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Telegraph Health: Why risks of outsourcing make case for keeping services in public hands

The Government keeps insisting that it is not privatising the NHS – but it’s not for want of trying.

A new exhibition ‘How come we didn’t know?’ by London photographer Marion Macalpine, opening on November 8 at Theatre Delicatessen on the Moor, charts the extent to which NHS services have been contracted out, especially in the South of England.

At 7pm (same day, same venue) the Festival of Debate hosts a reading of Laurence Peacock’s play ‘A Duty of Care’ on Labour’s changes to the NHS in 2003 – which paved the way for the later Tory NHS reorganisation.

Although recent years are littered with contract failures, almost half of all new service contracts in the NHS still go to private companies.

At least 7.6 per cent of the NHS is currently outsourced and perhaps the worst thing is how often profit-making companies operate under the NHS logo.

For instance how many people know that the Sheffield GP walk-in centre is run by First Medical Group?

How many people accept what look like NHS referrals only to find the provider is a private one?

Why does this matter? Because outsourcing erodes the NHS as a public service; is damaging for staff; fragments services; and most of all because it places them under the control of owners and managers whose reference points are contracts and cost control, not any broader commitment to the public’s health.

If something is not in the contract, out of the window it goes and patients find it even more difficult to secure redress.

Where there is trouble, performance data has been manipulated or contractors have just walked away, leaving the NHS to try and make it up to patients just as happened at Westfield Health Centre this year when Danum withdrew or, further afield, at Hinchingbrooke Hospital.

Of course cost controls are not entirely due to the search for profit. Government cuts to local authority budgets are far too large to be made up by the two per cent council tax social care precept whatever the government likes to pretend.

The Care Quality Commission warned last month that the social care market was at a tipping point.

Between November 2015 and May 2016 32 councils had care home contracts handed back – 59 had home care contracts cancelled.

Recently a reverse trend has begun as public authorities begin to bring services back in house – ranging from social care to street cleaning. The resulting services are reported to be cheaper and more efficient.

Within the NHS the drive for competition is less overt than it was. But that doesn’t mean it isn’t still happening or that the likes of Virgin Healthcare will not sue the NHS if they feel excluded.

In Sheffield, where closer partnership working is developing, major privatisations are not yet on the horizon.

But the still unpublished Sustainability and Transformation Plan to move more services to the community under a cost limit set by NHS England below the level of need will depend on cuts and it risks more publicly provided services disappearing as they can more easily be bundled up into parcels which companies can bid for more cheaply than the NHS can.

Without safeguards (including social value commissioning) NHS community services could easily go the way of social care, especially if they are subcontracted out of public view through one of the local trusts.

There may be instances where local or niche services can be more flexibly provided by third sector or similar organisations (proposals for patient transport are being considered) but open tender should not be the default position. Longer term, the Accountable Care Organisation model being pushed through the STPs sets up a structure which could more easily be absorbed in a later private sector takeover.

n On November 22 Sheffield Save our NHS and the Festival of Debate will host an open debate on the future of the NHS with a panel of local NHS leaders, academics and campaigners. Visit www.festivalofdebate.com/november-2016.html and www.sheffieldsaveournhs.co.uk for details of all events.

Article source: http://www.sheffieldtelegraph.co.uk/news/health/telegraph-health-why-risks-of-outsourcing-make-case-for-keeping-services-in-public-hands-1-8215751

Return the Bardsey Crown

The Bardsey Crown to Return to the land of Merlin

The Bardsey Crown to Return to the land of Merlin

No doubt everyone is watching with great interest the attempts by the Bardsey inhabitants (all ten of them) to have the Bardsey island Crown returned to its rightful place in Wales.
The Island is a god forsaken lump of rock off the Llyn Penninsula in the North of Wales once inhabited by Monks in a colony established there in the 6th Century by one Saint Cadfan. – and as an interesting side note is the imputed last resting place of Merlin – further emphasizing that the whole Arthurian legend is based on the Welsh Princes fighting off those pesky Anglo Saxons.

For many years, the Island had formed part of the estates of the Newborough Family of Glynllifon near Caernarfon who cheered up the locals by crowning the oldest male on the island as King – to be called Brenin Enlli (King of Bardsey). The coronation celebrations being the only known official example in the UK where the Queen of Bardsey was also heir presumptive to the Crown and the entire congregation were either cousins, brothers and sisters. The actual Crown is kept at the Maritime Museum in Liverpool who acquired it when the maritime collection of the Newboroughies was flogged off around the 1980’s for four pence halfpenny and a route map out of Wales – and there in lies the conundrum – those nasty English Liverpudlians are hanging on to it and not inclined to repatriate this artefact of past Welsh glory to its homeland.

The symbolism of the crown goes well beyond the tatty tin and brass it is made of and now assumes the role of an icon and memorial to those former Welsh Princes who went down gloriously in defeat at the hands of the invading Angles; from those at the dawn of time, to Lywelyn ap Iorwerth, Dafydd ap Lywelyn, Lywelyn ap Gruffudd (the Last) to Owain Glyndwr – this latter prince was the last real Welsh prince when the principality was lost by conquest at or around 1415.

Since the time of the Welsh Princes we have been fobbed off with a motley collection of loser princes and elder sons of Kings of England from Edward Blackadder of Caernarfon to the latest incarnation Prince Charles ap Windsor the Halfwit. This Prince whose only known attempts at Welsh are ‘ble ydy ‘r doiled’, and ‘ca ‘m oddi hon dduw adawedig chyflea’ – which roughly translated means ‘where are the toilets’ and ‘get me out of this god forsaken place’ which shows his commitment to the job.

I support any initiative that repatriates ethnic aboriginal art and artefacts to their rightful place – and the Bardsey Crown is right up there with the Elgin Marbles and the African Art pillaged from their rightful owners over the centuries. A suitable place for its final resting place must surely on the mantle piece in the gallery shop at the Oriel Plas Glyn-y-Weddw at Llanbedrog near Pwllheli where for a suitable fee visitors will be able to eat their welsh rarebit whilst reliving the days of yore by wearing the crown.

As a point of interest for our American cousins it may not be well known that Prince Madog ab Owain heir of Owain discovered America around the year 1200 and founded a colony near to Alabama. For more information about the welsh in Alabama visit : http://www.alabamawelsh.com/ and if your interested in signing the petition to restore a monument to the great prince go here:
http://www.petitiononline.com/AWA0987/petition.html

Above is a nice Picture of one of the ‘Brenin Enlli’ His Royal Highness John Williams taken around 1920.

Cheers

Royston

Whitehall outsourcing scheme cost £4m more than it saved, MPs say …

A scheme to reduce government expenditure by outsourcing back-office functions has cost taxpayers more money than it has saved, MPs have said. Officials had hoped the programme could save up to £400m a year, but after two-and-a-half years of operation the scheme has saved £90m while costing £94m.Criticising what it described as “ineffectual” management of the scheme, the public accounts committee warned ministers they must act to improve leadership and governance to prevent more money being wasted.

The two shared service centres are run by Arvato UK and Shared Services Connected and it had been planned that 26 different organisations would use them to provide back-office functions to cut costs.

Officials had hoped the centres and the introduction of a single operating platform they claimed would save £128m a year, with further efficiencies allowing that figure to increase to between £300m and £400m.

But just two of the 26 organisations had signed up and officials now estimate the centres will deliver total savings of £484m by 2023-24.

Among the issues identified in the public accounts committee report was a “failure of governance and leadership by the Cabinet Office” and “the lack of a realistic business case”.

It said: “The result is that the two shared service centres considered as part of this inquiry have only delivered £90m of ‘savings’ in the first two-and-a-half years of operation but at a cost of £94m and, therefore, a net cost to the taxpayer of £4m.

“The Cabinet Office now estimates that the centres will deliver savings of around £484m in total by 2023-24, which compares unfavourably with the anticipated £300m to £400m a year savings set out in the next generation shared services strategy in 2012.”

The report said the Cabinet Office had failed to have effective governance in place at the start of the project and had not managed to persuade Whitehall departments to “buy in” to the scheme.

It had been too easy for ministries and agencies to back out, which meant the potential benefits of sharing services were jeopardised.

Some departments pulled out of the programme and sought other arrangements to protect their own interests, or because the benefits would be marginal, the report said.

“They had not been persuaded by the argument that remaining in the programme would generate benefits for the whole of government.”

The government was also criticised for its relationship with the two private providers and over the failure to move organisations on to the new systems.

“The Cabinet Office was ineffectual in managing this risk because of its inability to force departments to take crucial decisions and an unwillingness to hold the suppliers to account as delays arose,” the MPs said.

The committee recommended the government should produce a “realistic and complete” business case for the centres by the end of the year.

The Labour MP Meg Hillier, who chairs the committee, said: “The government set out to save money with this programme but it launched with critical flaws [that] Whitehall then failed to address.

“Each department was able to request multiple changes, which led to big cost increases. The result has been a net cost to taxpayers and a significant scaling back of ambition for the savings likely to be achieved in the years ahead.

“If government is serious about making a success of shared services, and indeed future projects running across departments, it must act on the serious concerns set out in our report before any more public money is wasted.”

Article source: https://www.theguardian.com/politics/2016/oct/19/whitehall-expenditure-reduction-scheme-cost-more-than-it-saved-mps-outsourcing-back-office-functions

Why it may be time to stop outsourcing IT – TechRepublic

Thirteen years ago Nick Carr published a seminal article in Harvard Business Review arguing that IT doesn’t matter. As the thinking went, enterprise IT spent far too much time and money rebuilding the same applications and infrastructure that was essentially commoditized. The rise of cloud computing and open source seemed to confirm his suspicions, leading many to conclude that outsourcing was the right way to minimize investments in such commodity code.

Those people were wrong.

As Redmonk analyst James Governor correctly argued a year ago, “Cloud is of course itself a form of outsourcing, but one that allows for speed of delivery, and encourages reshoring of skills. But people and processes changes are needed to do the work.” Those people who make an ever-bigger impact on an enterprise’s ability to differentiate and compete are developers, and outsourcing them was one of the worst ideas ever conceived.

Getting rid of IT

Thirteen years ago, Carr suggested that enterprises didn’t need to bother with infrastructure (or, by extension, the people that fed it):

[T]he core functions of IT—data storage, data processing, and data transport—have become available and affordable to all. Their very power and presence have begun to transform them from potentially strategic resources into commodity factors of production. They are becoming costs of doing business that must be paid by all but provide distinction to none.

This led enterprises to outsource, with outsourcing dollars climbing year after year. Though the IT outsourcing market may be cooling off in 2016, it still topped a whopping $442 billion in 2015, climbing each year since Carr’s article was written. While he can’t take all the credit (or blame), he helped encourage the belief that hardware and software could be best managed as a cost of doing business, with outsourcing firms well-positioned Why it may be time to stop outsourcing IT – TechRepublic

Whitehall outsourcing scheme cost £4m more than it saved, MPs say

A scheme to reduce government expenditure by outsourcing back-office functions has cost taxpayers more money than it has saved, MPs have said.

Officials had hoped the programme could save up to £400m a year, but after two-and-a-half years of operation the scheme has saved £90m while costing £94m.

Criticising what it described as “ineffectual” management of the scheme, the public accounts committee warned ministers they must act to improve leadership and governance to prevent more money being wasted.

The two shared service centres are run by Arvato UK and Shared Services Connected and it had been planned that 26 different organisations would use them to provide back-office functions to cut costs.

Officials had hoped the centres and the introduction of a single operating platform they claimed would save £128m a year, with further efficiencies allowing that figure to increase to between £300m and £400m.

But just two of the 26 organisations had signed up and officials now estimate the centres will deliver total savings of £484m by 2023-24.

Among the issues identified in the public accounts committee report was a “failure of governance and leadership by the Cabinet Office” and “the lack of a realistic business case”.

It said: “The result is that the two shared service centres considered as part of this inquiry have only delivered £90m of ‘savings’ in the first two-and-a-half years of operation but at a cost of £94m and, therefore, a net cost to the taxpayer of £4m.

“The Cabinet Office now estimates that the centres will deliver savings of around £484m in total by 2023-24, which compares unfavourably with the anticipated £300m to £400m a year savings set out in the next generation shared services strategy in 2012.”

The report said the Cabinet Office had failed to have effective governance in place at the Whitehall outsourcing scheme cost £4m more than it saved, MPs say