Lenin’s Alternative NMC Code for Nurses

This is rather  a “tongue in cheek” alternative code for nurses from Lenin Nightingale. Please add any more suggestions!

The NMC is the nurse registration body that applies to the UK. Feel free to produce one for  a  different country.

NMC to provide free placard for displaying concerns about poor care. Nurses to march outside the hospital/care home

Stand with megaphone at hospital gate voicing concerns.

Nurses to be honest- and contribute to their complaint.

No nurse to complain to managers- go outside the establishment.

Advise people to contact the police if necessary in serious cases of abuse .

Nurse to take photographs of all records if have concerns.

Secretly tape record  any interviews about concerns.

Nurses make honest records eg short staffed so Mrs smith could not be  bathed today.

Make copy/ photograph  of staffing rota if short staffed on that shift.



85Having finished reading a blog entry by a care assistant in a private nursing home, who informs of her and one nurse having to attend to the needs of 25 elderly residents on a night shift, and of her thinking the food given to residents during the day was on par with what would go in the bin of very cheap boarding house (this as the homes’ administrator received a bonus for cutting costs), it occurred to me that all private nursing homes should be open to scrutiny by residents’ friends and relatives.

For this purpose, I have adapted an assessment form used in America, from the National Caregivers Library, by which friends and relatives can give scores on a 1-5 rating scale for a series of nursing home performances that impact on their loved one’s daily routine.

The assessment document, which I have named NURSING HOME ASSESSMENT BY RESIDENTS’ FRIENDS AND FAMILY, assesses the home’s performance in the areas of Quality of Life, Quality of Care, Nutrition, and Safety.

The nursing home is given overall score out of a possible 200 points. It is strongly suggested that any score of below 150 points should be a cause of concern regarding the overall care of a resident. Specific areas of concern can be highlighted, and the assessment form ends with an additional comments section, in which such concerns and more general impressions can be given.

The assessment form is not one so worded by a nursing home as to minimise any criticism, it asks probing questions.

There is a need for friends and relatives to become involved with assessment, in that they are often as isolated within a nursing home as their loved one, feeling that they have no one outside of the home that they can share their concerns with, with the CQC inspection regime only geared to investigate general concerns within a nursing home, effecting all residents, and not individual ones. Yet, if a number of residents’ friends and relatives within a nursing home complete the assessment form, with assessments all pointing to the same areas of concern, and these forms are posted (I advise by registered letter) to the local Contracts Compliance Department of the local council, this department will be legally bound to pass on these widespread concerns to the CQC, triggering an inspection.

Friends and relatives should be encouraged to photocopy the assessment form, and distribute it to others. Nursing staff who feel that the homes’ management are not responding adequately to concerns about residents’ care should be encouraged to inform residents’ friends and relatives about the assessment form. Permission could be given for a homes’ assessment forms to be viewed by those thinking of placing their loved one there.

Too many people believe that their loved one is being cared for as someone from whom a profit can be extracted. They see their concerns not being addressed by the head office of the multinational corporation that owns the nursing home, with concerns being repeatedly referred back to the care home manager, whose main remit is bed occupancy levels/low staff ratios/economical menus, that is, profit. People feel isolated and powerless under such a system, with (mostly announced) inspection visits by the CQC being nothing more than a theatrical production for an invited audience of friendly critics.

Combine as friends and relatives to protect your loved ones. Become militant on their behalf. Keep copies of the assessment form. (Assessments could be used as circumstantial evidence in any ensuing legal action). As groups of the concerned, go to your local M.P. and raise issues that have not been addressed.

The government and taxpayers are paying for what is all too often is a poor service. In America, this is treated as a fraudulent use of funds, a felony that attracts criminal proceedings, with fines of millions of dollars being imposed on nursing home groups, and the threat of imprisonment for owners. The business-friendly approach of the UK offers no more than a slap on the wrist. It is time this changed.

Residents’ friends and relatives – Combine with others to be strong in the protection of your loved one.

Nursing staff – do not stand idly by if your concerns are not met by management, combine with residents’ friends and relatives to distribute assessment forms and to give advise as to where to send them.

The UK approach, backed by the NMC/RCN cartel, of persuing concerns within the offending establishment, stinks. It is like going to a bully to ask for leniency. The form also asks friends and relatives to state whether a nursing home is managed by a qualified nurse. It is a national disgrace that many are not, with the only response of the CQC being to ‘wave their handbag’ at the business owners of nursing homes who do not meet the cost of employing a nurse manager. Would you want your loved one to get into a taxi driven by someone who had not passed their driving test? Then why put them in a nursing home run by an untrained manager?

I urge everyone to distribute this form.

I urge militancy on behalf of nursing home residents.

lenin nightingale and carol dimon 2015


A list of basic questions to ask when you and your loved one visit a nursing home.

Facility Name: ——————————-

Date Visited: ——————————–

Address: ————————————-

Nursing Home Information
1. The person in charge of the home is a registered nurse. YES NO
2. The home conducts background checks on all staff. YES NO
3. The home has Abuse Prevention Training. YES NO


1. Residents can make choices about their daily routine. Examples are when to go to bed or get up, when to bathe, or when to eat. 1 2 3 4 5
2. The interaction between staff and patient is warm and respectful. 1 2 3 4 5
3. The home is easy to visit for friends and family. 1 2 3 4 5
4. Friends and family are made welcome. 1 2 3 4 5
5. Concerns raised by friends and family (including those of potential abuse) are taken seriously. 1 2 3 4 5
6. The nursing home meets you cultural, religious, or language needs. 1 2 3 4 5
7. The nursing home smells and looks clean and is well lighted. 1 2 3 4 5
8. The home maintains comfortable temperatures. 1 2 3 4 5
9. The resident rooms have personal articles and furniture. 1 2 3 4 5
10. The public and resident rooms have comfortable furniture. 1 2 3 4 5
11. The nursing home and its dining room are generally quiet. 1 2 3 4 5
12. Residents may choose from a variety of activities that they like. 1 2 3 4 5
13. The nursing home has outside volunteer groups. 1 2 3 4 5
14. The nursing home has outdoor areas for residents use and help residents to get outside. 1 2 3 4 5

1. The facility corrected any Quality of Care deficiencies that were in the CQC Report. 1 2 3 4 5
2. Residents may continue to see their personal physician. 1 2 3 4 5
3. Residents are clean, appropriately dressed, and well-groomed. 1 2 3 4 5
4. Nursing home staff respond quickly to calls for help. 1 2 3 4 5
5. The administrator and staff seem comfortable with each other and with the residents. 1 2 3 4 5
6. Residents have the same caregivers on a daily basis. 1 2 3 4 5
7. There are enough staff during the day to care for each resident. 1 2 3 4 5
8. There are enough staff at night and on weekends or holidays to care for each resident. 1 2 3 4 5
9. The residents association is independent from the nursing home’s management. 1 2 3 4 5
10. Care plan meetings are held at times that are easy for residents and their family members to attend. 1 2 3 4 5
11. The staffing mix adequately reflects the culture of the local community. 1 2 3 4 5

• A good patient/staff ratio is important to good care, but you should also consider other care factors. Examples are staff training programs and how long staff stay at the home. If staff changes frequently, ask why. If excessive agency staff are used, ask why.

1. The home corrected any deficiencies in these areas that were on the recent CQC inspection report. 1 2 3 4 5
2. There are enough staff to assist each resident who requires help with eating. 1 2 3 4 5
3. The food smells and looks good and is served at proper temperatures. 1 2 3 4 5
4. Residents are offered choices of food at mealtimes. 1 2 3 4 5
5. Residents’ weight is routinely monitored. 1 2 3 4 5
6. There are water jugs and glasses on table in the rooms. 1 2 3 4 5
7. Staff encourage residents to drink if they are not able to do so on their own. 1 2 3 4 5
8. Nutritious snacks are available during the day and evening. 1 2 3 4 5
9. The dining room environment encourages residents to relax, socialize, and enjoy their food. 1 2 3 4 5

• Ask the professional staff how the medicine a resident takes can effect what they eat and how often they may want something to drink.
• Visit at meal time. Are residents rushed through meals or do they have time to finish eating and to use the meal as an opportunity to socialize with each other?
• Sometimes the food a home serves is fine, but a resident still will not eat. Like everyone, nursing home residents like some control over their diet. Can they select their meals from a menu or select their mealtime?
• If residents need help eating, do care plans specify what type of assistance they will receive?

1. There are handrails in the hallways and grab bars in the bathrooms. 1 2 3 4 5
2. Exits are clearly marked. 1 2 3 4 5
3. Spills and other accidents are cleaned up quickly. 1 2 3 4 5
4. Hallways are free of clutter and well-lighted. 1 2 3 4 5
5. There are enough staff to help move residents quickly in an emergency. 1 2 3 4 5
6. The nursing home has smoke detectors and sprinklers. 1 2 3 4 5
FACILITY TOTAL  —-  (out of a possible score of 200)





The unelected Establishment mouthpiece which trades as the NMC would so gag nurses on essential issues that the only comments they could post online would be be ones that the STASI ‘thought police’ of the former East German Republic would have allowed. Their gagging code states that nurses and midwives must ‘uphold the reputation of your profession at all times” (NMC 2008), while students must “uphold the reputation of your chosen profession at all times” (NMC 2009a). This means that conduct online and conduct in the real world should be judged in the same way, and should be at a similar high standard. Nurses and midwives will put their registration at risk, and students may jeopardise their ability to join our register, if they:

• Share confidential information online.
• Post inappropriate comments about colleagues or patients.
• Use social networking sites to bully or intimidate colleagues.
• Use social networking sites in any way which is unlawful’.

If a nurse posts a generalised comment, not naming anyone, about poor nursing in the hospital or care home they work in, would that constitute sharing confidential information? Apparantly so, for NURSINGS’ MIND CONTROL guidelines also state:

• ‘Do not discuss work-related issues online, including conversations about patients or complaints about colleagues. Even when anonymised, these are likely to be inappropriate’. How, then, is poor nursing care to become a more widely discussed issue – one which attracts more public debate? Anonomysed reporting of poor care by those who observe it is the very life-line of informing the public. Blog after blog carry comments written anonomously by patients’ relatives about disgusting standards of care and endemic short staffing. Why should nurses who observe similar standards of care not be expected to raise these issues to as wide an audience as possible? Surely this would ‘uphold the reputation of your chosen profession’ by putting the nurse on the side of patients, which is what I thought was the essence of nursing, and not on the side of the profession, which is run as a Stasi tyranny by unelected Establisment mouthpieces. A nurse has a primary duty to the patient, as a doctor to theirs, not to any code which solely seeks to protect the professions’ ruling class. Their responsibility is not to their professional body, but to the body in the bed.

In many American States, it is a mandatory duty to report bad care directly to the police. In that country, hidden cameras have revealed nurses routinely not caring for patients, not giving them drinks or medication, etc., and has resulted in criminal prosecutions – it is a felony to misuse State funds. Why do NURSINGS’ MIND CONTROL advocate that complaints procedures should go through an in-house process? Why are cameras used to ‘protect’ NHS A&E staff and not patients? Why is nursing so suffocated by secrecy? Who are you protecting? The patient? I suggest not. If a nurse sees poor care being routinely given, why should they not publish it to the world? Why should they not, in an anonomised way – not naming patients or staff – shout out their concerns through a magaphone at their hospital or nursing home gate? Or, would this be seen as bullying or intimidation of colleagues, who, when passing the nurse with the megaphone, might feint and require smelling salts, as neurotic ladies of old? Why do the ruling class of nursing so seek to gag the working class of nursing? It is because nursings’ hierarchy reflect the hierarchial class structure of Britain, which is subject to some of the most draconian anti-union and anti-free speech laws in the world. You want to promote a false image, my dear NURSINGS’ MIND CONTROL, as if on the washing line of nursing there hangs only the whitest of knickers.

May I beg to ask you, oh Chosen Ones, what constitutes using ‘social networking sites in any way which is unlawful’? What is the twilight zone of what you would consider ‘unlawful’? Would advocating the violent overthrow of the Syrian State be considered such? That is, if a British nurse used social media to post such a view – which is the hidden agenda of America and its British deputy – would they, using the words of your code, ‘jeopardise (their) ability to join and stay on our register’? Can nurses take any strong political stances? What would you sanction? What would you ban? Could nurses tweet that private equity companies that have been given NHS contracts, and are allowed to run nursing home chains, are parasites of the capitalist exploitation of nursing care, which regularly donate to the Conservative Party? Or, would you, as I suspect, rather have nurses discuss which washing powder gets their knickers whiter? – as if women, the majority of the nursing workforce, are all somehow brainless and apolitical, and should be consigned to discussing flower arranging at the vicar’s tea party. Could nurses under your totalitarian rule tweet that the whole system of the nursing hierarchy is rotten and needs to be overthrown?

The entire tone of your ‘code’ is threatening, and encouraging of STASI-style informants – again I quote from your totalitarian edict: ‘If you are very concerned about someone else’s behaviour online, you should take steps to raise your concern, including if necessary with their university or employer. In the most serious circumstances, for example if someone’s use of a social networking site is unlawful, you should also report the incident to the police’.

In your vainglorious manner, oh Powerful Ones, you declare: ‘We do not advocate blanket bans on nurses, midwives or students joining or using social networking sites, and employers and educators should not suggest that this is our position. Even if such bans could be imposed on workplace or university computer networks, personal computers and mobile devices offer easy access. Blanket bans are likely therefore to be both unenforceable and counter-productive. We support the responsible use of social networking sites by nurses, midwives and students’. What type of Brave New World is this? Would you have a blanket ban if it were enforceable? What do you mean by ’employers and educators should not suggest that this is our position’? Do you mean they should merely hint that it is? That the white-knicker lady would prefer your knickers to be as unseen by the public as hers? ‘Bans could be imposed on workplace or university computer networks’, can they? Legally? Should they be? Is nursing now run by North Korea? Do you issue such sanctimonious and egotistical edicts from an ivory tower behind some Berlin Wall?

You would rather nursing and its brainwashing university brigade cosy up to capitalist exploiters of the health care ‘market’ – nothing wrong with social media then, eh? Nurses would be quite free to express that the Government’s health care ‘initiatives’ are only about ’empowering’ people, that is, to echo the mantra of weasel-word neocons. What would happen to a student who found this threatening?, or to a nurse lecturer who opposed such propaganda, and encouraged students to think for themselves, perhaps encouraging them to go online and read ‘alternative’ views? Your pro-capitalist stance is hinted at in your own ‘market speak’ – ‘Given the large proportion of the population using social networking sites, healthcare providers and universities can derive benefits through engaging with social media, both at a corporate and individual level. Having a corporate presence on social networking sites can also lend credibility when engaging students, nurses and midwives around these issues, and can provide a platform for encouraging responsible use’. The truth is out! Hospitals and universities are corporations!, and only innocent nurses should expect them to be places of caring and learning.

What really uncovers you as Nursings’ Big Sister is your chilling reminder to nurses that their responsibility is to the NMC – ‘Organisations should set out clear policies for staff and students on their use of social networking sites, encouraging responsible use. Where a policy is targeted at nurses and midwives, it should remind them of their responsibilities to the NMC’ – not to the patient! Or do you, oh Exalted Ones, think that the patients’ best interests are only served by following yours?

You complain that ‘Cyber-bullying can be intrusive and distressing’, well, so can having to attend one of your kangaroo courts on charges trumped up by vindictive colleagues or employers. Why do you suggest that employers should ‘revalidate’ nurses? Why do you actively assist non-EU nurses to obtain work permits? That is, why do you mimic government policy?

The answer is this, let this truth be known – the NMC is nothing more than a branch of the government, its members no more than hand-picked yes-people.

I call for the entire hierarchy of the Nursing Establishment (including the RCN), to be overthrown, and I urge all nurses to promote this demand on social media.

I call for the establishment of a democratically elected governing body of nursing.

Please distribute this article on social media (you are advised to do so anonymously if you are a nurse or nursing student, for they are listening!).



lenin nightingale 2015

Another Look at Freud

This piece may hopefully stimulate some discussion. It concerns an issue that has been on going for many years

This article will commence with an actual letter (as remembered by the individual) from  an elderly mother to her middle age daughter. The mother had not seen her daughter, who lived nearby, for 5 days;

“Dear Daughter,

If I’ve still got one? I’d like to know if you have left the country? If you have perhaps you’d let me know where you are so we can correspond. After all I have done for you, I deserve something from you.”

Whilst Freud discussed the oedipis and electra complex, referring to relationships from child to parent, it is proposed that similar situations occur in reverse. Mothers may thus be dependent or over-reliant upon their daughter or son. We shall term this the “elecutorix” complex. Fathers may be so dependent termed the “deepcutorix” complex. Yet this relationship; this dependency, need not be so. Indeed there are mothers who may be offered help from various people such as shopping but only allow their daughter to do it. Certainly in the UK, help does exist in the form of health and social or voluntary services though it may for some, involve  a charge and be inaccessible. Historically  parents had  a great number of children in order to assist them with work such as farm work and in order to assist them when they are older. Whilst not so essential today, there are still some individuals who are determined to assist their parents or parents are determined that they will do so. Is this done by the son or daughter, according to love- or according to duty?  A sense of duty may actually be enhanced by feelings of guilt, tradition or loyalty. All of which may be engineered by society. In comparison, pure love (Steinberg) may be regarded as true feelings in particular  unconditional love which expects no reward. Yet surely, if the mother had such love for the now grown up offspring, she would promote fulfilment of their personal wishes and aims? There are cultural implications here. Yet even in China and India, there is an increasing number of nursing homes as people work way from their place of birth . In China there has also been the affects of the one child per family rule, with few family members able to care for their old parents. Some family members have been taken to court by their parents to ensure that they care for them even if they already care for somebody else ( nydn 2013 ). In Tokyo there is  a huge waiting list of old people who need to enter the low number of nursing homes (Matsuyama 2015).  Additionally some countries are sending old people to nursing homes abroad (Dimon 2014) – even if they have had no prior connection with the country.

There have been  sons  or daughters whose whole life have revolved around their parents. Indeed, some may never even have left home or found a partner. One middle aged lady, had the opportunity of living abroad with her family. However, her mum commented, “I have lost one daughter (who lived away). I am now going to lose you as well”. Pangs of guilt overruled and the lady never achieved her ambition and died looking after her mother. As opportunities such as working away and careers have arisen (which may well be reduced again), the whole perception of society may be altering. Now however, there is an increasing number of old people with less young people to care for them and rising health and social care costs. Religion and tradition may both manipulate individuals and promote certain ways of behaviour.

Yet the guilt complex continues with comments such as “Oh you are here, are you?”, “I suppose I will have enough bread until you come again”, “I expected you earlier”. Yet such manipulative comments can  psychologically affect the younger person , causing resentment and lack of achievement. Indeed there may be further tactics, such as failure to encourage offspring especially if it entails moving away. Parents may also resort to lying about occurrences or arguments  which again, may greatly affect their offspring. The relationship between offspring and parent does and must change as they both mature. Parents need to allow the son or daughter to be independent and make their own decisions. The offspring also realise there may be things about their parent that they disagree with although the love for them remains. This may create conflict in itself. Some parents may wonder what on earth has happened to their son or daughter to suddenly make them question them or even answer back. Yes there does need to be a balance.

I for one, think carefully when I tell my children I missed them but they do need to know they are loved and also need to consider others. The way is not through guilt. Such promotion of guilt by the parent, indicates a selfish desire to be served and rewarded; not love. It is said  that one’s family does not refer to blood relations- but to those who understand you.

Carol Dimon (2015)


Dimon C (20140 Hasta La Vista Gran https://nursebloginternational.wordpress.com/2014/07/17/hasta-la-vista-gran/

Matsuyama K (2015) http://www.bloomberg.com/news/articles/2015-02-19/tokyo-s-elderly-turned-away-as-nursing-homes-face-aid-cuts

Nydn (2013) http://www.nydailynews.com/news/world/edlerly-chinese-woman-sues-daughter-care-article-1.1483711

Charity Scam

This article has been prompted by the latest Government proposal (Andy Burnham MP) that the NHS be charity run. Do not be  fooled people. Yet another copy of a failed USA system.

Copyright Carol Dimon 2015- with  a bit of Lenin’s magic.

Charities are usually considered  with high regard  by members of the public. They provide such essential care and services; many staff working unpaid. Are charities being used by the wealthy, as a tax free scam that  rely on the  goodwill of public and volunteers?

Over the last few years, the number of Registered charities within the UK  has mushroomed. To be registered as a charity in the UK, it has to earn more than £5000 a year (gov.uk).

Some charities are funded by central or local government. Some Directors are very well paid ; Seamark (2014) states  “Fresh demands to curb the salaries of fat cat charity bosses were made yesterday after it emerged that Save the Children is paying its top employee £234,000 a year”. There are others “Executives at one of the UK’s most prominent international aid charities were handed bonuses worth more than £160,000 last year”  (Ledwith 2013). In 2011 the average salary of charity hospital Directors in the USA was $600,000 with large remuneration for many other members of the hospital board; many of whom are local businesses who tend to win the contracts (Ostrow 2014). Would such human nature not be present in the UK? Are we immune from corruption?

Further,several cases of fraud within charities have been reported, for example in the USA (cironline.org). According to tampabay.com Wallace Christensen, a minister, started Shiloh International Ministries in 1981. Today, its IRS tax filings list this broad mission statement: “To provide medical necessities and moral support to needy children and to provide assistance to the homeless and hungry, our American veterans, children’s hospItals and Christians in need everywhere.” But the charity has spent little cash on its cause. Over the past decade, it has raised $8 million and paid 78 percent of that to the professional solicitors it hired to find donors. In comparison, the charity spent less than 2 percent of donations on direct cash aid to the needy. In the same period, the charity paid its officers a total of $860,000 — nearly eight times more than the cash it spent on its cause. In 2010, the charity was No. 1 on the Oregon attorney general’s list of worst charities, which ranks organizations based on how little they spend on their charitable causes over a three-year period. Officials at Shiloh did not respond to multiple requests for comment.

Charity hospitals may actually be bought by private businesses Prnewswire.com (2015) states “California’s largest nurses organization, the California Nurses Association/National Nurses United today issued the following statement on the conditional approval of the sale of six Daughters of Charity Health System (DCHS) hospitals in the Bay Area and Los Angeles that were “on life support,” facing imminent bankruptcy, huge reductions in patient services, and closure”.

”Charities are not required to detail by name how much their top executives are paid, and many express the sums in bands, disguising the true figures” “MPs condemned both the pay rates and the secrecy”- but somebody obviously does not condemn it . Indeed some Charity Directors have previous political roles, for example, the former advisor to Tony Blair (Ledwith 2013).

Regarding lower level staff  few charities pay them the living wage if they are not “volunteers” “About 200 (or 0.1%) of the UK’s 200,000 charities have so far signed up to be living wage employers, according to the Living Wage Foundation (Smedley 2015).
The profit is put back into the charity they say. In the UK charities are able to invest money as long as it “meets the aim of the charity” (gov.uk ). Individuals may also purchase charity bonds.  Could some of these individuals be politicians? Politicians are able to invest in private businesses including healthcare (Nightingale 2014). This could well be a conflict of interest. Indeed, in the USA (Kusnetz 2013) discusses such links between politicians and charities – “State lawmakers have used a variety of legislative tools to steer millions in government money to nonprofit groups with whom they’re closely affiliated. Such relationships are at the root of scandals that have ensnared at least eight state legislators in New York”.

Of course errors or malpractice can still occur within charities as it does anywhere for example, bbcnews (2011), Howell (2013), and  Cambridge (2014) within the UK.

Why propose that  the NHS be charity run?

The government  still puts some money in- the rest may be gained by fund raising. But the government is not then responsible for the service. This reflects many government proposals, such as the hiving off of the Manchester NHS. It is like an admiral giving control of the ship to the crew, then blaming them for the shipwreck.

Any complaints need be eventually made to the charity commission if all else fails.  There are separate charity commissions; one  for England and Wales, one for Northern Ireland, and the Scottish Charity Regulator for Scotland.

The USA, New Zealand, and Australia already have many charity run hospitals- many of which are proved to be failing, for example (Carville 2013) discusses  tax exempt status  in New Zealand .

Charities have to return money to the community. “In New Zealand there is a public expectation that if it is a charity it will be charitable but there is no accountability or regulation. It is not good enough. We need to raise the standards as we are way behind,” Gousmett said” (ibid).

Charities are not subject to FOI requests in the UK, so no information has to be provided regarding money and other issues. “Christchurch’s St George’s Hospital, which is run as a charity, made millions of dollars last year but gave back less than $100,000 to the community – an amount slammed by critics as “tokenism” (Carville 2013). The question is, where did the rest of the money go?

Charity owned hospitals in the USA are chasing people for debt- Gold 2012; does this not oppose the public perception of what a charity is? In this way charities are businesses that fund big businesses (Debt collectors). This suits politicians and big businesses.

Any agency that is government or business funded may have gagging clauses ; “Research by the Independence Panel, made up of senior charity experts, found the sector was facing strict contracts controlling what it could say publicly about schemes it was helping to run (telegraph.co.uk 2014). For example, government funded bodies may be less able to debate against the major political perspective regarding such issues as quality of care. RT.com (2015) states that “British charities say they have been targeted in a “subtle” yet “menacing” fashion by prominent political figures for publicly criticizing the coalition’s austerity policies. Others are silenced by gagging clauses in government contracts.” Funding may buy silence. Yet they who are funded are stronger agencies and considered with higher esteem. Are charities  a political means of hiding privatisation?  Weasel words Lenin, weasel words.



PHYSICIANS FOR A NATIONAL HEALTH PLAN (PNHP). Mark Almberg, PNHP communications director, told his American audience what is being hidden from UK citizens, that For-profit home care agencies are bleeding the Adult Social Care budget dry. Here is PNHP’s summary of how the free-market, private-sector managed home care model has failed in America:

For-profit home health agencies are far costlier for Medicare than nonprofit agencies, according to a nationwide study published today [Monday, Aug. 4, 2014] in the August issue of the journal Health Affairs. Overall cost per patient was $1,215 higher at for-profits, with operating costs accounting for $752 of the difference and excess profits for $463. Yet the quality of care was actually worse at for-profit agencies, and more of their patients required repeat hospitalizations.

Researchers at the City University of New York School of Public Health analyzed detailed Cost Reports filed with Medicare by 7,165 home health agencies in 2010-2011, as well as data for 22 quality measures from Medicare’s Home Health Compare database covering 9,128 agencies.

Compared to nonprofits, operating costs at for-profit agencies were 18 percent higher, with excess administration (at $476 per patient) accounting for nearly two-thirds of the $752 difference in operating costs. For-profits also did many more speech, physical and occupational therapy visits, which are often highly profitable under the complex Medicare payment formula. In addition, profits at for-profit agencies added 15 percent on top of operating costs vs. a 6.4 percent surplus at nonprofit agencies.

Despite their higher costs, for-profit agencies delivered slightly lower-quality care. On average, for-profits met each quality standard only 77.2 percent of the time, vs. 78.7 percent for nonprofits. Rehospitalizations, widely viewed as an important quality measure, were more frequent among for-profit agencies’ patients: 28.4 percent vs. 26.5 percent at nonprofit agencies.

For-profit home care agencies are bleeding Medicare; they raise costs by $3.3 billion each year and lower the quality of care for frail seniors,” said Dr. Steffie Woolhandler, professor of public health at CUNY’s Hunter College, lecturer at Harvard Medical School and senior author of the study. “Letting for-profit companies into Medicare was a huge mistake that Congress needs to correct.”

Lead author William Cabin, assistant professor of social work at Temple University, said: “While our study is the first to show that profit-making has trumped patient care in Medicare’s home health program, that’s no surprise. A large body of research on hospitals, nursing homes, dialysis facilities, and HMOs has shown that for-profits deliver inferior care at inflated prices.”

Cabin continued: “Our findings show once again that the free-market, private-sector managed care model has failed.”

Professor Cabin, who has decades of experience in the home care industry, undertook the research as part of his doctoral studies at the CUNY School of Public Health.

For-Profit Medicare Home Health Agencies’ Costs Appear Higher And Quality Lower When Compared To Nonprofit Agencies,” William Cabin, J.D., Ph.D., David U. Himmelstein, M.D., Michael L. Siman, Ph.D., Steffie Woolhandler, M.D., M.P.H. Health Affairs, August 2014.

Figures by UK Home Care Association (UKHCA) show that there are currently (March 2015) 7,121 Home Care Agencies in the UK, and 372 larger Home Care Groups. A BBC report (March 4, 2015) quoted a UKHCA ‘poll of more than 200 councils (which) found 28 paid a “minimum price” of £15.74 an hour. This is the price the body, which represents the agencies that provide the home care for councils, believes reflects the national minimum wage. The UKHA warned if the squeeze on fees continued, the care sector would become “unsustainable”. The “minimum price” has been calculated by using the national minimum wage and then adding to that the costs of running the service, including travel costs for staff and pension contributions’.

What this propaganda does not mention is the fact that, as in America, these agencies add 15 percent or so on top of operating costs, which are the excess profits (£2.36 per hour per worker taken out of council payments before operating costs are added), made by the business owners of these services.  It could be more than £2.36, or less, because the home care market is saturated with those attempting to keep their fingers in the Adult Social Care Budget pie.

It is a case of ‘dog-eat-dog’. UKHCA inform us (March 2015) that the CQC has now been given a role as a business analyst (hasn’t it got enough to do?), which will work hand-in-glove with the private sector to assess likely business failures in the home care market: ‘The Care Quality Commission has published draft guidance for adult social care providers in England on how its Market Oversight regime will operate when it starts in April (2015). The purpose of the scheme is to provide early warning where a “difficult-to-replace” residential or domiciliary care provider might run into financial difficulty, and to support continuity of care for the people using the service. UKHCA has helped CQC design the scheme, with other representative groups and stakeholders’ … The Orwellian ‘market speak continues: ‘UKHCA’s Policy Director, Colin Angel, said: “Government has given CQC additional powers in the event of a significant market failure. Designing a robust regime to protect the public, and which does not precipitate the very failure it seeks to guard against, is extremely important, a point we have made strongly to CQC’. (Naturally).

Every hour in every day in the UK over 7,000 businesses are leaching from the Adult Social Care Budget approximately £2.36 per hour for each home visit made by their combined workforce of 220,000, who may be working for less than the minimum wage, and on zero-hour contracts, and, as they speed between each client like racing drivers between short-as-possible pit stops, are likely to be repeating the standards of care meted out in America.

10 July 2014.Public Accounts Committee publishes report into Adult social care in England, HC 518 as Sixth Report of Session 2014-15. The Rt Hon Margaret Hodge MP, Chair of the Committee of Public Accounts, today said: “We are facing a great adult social care squeeze, with need for care growing while public funding is falling. The Government’s agenda to change and improve adult social care, most notably through the Care Act, is rightly ambitious. However, it simply does not know whether the care system has the capacity to become more efficient and spend less while continuing to absorb this increasing need for care. There has been an 8% real terms cut in spending on adult social care between 2010/11 and 2012/13, despite the growth in the number of elderly and disabled people, the groups most likely to be reliant on care. Care and support has been cut, as with less money to spend local authorities have had to focus on those with the most severe needs. We are particularly concerned that local authorities have cut costs, partly by paying lower fees to providers of care, which has led to very low pay for care workers, low skill levels within the workforce, and inevitably poorer levels of service for users. Safeguarding referrals recorded by local authorities have risen 13% in the two years from 2011. It is appalling that up to 220,000 people working in the care system earn less than the minimum wage. In some areas, whilst local authorities might pay private providers £13 an hour, the worker only earns the minimum wage of around £6 per hour. It is also unacceptable that around one third of the workforce are on zero-hours contracts. (i.e. the Public Accounts Committee report that privatised home care services in the UK mirror those of America, where the same privatisation experiment has been shown to be less efficient and more costly than a public service).

Yes, the government coalition’s ‘free-market’ scams have introduced appalling conditions for a wide-range of UK citizens, but one of their biggest disgraces is to allow thousands of businesses to feed from the Adult Social Care Budget like mushrooms on a dung heap. Their profits should be going to council workers, employed on a living wage, whose standards of work could be scrutinised by cameras, and whose time spent with the vulnerable would be sufficient to meet their needs as human beings.

Why does the UK repeat American ‘free-market’ experiments which have been shown to have failed in terms of efficiency and cost? – because although there is no real belief in the experiment, there is profit to be made by ‘friends of government‘.

How many M.P’s have commercial links to Adult Social Care providers?

Ditch for-profits parasites.

Ditch the QCC and all other quasi-government agencies.

Demand to live as one tribe of human beings, not as exploiters and exploited.


lenin nightingale 2015