New update produced for Unite by the NHS Support Federation reveals scale of NHS sell-off
“We will not be selling off the NHS,” said prime minister David Cameron on June 7, 2011.
These were his famous last words as the health and social care Act was pushed through Parliament in 2012 and came into effect a year later, paving the way for unbridled privatisation of the NHS.
Earlier this month, the Times revealed that the Tories themselves believe restructuring the NHS through the Act was a huge mistake, with one unnamed senior official saying that Cameron did not even understand the controversial reforms.
Another official said Chancellor George Osborne “kicked himself” for not preventing the health service’s restructuring, which has cost the taxpayer billions.
But for patients, health workers and all those who care about an NHS that is renowned the world over, these shameless politicians’ regrets are too little, too late.
The competition effect
The scale of privatisation as the health and social care Act began its destruction of the NHS a little over a year ago is exposed in a new Unite update by the NHS Support Federation.
Clinical commissioning groups (CCGs), which replaced primary care trusts (PCTs) in the Act, are groups led by local GPs to commission (or purchase) health services in a given geographic area. The purpose of CCGs was to create a clinically driven commissioning system that would ostensibly be more sensitive to the needs of patients.
As it turns out, they’ve ended up being more sensitive to the needs of private profiteers – unlike the PCTs before them, CCGs have greater legal obligations to open contracts to competitive tender, regardless of the public’s wishes or consideration for the service’s quality.
As the update reveals, since CCGs were first introduced in April 2013, the value of CCG contract awards has skyrocketed. In the first quarter last year, the total value of CCG contracts was £266m. Over the same time period this year, from April to September 2014, the total value was just over £2bn – a five-fold increase.
What’s even more damning is who has won these contracts. Fifty-six percent, or well over half, have gone to private sector providers. In total, CCGs have put £7bn worth of contracts before the market since the groups’ inception last April.
In response to these findings, NHS Support Federation director Paul Evans said, “This evidence is proof that the NHS changes will result in wide-scale privatisation.”
“CCGs are being forced to tender NHS contracts and the private sector is winning the lion’s share of these contracts put before the market,” he added.
Private sector takeover: who stands to profit?
The government will have you believe that the competition brought on by private bidder competition will translate into better care for a better price. But as is so often the case with the current government, promises never reflect eventual realities.
One prime example is the recent £235m contract for musculoskeletal services in West Sussex, which private provider Bupa won, beating out an NHS provider. The contract essentially hands over all control of orthopaedic services in West Sussex to the private provider.
Dr James Walsh, a local councillor and former GP, slammed the private takeover, saying, “I wonder where profits in a profit-making organisation are going to go. It’s a private company and I have serious concerns about this privatisation by stealth.”
He and others in the community are especially worried about how the takeover will affect the Western Sussex Hospitals NHS Foundation Trust, which lost out to Bupa in bidding for the contract. The loss could cripple the community’s hospital and A & E services, potentially draining the trust of £30m.
Earlier this month saw one victory for the NHS and the public, in which a CCG had been pressured into selling off public services to private contractors.
The Cambridge and Peterborough CCG had very secretively put out a jaw-dropping £800m contract to tender for a care pathway for older people’s services. Cambridgeshire campaigners launched a courageous offensive against what the Morning Star called “the biggest potential privatisation so far since the health and social care Act.”
Eventually, the NHS provider, Cambridge University Hospitals, won the contract, but only after campaign groups demanded the CCG engage the local public in the decision.
The contract bidding process, as detailed in the Morning Star article, shows just how underhanded these deals can be. The CCG secretly shortlisted mostly private providers, and after public pressure and threats of legal action demanding greater transparency, the CCG published a heavily redacted report in the very last minute.
To make matters worse, it was revealed that the clinician leading the tendering process had recently been a director of a subsidiary of Virgin, one of the private providers bidding on the contract.
Though this is one victory against the mounting privatisation of the NHS, surely it is a pyrrhic one – the £1m wasted on the tendering process could have been completely avoided had NHS services simply been awarded to the NHS from the outset.
And if the tide of private contractors taking over the NHS continues rising unabated, as the Unite update suggests, then local campaign groups may just not be enough to stop it.
For more information about the NHS’ continued privatisation and how you can get involved to protect to our health service, visit the NHS Support Federation website here.