Health and Social Care Bill

Memorandum submitted by John Kapp (HS 110)

I support this bill, which I think will massively improve patient care at less cost to the taxpayer if enacted. I specifically support the Bill’s provisions to increase competition by opening up the NHS market to Any Willing Provider. This issue has come under attack by the British Medical Association, other trade unions, and groups such as 38 degrees, which has just launched an online petition saying ‘don’t break up our health service and hand it to private companies, listen to the real experts, doctors and nurses’. These vested interests have had 63 years of a meal ticket for life, whose mission statement is: ‘a patient cured is a customer lost.’

My background

I have been a patient representative in the NHS for the last 11 years. I was in the Sussex Cancer Patients Forum (2000-6) the Patient and Public Involvement Forum, Brighton and Hove (2006-8) and the Local Involvement Network (2008-date) the National Association for LINk Members (NALM) representing Sussex (2008-10) I have been a Conservative councillor (1995-9) and active member (1974-present)

Creation of SECTCo as Any Willing Provider

In May 2010 I founded the Social Enterprise Complementary Therapy Company (SECTCo, see It exists to provide the following NICE-recommended complementary treatments, to which patients have a statutory right under the NHS Constitution if their doctor says that it is clinically appropriate:

a) The Mindfulness Based Cognitive Therapy MBCT 8 week course for depression to CG23 (Dec 2004)

b) Hypnotherapy for Irritable Bowel Syndrome (IBS) to CG61 (Feb2008)

c) Spinal Manipulation for low back pain to CG88 (May 2009)

Depression, IBS and low back pain are long term conditions suffered by some 10 million people in UK, so the scope for what we provide is huge. Polls show that 3 out of 4 patients want these complementary treatments free on the NHS, and that half the GPs recommend them to their patients, but the patients have to pay, which most cannot afford. They are provided free on the NHS, (so that the commissioners can tick the box that says ‘complies with NICE guidelines) but in such small quantity that the waiting time is thousands of years. The cause of health inequalities is that the rich can afford these treatments, and improve their health thereby, and the poor cannot, so die 9 years earlier, and suffer long term conditions 18 years earlier. (Marmot report figures)

For example, the sole (monopoly) provider of mental health services in Sussex (Sussex Partnership Foundation Trust SPFT) provides one part time MBCT course facilitator (Robert Marx) to provide 4 MBCT course pa for up to 20 patients per course (80 places pa) This is for the whole of Sussex, with a population of 1.5 million, of whom 160,000 are on antidepressant medication. The waiting time for these depressed patients for a course with Robert is therefore 160,000/80=2,000 years.

SPFT is currently training 14 more facilitators, which will reduce the waiting time to around 100 years. Treatments are supposed to be provided within 18 weeks (1/3 year) To get the waiting time down to this will require 300 more facilitators.

SECTCo is set up as an Any Willing Provider who has 15 complementary therapists (including 4 MBCT facilitators) on our books offering these treatments to the NHS. However, the commissioners (NHS Brighton and Hove) have steadfastly refused to contract with us. We have written to all 150 GPS in the city, offering to provide MBCT courses to their patients against vouchers for our tariff price of £400. Two GPs (Drs Susie Rockwell and Charan Koka) have registered with SECTCo, but have not yet referred any patients to us. We believe that this is because the PCT told them not to, and said that they will not pay SECTCo for the vouchers if they do refer. We have said that we will treat patients on credit until the funding is sorted out.

Scope for Any Willing Providers of NICE-recommended treatments

We believe that the scope for Any Willing Providers like SECTCo is enormous, because millions of patients with long term conditions could benefit from these treatments. SECTCo is willing to tender to win contracts for our services, but our attempt at tendering for the Occupational Health contract of the Brighton and Hove Council has fallen at the first fence. To receive tender documents we have to pass a Pre Qualification Questionnaire of 30 pages, requiring references from 3 previous contracts of a similar nature. As a start up, we have no previous contracts.

We request the drafters of the Bill to ensure that the playing field for tendering be a level one, that allows entry by Small and Medium Enterprises (SMEs) We welcome the statements to this effect by the prime minister on 11.2.11, and in Cardiff, reported on 7.3.11.

March 2011