John
Lister, Director, Health Emergency
July began with health ministers once more on the back foot. They were
caught out for a second time trying secretly to hand control of the £64
billion NHS commissioning budget to private insurance companies, being
forced to recant, and then frantically denying the patiently obvious –
that Blair’s market-style “reforms” to the NHS are driving
a rapid and widespread process of privatisation.
Cornered Health Secretary Patricia Hewitt has been trying to minimise
the latest damage to her department’s credibility, while Department
of Health civil servants lied through their teeth on the scale of the
wave of redundancies ripping through the NHS, and attempted to discredit
campaigners publishing the genuine figures.
The note of panic in the Department was reinforced by the abject chaos
as Patricia Hewitt was forced publicly to intervene and order the withdrawal
of an advert placed in the Official Journal of the EU inviting insurance
companies with commissioning budgets in excess of £300m a year (i.e.
major private sector insurers including some of the most notorious multi-billion
dollar corporations in the US which made their fortunes by excluding the
poor and sick from health cover) to bid for contracts ‘framework
contracts’ to deliver a wide range of commissioning and management
services to Primary Care Trusts, which act as “commissioners”
of services, controlling 80 percent of the £80 billion NHS budget.
The terms of this invitation made it quite clear that virtually all aspects
of the PCTs’ role – including control over the lion’s
share of their budget for purchasing care for their local resident population
– were to be offered out to private bidders:
“This will include, but not be limited to, responsibility for population
health improvement, the purchasing of hospital and community care, supporting
local GPs develop practice-based commissioning [sic], the management and
development of community health services for the PCT resident population,
and other services.”
Such an arrangement would sound the death-knell for PCTs, which were only
established in 2002 and are still in the throes of the latest reorganisation:
it would leave them with next to nothing to do, other than warm up the
vol-au-vents, shine the shoes of the private sector commissioners and
arrange the paper clips for occasional board meetings.
Yet, staggeringly, this massive exercise in privatisation had been hatched
up behind closed doors by a small cabal of ministers and free market fundamentalist
advisors, with not the slightest attempt at consultation with MPs, health
unions, NHS managers or the medical profession.
News of the plan leaked first in the Financial Times on June 19, but it
was not until a full week later, as copies of the advert landed in the
emails of health correspondents, that the story was more widely recognised
– and ministers forced to account for themselves.
In the aftermath of the disastrous by-election results and New Labour’s
catastrophic showing in opinion polls, it was obvious that not even the
most servile and dim-witted Labour MP with any aspiration to re-election
would fancy their chances of flogging this policy to a hostile electorate,
and the law of political gravity was reasserted: the policy was dumped,
at least for the time being.
This makes it a second time that ministers have been caught out trying
to hand over hundreds of millions in NHS budgets to the stewardship of
money-grubbing US health insurance companies that have become a by-word
for inflated costs, bureaucracy, inefficiency, exclusion and fraud.
But however much Hewitt denies a mission to privatise the reality is that
every aspect of government health reforms now focuses around maximising
the involvement of the private sector, while all of the cutbacks and closures
centre on the NHS.
Having been criticised in the courts for a failure to consult local people
in the imposition of private sector GP services in Derbyshire, ministers
are looking to evade future consultation by negotiating a national contract
that would impose private sector GPs on 30 “under-doctored”
areas around the country: the target is to privatise 15 percent of GP
services.
In Kent, one Trust Chief Executive is openly predicting that the private
sector will take over the large majority of waiting list operations: BUPA
has just picked up two new lucrative contracts to deliver NHS-funded care
in new treatment centres – while existing NHS capacity faces cuts
and closures.
But campaigns are still starting up around the country. In Waltham Forest,
angry health visitors and community staff have persuaded the council’s
Oversight and Scrutiny Committee to vote unanimously to use its power
to block cuts by the PCT that would leave just one health visitor per
1,000 children.
In SE London UNISON’s South London & Maudsley branch is launching
a major community-wide “Hands Off Slam” campaign to halt £8m
in cuts to mental health services being imposed by the PCTs in Lambeth
and Southwark.
There are plenty of signs that we are not yet too late to roll back some
of the cuts and block further privatisation: but local campaigns have
no time to lose. The privatisation juggernaut is cranking up and accelerating:
we have a fight on our hands to Keep Our NHS Public!
More details on the campaigns from:
www.healthemergency.org.uk
www.keepuornhspublic.com