The destruction of the NHS has been a prize in the eyes of many Tories since 1947. Now it is in their grasp, they aren't going to let anything stand in the way of achieving it.

However, Circle have no experience in running an entire NHS hospital. They have run their own small private hospital and they have run Independent Sector Treatment Centres (currently only the Nottingham Treatment Centre). In spite of this, Circle has not been able to make a profit. According to the Bureau of Investigative Journalism, the latest published annual accounts from Circle show that it has a turnover of £63m on which it makes a loss of £27.4m.

More recent half yearly accounts reported by HealthInvestor show that Circle made an operating loss of £10.1m for the first half of 2011, which is less than the previous year, but shows that Circle is still unable to make a profit. This raises the question of how can a company that cannot break even be expected to turn around an NHS hospital?

Circle’s business so far has been in the lucrative “boutique” end of private healthcare with the small designer hospital in Bath (just 28 beds), clinics in Stratford and Windsor, and taking preferential rates from the NHS for its ISTCs. It is unlikely that local Clinical Commissioning Groups will pay Hinchingbrooke more than the national tariff (although there is an option in the Health and Social Care Bill to do this). This means that money will be tight.

The elective care that that Circle has provided in its private operations and ISTCs are very different to Hinchingbrooke, which has to cover much larger volumes of patients and, significantly, has to cover emergency care through its A&E department. Further, although the Department of Health says that the trust will remain in the NHS, it has not said what will happen to the 30-year PFI Hinchingbrooke Treatment Centre (24 beds, operated by Kier Project Investment) – and Circle has not said what will happen to Mulberry Private Healthcare, operated by the trust.

Overhead
2 February 2012 4:15PM
Will it make a profit at the expense of NHS patients? No. The hospital will continue to be paid at NHS prices, meet NHS quality standards, have NHS contracts and be subject to the same regulatory framework as other NHS providers. And Circle only gets paid after Hinchingbrooke is in surplus.

So the Circle have to actually provide the healthcare they're being contracted to before they keep the money that in any other hospital would go towards looking after patients? Revolutionary!

Yes, Hinchingbrooke hospital will be run privately. No, that's not a bad thing
*In its running of the NHS hospital, Circle wants to empower clinicians. It will not profit at the expense of patients

http://www.guardian.co.uk/commentisfree ... nhs-circle



The author (who happens one of the Trust's head honchos) gives the impression he's a "Doctor", but seems more focused on Post-Keynesian Economics rather than health.
http://www.amazon.co.uk/Uncertain-Found ... 0415588790

It's encouraging to see him getting a caning in the comments though. One of the top rated is for someone calling him an "arrogant bean-counter more interested in money than the well-being of patients."

September 2003 – November 2004 (1 year 3 months)

Commonwealth Fund Harkness Fellow, visiting fellow, Graduate School of Business, Stanford, 2003/4
Examined US regulatory framework and lessons and evolving trends in their payment systems and drew out policy implications for England. Key lessons were presented to ministers and fed into the assurance framework for the NHS finance system, payment by results, and the Our Health, Our Care, Our Say White Paper. Mentors: Prof. Alain Enthoven (Graduate School of Business, Stanford University) and Prof. Hal Luft (Institute for Health Policy Studies, UCSF).

Circle Health, called the "John Lewis of health" as it is 49.9% owned by clinicians, has been described as "at the cutting edge of reshaping healthcare". But the Bureau of Investigative Journalism has found it is just one subsidiary in a complex corporate structure that spans the British Virgin Isles and Jersey.

Circle's backers include Paul Ruddock, whose company, Lansdowne UK, owns 18.9% of Circle Holdings. Ruddock is one of the Conservative party's most generous donors. Other shareholders include Odey Asset Management with a 21.4% share; its founder, Crispin Odey, pocketed £28m in 2008 after betting correctly that Bear Stearns would collapse. He also funds the Tories.

Circle's accounts reveal it was forced to delay a number of key hospital building projects as finance dried up, incurring hefty interest charges. While the company has recently secured £50m institutional funding for a hospital in Reading, last year it was forced to put a project in Edinburgh on ice after the collapse of its developer. Developments in Manchester, Plymouth and Tunbridge Wells have also been delayed.

And, of course, Circle is yet to make a profit and has no experience of running a hospital of comparable size to Hitchingbrooke. What could possibly go wrong?



http://falseeconomy.org.uk/blog/circle- ... a-hospital

Entirely predictably, there's a Tory MP with his snout embedded firmly in the trough, picking up what amounts to £400 an hour from Circle for the square root of fuck all.

http://www.skegnessstandard.co.uk/commu ... _1_3222017

Mark Simmonds M.P.

http://www.theyworkforyou.com/mp/mark_s ... s#register

Bemused, befuddled and baffled, health minister (Third Degree) Burns told the BBC he 'didn't understand' why the RCGP had voted to oppose his Health and Social Care Bill and ask for it to be withdrawn.

This lines the RCGP up with the BMA, the RCN and the RCM. All the groups who might benefit most from LaLa's reforms. I think I'm right; all the medical and clinical colleges, institutions, faculties and membership organisations have expressed serious concerns, short of calling for the withdrawal of the Bill. Late on Friday the physiotherapists urged scrapping the Bill (Full reasons here) I'm told to expect more to follow. If you are in a RC and want them to take action contact them here.

It is impossible to underestimate the significance of the continuing opposition to the Bill. Chris Ham dismisses it as Grandstanding and Burns says his evidence is that Docs are luvin'-it. But, if I am to trust the evidence of my in-box this simply cannot be right. We have nearly 100,000 readers a week. I asked for someone to write an article in support of the reforms and got one reply.

It is true GPs are setting up CCGs and flirting with the outside edge of what the law and the Treasury will permit, all without Parliamentary approval. The question is why?

Simple; the McKinsey Challenge (AKA Nicholson) to cut £20bn by 2015 and recycle it, has lead to slash-and-burn; 45% of PCT managers gone. To keep their organisations stable they have clustered but it's still not safe. Hence, the Big-Beast has had to bring forward CCG formation.

GPs are rolling up their sleeves and getting on with it in the same spirit they'd man-the-life-boats and row for the shore. The Good-Ship NHS is holed beneath the waterline and sinking. GPs are bailing out the water and handing out the life jackets. They are not there because they want to be.

Burns says; the new amendments to the Bill have 'addressed everyone's concerns'. Well, I had a good look at the amendments and at the risk of 'grandstanding' I'm not sure I agree. Perhaps I'm wrong? It seems to me........

The key battle ground is LaLa's 'duty'. The wording has been fiddled with (page 4); The SoS will have a duty to 'promote' a 'comprehensive health service' through the 'Mandate' he passes to the NCB. The NCB has a concurrent duty to promote a comprehensive health service and will require the CCGs to deliver, presumably in line with the guidance the DH issued to Consortia in March last year; "To commission healthcare to the extent the consortium considers necessary to meet the reasonable requirements of patients registered with the GP practices who are members of the consortium".

Call me old fashioned; I don't see this daisy-chain in quite the same light as foundation-oak of the 1948 Act!

The RCGP raise concerns about the private sector. They do so knowing GPs are 'the private sector'. A bit rich? Well, think Southern Cross, PIP and the Harley Clinic. The DH escaped by the skin of their teeth on the Southern debacle and the PIP thing isn't over. What happens if the tariff tightens and bigger private suppliers such as Circle and Virgin realise what we all know; they can't make money and quit. We don't have a failure regime. Monitor is still struggling with a consultation; private companies are resisting stumping up cash.

There are other risks issues. I'm told the Risk Register, when it is finally published, will (in terms) say; "The chief warning is that the reforms will spark a huge surge in health costs and the NHS will become unaffordable as the private companies siphon off profits". It will also include a darker warning; "GPs have no skills or experience to manage costs effectively".
There is a clear disconnect between the reality on the ground and what Ministers say. They either know and won't confront reality, or they're right. Maybe, but DH insiders tell me they have had consultants working on a 'Plan B'; to cover the eventuality the Bill is pulled.

Anyone with half a brain knows the Bill is a dog's breakfast. If Ministers really wanted to improve the NHS they might ask why more people die in hospital at the weekends and do something about that.

Some parts of the NHS are dying from reform in other parts patients are dying for the want of it.