Pulse is a GP focussed newspaper. In this week's edition it notes that English hospital trusts are seeking to set up GP practices. But what is particualrly interesting is who is behind this scheme:
Exclusive Management consultants have held seminars with several hospital trusts about setting up new GP practices as outlined in NHS England's five-year plan, and have told Pulse they have seen a ‘huge appetite' for the move.
PwC have been holding the seminars following NHS England's Five Year Forward View, which outlined new ‘primary and acute care services' (PACS) that would allow hospital trusts to use their surpluses to set up GP practices with their own registered list for the first time.
Pulse has learned that PwC has observed an ‘extraordinary level of interest' among trusts in setting up GP practices, as they could benefit from it financially and prevent the current drain of funds due to early discharge and community care schemes.
So PWC have moved to Luxleaks to taking over the NHS.
Is there any limit to the harm they can do?
Thanks for reading this post.
You can share this post on social media of your choice by clicking these icons:
You can subscribe to this blog's daily email here.
And if you would like to support this blog you can, here:
Buy me a coffee!
Where is the tax angle to this? The article only talks about management consultants, and the benefits to trusts are financial rather than tax – presumably because the trust would be entitled to any profit from the practice, rather than it going to the GP partners as in the current normal model.
The closest I can find to a tax angle is the quote: “There’s a real danger that the outcome of a hospital-dominated, secondary-care dominated model is that general practice become largely salaried, with GPs losing their status as independent contractors”
The major tax impact would seem to be to replace GPs who are partners on Class 4 NI with salaried ones paying Class 1, both primary and secondary. If the income is the same, then the tax payable will be higher; if the tax is lower, it will be because income is going to the trust rather than to the GPs – which would sound like a good deal for taxpayers (or at least, those who are not GPs).
The much more important issue would seem to be the question of whether GPs should be private contractors rather than public employees.
Andrew
I frequently despair at your inability to understand nuance
The link is PWC
Not tax
But just for the record – I do argue GPs should be employees
Richard
You suggest PwC are “behind the scheme” and are “taking over the NHS” and that this is more evidence of the “harm” that they do.
You have, of course, no evidence that they are behind the scheme or that the scheme will do harm.
As for taking over the NHS, even for someone as deludedly paranoid about big business as you, that’s a corker.
Not according to those I talk to in the NHS
And they’re not all paranoid
“Your new doctor is a tax consultant”
You explicitly brought tax into it, so I’m not terribly ashamed of thinking that you thought there was a tax angle 🙂
Oh dear
Irony bypass
‘Is there any limit to the harm they can do?’
No, none. Any opportunity to exploit any piece of public policy – regardless of the area, subject matter or intent – will be exploited for the benefit of PWC (and similarly by their kindred across the Big Four), and the people in organisations such as the “new”, commercial, NHS who share their neoliberal veal and values. Furthermore, given that representatives or alumni of PWC and co are frequently involved with advising/drafting policy then they have an inside track when it comes to designing opportunities for exploitation and profit maximisation.
You’re talking about the corrupting and corrosive role and impact of The City on democracy this evening, Richard. The Big Four are part and parcel of that system and frequently the conduit for the export of its ideas, values and demands into every corner of government and public service.
You could do this gig for me
No, I’m fairly sure that the objective is for those trusts to set up GP ‘practices’ with the intent that those services are bought in from large-scale commercial providers..
I’m sure that there’s no conflict of interest in the advice: do PWC have any involvement in primary healthcare provider ‘partners’?
However, I do see a potential conflict of interest with General Practitioners being employees, wholly-owned subsidiaries, or in commercial partnerships with profit-driven hospitals.
KPMG has been more associated to date
I think PWC are catching up
Not sure that many NHS Trusts are in a position of financial surplus with which to do this. In theory, a more integrated system could be good news, but with PwC involved there has to be some doubt about whether they will implement something that would benefit patients or staff.
There is going to be a billion pounds available to implement this. THAT is why it is being pushed. I expect that the management advisors will get about 500 million of it. Probably the GP take-up of available bribes is not high at the moment. Solution: Get rid of the present GP structure. With over a hundred closing every year, the GP service moving to extinction anyway.
Reference:
http://www.pulsetoday.co.uk/home/stop-practice-closures/one-in-20-gps-considering-closing-their-practice-by-spring-2015/20008607.article#.VJEo-vmuo6I
Another 5 billion going, going:
http://www.pulsetoday.co.uk/your-practice/practice-topics/employment/hundreds-of-physician-assistants-to-support-gps-in-5bn-plan/20008767.article#.VJEpU_muo6I
I see the “futures” or maybe “derivatives” market is moving into medicine….
http://www.zerohedge.com/news/2014-12-16/great-generic-drug-rip