Cambian Workers Reveal the for profit world of ‘community living’.


This review was posted on Indeed website when Lifeways owned the residential care and day centres for the autistic and learning disabled

‘confidentiality staff morale low’
care group (Current Employee) –  woodhouse sheffield – 12 August 2012

i drive a minibus for work i pick service users up then take them to the day centre then i will work with my two clients 1 having autism 1 having challenging behavior doing activities to suit them both. i would love to concentrate on just one of them. i put all into my job if my service uses have a good day i know ive done a good job.

Hardest part not having enough time to do the things i would like to do or staff to do it i believe in if your staff are happy then you get a good atmosphere and better quality of work which you should have

Pros -meal provided
Cons-not enough staff always short
Business model that relies on paying minimum wage.

In 2014 Cambian financed by Omers bought Lifeways ‘disabled’ including Thomas Rawnsley for £207 million.

Cambian reduced workers hourly rate to below the minimum wage and many staff left

As this was illegal the rate was put up to the current £7.76 p for a support worker and £8.13 p for a Care Worker.

Cambian’s boss earns over £450,000 a year .

In October 2016 the Cambian Group was bought by Universal Health Services, and two months later sold off its adult services , 18+, to Cygnet Health Care for £377m also owned by UHS.

With a return of capital of £40m to its shareholders .

Cambian’s services are enforced, and the only funded ‘care’, costing a weekly average of over £5000 from Department of Education if under 25, NHS Continuing Healthcare and LA Social care .

In Sheffield the autistic/LD no longer have day centres, not owned by a community/independent living provider.

Privatised Sheffield Health and Social Care provide all mental health services including referrals to Cambian’s residential services, as the only ‘specified provider’ under the Health and Social Care Act 2012..

433 million has been provided to ‘safeguard’ the vulnerable living with family under the Care Act to enable court removal to ‘community living’ for life.

All are now herded via COP and their MCA ‘best interests’ into Cambian residential care..

But whilst Lifeways, Cambian, Cygnet and UHS asset strip and account, to maximise profit from our public money, the morale of staff and quality of service worsens.

And is allowed to, with scant oversight of announced CQC inspections and visits from the private LA/NHS who commissioned the service.

Our only insight into this secret world is from workers Reviews as shown below from last month back to 2016 on Indeed.

Business model that relies on paying minimum wage’.

Support Worker/Carer (Former Employee) –  Wales – 23 August 2017
Worked for this company for a number of months.

Staff overworked and underpaid.

They sell parts of company to raise cash but the cash stays in the bank as cash reserves, and used on share dividends to investors and directors. (lots of money to be made out of the care industry)

The staff on the front line are caring and hardworking, and deliver the best they service they can, but most are struggling to live on the low wages.

Lots of tick box training to cover the company against regulations claims etc.

But not real career training.
When care is provided by a private company its a business to make money.
When run by the state its a social care service for people first.
Pros-Free lunch
Cons-Not a company to have a career with.

THE FORUM SCHOOL- wonderful place to be!

Various Positions (Current Employee) –  Shillingstone, Dorset – 22 August 2017
– A very strong, energetic, supportive network of people around you
– happy, safe, enjoyable environment full of wonderful young people!
– Place to feel appreciated for the efforts you put in to your role.
– Flexible working pattern around social life.
– constant career oppotunitities and chances of progression.
– benefit scheme.
– A different day every day!
– Clear management structure.
– Feeling of being looked after.
– regular, dinamic, engaging training sessions
I have worked at The Forum School for the past 5 years, and I plan to work here for many more years to come.
I would encourage others to do the same!
Pros-supportive, line management, flexible working, interesting, career oppotinities, benefit scheme, great pay, lots of training

‘Horrendous and stressful’

RCW (Current Employee) –  Cambridgeshire – 19 August 2017

No appreciation for anything you do. Long hours..unsupportive management.. underpaid for sleep duties..violent children with no consequences as our hands are tied.. management have their favourite staff who are actually no good at there jobs.. had an interview for a senior position and was told to step up..well I ve stepped up since i got there and had no appreciation so sod it.. expected to run shifts and cover for pretty much everyone including management.. absolute joke of a company.. senior staff with no experience..

staff turnover horrendous..
Pros None
Cons Taken for a complete mug

‘Good Experience’

In-House Recruiter/ Bank Support Worker (Current Employee) –  Manchester, Greater Manchester – 17 August 2017

I have worked at Cambian as a recruiter and a Bank Support Worker. I must say that I had great experience. The managers are really supportive and are always looking at ways to make our job easier.
Pros-Free Lunch
Cons-Long Hours

Avoid this company!!!!!’

Rcw (Current Employee) –  Hereford and Worcester – 16 August 2017

This company is the worse company I have worked for they do not care about their hard working staff who are told they have to stay on after working 24 hours if someone calls in sick as the staffing is so short (hence continuous advertisement on here).

Management if I can call them that think they are above everyone else and look down on staff and half the managers have got there position because of not what they know it’s who they know, they all stick together which is very unprofessional they never work there full hours turn up at 11am and go home at 2pm in the afternoon they practically work part time hours, and they do not support staff with shift cover!

The kids are great and the staff are great but the managers and fat cats at the top only care about money and how much they are making, they really let this company down!

Pros Get to meet some great staff and young people
Don’t bother your time
Cons Long hours, rubbish pay, no life, too much expected from management!

Hard work, long hours!

Residential Care Worker (Former Employee) –  Northampton, Northamptonshire – 23 July 2017
Working at Cambian I met some amazing young people, and some great colleagues.

However for the long hours, they need to pay people a better wage (on time, every time).
Always expect to be chasing them for money owed. Always use a pool car to avoid the inevitable.

Pros -Young people, staff
Cons -Poor pay (hardly ever on time), very long hours
Senior Residential Support Worker (Former Employee) –  Middlesbrough, North Yorkshire – 14 July 2017

i was employed as a senior support worker in Middlesbrough there was non-stop messing about from head office, they lost a number of documents also they failed to inform me that you have to go on a week training course which is a pass of fail. It is like the company has progressed too fast and their head office can’t keep up with them.
The company seems to focus on the money side of the business rather than the staff, all you need to do is look how many adverts for staff they have because there are so many people leaving.

In other words, do not apply for any of their jobs also tell everyone you know you will be messed about
Pros-pay if you actually get the job
Cons-so many to mention

I felt bullied throughout my time here’

Team Leader (Former Employee) –  West Midlands – 30 June 2017
Throughout my time I feel like management have bullied me or demanded that I have to work when I am unable to.

Management seem to lack the knowledge needed for the house and will refuse to cover shifts when needed.

On one occasion I was injured by a child and management would not come in to cover so I could go to the hospital.

The work pension scheme has not been set up and I was only informed it was starting a week ago. This is over 2 years late.
You are not safeguarded there and are put in so many vulnerable positions. It feels like they do not value your safety or commitment to the job.

They only value the money they can make or how they can cut corners.

Young people are placed in any house. Consideration of the placements doesn’t seem to happen and it leads to children struggling all day and becoming aggressive towards each other and staff.

I have not felt safe in this company for a long while and think the CQC need to start getting involved as so many compliances are being broken.

You will never have a stable staff team to work with as people are constantly leaving.

Pros-Care workers (not management) will go above and beyond to help the young people
Cons-You will not feel safe or valued in this company, A lot of other similar positions in other companies offer better rates of pay and benefits.

‘Avoid this place’
Education (Former Employee) –  Lymington, Hampshire – 24 June 2017
Really bad place to work in both education and care.
Culture of bullying of students and staff.

Management don’t know what is going on. a lot of relationships between senior Management don’t know what is going on. a lot of relationships between senior management meaning promotions for those in relationships.

Staff get hurt and no action is taken unless senior managers are hurt.

Training is poor and just tick boxing.

Most of the students are great but sad the way they are treated – rats and mice seen in food stores. Very poor value for what the local authorities spend on place.

‘Fun work place’
Support Worker (Former Employee) –  Shillingstone – 14 June 2017
getting children up hand over hand care, breakfast geting them to school on time.
ensuring activities are met and all relevant paper work is filled out.
promoting a healthy lifestyle
Pros-rewarding job for the right person
Cons-Mangament are a bit all over the shot and the training programme is to be desired

Was this review helpful? Yes 1No 7 ( On reviews helpful score appears to reflect the reader’s belief in the truth of the comment.)

Residential Childcare Worker (Bank staff) (Current Employee) –  UK – 13 June 2017

Work can be really busy and be challenging depending on the mood of the children and also how the home manager runs the home. There is plenty of op[pportunities to learn within the company especially if you’re a bank staff as you work in different homes. I enjoy going home knowing that I left a child reflecting on their behaviour whether good or bad as this gives them an opportunity to learn from it.

The hardest bit about the job is the long hours and working understaffed.
Pros Free meals
Cons Long hurs
Was this review helpful? Yes 1 No 3

‘place to avoid’

Support Worker (Former Employee) –  Colchester, Essex – 2 June 2017
I worked there for just short of 7 years and that was due to the support staff they had there and how close it was to where I lived, but as for the company itself wasn’t the best.
my money went up less then 55p in that 7 years, the training you get is very basic, it was more like a tick box exercise than a learning one
Support workers are shown little or no respect, on their job advert they say you will be given meals and that’s a lie and progress in your career which is another lie.

Management care more about numbers then their staff and don’t listen to you when you have concerns.
Was this review helpful? Yes 14 No 1

‘Productive Workplace’
Support Worker (Current Employee) –  Leeds – 30 May 2017
I have been working for this company for 1 year I find it enjoyable. This company prefers to progress the younger end rather than the older end good to get the experience then move on to better things
Pros Nothing
Cons-Long hours and always short staffed
Was this review helpful? Yes 6 No 2

‘Awful stressful place to work. Accidents waiting to happen’

Support Worker (Former Employee) –  Long Eaton, Derbyshire – 14 May 2017

All the experienced staff have left.

They recruit people who have no interest in working in complex care and have no skills to do so as any experienced member of staff would not work here.

so short staffed and staff morale is awful. when anything gets suggested to management it is just ignored. managers belittle support staff and never give any positive feedback always wanting more.

you never get a break unless you smoke, staff are often refused breaks even when on 12 hour shifts yet manager will have their dinner first, without even seeing if any clients need support with dinner.

accident waiting to happen here, I know someone will get hurt one day as the place is a danger

Pros-some really hard working staff- nealry all left

Cons- long hours, no breaks, low morale, dangerously short staffed
Was this review helpful? Yes 16 No

Immoral and corrupt company needs to be shut down

Support Worker (Former Employee) –  Bradford, West Yorkshire – 3 May 2017

Immoral company managers do not have a clue what they are doing staff turn over is so bad they recruit every month, I do not know how on Gods earth this company still exists.
Was this review helpful?Yes 29 No 4

Not much fun at start

Residential care worker (Current Employee) –  Birmingham, West Midlands – 21 April 2017
I didnt work in care and wanted to try it out,traning was really good but the care home i went in the kids wer fine but the staff didnt know how to work in a team, i have been moved to another home and will see how that goes

Pros-Free lunch dinner
Cons-Long hours and the days off you have ur just tired all the time
Was this review helpful? Yes 12 No 1

Awful place to work

Residential care worker (Former Employee) –  Loughborough – 27 March 2017

Poor management, young people run riot, over worked and under paid!!! Horrendous full 24 hour waking shifts due to being unable to control the behaviour

Pros Non
Cons Long hours, low pay
Was this review helpful? Yes 30 No

Productive in terms of recovery
Senior recovery practitioner (Current Employee) –  Overseal – 24 February 2017
Having been employed by SACCS (a company taken over by Cambian)

I feel that priorities within the company have changed. There has been a drastic change in the support I received which in turn, has an effect on the recovery process for the child.

I currently work with several employees that are dedicated in for the best in terms of the long term recovery process of the child.
Pros Valuable team members striving
Cons Not being paid correctly on several occasions
Was this review helpful? Yes 6 No 3

productive and fulfilling place to work
Support Worker (Current Employee) –  West Midlands – 17 February 2017
every day would be varied, the staff are friendly as well as the residents. The job is fulfilling and very rewarding. Would recommend anybody to work here.
Pros free lunches and awesome trips out
Cons long hours
Was this review helpful? Yes 3 No 14

Childcare Worker (Current Employee) –  Cambian group – 16 February 2017

I feel after ten years, I have enough experience to speak with some experience, Cambian took over my company, and since there has been very little to be proud about.
The training is pitiful and inadequate, the H.R people either are not trained well enough, or just do not care.

I have been asking for my expenses since September also some money that was taken from me for no reason that I can see. We are asked to put ourselves out, but the company do not. Why do we need to ask month after month for pay which is owed to us. I unfortunately am unable to recommend this company to anyone.
Working with children is very rewarding the company just leaves a bad taste. I am really sorry to be so negative about a job which I used to enjoy.
Pros Very little
Cons As above
Was this review helpful? Yes 27 No 1

to much expected
rcw (Current Employee) –  West Midlands – 10 January 2017
you cannot do this job if you are a single parent, not enough support.
children run the staff,
to much expected not enough support
long hours, no life outside work
Pros-can move your career on
Cons-long hours
Was this review helpful?Yes 19 No 1

Official response from Cambian Group
20 January 2017
I’m sorry your experience has not been positive. If you would like to discuss your concerns in confidence, please call 0161 266 1550 and ask to speak to the Recruitment Administrator.

Fun workplace with benefits
Senior Support Worker (Former Employee) –  North East – 6 January 2017
Brilliant staff who are hardworking and have a laugh, pay and holidays are fair. The most enjoying part of the job is getting out and about into the community
Was this review helpful?Yes 2No 19

kids great,company awful
Residential Care Worker (Former Employee) –  Wolverhampton, West Midlands – 3 January 2017

Fantastic residential care workers.The company only cares about how much money they make !! Kids should be priority but of course they are not !!!

Pros-kids are great !!
Cons-poor pay, company don’t care
Was this review helpful? Yes 29 No

Official response from Cambian Group
20 January 2017
I’m sorry your experience has not been positive. If you would like to discuss your concerns in confidence, please call 0161 266 1550 and ask to speak to the Recruitment Administrator.

Terrible place to work, stay away!!!!
Support Worker (Former Employee) –  Sheffield, South Yorkshire – 24 November 2016

This company is horrendous, they are only bothered about money they earn, they don’t care of service users or staff.

I have recently left the sheffield day service which is situated in woodhouse, and it’s been the best thing I have done.

The manager is unprofessional and is unexperienced of her duty of care as a manager.
They work short staffed and put the individuals and staff at a high risk harm/danger.
If you report a problem you get laughed at.

I believe the place needs investigated.

I wouldn’t want my family members to be going or to be in a place from this company.
Some staff get treated better then others, and these tend to be the managers “friends”.

The food is poor and activities are shocking.

From what I can gather from the rest of the reviews on here all cambian settings are all the same.
Cons-Company, manager, team leaders, food, activities safety, e.g everything
Was this review helpful? Yes 39 No

Official response from Cambian Group8 December 2016
I am sorry to hear about your experience with us.
We do have a recruitment team dedicated to recruiting the best staff for our homes.
I have passed your comments on.
Please feel free to call us on 0161 367 5934 to discuss further.

Pay not great and very little time off
RCW (Former Employee) –  Yorkshire – 17 November 2016

Monthly pay constantly wrong… every time I telephoned payroll about it they were often defensive and rude.

Regularly working between 60-70 hour weeks on top of being expected to be on call when I did get a weekend off.
Was this review helpful? Yes 12 No

Official response from Cambian Group
23 November 2016
Thank you for your comments – they have been passed on the relevant department.

Great Kids and career prospects.
Team Leader (Current Employee) –  Midlands – 2 November 2016
Came from a completely different career background and was not planning to stay as the money was not great. Started with a great staff team and fell in love with the job. Its not for everyone and judging from the other reviews there are a lot of people who could not hack it. If your attitude is good then you will do well. If you are afraid of hard work and feel that you are owed a living then also avoid. You will work for your money and have bad days when you feel like you have made the wrong decision. These days will disappear when you help kids and laugh with you team. Been my pleasure to work with some wonderful kids and help them through the hardest of times.
The hours are long but for me never seem to be quite enough to get everything done and it is hard to balance having young children and working shifts.
Pay could and should be more but its competitive with the market sector.
I have worked here for nearly 8 years and have been encouraged at every turn to advance and progress.
Pros Career advancement and work in a great team.
Cons long hours
Was this review helpful? Yes 5 No 19
Senior Carer (Current Employee) –  South – 27 October 2016

Young inexperienced and clueless managers.

Poor salary paid 10 days into the following month. Often overtime worked in the month is not paid until nearly 2 months later. We have a director who I heard bragging to some 18 year old residents about her rise to power and all she had achieved within the Company they were trying to ask questions but she kept steering the conversation back to herself!

Been here 5 years and if I wasn’t close to retirement I would be gone.
Pros-It’s a job
Cons-Poor pay, management. Culture of blame
Was this review helpful? Yes 22 No 3

Not a nice company

Education (Former Employee) –  South – 17 October 2016
The Cambian group are a hypocritical company that see staff as an expendable commodity, as they are a CARE company this is last on their list .

Their ethos of making money by which ever means necessary even to the detriment of the services users and staff is unethical to say the very least.

The pay is very poor given the responsibility that is placed on you, the management even worse, and if you don’t fit in or you speak up about problems they will make your life difficult, and find ways to either get you too leave or find things to fire you for, this could follow you to other jobs as the only thing they are thorough in, is destroying peoples careers and lives.

I cannot warn people strongly enough to STAY AWAY from this company they are dangerous .
Was this review helpful?Yes 28 No 4
Official response from Cambian Group
9 November 2016
I am sorry about your experience with us – there is a whistle blowing policy in place so that you can raise issues and a HR contact to discuss concerns.
Please call us on 0161 367 5934 to discuss further.

unprofessional and uncaring lazy management

RCW (Former Employee) –  Manchester – 16 October 2016
I worked there for five years , long hours no support from management.
No support
Easy to blame slow to appreciate
Some regional managers se bullies
HR not helpful at all
Pros-water in taps
Cons- longg hours mansgers Bullies attitude not caringWas this review helpful? Yes 26 No 2
Long hours

Residential Childcare Worker (Current Employee) –  Durham – 8 October 2016

The days are long and so are the nights. You don’t seem to get any appreciation for the hard work you do. A lot of the young people seem to get away with anything with no long term consequences
Pros Free lunch
Cons Long hours, bad pay
Was this review helpful? Yes 24 No 1
Official response from Cambian Group
9 November 2016
Thank you for you comment.
I can assure you that you are appreciated – I am sorry you didn’t fell that way.
There are structures in place for the young people and their behaviour.

Good company with good opportunities
care worker (Current Employee) –  Leicestershire – 12 September 2016
i have worked for cambian for 2 years now, the company is good, and its a shame to see negative reviews, people always have bad stuff to say and not the good stuff.
my manager has supported me to develop in my role and made me a better carer for the young people we look after.
there are always hiccups in every business, I personally have never had any issues with payroll, but I know if there has been a mistake with pay then its sorted 48 hours after, we have just received a pay increase too in our sleep in rate which is good.
staffs hard work is recognised, my manager always thanks us and brings us in cakes on Fridays!
and we have a staff awards ceremony at the end of the month to thank us for our work.
this job isn’t for everyone, it is challenging at times and it is hard, but if you want a rewarding job that changes young peoples lives then I really recommend this job, I don’t see myself leaving cambian, so that can only be a good thing!!!
Pros-Longevity and development
Cons-Staff leaving, the job isnt for everyone
Was this review helpful? Yes 12 No 22
Official response from Cambian Group
11 October 2016
Thank you for your comments. I am please you are enjoying your employment with us.
Can I please use your comments further?

Terrible Management! Run Incorrectly!
Support Worker (Former Employee) –  Keighley – 23 August 2016

This job itself was very rewarding, but management were running it very badly! The actual manager didn’t know what he was doing! A rota for one week ahead?
The manager had to wait till the deputy got back off annual leave so he could put out a new rota because he didn’t know how to do one himself! (baring in mind rotas should be put out for at least a month in advance!).

Badly organised! Social life and other commitments, how are you supposed to run your life around a 1 week rota?
They’re all for calling you in to cover shifts and do things for them but what gratitude do you get for it? None!
There also good for pulling you in the office due to people’s ‘hearsay’. They don’t appreciate the work you do!
Time and effort you put in, they have no idea how us support workers work, only our fellow colleagues do. They are always there when you’ve done something wrong, but not so quick to praise you positively!

I could go on forever, but all i can say is you are stupid if you get yourself involved with this company! Absolutely terrible! Utter disaster!
Pros- Breaks
Cons-Managers, Days off
Was this review helpful? Yes 44 No 7
Official response from Cambian Group
7 September 2016
Sorry you weren’t happy with your experience with the Cambian Group.
We want everyone to be happy and will do our best to resolve the problems.
Please contact us on 0161 367 5934 to discuss this further and we’ll deal with it straight away.

Payroll is inadequate & incompetent
Residential Support Worker (Current Employee) –  Leicestershire – 26 July 2016
Month on month our staff team were paid inconsistently & incorrectly. This is useless when they don’t correct the issue until the end of the following month, not considering the fact that employees have bills to pay and children of their own to feed.
Was this review helpful? Yes 45No 3

Completely misleading advertising for Tutor role…AVOID!

Tutor (Former Employee) –  Corbridge – 22 July 2016
Attended an interview at the Dilston College, Corbridge venue for the role of Tutor.
I had been advised earlier by HR that this was an academic teaching role with no aspects of personal care.
However, after taking a day off work & travelling a considerable distance, I was told right at the end of the interview that I’d be expected to carry out all aspects of personal care including getting the learners out of bed in the morning, washing & dressing them & all toilet duties. This in addition to teaching them.

This is not a Tutor role, it was totally misrepresented throughout.

The staff who interviewed me had only been in the post for a very short time & were completely out of their depth.
The whole place has an atmosphere of confusion and nobody knowing that they’re doing.
Pros None
Cons Misrepresentation
Official response from Cambian Group
7 September 2016
Thanks for your comments, they have been passed onto the relevant department.

Here are more reviews from Glassdoor
Former Employee – RCW/Senior in Shrewsbury, England
Doesn’t Recommend
I worked at Cambian Group full-time (More than a year)

Pros-The young people can be great fun to work with.
Cons-Poor Management
Poor Recruitment
No Direction
Wages wrong

Advice to Management
Root to branch investigation needed in Shropshire area.
Homes in and out of crisis and Senior management slow to react. Home managers employed with no direct experience in the sector. Bullying,Buddy and blame culture is rife.

Education is a joke. Rotas and rota system non existent on the whole.
Poor exit interview that is geared to make the company look good and the employee disgruntled. cannot recommend would never …

These comments were made 2 years after Thomas Rawnsley died in Cambian’s ‘care’.

It took 10 months for the CQC to do a routine announced inspection of Kingdom House where he died. They rated it as ‘good’.

The only future for our autistic and learning disabled is to be a voiceless commodity bought and sold to maximise profits and minimise service.









Universal Health Services own Cambian and Cygnet. What do we know about them?


UHS PIC 1e275a4f3c2d6020578c358a360dd8f9

UHS own more than 200 psychiatric facilities in the USA and admitted nearly 450,000 patients last year.

UHS now run nearly half of UK NHS mental health services, owning both the ‘community living’ provision of the Cambian group and the Cygnet group

Health and Social Care Foundation Trusts commission UHS services for Clinical Commissioning Groups, as the only ‘qualified providers’ under the Health and Social Care Act 2012.

Nearly a quarter of NHS England’s budget is spent on mental health services.

New inpatient admissions are private, and mainly enforced under MHA section, or MCA ‘incapacity’, and unlike in the USA insurance system, NHS funding never runs out.

And in the UK there is no contractual liability to the service users via insurance contracts.

What do we know about UHS service provision, precious little, as they can hide behind commercial confidentiality.

We have employees reviews, a staff registered nurse posting last month;

‘Quit lying about how great your facilities are, because they’re truly a disgrace and are a reflection of how ignorant upper management is concerning how ethical the patient care within their facilities actually is.’

And in 2012, UHS settled a lawsuit filed by the government against one of its youth facilities in Virginia.

A federal complaint alleged the hospital was delaying the release of patients, who no longer needed care in order to increase Medicaid payments, and deliberately provoking patients to gain reactions which would warrant longer stays, and altering therapists’ records to justify longer stays.

UHS closed the facility and later paid just under $7 million dollars to resolve the case.

Currently, at least three USA federal agencies are investigating whether UHS held patients longer than medically necessary to maximize profits, a claim UHS denies.

UHS stock fell 12% last December, losing $1.5 billion, on the release of a year long investigation by Buzzfeed.

‘’A yearlong BuzzFeed News investigation — based on interviews with 175 current and former UHS staff, including 18 executives who ran UHS hospitals; more than 120 additional interviews with patients, government investigators, and other experts; and a cache of internal documents — raises grave questions about the extent to which those profits were achieved at the expense of patients.”

“Current and former employees from at least 10 UHS hospitals in nine states said they were under pressure to fill beds by almost any method — which sometimes meant exaggerating people’s symptoms or twisting their words to make them seem suicidal — and to hold them until their insurance payments ran out.”

“Several people who ran UHS hospitals said corporate bosses pushed them to cut their hospitals’ staff further and further each year, regardless of the impact on employees’ safety or on their ability to care for the people being admitted.

Each year, hospital administrators presented their budgets to a panel of corporate leaders. And each year, people who were involved with the process say, corporate execs offered the same prescription: Cut more staff.”

The publication also spoke with several former patients of UHS, who allege they were held against their will, and that counselors twisted their statements during evaluations in order to forcibly admit them. Even the vaguest or passing mention of suicidal thoughts was used to hold them, the report said.

The report went on to describe a corporate culture that included more annual bonuses for outstanding financial performance, than payments for outstanding patient care. One former hospital administrator described it by saying that the priority was the bottom line, not the staff and patients.

The Buzzfeed 2016 report is here

Two nurses from the facility, Brooke Glen Behavioral Hospital, said they had direct experience with the company holding patients longer than necessary to collect higher insurance payments.

They recalled telling doctors that patients were safe to be discharged, but that the doctors would ask when their “last covered day” was — the last day Medicare, Medicaid, or their private insurance would pay for — and discharge them then, regardless of their condition.

Facilities advertise free mental health assessments.

For example; “Highlands can help,” proclaims the website for Highlands Behavioral Health in Littleton, Colorado, announcing, “but only if you call to speak with a caring professional, or to schedule a free confidential assessment 24 hours a day, 7 days per week, please call.”

Staff members from across the country said such assessments were often not what they appeared to be.

As when people called to ask for help or inquired, internal documents and interviews show, UHS tracked what a former hospital administrator called each facility’s “conversion rate”, that was the percentage of callers who then actually came in for psychiatric assessments, and then the percentage of those people who became inpatients.

“They keep track of our numbers as if we were car salesmen,” said Karen Ellis, a former counselor at Salt Lake Behavioral.

In the UK a mental/ behaviourally disordered patient, nor his family has any effective rights either under the MCA and/or the MHA.

As CQC reports show an increase in admissions after assessment, longer and more detentions in mental hospitals.

And as GPs, schools, social services, hospitals, police, carers, employers and charities are now promoting and assessing our mental health, should we not investigate mental health services independently, as has happened in the US.

And not leave our most needy at the mercy of apparently our most greedy ?





‘Blood on our hand’. State trumps autonomy and Care feeds mental .


Sir James Munby proclaimed in a highly publicised judgment ‘we would have blood on our hands’, if the NHS could not find a low secure inpatient bed for a 16 rather than an 18 year old.

A number of suitable beds were found the next day.

No concern was voiced for the Local Authority’s treatment of 16 year old X, after her removal from her mother and siblings at 14 , nor, that her desire to be reunited with the only people she knew and loved was the reason for her beyond desperate despair.

Only last year Local Authorities attempted to statutorily exempt themselves from liability for those, like X, they are paid to protect.

X’s Guardian had stated of X’s years in care:

“The facts of this case are calamitous. Indeed, a review of the initial evidence of the local authority from April 2015 makes for sobering reading at what must today be the final hearing.

At the time these proceedings were issued, the local authority were concerned for a child with poor school attendance, ‘low-level criminality’, periods of absconding and a mother who lacked the insight and parenting capacity to assist.

Now, in June 2017, the court finds itself tasked with determining issues of welfare for a child seemingly committed to killing herself, with a raft of serious criminal convictions to her name and a toxic relationship with her mother’.

So who, one wonders, proved the better parent?

The local authority’s final care plan set out three ‘contingency’ plans, each involving a return to the community with support from an organization whose employees operated under a ‘no restraint policy’ and would be reliant on the local police.

The first two plans provided a return by X to her home town, either living with her mother, or in a “bespoke placement”.

The third plan was a similar “bespoke placement” but outside X’s home town.

But by the penultimate hearing when a further care order was made although it would expire in weeks on X’s 16th,, a care plan was still not in place.

Six weeks later, at a final High Court hearing 11 days from the expiring of X’s Youth Custody Order and freedom for X, these plans were scrapped, because of a visit by X’s guardian, the opinions of X’s care staff and the belated notification of 85 Reportable Incidents since X’s arrival in Youth Custody, all of which apparently were ‘as a result of self-harming risks and behaviours’. The vast majority resulting in restraint.

Sir James Munby in this High Court hearing, relied heavily an email by the guardian to the Local Authority the day after her visit saying;

’ It requires to be read in full, and considered very carefully indeed, by everyone concerned with X.

While at ZX the guardian witnessed a profoundly disturbing and distressing scene when X self-harmed by repeatedly banging her head and face against the wall. The guardian commented that:

“This … came out of nowhere. My visit to her had been pleasant … She was full of smiles and laughs. Within 15 minutes however she was beyond herself.”

We are not told why, or what had been discussed in this 15 minutes, that might have made X ‘beyond herself’ but the Guardian later reports,

“… there has been no assessment of risk or contact planning ( with X’s mother). This needs to happen as a matter of urgency. At this time, the guardian does not support unsupervised contact and would not support an increase from the current fortnightly arrangement; telephone contact needs to be fully monitored.”

The guardian adds in her email,

“I have never seen or heard anything like it in my 32 years of practice.”

The email then went on to summarise what the guardian had been told by the staff at ZX:

“The entire staff group’s opinion that:
‘X’s goal is not to go to [her home town] it is to kill herself’ (emphasis added)

Any care plan that allows X to visit home yet not live there is likely to underline this feeling of rejection and is therefore dangerous to X and to other people.

… The unit has 2:1 staffing levels, they have risk assessed every inch of X’s surroundings. She has still managed to eat all the silicone around the windows, still attempts to tear up doorplates to ingest either pieces of wood or screws, all the plastic sockets had to be replaced with metal, she cannot have carpet in her room (which is nothing more than a cell),

she has to be checked every 50 seconds in the shower and only this morning was found naked banging her head off the sink, the mirror had to be removed in case she smashed it and cut herself.

Staff feel their professional opinion has to be conveyed to the court as they believe X has begun to open up to them, make some level of attachments to staff, yet resents them for stopping her carrying out her deeply held wish to die.

They wish it to be known that their collective view is that X is not acting out because she is in a secure unit and this behaviour will stop as soon as she is given her freedom, they can only foresee X making continued attempts to kill herself due to whatever is buried deep within her and which intensifies whenever she experiences the negative atmosphere of her mother’s home where her emotional needs are not met (they state contact is poor quality and is not emotionally nurturing to X) and where in fact she feels she is less important and loved by [her mother] than her siblings’.

So, on the strength of the unopposed, untested, inadmissible, non expert opinion evidence of anonymous ‘staff’ on X’s relationship with her mother and home life and that X was a serious risk to herself if released, X’s fate was sealed, she could not be sent free, and all care plans were scrapped.

Yet psychiatric assessments had only made tentative diagnoses of Emotional Instability Disorder and ADHD, both understandable in X’s dire, 2.1, 24/7 supervised encaged existence, with an overriding diagnosis of Reactive Adjustment Disorder;

linked to her frustration, agitation and profound disappointment that her only wish is to return home to her mother … cannot be fulfilled and she is hopeless as to her future.’

But no depression and X’s suicidal tendencies,

‘are behavioural rather than issues of mental health’, so ‘a low secure facility which has the therapeutic facilities to manage her presentation, rather than a medium secure facility’ was recommended.

As experts, at most found ‘mild learning disabilities’, they assessed X as having capacity under the MCA so COP and a DOL could not be used to remove her freedom.

Neither could a section under the MHA as X’s issues were behavioural not mental.

Her Care Order expired at 16, therefore, in 11 days time, when X’s youth custody order expired, X could not be detained unless an order was made under the High Court’s inherent jurisdiction.

And, practically, X could not be detained in Youth Custody, or receive the suggested care packages, as these could not involve restraint, or medication, whilst a mental facility could.

So what of X’s undisputed ‘toxic relationship’ with her mother, who care workers’ hearsay of X’s confidential conversations, and their observations and opinion on them conclude,

’ contact is poor quality and is not emotionally nurturing to X)and where in fact she feels she is less important and loved by [her mother] than her siblings’.

And a guardian who wanted to ‘risk assess future contact to further restrict the 2 fortnightly visits and for telephone contact needs to be fully monitored.”

X had fortnightly visits from her mum, on the unit the risks were assessed as too great to be held in the usual visiting areas.

The visits were closely supervised by two staff at all times, and extra staff are positioned on the unit should any incident arise during the visit.

X had made all allowed five visits, despite no doubt a lengthy ( 30 mile) public journey from Kendal, confidentiality excludes us knowing the name of the custody centre, but from hearings it appears in Liverpool.

And great significance, appears attached by the guardian to the fact that

‘ each of [ these visits] resulted in [her] demonstrating behaviours which have resulted in the need for her to be physically restrained later the same evening’.

Anyone, forced apart from their Mum, after not being allowed a word of private conversation, or expression, knowing they would not be back for two weeks, would indeed be upset and furious, this shows X’s need and attachment to her Mum and fury at the conditions of her containment.

A mother who sought out her own legal representation, which gave evidence that X was on “a path of self-destruction”.

And, that she was “deeply worried” that X would continue to self-harm, if she remains in secure accommodation, but equally is worried that X could attempt to kill herself if living in the community.

The mother as did her daughter believed her contact with X should be increased in frequency and take place under more relaxing conditions.

Not like the guardian and workers who wanted contact risk assessed and curtailed. Why?

X’s first preference, as expressed to her solicitor, when she visited her at ZX on 11 June 2017 , is to return to her home town to live with her mother; if that cannot be achieved, she would want to live nearby her mother so as to be able to see her every day.

This is showed, in her solicitor’s view, that X’s “determined focus”, as repeatedly expressed during her visit, is to return to her home town as soon as possible,

and she records X as simply shutting down at any mention of her actions and as being “not interested, or perhaps not able” to discuss possibilities when it comes to future care planning, we assume because these did not involve being reunited with her family.

All contrary to the guardian’s repeated worker hearsay.

Why cannot X return to her own town and see the only people she knows and lived with until she was 14 ? What else has she got and who else really cares about her ?

If this were the care plan surely this would allievate her suicidal tendancies.

It is assumed X was not in court, when her liberty was removed for a suggested 18 months with enforced medication.

The Judgment, nor I assume any lawyers made reference to X’s right to liberty under Article 5, nor to a family life under s8 HRA .

The High Courts Inherent jurisdiction trumped both, and who could or would appeal ?



Winterbourne Asset stripped for millions and sold to Danshell Group.

Danshell-Infographic-2017In 2006 the Jersey-based Castle Holdings, a company backed by Lydian Capital, purchased Castlebeck from HG Capital, a Venture Capital transfer Vehicle for £255m .

The sale earned HG Capital a £23.1 million fee.

£1 billion in fees were earned from just 5 healthcare sales in 18 months.

So much for our cash- strapped NHS.

Before the Panorama expose, Castlebeck’s finances were buoyant

Dispelling the myth that more money produces better care rather than more profit..

But in light of such  shocking abuse something had to be done, so bulldozers were sent in and televised .

Despite Castlebeck’s inevitable demise, an expensive business turn round specialist was paid to restore its reputation, two units closed and 3 million spent refurbishing the other 20.

The Company itself had already undergone a significant refinancing process, and by 2011 had debts of £431m.

And was taken over by its banks led by RBS, put into administration, and sold as a going concern to the Danshell Group for just £35 million.

So, the only Corporate accountability for the horrific abuse of our most vulnerable for years, was multi million pound asset stripping, a buy out and profits for consultants, accountants, agents, administrators and lawyers.

So what is life like for Danshell ‘s ‘patients’ worth on average £7,000 a week, £13,000 in a secure unit.

The Company now hold these very lucrative commodities mainly under the MCA in their ‘best interests’, rather than for ‘treatment’ under the MHA.

Unlike the MHA, under the MCA parents can be excluded on ‘best interests’ grounds and gagged.

The LA commissioners and the CQC are the only overseers.

Yet both knew of Winterbourne abuse for years and did nothing .

And the Courts will not intervene in care provision.

So what do we know about the Danshell Group Services ?

Only what is in the internet .

There is only one Google review by Jacqueline Penaranda

every people here in this company is afraid’

No one has left a review at NHS Choices.

Workers Reviews are shown below;

August 2015
I worked at The Danshell Group full-time (More than a year)
Gained invaluable experience whilst working there of working with young people with mental health issues.

Bad HR department – paid incorrectly on several occasions.

Understaffed majority of shifts with a high reliance on agency workers. Put support workers in dangerous positions with no support following incidents.

Advice to Management
Support current staff and work as a team to support the young people.

Mis-managed to point of being dangerous’

Support Worker (Former Employee) –  Dundee – 11 November 2016

It was once a good workplace but has, in recent years, declined to low standards for the support workers reflected in its typically high turnover of staff.

This has hopefully changed for the better since I left.

free meals
lack of organisation, training & staff

The place like all work places has its good points and its bad , mostly good A Typical day at work was helping the clients with personal hygiene, grooming medication and giving them their food .

Management most of the time were helpful , co-workers were easy to get on with, friendly, we all worked as a team,

The paper work it was constantly getting changed, so what you were doing one moment in report wise could be totally different the next day , The most enjoyable part of the job was the interaction with the clients.

long hours, you had to stay on the premises during your breaks unless given permission by management, which meant you really did not get a brake from the place.

In 2014 Healthcare Improvement Scotland carried out spot-checks on Denshall’s Monroe House after anonymous complaints were made about the impact of low staffing levels, and procedures not being followed.
In 2015 two autistic residents from  Danshell’s Wast Hills home, were abandoned in a van for over 2 hours until spotted and reported to the police who rescued them.

One of the men, Darren Browne had been moved to Wast Hills in 2008 – more than 300 miles from his home in Inchinnan – because experts said it was the only place available to deal with his needs and his father had campaigned tirelessly for his return.

Months earlier in the same home, nine members of staff had retrained a 20 year old autistic for 11 hours , and eventually on calling the police, he was restraint belted, spit hooded, handcuffed, caged and removed to a cell .

NHS Improvement insist Danshell produce their own Quality Reports below.

Let us remind ourselves of Winterbourne View and how millions were made.

No Waynesickening-abuse




NHS Foundation Trusts – Monopoly Unaccountable Services ?

cAR PARKING FEES article-2683772-1F77638500000578-695_634x293

In 2016/17 NHS England transferred £71.9 billion to CCGs to commission services from Foundation and NHS Trusts.

Foundation Trusts are semi-autonomous bodies not directly accountable to Parliament.

It took years of campaigning to even acknowledge the deaths, neglect and abuse in Staffordshire Foundation Trust, whose public inquiry and insolvency cost the tax payers millions.

Successive governments set target dates for all NHS Trusts to reach Foundation status.

Staffordshire was the ultimate Status that all the expensive management and consultancy aspired to.

Despite Bill Moyes, former NHS Regulator Monitor’s executive chair, urging the NHS in 2014 to reconsider, “whether the model of foundation trusts is sensible”,

He argued,
“If one-third of the hospital system is permanently not demonstrating good viability and good governance, is that telling you something about actually how the system should run as opposed to how we thought it should run?”

But still the NHS went on to spend huge sums of public money on merging trusts to gain Foundation status often at the expense of services .

The Department of Health spent nearly £2 billion on 12 mergers alone, compared to £200 million on new care models .

By 2016 the distinction between Foundation Trusts and other NHS trusts had been largely eroded, particularly when their regulators combined to form NHS Improvement .

It appears even after the Staffordshire Scandal and the Francis Report, accountability of  NHS services has not improved, as this new overarching body only  requires CQC compliance.

Foundation Trusts were created by ‘third way’ Alan Miliburn back in 2002

They were a radical departure from the traditional means by which the NHS was held to account.

Which was directly to the Department of Health and the Secretary of State for Health.

Foundation Trusts are not accountable to Parliament and only to the NHS via NHS England.

So free from political control, and effectively any control other than the CQC and NHS Improvement .

Instead, their accountability is through their local governors.

Governors, who do not have the right to veto individual decisions of a Trust’s Board of Directors.

And the chair of the board of governors is also the chair of the board of directors.

So there is a conflict of interests and this is effectively self regulation..

And the Department of Health does not, in any event, expect the governors to take an active role in the day to day management of the trust, but leave that to the Trust’s management team and the board of directors (Departmentof Health 2003).

The Audit Commission and Healthcare Commission found continued confusion around the role of foundation trust governors, and no significant evidence that they had had an impact on the development of trusts (Audit Commission/Healthcare Commission 2008).

Governors interviewed for another study (Storey et al 2010) reported, that they were easily controlled by the chief executive and the boards of directors, and that their input into the strategic operation of foundation trusts was largely passive, as information receivers, rather than actively shaping the organisation.

The recent history of the NHS suggests that commissioners are relatively ineffective in holding powerful providers to account (House of Commons Health Committee 2010a),

By March 2013 there were 145 NHS foundation trusts (41 of them mental health trusts and five ambulance trusts).

The most lucrative Trusts are the 41 mental health trusts, as nearly a quarter of our NHS budget is spent on mental health.

Most likely, as they are the most profitable services, such trusts as with Sheffield Health and Social Care NHS Foundation Trust has been, will be converted to private companies, with existing Foundation Trust directors made private company directors and shareholders in charge of their own salaries, and effectively through the CCGs the provision of all NHS mentally related services including residential care in their region.

And as Private Companies, they can rely on ‘commercial confidentiality’ to hold the main parts of their meetings in private and as private companies, they are not subject to the Freedom of Information Act.

Yet they still maintain the NHS logo, so no one would, or even could know their services were from a private company..

Nor can there be accountable competition for these services, as Foundation Trusts buy in the services as needed, and are usually, the only ‘specified provider’ within the Health and Social Care Act 2012, the CCGs could use, in fact the Foundation Trusts are even buying up the GP practices that make up the CCGs.

And, as the caption above shows, billions are made just from NHS Trust parking from  public land and services.


Private Mental Hospitals Increase as the Cygnet Autism Empire grows.


So what has six years of post Winterbourne initiatives, campaigns and the end of public NHS mental bed admissions achieved ?

The increase of private hospital inpatient admissions.

Yet, Winterbourne View was a private hospital.

‘Independent ‘psychiatrists in private hospitals, are apparently, being paid for second opinions to enable the discharge of autistic patients from public ATUs to the private hospitals where they are employed.

Some might call that poaching, and the psychiatrists, anything but independent.

Cygnet’s Headlines portray expansions, as improving autistic ‘services’;

New Autistic Disorder Service Opening Soon’– November 2017.

To ‘enhance the care pathway in specialist Autistic Spectrum Disorder (ASD) services available within the hospital. This new service will be funded by Clinical Commissioning Groups (CCGs).

The Springs Centre will support up to 14 men with a primary diagnosis of ASD and comorbid mental ill health difficulties and/or mild learning disabilities in a locked rehabilitation environment.

It will be positioned “between” the existing specialist services within the hospital; 16-bed The Springs Unit which provides low secure accommodation and 10-bed The Springs Wing, our open specialist rehabilitation service.

The Springs Centre will also provide four rapid or emergency access beds which will support those who may be in crisis or have high dependency needs – for example, if a community placement has broken down or if they are struggling in open rehabilitation environments’.

Note it is assumed the autistic will not be living with their families but in a ‘community placement or ‘open rehabilitation’.

In addition, Cygnet Hospital Maidstone, a new 65-bed build is to open next Summer

Let us remind ourselves of Cygnet’s record on ‘treatment’.

And the fact that Cygnet is now owned by US Universal Health Services, whose executive was Simon Stevens now head of NHS England.

And let us remind ourselves that rehabilitation to enable going ‘home’,  is a home of drugged containment termed ‘community living’, also increasingly owned by US Universal Health Services via Cambian.

And here we have workers comments on Cygnet’s services.

And why is this happening?

The autistic are huge cash cows, they earn £13,000 a week being rapidly tranquilised in a secure Unit, whenever they are deemed ‘unmanageable’ in community placement or rehabilitation .

The Spring Centre with this new provision for an extra 14 men in locked rehabilitation and 4 rapid/emergency tranquilisation beds, earn £13,000 a week per ‘patient’ in addition to the existing 26 bed low secure units where each ‘patient’ earns £7,000 a week.

That is £416,000 a week.

Over one and a half million a month over 16 million a year ‘to look after’ 44 autistics.

And what do they get for this colossal amount of public money ?

Renovation of a large house in a cheap area, plenty of drugs until compliant, containment, a consultant psychiatrist, clinical psychologist, a nurse practitioner, an occupational therapist, a manager and deputy, and minimum ratio to patient care workers/nurses on shifts, and cooking, cleaning and laundry provision.

How long is the income guaranteed for ?

For ever and increasing, despite our crippled NHS.

Is there any competition ?

No, as Cygnet is deemed the only ‘specialist provider’ under HSCA 2012.

Does it improve the quality of life/outcomes for the autistic ?

There is no data kept on this except  a three year old report that 3 mental patients a day were dying unnecessarily.

What is their life like for £13,000/£7,000 a week ?

Drugged, washed, dressed, fed and maybe after years taken out in a van for an outing strapped into a wheelchair and perhaps visits from family who by now they may barely recognise.

The ‘patients’ have no rights, as sectioned each year under MHA and if necessary deemed ‘incapable’ for life under the MCA with yearly rubber stamped reviews of Deprivation of Liberty Safeguards.

All in their ‘best interests’.

And all agencies and experts are primed and employed to increase this empire by detection and meltdown as this is the only funded ‘support’.

Cygnet this year were given a a £300m commissioning budget for 11 new care model programmes, to create a new models of care for low and medium secure adult mental health services, Tier 4 child and adolescent mental health services and eating disorder services. By creating new partnerships the aim is to explore new opportunities to improve care pathways for our service users.

So we have a seamless cabal, effectively  from diagnosis,  with providers made too big to fail or fight.

And always on the look out for new lucrative captive consumers to pathway.



NHS Clinical Commissioning Groups subsumed into private monopoly providers?


At 69 the NHS is in its last gasps of life.

Silently asset stripped by large corporate multi nationals and managers.

And strategic cost cutting is used to streamline services into lucrative cherry picked privatisations.

And at the same time more money is pumped into the NHS as the solution to its woes.

Money used for its more lucrative, privately grabbed ‘services’ like mental health whilst A and E and frontline services remain starved.

So much so that over 20% of the NHS total spend, is now on mental health but only 7% on GPs, with 7 minutes consultations, herded as salaried GPs, into ever larger corporate practices.

All ‘legalised ’under The Health and Social Care Act on the lie of GPs commissioning the best services for their patients on ’competitive’ tender.

In 2016/17 NHS England transferred £71.9 billion to Clinical Commissioning Groups.

These groups are responsible for the commissioning and delivery of regional NHS services, all GPs are members but by 2014 only half of GP practices felt involved in CCG decision making processes.

Meanwhile GP Practices are being merged into corporately owned super GP Practices with 70,000 patients on the excuse of cost cutting.

Yet, on an analysis in 2015 of more than 2,500 CCG managers, 56% of 225 were paying themselves more than the salary range recommended by NHS England of £95,000 to £125,000 a year.

CCGs have merged 211 to 174, and many are outsourced.

And by October 2014 NHS England had introduced a special measures regime for those in financial difficulties.

At least 20 may have already been placed in special measures and taken over.

Shropshire Clinical Commissioning Group was put in special measures with a deficit of £10.6m for 2015/6.

Bristol, South Gloucestershire and Somerset’s 3 CCGs were taken over by one chief earlier this year.

These multimillion pound deficits/debts ploughed into executive salaries and private foundation trusts coffers.

CCGs were told by NHS England to procure ‘support services’ by a tender process by April 2015.

The first of such ‘support services’  for South Lincolnshire and South West Lincolnshire CCGs was won by Optumhealth,  who were given a £9 million 3 year contract, this being half the total running costs of the CCGs.

Optumhealth is part of US United Health Group, which employed Simon Stevens for 9 years, after he left his position as Blair advisor, he is now head of NHS England.

When originally established CCGs did not have any responsibility for Primary Care, which was commissioned and managed by NHS England.

But in November 2014 CCGs were invited to become co-commissioners of primary care in their area.

Responsible for the performance, management and budgeting of their member GP practices including managing complaints about practices and GPs.

Foundation Trusts  are  being converted to private companies like Sheffield Health and Social Care and are buying up GP practices.

What now then is the distinction de facto between the Commissioner and overseer of services- the Clinical Commissioning Groups, and the  Foundation Trusts providing the commissioned services ?

What effectively is the function of CCGs now?

CCGs appear to have been a device to legitimise commissioning of services from the Foundation Trusts until they are set up and running.

And then the CCGs will as they are  being  surreptitiously merged and subsumed into private service providers allowing self regulation and autonomous service provision.

The eventual goal; a few supersized, too big to fail providers, controlling our public 100 bn pound + budget, whilst accountability falls on NHS England- the tax payer.

An opaque, totalitarian mess, without oversight, riddled with self and conflicts of interests.

Without competition nor patient voice.