Monday, June 4, 2012

Jon Williams on NHS Privatisation

Pre and post Health and Social Care Bill private companies are being used in the NHS from cleaning contracts to Independent and Foundation run Hospitals. Ideologically making a profit from sick people is shameful way to run a public service. The opposing argument is by bringing competition and choice into the NHS will lead to efficiencies and cost savings – but how will this benefit the patient? A private company modus operandi is to make an organisation run for a minimum return on investment. It disregards any human element and treats patients as customers. Profit is paid in dividends to shareholders instead it should be reinvested in the service / structure of the organisation. Any gains are privatised and losses are socialised. Our taxes are increased to bail out these private companies that have been run to maximise a profit in the short term. They have no sense of place or identity where they operate, no ethical or social awareness.

Parts of the NHS privatisation process are CCGs (Clinical Commissioning Groups). This year they will start running PCTs (Primary Care Trusts) and spending billions of NHS tax payer’s money contracting in services. Complete hand over by April 2013. Some will use PCT staff others will use private health companies such as Virgin and Serco. Please see examples here and here.

Locally NDCCG (North Derbyshire Clinical Commissioning Group) has brought together GP surgeries / practices from across North Derbyshire to contract in services. Large sums of money will be available to this new organisation. Do they have structures in place to handle this capacity within local surgeries / practices? There are statements in the new NDCCG website “Our Vision and Values” such as,

“To encourage innovation and strive to find new and better ways of commissioning services”

“To support improvements in productivity and deliver cost reduction and value for money by commissioning quality services”

This suggests private sector methods. An example in NDCCG March Board minutes states,

“Some services or products, such as payroll and HR could be done at a regional level and at the moment Greater East Midlands (GEM) was within the NHS. This was expected to move into the private sector or become a social enterprise by 2016”. See here and here.

Bringing new innovative cost reducing services into a new public sector organisation will inevitable involve private sector expertise – as can be seen in other areas in the UK (examples given above) and Dr √Čoin Clarke’s website “The Green Benches”,

NDCCG Chair Dr Ben Milton states “the NHS undergoes one of the greatest upheavals in its history” and “enormous task of the structural change whilst meeting the financial challenges” in the May NDCCG newsletter shows what an immense task this will be. At this point whether asked or not private companies will be called upon to advise or provide backroom support from CSS (Clinical Support Services).

Examples of early CSS failure has been detected in West Mercia and Peninsula (Devon and Cornwall) had to be abandoned.

Inviting private sector companies to run public sector bodies only produces poor outcomes with many examples such as transport and utilities run for a quick return and no future investment in infrastructure or equipment. Hospital PFI’s (Private Finance Initiative) are another example that has been a disaster waiting to happen with huge debts hidden away off the Governments books. Let’s hope for involvement from other sectors such as cooperatives or mutual’s can come forward to offer support services to the new CCG’s.


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