Calls for greater disclosure on NHS chiefs’ meetings with private US health insurer


UnitedHealth used to employ Simon Stevens, above, NHS England’s chief executive. Photograph by Owen Humphreys/PA

Courtesy of Jamie Doward @ The Guardian:

A handful of consultancy firms and a health insurance giant bidding for NHS contracts have been operating a discreet forum at which they receive regular briefings from senior health service managers charged with ushering in the new era of competition among its providers. The revelation has raised fears that the NHS is falling victim to a land grab by a few powerful business interests.

Documents obtained under the Freedom of Information Act by the campaign group Spinwatch shine a light on the workings of an obscure group whose existence and limited membership has alarmed campaigners who want the NHS to remain public.

The Commissioning Support Industry Group (CSIG) is largely unknown to outsiders. Its members are jockeying to win an estimated £1bn of contracts advising the new doctor-led clinical commissioning groups that will be responsible for spending more than two-thirds of the NHS budget on purchasing patient care.

Supporters say it will empower doctors and bring in competition among NHS providers. Those awarded contracts to advise doctors’ groups will be involved in patient care reforms, drug purchasing, negotiating hospital contracts and, crucially, outsourcing services to the private sector.

Critics who warn the reforms will see big consultancies given contracts to advise doctors’ groups say their fears are confirmed after learning more about the CSIG. A series of emails between members of the group and NHS England officials reveal that UnitedHealth, the giant US health insurer that formerly employed NHS England’s chief executive, Simon Stevens, chairs the group, provides its secretariat and recently paid for senior health managers to visit its care centres in the US on a five-day fact-finding mission.

Dr Chris Exeter, UH’s lobbyist, who in 2011 worked on non-health matters for Low Associates, a lobbying firm run by Sally Low, wife of former health secretary Andrew Lansley, helps co-ordinate meetings of the CSIG, whose other members are consultancies KPMG, Capita, McKinsey, EY and PWC. Its meetings, which began in May 2013, are unminuted. Continue reading

Invisible art of etiquette: Having good manners delivers all sorts of unexpected gains


Courtesy of Paul Ford @ The Independent:

Most people don’t notice that I’m polite, which is sort of the point. I don’t look polite. I am big and droopy and need a haircut. No soul would associate me with watercress sandwiches. Still, every year or so someone takes me aside and says, “you actually are weirdly polite, aren’t you?” And I always thrill. They noticed.
The complimenters don’t always formulate it so gently. For example, two years ago at the end of an arduous corporate project, slowly turning 1,000 red squares in a spreadsheet to yellow, then green, my office mate turned to me and said: “I thought you were a terrible ass-kisser when we started working together.”

She paused and frowned. “But it actually helped get things done. It was a strategy.” (That is how an impolite person gives a compliment. Which I gladly accepted.)

She was surprised to see the stubborn power of politeness over time. Over time. That’s the thing. Mostly we talk about politeness in the moment. Please, thank you, no go ahead, I like your hat, cool shoes, you look nice today, please take my seat, sir, ma’am, etc. All good, but fleeting.

When I was in high school I used to read etiquette manuals. Emily Post and so forth. I found the manuals interesting and pretty funny. There was good stuff about how to write a note of condolence, and ridiculous stuff about how to behave on boats or at The White House.

I didn’t expect to apply my findings to my daily adolescent life. I was peripheral in high school – uncool but also untortured, voted “most scholarly” of my class, roughly equivalent to “least likely to have sex”. In high school no one noticed my politeness except for one boy. He yelled at me about it. “Why you always so polite, man?” he asked. “It’s weird.” I took it as praise and made a note to hide it further, to be more profane. Real politeness, I reasoned, was invisible. It adapted itself to the situation. Later, that same kid stole my cassette copy of Aqualung. Continue reading

The Problem with Economics

Courtesy of Sandeep Jaitly @ Fekete Research:

“Thank goodness my task is to teach economics to a bunch of physicists and engineers. The other way around would take an infinite amount of time,” was the comment made by my economics lecturer on a supplemental course to my maths degree at Imperial College.

Economics is an often maligned subject, especially to the scientifically inclined. To the physicist, mechanical engineer or chemist, economics is a mystery. They cannot see why graduates in the subject could be honoured with a bachelor of science. Is this disdain justified? With the current state of classical economics, it most certainly is. Scientific enterprise has achieved many things that have improved the living standard of humanity, for example: the pyramidal teabag; the jet-propelled aircraft and the suspension bridge. Classical economics has no such claim.

The sciences are based on ‘axiomatic systems.’ An axiom is a proposition that cannot directly be proved but is rather self-evident. For example, in Euclid’s geometry one axiom is ‘all right angles are equal to one another.’ From a system of axioms, a science such as planar geometry can be described. Axioms might seem too obvious to individually contemplate – but are the sine qua non of all scientific endeavour. But what is the axiom or set of axioms that defines the subject of economics? Is it even possible to have a set of axioms that defines the essential character of economics? The German word for economics ‘volkswirtschaft’ is a better starting point for this question than the word ‘economics’ itself. The former describing activity with relationship to people and the latter implying a set of ethereal household rules that don’t really exist (‘economics’ is derived from the Greek work όικος and υομος meaning ‘house’ and ‘law’ respectively.)

There have been many attempts to define the characteristic principles of economics in a similar vein to Euclidean geometry and all were utterly lacking until the mid 19th century. For it was then that the father of what was to become the ‘Austrian’ school, Carl Menger, espoused the true and simple nature of economics with just one axiom…

Value does not exist outside of the consciousness of mankind.

Continue reading