This week Circle Healthcare group became the first private company to take over the running of an NHS hospital — Hinchingbrooke hospital in Huntingdon, Cambridgeshire.
Hinchingbrooke is one of the so-called “failed hospitals”. Under the internal market, it has run up a debt of £40 million. The for-profit, offshore, hedge-fund backed, Tory-donor organisation Circle Healthcare have taken over the hospital buildings and the hiring and firing of staff under a £1 billion deal.
In a recent company report they explained that they expect their need to maximise profit will have a negative impact on patient care!
As the government seeks to cut NHS costs by 37% over the next five years, there will be many more privatisations of this sort.
This process will be accelerated by the Health and Social Care Bill.
The Bill is currently opposed by almost everyone except the government and private health corporations. It is so controversial that Malcolm Grant, the newly appointed head of the NHS Commissioning Board (the organisation that will have to implement the Bill) has described it as completely unintelligible .
But the Tories have already driven the NHS down the road towards a US-style private healthcare system.
Many patients are being denied treatment for painful but non-life threatening conditions.
In north-east Manchester 57 types of surgery are no longer available on NHS. Hysterectomies are only being offered in an emergency, and many patients are being denied cataract operations and hip and knee replacements. Some patients choose to go private rather than wait in pain.
£1 billion worth of community services will be opened to the market from April 2012. Whilst the world’s attention was focussed on Rupert Murdoch and the phone-hacking scandal, Andrew Lansley took the opportunity to announce the privatisation of eight NHS community services worth £1 billion.
As of April 2012 the following services will be opened up for bids from the private sector:
• Services for back and neck pain
• Adult hearing services in the community
• Continence services (adults and children)
• Direct Access Diagnostic tests
• Wheelchair services (children)
• Leg ulcer and wound healing
• Primary Care Psychological Therapies
• Podiatry services
In November 2010 David Cameron gave Central Surrey Health a “Big Society”award, championing this staff-run social enterprise as a model for clinician-led services. Less than a year later, CSH failed to win community health services, outbidded by Virgin Healthcare subsidiary Assura Medical. Unconfirmed reports suggest CSH was unable to raise the capital to compete. Social enterprise is another route to backdoor privatisation.
According to Pulse magazine, private companies snapping up a series of GP practices previously run by trusts.
Pulse revealed that 41 practices in England have either been re-tendered or are due to be, and at least two are due to close.
GPs are not equipped to commission services and are having to buy in extra support from the private sector. To make this process more efficient Clinical Commissioning Groups (CCGs) are rapidly merging, replacing PCTs, which have just been abolished, but with a much greater role for the private sector.
The Practice Plc runs 60 GP surgeries and further clinical assessment and treatment services (CATS) across the UK. It has recently acquired the UK provider arm of US healthcare giant UnitedHealth and is now controlling commissioning budgets in Buckinghamshire, where it has formed a small consortium of its two practices in the county.
With GPs in control of the NHS budget, clinical decisions may easily be influenced by personal financial gain. If they can keep costs down, or commission services to a private company where they hold shares, then GPs could see significant personal rewards.
The Bureau of Investigative Journalism found that over half of the board members in some GP consortia have links with Assura Medical, part of Richard Branson’s Virgin Group.
With privatisation running at such a pace, what difference will the Bill make?
Clause 1 devolves responsibility for deciding what constitutes NHS care to individual GP consortia. At the moment the Secretary of State has a legal duty to ensure NHS care is free at the point of need and thus has to decide which medical treatments fall within the remit of the free service. Without this legal responsibility on the Secretary of State, GP consortia will have the power to decide what treatments they are willing to offer as part of the free service.
Moreover, the move from PCTs to GP consortia means there are no NHS bodies responsible for all the people within a geographical area. So we can imagine a situation where some patients are rejected by their local GP surgery in the same way that many people can no longer access a NHS dentist.
The links between government and business are now seen at all levels of the health service. A Freedom of Information Act request revealed that NHS Partners Network, a lobby group which represents companies including Care UK, Circle, General Healthcare Group, Bupa and United Health, helped draft a letter requesting a formal investigation into how firms were being blocked from getting NHS work.
The lobby group took the regulator out to a £250-a-head gala dinner.
The network began lobbying for the investigation in October 2010 and it was given the go-ahead two months later.
The resulting report published in July 2011 included recommendations to offer patients “more choice” because people were “dying” while waiting for operations in NHS hospitals.
In September 2011 the Guardian revealed top level talks between the Department of Health, NHS London and German healthcare giant Helios. This meeting, orchestrated by management consultant firm McKinsey’s, talked about how Helios could break into the £8 billion acute hospital sector, specifically taking over London hospitals. Helios have a reputation for driving down wages and staffing levels.
Most shocking is the talks between government and a subsidiary of Netcare, a firm that has admitted organ-harvesting kidneys from children in South Africa. These people may shortly be running the NHS’s organ transplant operation!
The privatisation of Hinchingbrooke hospital will be celebrated in the board rooms of the health corporations around the world. For the last twenty years, the health giants have been trying to break into the European healthcare market. Hinchinbrooke is just the first in a number of planned privatisations. Three hospital trusts, Trafford Healthcare NHS Trust, the Royal National Orthopaedic Hospital and the Whiston Hospital (St Helens), have publicly announced that they would also consider this option.
The government is far from secure about their plans. But what has been lacking is a vocal working-class force capable of forcing them back. The Labour Party, which advanced NHS privatisation during its time in office, is not offering any significant opposition.
The working-class force may yet come with the upcoming pensions dispute. The major barrier to full scale privatisation is the NHS pension scheme. When the Tories initially commissioned Lord Hutton to write his report on public sector pensions they were motivated by the fact that public sector pensions “presented a barrier to greater plurality of provision of public services”.
When the Tories and Lib Dems say that public sector pensions are unaffordable they mean they are unaffordable for the private sector.
The fight to defend our pensions is also a fight for the social provision of healthcare for all.