When the New Labour government decided to implement the Tory policy of PFI they said that clinical services would remain with the NHS. Today they are opening up the entire NHS to private healthcare. In place of planning they are introducing a market in which public and private providers compete for patients. The article below was written for Swindon TUC's April E-Newsletter.
When the New Labour government pressed ahead with PFI we were told, don’t worry, clinical services will remain in the public sector. Yet today the government is opening up clinical services to private companies. They have abandoned the principles on which the NHS was founded. The latest indication of this is the news that hospitals will be allowed to ‘advertise’ to attract patients in a competitive market in which doctors and nurses will never be sure how many people will chose to use their services.
Sir Nigel Crisp, the NHS Chief Executive, has published a report setting out how a “patient led” service will develop over the next three years. The NHS management is abandoning planning at the national level.
Under the new system:
• Hospitals will no longer contract with local NHS trusts or GPs to carry out a number of non-emergency treatments;
• Patients will be entitled to be treated at any hospital, public or private;
• A target to give private hospitals 8% of NHS work will be dropped and they will be allowed to compete for all they can get.
A Health Insight Unit will be established to provide Primary Care Trusts with ‘marketing information’ about their local populations, like that used by supermarkets to target customers.
The document, “Creating a Patient-led NHS” says:
“Risk management in the future will involve a clearer approach to dealing with failure. High performing systems accept that failures will occur, and handle them decisively. In health this means recognising that some service are indispensable while others can be displaced.
The approach to failure will distinguish between contestable services, which can be allowed to exit, and indispensable services, where the response to failure needs to ensure the service remains in place.”
In other words, services that are not ‘successful’, in terms of the number of patients they attract and the money they make, will be dispensed with. This will mean that for all the talk of ‘choice’, hospitals are likely to dispense with unprofitable services and the actual choice will be progressively reduced.
The idea of patient choice in relation to health is in any case preposterous. A sick person does not want a choice. They want to be able to be treated in their locality to a good quality. They do not want to travel a long distance when they are sick.
In reality this is not a ‘patient-led’ NHS but cost led. The more patients attending a hospital the more money they are likely to make. But just as ‘choice’ in relation to schools has led to ‘sink-schools’, this crazy market based system can only lead to declining hospitals in areas, particularly metropolitan areas, where there are a number of hospitals, rather than the situation in places like Swindon where there is only one.
The competitive market which the pro-privatisation New Labour government is introducing can do nothing else but lead to an increased polarisation between ‘successful’ and ‘unsuccessful’ hospitals rather than doing what the NHS was set up to do, which was to develop equality of service on the national level. This government will go down in history as one which undermined equality of service.
The private healthcare vultures are gathering for the NHS pickings.
BUPA medical director Andrew Vallence-Owen welcomed the policy shift:
“We are awaiting an announcement as to what we can bid for. We and our colleagues in the sector are very keen to bid for the work, whether through national contracts or local commissioning.”
He added: 'We are in the private sector; competition is what keeps us fit. Customers can walk if they don't like what we do. Most private hospitals are already doing a lot of work for the NHS, so why should [PCTs] not offer choice of another private hospital that has the capacity?'
The NHS is being abandoned to profit making from ill health.