Livid – North Tyneside on the slippery privatisation slope

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The private firm Livi has been awarded a contract to carry out virtual consultations in Primary Care in North Tyneside – see here. Whilst this is claimed to be a pilot scheme, and it is to be seen as an addition to the usual GP clinical work, it is undoubtedly part of a very slippery privatisation slope.
Livi claims to be Europe’s largest digital healthcare provider and we anticipate that it may only be a matter of time before their services are more widely commissioned by Clinical Commissioning Groups in the North East and throughout the UK. 
In this instance, the contract was awarded by North Tyneside CCG and patients registered with North Tyneside practices received this letter over the summer:
 
“I’ve been very surprised about this whole process from the CCG and from Livi, and all the residents I speak to are also surprised. This seems to have come totally out of the blue. I want the CCG to come to the Health Scrutiny Committee, present their report, present their findings, tell us about the process and the contract, and I want to get down to the bottom of how much money this is taking out of the NHS for private profit”    North Tyneside Cllr Joe Kirwin speaking to Sharon Barbour, BBC Look North, 27th August 2020

 

KONPNE strongly objects to this insidious privatisation of the NHS. Apart from the central fact that North Tyneside CCG should not be wasting taxpayers money by contracting out to private, profit making companies with shareholders, a number of key issues need to be answered as a matter of urgency:
> the credentials of Livi – this business has only had a recent presence in the UK. 
> CQC reporting: the link here to the Care Quality Commission highlights that there is no public record of the type or outcome of initial assessments carried out by the CQC on Livi. 
The CQC website page also identifies that “follow up inspections of new services are undertaken regularly following registration”; however, the banner information point on the Livi page states that “CQC have not inspected this service yet”. We wonder if this is usual practice for NT CCG to go ahead with commissioning a service without CQC inspection?  The use of the CQC logo on Livi’s introductory letter gives an impression that all is well and good?
> the commissioning process – only Livi was asked to give a demonstration, the other two providers, Babylon (GP at Hand) and Push Doctor, were only “considered”; what criteria were used by NT CCG in commissioning Livi? See minutes here from NT CCG
> What steps were taken to enable local GPs to manage this service?
> contract details – how long is the contract for and how much is it costing? Why is there no mention of it being a pilot scheme in the Livi publicity material?
> continuity; continuity of care is of the utmost importance in Primary Care, yet it would be exceptional if the patient spoke to the same Livi Gp more than once
> local knowledge, local systems and organisations – our GPs link in with many non-statutory organisations and collaboration is a key feature of their work; Livi GPs (communicating to us from elsewhere in the UK) won’t have any knowledge about what is generally available in the local area
> virtual assessment – whilst on-line appointments may benefit some people (for example, those who find it difficult to travel to their GP), many difficulties are associated with virtual appoitments; many patients require a physical examination of some kind, and the assessment of people experiencing mental health issues may also be hindered.
> misdiagnosis – apart from having an immediate and potentially very serious impact on a patients health and wellbeing, an initial incorrect or lack of treatment will inevitably lead to a need for increased medical interventions at some later stage
> health inequality – the use of phone (especially with video) is likely to increase inequalities in health provision, as more vulnerable and older people are less likely to be using smart phones and iPads and are also less likely to have access to broadband, spare minutes and data
> Confidentiality – whilst Livi may not own, and be able to sell, health data we remain concerned that they will be able to retain and sell other personal data to third parties. 
> The bottle neck in General Practice is time…there are not enough GPs.  Looking at the bigger picture, this system clearly doesn’t create GP time – it steals it. How does it help if we continue to take more GPs out of mainstream General Practice and relocate them in 111, Out of Hours and now tuning into video apps.  These are not Add Ons – they are Takeaways
> and we keep coming back to the fundamental question – why is the funding provided to Livi not being invested in local, existing primary care services? It is clearly a cost-cutting exercise, increasing macro privatisation and undermining localised provision….
KONPNE supports innovation and new ways of working and, indeed, our NHS has evolved over time to the world-class service of today. What we strongly object to is cost-cutting, decreased quality and the insidious privatisation of the NHS –  North Tyneside CCG should not be wasting taxpayers money by contracting out to private, profit making companies with shareholders.

Click on these links….

Sharon Barbour, BBC Look North, reports on the privatisation currently taking place within North Tyneside GP surgeries (24th September2020)  here
Coverage in “Health Campaigns Together” News Bulletin is here (page 4)
KONPNE letter to the Chronicle, Journal and local newspapers in the North East (14th September 2020): Letter to newspapers re Livi September 2020
Article in Pulse magazine (1st September 2020) re North Tyneside CCG and Livi: Livi -North Tyneside CCG – Pulse 9-2020 
Read the research by Healthwatch North Tyneside (29th July 2020) “Accessing Primary Care” 
Hear North Tyneside Councillor Joe Kirwin speak (27th August 2020) here 
Hear from North Tyneside CCG (26th August 2020) here
Not everyone is happy – hear what Dr D Tomson, North Tyneside GP says (26th August 2020) here
Transcript of the BBC “Look North” item (26th August 2020): Livi Look North item 26th August 2020
Financial Times (21st January 2019): NHS Englands digital chief is criticised after joining start-up here
Article from “999 Call for the NHS” (14th June 2019), providing much background information, is here

Current Action for everyone – September 2020

North Tyneside CCG are sliding further down the slippery privatisation slope by using public money to provide private health care services to the public – and what is happening in North Tyneside today may well be happening in other NE localities tomorrow.
It is now crucial for all people living in the North East to voice concerns about this insidious privatisation of our NHS; email your Clinical Commissioning Group (addresses are here), with copies also to your Healthwatch (here)  and MP (here). Please also feel free to write to (or copy in) your local councillors (here) and GP Practice. Please let us know how you get on, including responses – our KONPNE email address is konpnortheast@gmail.com   Thank you.
KONPNE are now urgently gathering information (Freedom of Information request to the CCG), informing members of the public and liaising with key people (patients, local media, GPs, British Medical Association, surgeries, Councillors, MPs). Please keep an eye on this website page and our social media for updates on developments and information about how to join in.

Some email addresses for North Tyneside patients

⇒ The NHS North of England Commissioning Support (NECS) manages complaints on behalf of NHS North Tyneside Clinical Commissioning Group (CCG). Email your complaint to NECS at this address: necsu.complaints@nhs.net
⇒ Healthwatch represents the opinions of patients and ensures that the views of patients shape local services.  Email your message to Healthwatch North Tyneside at this address: info@healthwatchnorthtyneside.co.uk
⇒ Two MPs cover the North Tyneside area. Mary Glindon is MP for North Tyneside. Email:  mary.glindon.mp@parliament.uk
Alan Campbell is MP for Tynemouth. Email: campbellal@parliament.uk

NHS privatisation: Question to full Council meetings

Prompted by “Livi” and the recent growth in “outsourcing” (aka NHS privatisation), members of KONPNE are putting questions to local North East Councils about privatisation in their area.
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****Gateshead Council Tony Dowling, KONPNE member and Gateshead resident, put the following question to the full council meeting on Thursday 17th September: Question to Gateshead Council Sept 2020
Cllr Lynn Caffreys response is here: Question Response By Councillor Caffrey, Gateshead
The link to Gateshead Council webpage for the meeting, incl agenda and KONPNE question, is here: http://democracy.gateshead.gov.uk/ieListDocuments.aspx?CId=140&MId=2678&Ver=4
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****Sunderland CouncilSunderland KONP’s Laura Murrell and Dr Pam Wortley forwarded the following question and information sheet; the question was read out by the Mayor at the full Council meeting on 23rd September 2020, and Cllr Geoff Walker responded on behalf of the Council. We await a transcription – please see here and scroll to 23rd September
Question to Sunderland City Council from KONP Sunderland and District
Question to Sunderland Council additional information 23 09 2020
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****Plus more to follow – Newcastle City Council (4th November), Northumberland County Council (4th November) and questions have been forwarded to key Councillors in North Tyneside, South Tyneside and County Durham (these three Councils are not currently holding Council meetings, or opportunity for public questions are on hold due to Covid 19)  Links to follow…