivises so-called ‘Integrated Care Boards.’ Forty two of these boards were set up by the Tories to cover the whole of England, not to treat patients, because they receive a share of any budgeted money they don’t spend back as profits.

‘Integrated care’ where

This system of perverse incentives has led to a huge drive to close hospitals and to drive down staff costs. All to ensure that private providers can make the biggest possible profits. This drive has already seen the government authorise – with Starmer’s Labour then in supposed ‘opposition’, collaborating fully with the Tories to push through the required legislation – the expanded use of so-called ‘physician associates’ (PAs) and ‘anaesthetist associates’, who have less than half the training of qualified doctors and are being used by many trusts to replace actual doctors. Several patients have already died as a result of misdiagnosis by PAs and related roles. That includes a child earlier this month in Leeds, who died of sepsis after apparent misdiagnosis by an unsupervised doctor:

‘Safe scope’

A recent study found that there is almost no evidence that any‘safe’ scope for the use of these PAs existsat all. The study, by Oxford University, concluded that far from enough studies have been done to assess whether any such safe scope is possible. And, there is no evidence that using them adds any value to NHS patient care:

No evidence was found that physician associates add value in primary care or that anaesthetic associates add value in anaesthetics; some evidence suggested that they do not.

This cannot come as a surprise to Wes Streeting or any of his executioners in NHS management. In fact, the government’s own studies concluded that using PAs poses ‘high risk’ to patients:

But shamefully, while ninety percent of doctors agree that the use of PAs is dangerous, some are eagerly collaborating with the Starmer government in its slash-and-burn assault on the NHS and its degradation of patient care – euphemistically termed ‘workforce substitution – as NHS consultant Dr Louella Vaughan showed in a thread on X:

Downskilling

Starmer’s health secretary Wes Streeting is an avid proponent of this downskilling of the NHS, which he calls ‘reform.’ Now, his NHS executioners are expanding this misuse of non-medical roles beyond just ‘physician associates’:

“When are we going to talk about Associated Care Practitioners? Saw an elderly patient today, seen by an ACP in general practice for racing heart, lightheadedness and wobbly legs. No ECG, started on Propanolol for anxiety. Came to emergency department with [life-threatening] atrial fibrillation [complicated by] rapid ventricular response. Like wtf are we doing?”Like the blue Tories before it, the Starmer government is waging war on the NHS under cover of mandatory ‘reform’, from paying GPs extra for not referring sick patients to hospitals to plans to tell patients to treat themselves and every other private-health-driven corner-cutting under the threat of ‘reform or die’.

And it is literally killing patients and putting many more at risk, so that (mostly US) private corporations can cut costs and fatten their profits.

Featured image via Unsplash/Ian Taylor

By Skwawkbox

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