In February 64 Bristol GPs signed an open letter to the Bristol ‘Clinical Commissioning Groups’ (CCG – responsible for commissioning services to providers and administering the tendering process to the private sector) highlighting the shocking wastage of money represented by the Emersons Green ‘Independent Sector Treatment Centre’ (ISTC). There letter – available here – compellingly highlights many of the problems creeping privatisation by stealth is introducing into our NHS. Hopefully their letter and their campaigning and the campaigns of activist groups like Protect our NHS (who have helped organised the letter) can help generate interest in both this individual case of the perils of privatisation; and the wider place of health care in our society.
Reforms over the past few decades, greatly exacerbated by the 2012 Health and Social Care act, have been slowly but surely introducing a marketised health care model into our NHS. Greens (and many others who care about our NHS) believe this model not only fails on its own terms of reducing cost and increasing efficiency (in fact doing the opposite) but also reduces standards of care, working conditions of staff, and has reprehensible moral implications.
From our conversations with health workers we repeatedly hear that Emersons Green ISTC does not provide as good care as the NHS centres, yet (as scandalously highlighted by the loss of £7 million over the last three years) the NHS has to pay Care UK regardless of the actual treatment it provides. This puts GPs in the unenviable position of having to either refer patients to the Emersons Green ISTC to receive poorer service, or to effectively waste NHS money by sending them for treatment elsewhere.
This local wastage of NHS money provides a microcosm for the wider problems across the country. We currently waste billions of pounds every year artificially forcing our health service to function as a fragmented market. Recent studies have found the NHS to provide the best value for money service in the world. The USA spends roughly 1/3 of its entire health spending on administration costs, whilst spending twice as much as the UK per capital on health for much worse results. Yet this is the very model our leaders seem to be emulating.
In 1980 before Thatcher first introduced an internal market into the NHS, administration costs were around 5%. Since then the main inflationary pressures to providing health care should have been the cost of pharmaceuticals and medical equipment, yet administration costs have now risen to over 15% of the total budget. Much of this is down to the extremely time consuming and expensive bidding system for service contracts and the purchases provider split. The government doesn’t collect reliable statistics for the costs of these measures, but it is estimated to cost around at least £10 billion a year. This is a colossal wastage of funds that should be going to providing health care, before even taking into consideration the profit that private providers extract for running services. Finally the hugely inefficient PFI deals pioneered by the Blair government and continued by the current coalition critically undermines NHS budgets to finance servicing debt repayments frequently far out of all proportion to the value of their investment.
As highlighted by the GPs letter, staff working for private providers are often unknown to NHS staff, and not fully integrated into local health care networks. This adds unnecessary confusion and communication problems that lower potential healthcare outcomes. In general wherever the private sector has been given a greater role in providing services, standards of care are depressed. The flagship example of Hinchingbrooke hospital which was until recently completely run by the private company Circle Health is a case in point. Quality of care, hygiene standards and patient safety were all compromised in the interests of profit. The care quality commission (CQC) gave Hinchingbrooke the inspectorate’s worst ever rating for “caring”, and found it “inadequate” (the worst rating) for safety and leadership. Circle have since pulled out of the contract, leaving the hospital under special measures. We cannot let this happen elsewhere!
Locally Greens will be campaigning for the NHS to provide services to Emmersons Green and all health services except in extremely exceptional circumstances. We hope the GPs letter and campaign will help pressure the Bristol CCG into making this a reality. This will only happen if more and more people join with campaigns resisting privatisation like Protect OUR NHS (and political party’s committed to doing the same like the Green Party). Nationally we aim to restore the ‘duty to provide’ healthcare by the Secretary of State for Health (removed in 2012); to ensure the NHS remains a unified public service; and to remove the internal market and private sector involvement that so blights the service. To this end we are fully supporting Dr Allyson Pollocks’ NHS Reinstatement Bill that does just that and more to return the NHS to its founding principles and ensure our society has the health service it deserves. On top of this we must ensure the NHS is given adequate funding to provide the service so many of us depend on, and has enough staff to meet its need. We are committing to provide an extra £12bn of core funding every year to the NHS, to support and restore services and pay, improve mental health care, and make vital updates and improvements.
This extra money would be funded through progressive general taxation. As already noted though we could save billions by remove ideological vanity projects that artificially force the NHS to run as a fragmented part-privatised service. Greens seek to reduce the overall cost of healthcare not by simply treating the symptoms of ill health in individuals, but their causes among society at large – chiefly inequality and poor environments.
To reiterate the words of the much quoted founder of the NHS Aneurin Bevan: ‘The NHS will last as long as their are folk left with the faith to fight for it’. Our NHS is being undermined and sold off by politicians who frequently are directly financially benefiting by its privatisation, to give greater profits to private companies (usually owned by their supporters and peers). We need to go out there and fight for it. Join campaigns against privatisation, and this May the 7th, use your vote for the NHS.