Posts by finolamoss

Solicitor qualified 1981.Weightmans, Liverpool. College of Law Chester Senior Lecturer 1981-89, Litigation, Evidence, Employment and Consumer, Conveyancing and Landlord and Tenant. Law Society examiner in above topics, Senior Lecturer Sheffield Hallam University 1993- 2012. Equity and Trusts, Land and Evidence. Commissioned writer for New Law Journal, Solicitors Journal and Expert Witness Institute. Born and bred in Liverpool. Married, 2 daughters 15, 18, One autistic, abused by the state, and a huge present, and future cash cow. Email finolamoss@gail.com www.youtube.com/watch?v=586TEFU-vr0

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

autonomy-in-bioethics-2-638

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.

https://www.judiciary.gov.uk/wp-content/uploads/2017/08/in-the-matter-of-x-a-child-no-4.pdf

A number of suitable beds were found the next day.
http://www.itv.com/news/granada/2017-08-04/beds-identified-for-suicidal-girl-after-judges-blood-on-our-hands-warning/

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 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 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.

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 ?

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.

http://citywire.co.uk/money/hg-capital-receives-boost-from-healthcare-sale/a274856

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.

http://www.express.co.uk/finance/city/426055/Care-home-operator-snaps-up-firm-for-35m

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.

https://finolamoss.wordpress.com/2017/05/06/best-interests-no-choice-no-outcomes-no-accountability-the-story-of-mn/

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;

https://www.glassdoor.co.uk/Reviews/The-Danshell-Group-Reviews-E1035182.htm

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

Cons
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.

https://www.indeed.co.uk/cmp/Danshell-Healthcare/reviews

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.

Pros
free meals
Cons
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.
Pros
Clients

Cons
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.

https://www.eveningtelegraph.co.uk/2014/05/15/complaints-spark-probe-at-dundee-mental-health-hospital/
..
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.

http://www.mirror.co.uk/news/uk-news/two-carers-suspended-after-vulnerable-5470315

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 .

http://www.bbc.co.uk/news/uk-england-40704993

NHS Improvement insist Danshell produce their own Quality Reports below.

http://www.nhs.uk/aboutNHSChoices/professionals/healthandcareprofessionals/quality-accounts/Documents/2017/Danshell-qa-2017.pdf

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 .

https://www.hsj.co.uk/topics/foundation-trusts/bill-moyes-questions-whether-ft-model-remains-sensible/5071945.article#.U8PwnvldUk4

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

https://www.kingsfund.org.uk/sites/files/kf/field/field_publication_file/Foundation-trust-and-NHS-trust-mergers-Kings-Fund-Sep-2015_0.pdf

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

https://www.theguardian.com/society/2002/nov/13/health.theissuesexplained

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..

http://www.sheffieldtelegraph.co.uk/news/health/health-bosses-planning-new-company-to-run-key-nhs-services-in-sheffield-1-7299410

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.

HARROW-8 CGYNET

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.

https://markneary1dotcom1.wordpress.com/2017/07/06/three-new-monstrosities/

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’.

https://www.cygnethealth.co.uk/news/new-autism-spectrum-disorder-service-opening-soon/?utm_source=twitter&utm_medium=social&utm_campaign=news

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

https://www.cygnethealth.co.uk/news/development-cygnet-hospital-maidstone-underway/

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

https://finolamoss.wordpress.com/2016/12/25/a-christmas-tale-of-autistic-lives-and-cygnets-12500-a-week-nhs-bonanza/

https://finolamoss.wordpress.com/2016/12/09/jodies-cygnet-help-no-psychologist-communicationassessment-plan-protection-death-for-21000/

https://finolamoss.wordpress.com/2016/12/01/24-year-old-dies-in-cygnet-after-11-forced-olanzapine-injections-in-10-days/

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

https://finolamoss.wordpress.com/2016/11/25/payers-of-8-4-million-for-false-claims-universal-health-services-take-over-cygnet-health-care-for-205-million/

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.

https://finolamoss.wordpress.com/2017/07/01/adult-treatment-units-to-community-living-turf-war-for-billions/

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

https://finolamoss.wordpress.com/2016/12/29/comments-on-cygnets-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.

https://www.cygnethealth.co.uk/news/new-care-model-projects/

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?

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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.

https://www.hsj.co.uk/news/commissioning/fall-in-gp-engagement-with-ccgs-nhs-england-survey-finds/5075901.article#.VFa5Hp_raKI

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

http://www.pulsetoday.co.uk/your-practice/practice-topics/employment/hospital-in-mass-takeover-of-gp-practices-will-soon-have-70k-patient-list/20034631.article

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.

http://www.dailymail.co.uk/news/article-2987218/NHS-bureaucrats-140-000-20-bosses-award-higher-salary-PM.html

CCGs have merged 211- 174 and many are outsourced.

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

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.

https://www.hsj.co.uk/hsj-local/commissioners/nhs-bristol-ccg/special-measures-ccg-group-hires-stp-lead-as-joint-chief-officer/7015665.article

These multimillion pound deficits 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 before he took up his position as head of NHS England.

https://www.hsj.co.uk/news/commissioning/updated-private-firm-wins-first-full-commissioning-support-tender/5090717.article#.VhP3uUpfZ1A

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.

http://www.pulsetoday.co.uk/hot-topics/stop-practice-closures/five-gp-practices-merge-with-hospital-trusts-to-shore-up-their-finances/20034282.article

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?

As it  appears 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.

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Adult Treatment Units to ‘Community Living’ – Turf War for Billions ?

Trade in people 1700s-1850s-1856-sketch-of-slave-sale-in-charleston-south-carolina-DC0TH0

I thought long and hard before writing this post, as I did not want it to appear to condone in any way, the atrocity of life and death in an Adult Treatment Unit.

Atrocities like the 7 year ‘treatment’ of 18 year old Stephanie Bincliffe in an Huntercombe ATU, paid £1761 a day to lock and drug her in a windowless cell.

And no one was held accountable when this fit young woman’s heart stopped after she ballooned to 25 stone.

http://www.blogistan.co.uk/blog/mt.php/2017/06/27/seven-days-of-action-poor-excuses-for-poor-care

Clearly, it is illegal and morally reprehensible to imprison and drug anyone, let alone the autistic and learning disabled, as this is not ‘treatment’, or, determinable, as required by the MHA.

But is the solution of ’community living’ any better ?

And why is it, that the purpose of all campaigns are only ever to move the autistic and learning disabled to local ‘community living’ placements ?

How is merely moving, from an ATU regime of MHA yearly reviews and ‘treatment’, to that of MCA ‘incapacity’ and ‘best interests’ living under Deprivation of Liberty Safeguards, in the area you originate from going to improve your life and care ?

What use is being close to family, when access is restricted, supervised, and can be terminated in a person’s ‘best interests’.

And access to your ‘community’ is strictly controlled by deprivation of liberty safeguards and the availability of care home staff ?

How is care revolutionised in ‘community living’ ?

A person is still locked up and drugged, the only difference is, he is taken out occasionally.

And there is even less accountability, with no mental health reviews or appeals,  just CQC paper and Adult Services manager employed by the services Commissioners oversight.

And as providers are private companies, they can hide all behind commercial confidentiality.

Parents can’t complain and unlike under the MHA are gagged under MCA, so even if they did know what was happening, could not reveal it as Thomas Rawnsley’s mother found out.
https://finolamoss.wordpress.com/2016/05/08/thomas-rawnsley-a-deadly-legal-gag/

Before the autistic/LD became cash cows things were very different.

A few might be forced to spend a short time in a mental hospital and then were sent home.

ASD/LD were not sectionable as they were only made subject to the MHA  in 2007.

Now ATUs are the only solution to any ‘incident’, as GPs, nor anyone will help, there is no support and parents are told to ring the police.

And the autistic/LD are then sent to and remain in ATUs for years.

And ‘being sent home’, now means being sent back to the area you originated from to live in ‘community living’ for life.

Why is this happening?

Because NHS local foundation trusts are being converted to private companies under the Health and Social Care Act and want to and are making huge profits from commissioning or providing ‘community living’.

Eye watering sums are available despite austerity.

£477 million a year is forecast to be needed to keep present 2,500 LD/ASD in ATUs.

£284 million was spent on private ATUs alone last year..

£136 million has already been provided to remove the 3000 ATU inpatients, to ‘community living’ after a’ Valuing People ‘audited them to find out which authority they belonged to.

https://finolamoss.wordpress.com/2016/08/23/care-reform-136-million-to-move-ldautistic-from-public-nhs-units-to-community-living/

Transforming Care Partnerships forecast a spend of £1,478 million on “individual community support packages for former inpatients and those at risk of admission” for aftercare packages for just for 2015/16. By s117 MHA such a package is a prerequisite tor ‘community living’.

And lets not forget the £433 million to implement Care Act ‘safeguarding’, to relentlessly remove every ASD/LD from their family to ‘community living’ .

https://finolamoss.wordpress.com/2016/05/19/how-will-433-million-carers-act-implementation-money-be-spent/

Money is no object when it comes to feeding private companies.

But no funds are made available for support within the family home, nor for respite, or community centres.

In fact benefits have been reduced.

Families are left to cope alone on £62.50 Carers Allowance and £105 DLA ,whilst ATUs are paid £13,000 per week and community living placements £6,000 +.

Since when, has a society needed to remove those whose behaviour is different, from their families and society, drug them, and spend billions doing so.

And since when have all charities including the National Autistic and Learning Disabled allowed them to ?

Is this not the worse form of opportunism, extortion and exploitation ?

As ‘community living’ is private and NHS Foundation Trusts increasingly so, FOIA Notices, nor even the Public Accounts Committee can find out how  these huge sums of public money are spent.

The latest research in this area is entitled ‘A Trade in People’.
http://wp.lancs.ac.uk/cedr/files/2017/06/A-Trade-in-People-CeDR-2017-1.pdf

It blames the continued holing up of thousands in ATUs, not on the illegality that the MHA is not being complied with, but on;

‘a reluctance on the part of some “exporting” authorities to fund people’s return home’, as by s117 MHA, an individual community support package, must be in place before a person can be moved to ‘community living’.

According to  information received under Freedom of Information request, Transforming Care Partnerships were forecasting a spend of £1,478 million on “individual community support packages for former inpatients and those at risk of admission” just for 2015/16 aftercare packages..

They conclude that ‘ levels of spending involved go some way to explain why many of our families cite arguments about who pays for aftercare as one of the reasons that they have struggled to get their sons and daughters home’

Home meaning back to the area they originated from.

The report claims 5 years in an ATU generates £950,000 income.

So after 5 years of ‘treatment’, costing nearly a million, an autistic/learning disabled person is still in need of a further hundred thousand pound support package, before he can commence his ‘community living’ ?

This speaks volumes of the inadequacy of ATU ‘treatment’.

And what does the package pay for, and why was it not part of the £13,000 a week spent on the ATU?

It also begs the question, can autism and learning disability be ‘treated’ ?

They are not ‘mental disorders’ but life long behavioural issues that need to be understood.

The Report concludes; .

“We think that the European Convention on Human Rights is not being followed. Mainly Article 5, the right to liberty and Article 8, the right to a private and family life. The right to a private and family life has been torn from many families in the fight for their loved one’s freedom.”

But in ‘community living’ there is no art 5 Right to Liberty, as all movement is restricted under MCA Deprivation of Liberty Safeguards, nor Right to a Private or Family Life, as parents have little access, which can be terminated at any time.

And last year Art 3 Right to Life, which allows an automatic right to a jury, if you die in ‘state detention’ was removed for those subject to an MCA DOL, as all are in ‘community living’.

So even death does not need to be externally investigated.

Let us remind ourselves of what life was like in ‘Community Living’ for Thomas Rawnsley, provided by today’s main provider Cambian owned by US Universal Health Services .

https://finolamoss.wordpress.com/2017/02/04/thomas-rawnsley-died-two-years-ago-today-and-still-no-answers/

And from the words of those working in ‘community living’.

https://finolamoss.wordpress.com/2016/04/14/workers-expose-life-in-lifeways-supported-living/

It is indeed a Trade in People.

 

The Scandal of UK’s £15.1 Billion+ Elderly Cash Cows.

older-woman-medicines

Some months ago I’d seen a sign go up on a slightly dilapidated Victorian house – Alzheimer Nursing Home

And driven past its silence most days, wondering about the lives inside.

I saw no one through its windows.

Short plump ladies in blue overalls went in and out .

Once a white aproned man stood smoking outside and a black suited lady alighted a 4 by 4..

But no residents were to be seen

Then last week a tall older lady sprinting along the road caught my eye.

Without bag, or key .dressed in a spotlessly white cardigan and patterned, belted polyester dress, her neat dyed auburn curls freed in the breeze.

Her face ecstatic.

Appearing to embrace not just the air, sun and trees, but the euphoria of freedom.

Rarely had I seen such a look of joy and expectation.

Later I realised she was most likely a resident.

And was struck by the pathos of the futility of her escape and her last moments of freedom .

She is one of nearly a million, increasing every 3 minutes The Alzheimer Society quote, and on whom their recycled profits depend.

As do those of experts, lawyers, social workers, trainers, nurses, GPs, care agencies, community groups, charities and pharmacies.

As with the disabled, children, education, prisons; the old are our new growth industry.

The Care Act 2014 diluted ‘capacity’ to ‘difficulty making a decision’, and £ 433 million has been paid to LAs to safeguard and feed this industry.

https://finolamoss.wordpress.com/2014/11/20/carers-act-2014-care-to-ensnare/

https://finolamoss.wordpress.com/2016/05/19/how-will-433-million-carers-act-implementation-money-be-spent/

Anyone can assess a person covertly and remove their decisions and property, making them ‘insentient’ with no rights for life.

The Court of Protection is secret and unchallengeable .

An ‘altzeimer tax’ was unnecessary, as all property is seized by the state via COP, and powers of attorneys and Guardianships voided.

The lady in the white cardigan and her family didn’t stand a chance.

And May’s Queens speech promises consultations and more information for families on the care provided.

But not for all those families deemed ‘abusive’, or if, as it usually is, such information provision may prejudice service provision and not in the ‘cared’ for’s ‘best interests’.

And what is the use of information per se, particularly, from those providing the service?

No spy cameras will be allowed.

No check on services or medication, except by those who commissioned them, and a paper check by a CQC with no teeth.

There appears to have been no improvements to elderly care since it was exposed abusive years ago in Panorama’s ‘Behind Closed Doors’

http://www.bbc.co.uk/programmes/p01y7ygj

So why the push to help our elderly ? Why the concern that  family not be burdened?

In 2014 Anchorage Capital saw their second block care home sale in less than a year – 27 British Care Homes to the Wall St hedge fund responsible for the sale of Hollywood film studio Metro-Goldwyn-Mayer .

The Financial Times reported a ‘global appetite’ form US, Asia – Pacific and Middle Eastern hedge funds for Britain’s then £15.1 billion care home sector.

https://www.ft.com/content/6da9f5bc-f08d-11e3-8f3d-00144feabdc0?mhq5j=e3

In 2015 the Bureau of Investigative Journalism urged Minsters to investigate the buy to let boom in care homes which involved Dementia UK and Lancashire County Council..

https://www.thebureauinvestigates.com/stories/2015-12-11/ministers-urged-to-examine-new-buy-to-let-boom-in-uk-care-homes

https://www.lovemoney.com/news/48163/care-home-investing-ethical-alternative-investments

Yet despite profit motive and conflict of interests, our new government proposes even more money be siphoned off into this sector, to solve its problems, and care home closures, caused not by a shortage of money, but by greed,  lack of accountability, lucrative  buy outs and alignment for maximum profit take overs.

http://www.health.org.uk/publication/spotlight-dementia-care

It is no coincidence that our latest social epidemics- altzeimers, mental disability, adult and child abuse allow court enforcement of services for huge and increasing private profit.

Think about the millions already made in deals which, Graham Rowan, a wealth coach, described as ‘the hottest investment sector of the decade’.

How could such a sector be cash strapped ? Do hedge funds, or indeed anyone, invest in a cash starved sector ?

And think of how this money is made, on the backs of old ladies in cardigans, who should be helped to live at home with their families, not forcefully medicated and hidden in misery from society for profit.

old lady rainrun-og