Here is a ‘government-funded’ workfare company advertising ‘free labour’
welfare reform
On the Andrew Marr show on BBC IDS was speaking about the Poundland case in which Cait Reilly was forced to work in a Poundland store for two weeks and thus had to abandon a voluntary position at a museum. During the interview he said:
‘She was paid jobseeker’s allowance by the taxpayer to do this.’
thereby confirming what most had known all along that, far from being an individually-tailored training scheme, the Work programme is nothing other than Workfare in which the benificiaries are the companies who get a free workforce at taxpayer expense.
This video shows you all you need to know:
As part of a discussion in the DT on 5 Feb 2013 the following comments were made:
The Gas chambers didn’t start fully formed but with the ill-informed prejudices of those who believe in the primacy of ‘common sense’
House of COMMONS
Oral EVIDENCE
TAKEN BEFORE the
Work and Pensions Committee
Personal Independence Payment
MONDAY 21 January 2013
Esther McVey MP, Simon Dawson and Dr Bill Gunnyeon
Esther McVey: We have always said that [PIP] is a personalised benefit. Everybody will be assessed-not all then on a facetoface, as we have said, but everybody will be assessed and it is personalised. What we have also said about this benefit is that it is not about the condition; it is about how that condition affects the individual, and those are key to this benefit. It is how the barriers affect the individual, and how the barriers affect them having an independent life.
Q34 Sheila Gilmore: So the DWP will intend, when it sees people and keeps in touch with them, to help them find help and support. So that will be an integral part of what you are doing.
Esther McVey: When you are assessing people and you are meeting them for an hour, as these meetings would be, then you have an overview and you will engage in a conversation with that person and, yes, of course you will, in an hour’s conversation, be talking about different things within that-how best you can get support and help. Of course you do; anybody would do that.
http://www.publications.parliament.uk/pa/cm201213/cmselect/cmworpen/uc916/uc91601.htm
This answer could possibly be believable were it actually based on the facts on the ground.
The whole thrust of the debate around ‘welfare reform’ is based on the Biopsychosocial model:
The biopsychosocial model (abbreviated “BPS”) is a general model or approach that posits that biological, psychological (which entails thoughts, emotions, and behaviors), and social factors, all play a significant role in human functioning in the context of disease or illness. Indeed, health is best understood in terms of a combination of biological, psychological, and social factors rather than purely in biological terms.
The problems are largely that the social factors are being ignored.
How much help is it to assess somebody as being fit for work and thus to immediately stop their benefits on the basis that they would be more mobile through the use of a wheelchair or other appliance EVEN WHEN THEY DO NOT ACTUALLY HAVE THE WHEELCHAIR OR APPLIANCE. Surely any system fit for purpose would provide the necessary equipment and any relevant training and support PRIOR to stopping benefits?
The problems however do not stop there because the system most definitely is NOT personalised.
Say the DWP exhibit the first glimpse of humanity in years and made the change such that they provide the mythical wheelchair to two people one living in the centre of an urban area with good transport, local hospital and support services etc. They could well be more independent than before and a reduction/ removal of benefits may be justifiable.
The second person in our example lives in a rural area, no public transport and the loss of benefits includes removal of MOTABILITY. Exactly how much ‘help’ have they received with their ‘personalised’ needs?
Q28 Jane Ellison: Could you confirm that 71% have never been reassessed?
Esther McVey: They are on a lifetime award. Our view on that is that some of them-50%-never had medical supporting evidence. What we are saying now is one of the positive things about PIP really is to look at a systematic review and, as we say, see how can we help, because our view is the very opposite way: if you have put these people on benefits for life, what are we doing as a society to help and enable those people? Yes, I appreciate some people’s conditions will not get better, and maybe some will get worse, but there is a percentage of people who will get better, and we have to be there for them in a very different way. How can we help them to progress, to take an active part in society?
THERE IS NO SUCH THING AS A LIFETIME AWARD – THERE ARE INDEFINITE AWARDS (this is one of IDSs most oft-repeated untruths) and these are subject to review whenever the DWP decides and thus there is no need to change the previous legislation.
We received a brief from the MS Society, who are very exercised by this change. They are incredibly exercised by this change. On Saturday I saw someone with MS, who was attending the same meeting as me. The disabled parking was 30 or 40 metres from the door. He got out of his car and walked with his walking stick. He stopped more than twice and was absolutely exhausted by the time he got into the meeting. By the criteria here, that means he would only get 10 points, because he can move more than 20 metres. Actually, he probably managed 50 metres and he could probably do more than 50 metres, but from his first step-
Dr Gunnyeon: Chair, can I clarify? The issue of safely, reliably, repeatedly and in a timely manner would become highly relevant here. You have identified the fact that not only did it take a while, but there is an issue about his being exhausted at the end of it. That is why that ability is so important throughout all of the descriptors. Somebody may be able to do it, but if they are then not able to do anything for the next few hours or are exhausted the next day, clearly they are not then considered able to do it and they would actually get the points.
How will an ATOS/CAPITA interviewer be able to judge this in a 30 minute tick-box exercise in an office?
The next statement however is absolutely kafkaesque.
Q64 Chair: Where does the measure start? If he could walk the first 30 metres comfortably and then struggle, would that mean he ends up not getting the enhanced rate? Is that right?
Dr Gunnyeon: If that is correct and there are no other factors around the safely, reliably and repeatedly, then yes, that would then be the case.
But both have to travel the same distance, both have the same reaction in terms of exhaustion and other symptoms the only time the second person would be in a different position medically, socially and in terms of independence would be if they were constantly require to travel between 20 and 30 metres; an obvious nonsense in the real world.
These are questions based on the uncorrected transcript and Ms McVey comes from the John Prescott school of English so it is often difficult to decipher what it is she is actually saying but the DWP incompetence remains as it has been for several years.
Having received millions in public funding it seems the estimable @toadmeister is the perfect person to run a taxpayer funded Free School. Here in an article from The Spectator the odious bigot makes his thoughts abundantly clear:
If this self-entitled, ignorant shit is, along with the Policy Exchange Spads and a Murdoch-hack, considered fit to have input into the education of other people’s children then I really am glad that Scots education is outwith their control.
What is the meaning of the phrase ‘largest deficit in history’? Try watching this video from around 2:25 on for the answer.
Again the entire document is reproduced in full. Annotations have been made where something of interest was noted. Anyone interested in what McKinsey proposals could mean for patient charges at the point of use should go directly to slides 118 onwards.
As this document is very slipshod a fair amount of annotation has been made.
Some notes made during perusal of this document:
There is a recommendation for an acute GP Unit in Cornwall, the county that has recently had one GP to cover all out of hours provision supplied by a private company! (Slide 10)
Warren Farm is not open overnight (Slide 13)
Up front costs are required for example to satisfy the recommendation that all nurses and specialist carrying out home visits be supplied with GPS/Tablets/PC – no costs appear to be assigned to this suggestion.
The sources quoted on many slides appear refer to results obtained from ‘one English hospital or ‘one English PCT’
Many sources quoted go back as far as 2001.
One would hope that reducing the amount of drugs supplied to patients doesn’t include pain medication!
The argument that there is an inverse relationship between the size of the purchasing costs and the possible savings from reduced drug prices would seem to argue against the McKinsey model being followed in England! (Slide 69)
In addition to using data from 2001 they also appear to be using US data as a proxy for the NHS (Slide 76)
Slide 73 indicates a potential saving that doesn’t take account of savings already achieved? Slide 81 then repeats the same savings figure without the caveat?
Whether a slide is marked ‘indicative’ or ‘illustrative’ appears to be arbitrary throughout.
Slide 112 appears to have the spin inbuilt – giving a gross figure that ignores a known figure of already achieved savings.
NOTE: Trawling through this bull for hours now some errors may have been made that do not flow from the document. Tough; they should have published them for publid discussion!
Reshaping the System Part 2
Given the following presentation includes as ‘evidence’:
Press Articles
‘Indicative’ Figures (aka a guess)
Interviews (aka anecdote)
Presentations to Investors
The one suggestion which surprises by its omission is: STOP PAYING THESE CHARLATANS A FORTUNE TO PRODUCE THIS DRIVEL!
As with all the documents dealing with this subject this is produced unedited and in its entirety.
The following document is complete and unedited the only changes made by myself are to add some highlighting to points that I found of interest.
The paragraphs highlighted are:
Few healthcare organisations have achieved this level of improvement across all parts of the system simultaneously.
- page28
It is unclear whether the identified productivity and quality improvement opportunities will suffice to close future funding gaps. If not, then there are other actions which can be taken to reduce required funding in future, which do not fundamentally improve (and may worsen) quality and the system’s allocative and technical efficiency. These include: co-payment by the service user; controlling staff wage inflation; and restricting access to services. These are discussed in more detail in section 6 of this document.
- page 28
Less hospital capacity will be needed, e.g., ~350 fewer hospital beds and ~30% fewer hospital outpatient appointments than were required in 2008/09.
- page 32
Overall, our very preliminary estimates are a net reduction of ~1,000 staff relative to 2008/09 levels – a reduction that is likely to be more than adequately covered by 2014/15 through natural attrition and retirement.
- page 33
It will therefore be vital to get together a group of leaders who will work together to champion the reforms, pioneer and support innovation, speed up decision making and ensure that actions across the system are coherent and aligned.
- page 34
A workforce pipeline and talent management process that is aligned to the strategy.
- page 35
We cannot afford to wait for innovation and clinical/ professional breakthroughs to trickle slowly through the system, or to have organisations attempting to ‘reinvent the wheel’. We therefore plan to assess opportunities via ‘test-bed’ pilots that can be rapidly rolled out to other Trusts once completed.Finally, we must not wait until reconfiguration of services is complete before turning attention to workforce issues. We will need to make proactive and immediate changes to our workforce pipeline and deployment of staff to reflect the future delivery of services – for instance by influencing graduates to apply for roles that will be of growing importance in future, and by developing training that reflects new roles and/or helps individuals to switch between roles.
- page 35
We need to communicate the case for change and the vision for future services effectively, and involve stakeholders in making change happen. We will need to begin this process soon, to engage communities, patients, clients9, professionals and all staff in shaping and supporting system-wide changes – such as individual budgets and home-based care – before implementation, as well as effectively engaging opinion formers (e.g., the press, unions) in the rationale and direction of change. We will also need to establish a robust clinical and professional rationale for changes very clearly early on, if we are to successfully engage health and social care professionals themselves in driving the changes.Finally, we must think carefully about who tells this ‘change story’ to partners,
- page 36
If more than this £0.6 billion is needed, a further ~£0.1-0.3 billion could be achieved through the introduction of co-payment and further savings through a freeze in staff pay costs. Any further savings will involve reducing quality by restricting access to services – risking the integrity of the health and social care system.
- page 39
Experience in private and public healthcare and non-healthcare sectors in the UK and other countries suggests that an organisation can typically deliver 2-5% improvement p.a. – but that within public healthcare, it is difficult for the payor/ commissioner to deliver more than 2.5-3.0% p.a.
- page 42
there may be additional ways to reduce required funding without damaging quality by making regionally- and/or nationally-led changes to income and costs. Such changes would require decisions by political leaders and challenge the principle that the NHS is free at the point of delivery. However, the content suggests that such options may need to be considered.
- page 44
In addition to this, other co-payments such as are used in other European countries – or beyond that – could potentially be introduced, if there was need and will. For example, people could pay for attending A&E (as in Republic of Ireland); for access to primary care (as in Germany); for inpatient stays (as in France).
- page 45
If further reductions in funding were to prove necessary, beyond the identified improvements in productivity and quality, and the changes to income and staff costs described above, then quality of care and the integrity of the HSC system would be put at serious risk. We would need to restrict access to services and treatments, for example by:■ Enforcing tougher eligibility criteria for treatments, e.g., hip replacements only for the over 80s, social care packages only for the acutely-ill, asking people who need it to buy their own equipment■ Introducing means-testing, i.e., making people pay for care if they can afford to■ Denying treatments that are high cost per Quality-Adjusted Life Year (QALY), e.g., high-cost end of life treatments such as chemotherapy■ Reducing funding of services seen as ‘non-core’, e.g., voluntary and community groups – which currently substitute and/or prevent need for statutory care.
- page 46
While we may not capture the full savings potential until necessary legislation and consultation is enacted (e.g., for reconfiguration), we can start to develop the new ways of working and protocols that will underpin future savings, and can start to make some structural changes if we have the discipline to not fill up freed-up capacity. This will be critically important where we need to test and pilot changes.
- page 48
RESHAPING THE SYSTEM
This document is supported by 3 appendices which are on other pages on this blog.
