It's one of the many pieces of wisdom – trivial, and yet not – that this slight, nervous mother-of-three has picked up over her 16 years as a support worker looking after people in their homes
Contents contributed and discussions participated by CPAS RECHERCHE
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TThe 'Make or Buy' Decision in Long-term Care: Lessons for Policy - 0 views
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Executive Summary This report was commissioned by the Swedish Ministr y of Health and Social Affairs with the aim of analysing the decision to make or to buy long-term care services, i.e. whether to deliver long-term care services through public providers or contract them out to public and non-public providers. This report reviews existing literature on the theoretic al underpinnings of the make or buy decision and how it applies to the specificities of long-term ca re. It analyses the implementation of quasi-markets in four European countries that represent different long-term care systems: England, Denmark, Germany and the Netherlands. It also critically rev iews six quality assessment and quality management systems in Europe and the issues surroun ding the definition and assessment of quality in long-term care.
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The care workers left behind as private equity targets the NHS | Society | The Observer - 0 views
www.theguardian.com/...private-equity-targets-the-nhs
privatisation financing soins à domicile home care UK
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Her £8.91 an hour used to go up to nearly £12 when she worked through the night helping John and others. It would go to around £14 an hour on a bank holiday or weekend. It wasn't a fortune, and it involved time away from the family, but an annual income of £21,000 "allowed us a life", she says. Care UK ripped up those NHS ways when it took over.
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"The NHS encourages you to have these NVQs, all this training, improve your knowledge, and then they [private care companies] come along and it all comes to nothing.
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In 1993 the private sector provided 5% of the state-funded services given to people in their homes, known as domiciliary care. By 2012 this had risen to 89% – largely driven by the local authorities' need for cheaper ways to deliver services and the private sector's assurance that they could provide the answer. More than £2.7bn is spent by the state on this type of care every year. Private providers have targeted wages as a way to slice out profits, de-skilling the sector in the process.
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1.4 million care workers in England are unregulated by any professional body and less than 50% have completed a basic NVQ2 level qualification, with 30% apparently not even completing basic induction trainin
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Today 8% of care homes are supplied by private equity-owned firms – and the number is growing. The same is true of 10% of services run for those with learning disabilities
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Those profits – which are made before debt payments and overheads – don't appear on the bottom line of the health firms' company accounts, and because of that corporation tax isn't paid on them.
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Some of that was in payments on loans issued in Guernsey, meaning tax could not be charged. Its sister company, Silver Sea, responsible for funding the construction of Care UK care homes, is domiciled in the tax haven of Luxembourg
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.voterDiv .ob_bctrl{display:none;} .ob_pdesc IMG{border:none;} .AR_1 .ob_what{direction:ltr;text-align:right;clear:both;padding:5px 10px 0px;} .AR_1 .ob_what a{color:#999;font-size:10px;font-family:arial;text-decoration: none;} .AR_1 .ob_what.ob-hover:hover a{text-decoration: underline;} .AR_1 .ob_clear{clear:both;} .AR_1 .ob_amelia, .AR_1 .ob_logo, .AR_1 .ob_text_logo {display:inline-block;vertical-align:text-bottom;padding:0px 5px;box-sizing:content-box;-moz-box-sizing:content-box;-webkit-box-sizing:content-box;} .AR_1 .ob_amelia{background:url('http://widgets.outbrain.com/images/widgetIcons/ob_logo_16x16.png') no-repeat center top;width:16px;height:16px;margin-bottom:-2px;} .AR_1 .ob_logo{background:url('http://widgets.outbrain.com/images/widgetIcons/ob_logo_67x12.png') no-repeat center top;width:67px;height:12px;} .AR_1 .ob_text_logo{background:url('http://widgets.outbrain.com/images/widgetIcons/ob_text_logo_66x23.png') no-repeat center top;width:66px;height:23px;} .AR_1:hover .ob_amelia, .AR_1:hover .ob_logo, .AR_1:hover .ob_text_logo{background-position:center bottom;} .AR_1 .ob_org_header { border-top: 10px solid #D61D00; display: block; font-family: georgia,serif; font-size: 14px; font-weight: bold; padding-bottom: 10px; padding-top: 5px; } More from the guardian Rogeting: why 'sinister buttocks' are creeping into students' essays 08 Aug 2014 Theatre's decision to ban Jewish film festival is 'thin end of wedge' 09 Aug 2014 Sir Paul Nurse: 'I looked at my birth certificate. That was not my mother's name' 09 Aug 2014 Adventures in contraception: eight women discuss their choices 10 Aug 2014 Child prison deaths 08 Aug 2014 [?] .voterDiv .ob_bctrl{display:none;} .ob_pdesc IMG{border:none;} .AR_2 .ob_what{direction:ltr;text-align:right;clear:both;padding:5px 10px 0px;} .AR_2 .ob_what a{color:#999;font-size:10px;font-family:arial;text-decoration: none;} .AR_2 .ob_what.ob-hover:hover a{text-decoration: underline;} .AR_2 .ob_clear{clear:both;} .AR_2 .ob_amelia, .AR_2 .ob_logo, .AR_2 .ob_text_logo {display:inline-block;vertical-align:text-bottom;padding:0px 5px;box-sizing:content-box;-moz-box-sizing:content-box;-webkit-box-sizing:content-box;} .AR_2 .ob_amelia{background:url('http://widgets.outbrain.com/images/widgetIcons/ob_logo_16x16.png') no-repeat center top;width:16px;height:16px;margin-bottom:-2px;} .AR_2 .ob_logo{background:url('http://widgets.outbrain.com/images/widgetIcons/ob_logo_67x12.png') no-repeat center top;width:67px;height:12px;} .AR_2 .ob_text_logo{background:url('http://widgets.outbrain.com/images/widgetIcons/ob_text_logo_66x23.png') no-repeat center top;width:66px;height:23px;} .AR_2:hover .ob_amelia, .AR_2:hover .ob_logo, .AR_2:hover .ob_text_logo{background-position:center bottom;} .AR_2 .ob_org_header { border-top: 10px solid #D61D00; display: block; font-family: georgia,serif; font-size: 14px; font-weight: bold; padding-bottom: 10px; padding-top: 5px; } /* updated via mysql on 2014-04-08 */ .AR_2 .ob_what { display: block; } /* added via mysql on 2014-06-20 */ .OUTBRAIN:hover .ob_what a { text-decoration: underline; } .ob_box_cont.AR_2 { padding-bottom: 5px; } /* end mysql add */ /* added via mysql on 2014-07-14 */ .AR_2 .ob_org_header span { color: #999; font-family: arial; font-size: 11px; font-weight: normal; display: block; } /* end 2014-07-14 */ More from around the webPromoted content by Outbrain http://paid.outbrain.com/network/redir?p=0iZOm4XuGW6R5uuT6ZFciNevzJlIfmxs0SRwpiMrH7gWrMXoPie4vIA9PlhaEW%2BXNi57pCgl9j8yOE3HuJT75pwCLNj4n18v3EKQDEV0YFQjOBxc46mOs
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Looking abroad to cure Canada's healthcare ailments | Financial Post - 1 views
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One of the hurdles to adopting ABF more widely is a lack of data about many dimensions of health care in Canada, including demographics and the specific costs of many aspects of delivering services, and the analytic capacity to develop an accurate funding formula based on those factors
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Global budgets provide predictability, which is useful for planning purposes for providers as well as administrators,” she points out, “and it helps hospitals to live within their means, which is generally a good thing. But the downside is that this can affect access to care, because there are incentives to do less if the hospital faces going over budget.”
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incentive to innovate or find efficiencies when funding levels are fixed by a global budget, rather than geared to delivery of services.
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Some countries using this system, including the UK’s National Health Service, found a tendency to “cherry pick”
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“Healthcare systems evolve within the context of a specific culture, economy, politics and history and what worked in one place or time won’t necessarily work in a different country, or now,”
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To that point, the differences between German and Canadian public health care go far beyond funding mechanisms
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It’s really the result of almost a century and a half of evolution, and it’s very organic to Germany.
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The negotiations between hospitals, providers and funds are really the key to lower spending, rather than direct competition between the funds.
NHS boss Simon Stevens criticises lack of diversity in management | Society | theguardi... - 0 views
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NHS: Hospital Corporation of America that donates to Tories handed huge contract - Mirr... - 0 views
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By Andy Lines 15 Comments Controversial American health firm that donates to Tories handed huge NHS contract 3 Sep 2013 00:00 It is already at the centre of a massive row after being accused of overcharging the NHS by millions of pounds in a damning report // Vital skill; Brain surgeon at work Getty A contract to treat NHS patients with brain tumours has been awarded to a controversial American healthcare firm that is a donor to the Tory party.
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Labour MPs are particularly angry because London’s University College Hospital – one of the best NHS brain treatment centres in the country – has been told to stop treating brain cancer patients and send them to HCA.
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Patients who were being treated there have been told to move to Barts. NHS England have told UCHL that they won’t pay for any more NHS patients to be treated there because they’ve signed a contract with two private hospitals – one of which is HCA
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HCA has a chequered history in the US and has been fined more than $1billion for mis-selling healthcare.
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A senior hospital source told the Mirror: “The radiotherapy community is very concerned about the way NHS England is handing out contracts for NHS patients.
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HCA is already at the centre of a massive row after being accused of overcharging the NHS by millions of pounds in a damning report released last week.
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HCA, along with two other private hospital groups, was at the centre of a scathing report from the Competition Commission last week which showed that between 2009 and 2011 they overcharged by up to £193million
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Serco: the company that is running Britain | Business | The Guardian - 0 views
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This time, attention was focused on how it was managing out-of-hours GP services in Cornwall, and massive failings that had first surfaced two years before. Again, the verdict was damning: data had been falsified, national standards had not been met, there was a culture of "lying and cheating", and the service offered to the public was simply "not good enough
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Amazingly, its contracts with government are subject to what's known as "commercial confidentiality" and as a private firm it's not open to Freedom of Information requests, so looking into the details of what it does is fraught with difficulty.
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As evidenced by the story of how it handled out-of-hours care in Cornwall, it is also an increasingly big player in a health service that is being privatised at speed, in the face of surprisingly little public opposition: among its array of NHS contracts is a new role seeing to "community health services" in Suffolk, which involves 1,030 employees. The company is also set to bid for an even bigger healthcare contract in Cambridgeshire and Peterborough: the NHS's single-biggest privatisation – or, if you prefer, "outsourcing" – to date, which could be worth over £1bn.
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When Serco made its bid to run NHS community-health services in Suffolk – district nursing, physiotherapy, OT, end-of-life palliative care, wheelchair services – it reckoned it could do it for £140m over three years – £16m less than the existing NHS "provider" had managed, which would eventually allow for their standard profit margin of around 6% a year. When it started to become clear that Serco was the frontrunner, there was some opposition, but perhaps not nearly enough.
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The strangest thing, though, is the gap between Serco's size and how little the public knows about it. Not for nothing does so much coverage of its work include the sentence "the biggest company you've never heard of".
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We've still got the same number of patients," she says, "so the workload has massively increased." As a result, she and her colleagues are having to cut people out of their previous entitlement to treatment at home. "That completely goes against our ethics," she says, "but that's what we're having to do.
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The NHS is a relatively new area of controversy for Serco, but concerns about their practices run across many other areas
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Serco was officially awarded the contract in October 2012, which meant that hundreds of staff would leave the NHS, and become company employees. Within weeks, the company proposed a huge reorganisation, which involved getting rid of one in six jobs. This has since come down to one in seven, two thirds of which will apparently go via natural wastage. In terms of their pay and conditions, the hundreds of people who have been transferred from the NHS to Serco are protected by provisions laid down by the last government, but it is already becoming clear that many new staff are on inferior contracts: as one local source puts it, "they've got less annual leave, less sick pay … it's significantly worse."
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The National Audit Office is doing work around the development of quasi-monopoly private providers, which is the world we're moving into. We don't really understand the size of their empires.
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Top A&E doctors warn: 'We cannot guarantee safe care for patients anymore' - UK Politic... - 0 views
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// div.slideshow img { display: none; } 1 / 2Top A&E doctors have warned 'We cannot guarantee safe care for patients anymore'Rex //
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A combination of “toxic overcrowding” and “institutional exhaustion” is putting lives at risk, according to the letter to senior NHS managers from the leaders of 18 emergency departments.
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Last week, figures showed that the number of patients attending casualty units in England has increased by a million in the 12 months leading up to January 2013.
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Speaking before his appearance at the Health Select Committee, he conceded that urgent care services were “getting closer to the cliff edge,” with A&E admission increasing by 51 per cent over the past 10 years
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The letter from the 20 A&E leaders talks of the “institutional exhaustion” of the nursing, medical and even clerical staff who being pushed ever harder by the growing volume of work with little outside support
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. It also describes how doctors and nurses are being forced to work in what are verging on dangerous environments
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They further warn that overcrowding is likely to lead to more deaths in hospitals and reveal that standards of care are deteriorating as serious clinical incidents and delays are rising.
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The letter states: “The aforementioned issues have led to us routinely substituting quality care with merely safe care; while this is not acceptable to us, what is entirely unacceptable is the delivery of unsafe care; but this is now the prospect we find ourselves facing on too frequent a basis
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Recent developments such as the introduction of 111 and financial penalties for holding ambulance crews in ED are touted as solutions to the crisis: however we as ED physicians recognise that these measures will actually make the problem worse instead of better, and evidence is already emerging to support our opinions.
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Furthermore, we firmly believe and strongly recommend that ED leads should be intimately involved with and consulted on the commissioning of Emergency services in the region, as well as other related emergency care changes-such as 111.