‘NHS Scotland in takeover by US health giant‘ Ben Borland, Sunday Express, 22 February 2015:
“THE astonishing and largely hidden influence of an American private healthcare giant at the heart of Scotland’s NHS can be exposed today.
Boston-based multinational Institute for Healthcare Improvement (IHI) has been paid millions of pounds in public money to introduce sweeping reforms across Scottish hospitals.
The extraordinary relationship was cemented two years ago when the former chief executive of Scotland’s NHS stepped down in the wake of a scandal to become Executive Vice President of IHI.
Derek Feeley and his colleagues in Massachussetts now work closely with Scottish Government and play a key role in steering policy in the NHS, as well as social services, early years care and education.
This is despite the SNP insisting that the private sector is only involved in the “margins” of the health service in Scotland.
Last week, Health Secretary Shona Robison praised a fall in hospital death rates and announced a funding boost for the “world-leading” Scottish Patient Safety Programme.
However, the programme was in fact developed by IHI and the firm has been instrumental in rolling it out across the country ever since the SNP first came to power.
Carol Hararden, another IHI Vice President, “currently leads IHI’s work with Health Improvement Scotland aimed at transforming the safety of every Scottish hospital over five years”.
The Scottish Government has paid IHI at least £5.6million in Scottish public money for its various contracts.
IHI – founded by Professor Don Berwick, who led the controversial ‘Obamacare’ health reforms in the USA – is a not-for-profit company.
However, accounts show it generated some £26million in operating revenues last year and had £62million in cash and investments. It also receives funding from a number of US health insurers, such as Kaiser Permanente and Blue Cross Blue Shield.
Mr Feeley resigned to join IHI in April 2013, with a glowing reference from then Health Secretary Alex Neil, just weeks after it emerged he had put pressure on Audit Scotland to water down a report on problems with hospital waiting times.
A career civil servant, who also served as Principal Private Secretary to First Minister Jack McConnell, he retains a gold-plated Scottish Government pension worth £1.1million. His new salary has not been disclosed, although IHI paid out £17million in wages and other benefits to its 140 staff last year.
Derek Feeley (Express photo)
Mr Feeley had to be granted special permission from then First Minister Alex Salmond and Permanent Secretary Sir Peter Housden, head of the civil service in Scotland, in order to take up his new role in August 2013.
A letter from Sir Peter, released by the UK’s Advisory Committee on Business Appointments, shows that Mr Feeley was forbidden from “lobbying” the Scottish Government for two years from that date.
However, he was back in Scotland earlier this month to attend a “strategic meeting” between IHI and the Scottish Government.
He also spoke at the firm’s National Forum in Orlando, Florida, last December, which saw a number of senior NHS and Scottish Government officials jet across the Atlantic at taxpayers’ expense.
They included Jason Leitch, the National Clinical Director Healthcare Quality and Dr Brian Robson, the Executive Clinical Director of Healthcare Improvement Scotland.
Indeed, so many Scots were present at the sun-soaked conference that photos have emerged showing Dr Robson leading a “Team Scotland huddle”.
It was held at the Orlando World Center Marriott Resort & Convention Center, a luxury resort with its own swimming pool “oasis”, giant waterslides, 18 hole golf course, award-winning restaurants and spa.
In December 2011, Mr Feeley – then still in charge of the Scottish NHS – was a keynote speaker at the Florida conference, alongside the Hollywood actor Michael J Fox.
Two years later, in 2013, he posted on Twitter: “Just arrived in Orlando for my 1st Forum as an IHI staff member. Can’t wait to get underway. Weather lovely – bring sun screen.”
Back in Scotland, the most recent contract has appointed IHI to act as NHS Scotland’s “Quality Improvement Partner”. Awarded in June 2013, it has so far been worth more than £860,000.
A “core team” of seven employees runs the “Scotland Programme”, making crucial decisions about the day-to-day operation of the NHS and advising on everything “from healthcare to road safety”.
Other programmes include Safety in Maternal Care, based on a project with disadvantaged mothers in Louisiana, and the Primary Care Safety Collaborative, which learns from IHI’s work with Native Americans.
IHI has contracts with with private healthcare providers across the USA, and also operates in England, Saudi Arabia, Qatar, Singapore, India, Denmark, Sweden, New Zealand, South Africa, Brazil, Chile and Colombia.
It was founded by Professor Berwick, who went on to become Barack Obama’s head of the Medicare programme and later carried out a review of patient safety in English hospitals.
Although his appointment was opposed by Republicans, his work with IHI – including his mantra that much health spending is “waste” – had previously won praise from ultra-right wing American politicans such as Newt Gingrich.
Last night, the Scottish Conservative health spokesman Jackson Carlaw said: “This exposes the SNP’s referendum rhetoric on the independent healthcare sector as a fraud.
“It’s incredible that the Scottish Government should be so damning of private health on one hand, yet so dependent on it on the other.
“These revelations have left the First Minister with some very tricky questions to answer indeed.”
A Scottish Government spokeswoman said: “The Institute for Healthcare Improvement is a not-for-profit organisation, and has been instrumental in helping to deliver the world-leading patient safety programme that has had such a positive impact on the safety of patients across Scotland.
“The programme has become internationally recognised for the improvements in care and safety that it has delivered, since 2008, as we have seen a reduction of 25.5 per cent in surgical mortality, an 80 per cent fall in C.Diff rates in the over 65s and an 89 per cent decrease in the number of MRSA cases in Scotland.
Derek Feeley has had no involvement in contractual decisions, has not lobbied Ministers or officials, and has operated within the Business Appointment rules.
“A small number of officials travelled to the Institute for Healthcare Improvement International Forum in order to ensure Scotland continues to learn from and share the very best practice on patient safety and quality improvement.””
Here are a series of my tweets from a masterclass with Derek Feeley on 5 November 2014, organised by the Health & Social Care Alliance through their #handsascademy (health and social care academy) initiative, which I attended and walked out of during Mr Feeley’s talk. (Alex Neil, MSP and CabSec Health at the time, launched the H&SC Academy 19 May 2014 at the Edinburgh City Chambers, another event I was present at)
I was annoyed at Mr Feeley’s response to my question about the “unreasonable treatment” and human rights abuse going on at Stratheden Hospital, Fife, where he used to work. I find it insulting that IHI, where he now holds a high position after receiving a large pension from Scottish Government, should be main players in the Scottish Patient Safety Programme.
I am also concerned about the links between IHI and HIS who have banned me from attending Scottish patient safety events and have blocked me from their twitter accounts. For speaking out about psychiatric abuse and the bullying of healthcare staff.
Link to Healthcare Improvement Scotland page on my blog