Campaigners Raise Alarm As 'Sicko' Corporations Target NHS, UK

Main Category: Public Health
Article Date: 22 Oct 2007 - 1:00 PDT

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The Keep Our NHS Public campaign is calling for an investigation into the probity of three American corporations given a key role in the NHS under new government reforms.

The corporations, Humana, Aetna and UnitedHealth, are featured heavily in Michael Moore's new film Sicko, to be launched at the London Film Festival on 24 October, which exposes the practices used by healthcare companies to deny treatments in the US.

Former Health Secretary Frank Dobson is tabling questions in Parliament today 22 October, which ask Alan Johnson if he "will ensure that no healthcare organisations indicted for fraud against the federal or state governments in the US are given contracts to provide services for the NHS or NHS patients."

The government this month published a list of 14 companies, including Humana, Aetna and UnitedHealth, that it wants to see take over the role of 'commissioning', or buying healthcare for NHS patients. These companies will gain control over which treatments patients receive and who provides them.

But experience from the US suggests they may not be as "trusted" as health minister Ivan Lewis has claimed.

UnitedHealth has repeatedly been fined for defrauding the American healthcare system. For example, in August 2004, UnitedHealthCare Insurance agreed to settle civil Medicare fraud charges with the US Attorney for $9.7 million. The US government claimed the company had inflated its costs under the state Medicare program in order to obtain higher reimbursement and greater performance incentive payments.

The NHS Support Federation - one of the groups behind the Keep Our NHS Public campaign - has written to the National Audit Office and the Public Accounts Committee requesting independent assessments of these companies, to establish whether they are fit to work in the NHS.

Meanwhile, a key scene in Moore's film shows US doctor Linda Peeno testifying before Congress that she caused the death of a man by denying him care in order to save Humana half-a-million dollars. In a separate landmark case in Florida, Humana were fined $79.6 million in 2000 for wrongly denying care to a 5-year-old girl, Caitlyn Chipps, with cerebral palsy.

Alex Nunns of Keep Our NHS Public said:

"Anyone who goes to see Michael Moore's film will question health minister Ivan Lewis' assertion that these corporations are 'trusted'. It's astonishing to see our government inviting companies that have been fleecing the Americans to come and fleece the NHS.

"This will see private sector giants at the heart of the health service, with huge power over the care patients receive. If we don't stand up and stop the gradual privatisation of the health service, then what we see in Sicko is what we are in for here."

1. The Department of Health has published the Framework for Procuring External Support for Commissioners (FESC), which confirms that PCTs can outsource their key commissioning roles. The document states: "the areas covered by the commissioning function will be: Assessment & Planning; Contracting & Procurement; Performance Management, Settlement & Review; and Patient & Public Engagement."

2. One method of payment for the companies contracted will be as a share of the savings they make to the NHS, offset against health improvement targets. As it is impossible to contract for all eventualities in healthcare, there is the potential for perverse incentives and gaming, which could result in a decline in the standard of care for patients. Corporations have proved adept at maximising profits in the US, both within and outside the rules.

3. Parliamentary questions to be tabled by Frank Dobson on Monday 22 October:

Frank Dobson (Holborn & St Pancras): To ask the Secretary of State for Health, if he will ensure that no healthcare organisations indicted for fraud against the federal or state governments in the US are given contracts to provide services for the NHS or NHS patients.(159277)

Frank Dobson (Holborn & St Pancras): To ask the Secretary of State for Health, if he will ensure that no healthcare organisations found by US federal audits to have practised deceptive sales tactics on Medicare or Medicaid recipients will be given contracts to provide services for the NHS or NHS patients.(159278)

Keep Our NHS Public

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