You might not know it, but the NHS as we know it is over in April 2013. This isn’t hyperbole, this is fact. The Health & Social Care Act 2012, which comes into force in April, ends the democratic and legal underpinning of the National Health Service. This might be news to you, it is to most. If you love the NHS, it is time to wake up and act.
The NHS Goldmine
There is a huge amount of wealth which could be getting made on the back of the sick. To some, this is a missed opportunity. In the sixty plus years since its inception, private enterprise has been seeking a way back in.
The NHS today employs 1.7m people – Only the Chinese People’s Liberation Army, the Wal-Mart supermarket chain and the Indian Railways directly employ more people. It treats over 3 million people, in England alone, each week. The NHS budget in its first year was £437m (£9bn in today’s money) for 2012/13 stands at £104.3bn (in revenue and £4.5bn in capital).
In short, the nation’s sick are a potential gold mine to the private medical industry. However, for all our complaints of waiting lists, uncaring nurses, ambivalent doctors and horrible food: Britain loves its National Health Service. It isn’t the best healthcare service in the world and we always want to make it better. But it is ours. If we get sick, we get treated. We do not have people in our country bankrupting themselves simply to be treated when they are sick.
So, no government has ever been able to even suggest the idea of privatising health care. We sold the gas, the coal, the water, the phone service, the postal service, and the railways. But there has never been anywhere near substantial support for selling the NHS, and moving to a system of privately run healthcare.
With a population stubbornly attached to their publicly funded institution, what were successive neo-liberal governments and private healthcare providers to do? Privatise by stealth.
If You Can’t Buy it, Bankrupt It
To use a football analogy, this is one situation where New Labour crossed the ball into the 18 yard box, leaving the Coalition to volley it, thundering into the back of the net. New Labour oversaw an unprecedented privatisation of the NHS. They entered the service into costly PFI contracts to build new hospital buildings to replace the worn infrastructure they inherited. However, these schemes which involved the government entering into partnerships with private providers have been proven to provide little value to the tax payer, but maximum profit to the private provider. The PFI loans, which like mortgages last 25-30 years, are at least twice the interest rate of normal government borrowing. The contracts also generally contain stipulations that outsource the services of the hospital (cleaning, repairs and maintenance, payroll, IT, finance etc) to the private provider, often at much higher costs than the hospital might otherwise provide the services for. In return for a capital investment of £11.4bn, once the last scheme set up by New Labour is paid off in 2049, we will have paid £70bn in repayments. Some hospitals are having to handover a fifth of their annual budget on paying for the PFI deal. Annual bills are due to rise year on year for the next 18 years, due to the inflation and the structuring of the deals.
I wrote an article a year ago, prior to the passing of this bill raising the concern that the subsequent financial struggles faced by the hospitals as a direct result of this policy would be used as a reason to further privatise the hospitals – namely that a failure of the private sector would once again be relabelled as a failure of the public sector. I hate it when I am proven right on such Machiavellian issues, but in this case, I was.
Where New Labour left off, the Coalition took over. After bemoaning New Labour’s costly PFI debacle while in opposition, the Tories and Lib Dems rushed through a further 34 PFI deals in their first two years in government. They have recently launched the revised PF2, stating it as a new and improved version of PFI which brings the tax payer greater value for money. However, PFI has always been sold in these terms to the confused and otherwise engaged tax payer. Expect no change, just to be short changed.
The PFI Time Bomb Explodes
The PFI chickens really came home to roost in the last two years. Up and down the country NHS trusts were going bankrupt as a result of these scurrilous deals. South London Healthcare Trust was placed into special measures and will be dissolved in October this year after finding itself shackled with £150m of PFI debt. The Trust entered into a £2.5bn deal during the Brown government, to rebuild its Bromley and Woolwich hospitals. This costs the Trust £61m per year; that it nearly 15% of its annual budget. It must make these payments every year until 2032. The Trust buckled under the pressure and folded. The story of this Trust is the same as the rest of the NHS.
The Public Accounts Committee (PAC) recently reported that thanks to PFI, one in five NHS Trusts is now in serious financial distress. The PFI contracts ensure that the private investors have first call on NHS money if and when the hospital goes into such distress. The tax payer is already, through the Department of Health, already facing a bill of £1.5bn to bail out seven trusts with PFI problems – equivalent to £60m a year, the PAC says. This means that we are paying private investors to bankrupt our health service.
In the face of these failures, the government is proposing more of the same poison. It is allowing private providers to swoop in and buy up contracts to run the beleaguered hospitals.
The government has already begun the process of handing hospitals over to private providers, at tax payers’ expense. Hinchingbrooke hospital was handed over to private provider Circle in 2011. In a fine example of the disasters that can take place in a private marketised NHS, a monumental cock up ensued. A PFI deal was also struck, at the same time for a hospital in Peterborough just 24 miles away. This created too much capacity for local demand, and two half empty hospitals.
The PFI deal was described as financially ‘catastrophic’ for the Peterborough and Stamford Hospitals Trust. While the private providers at both ends of this deal are guaranteed their profits, the taxpayer is paying one million pounds a week to keep the hospitals afloat. Worse, due to the long term nature of the agreements, the Public Accounts Committee report on the issue revealed that even if massive cost cutting and service provision cuts are made at the hospitals, the Trust will require £26m a year, for the next 30 years to remain viable. So goes the NHS.
The Act That Killed the NHS
The Health and Social Care Act 2012 is the Coalition government’s fatal shot in the already wounded body of the National Health Service. As of April this year the Secretary of State, for the first time since the inception of the NHS, will no longer be responsible for the National Health Service. There will no longer be democratic accountability, at the heart of government, for the provision of a National Health Service.
The Act also dismantles the strategic centres of the NHS, such as Strategic Health Authorities and Primary Healthcare Trusts. This effectively denationalises the service, removing the economies of scale and guarantees of standardised service regardless of where you live in the country.
The Act makes it possible for up to 49% of beds in any NHS hospital to be handed over to private providers.
Lord Owen, former Labour Foreign Secretary and Liberal leader put it perfectly when he said:
“The Act breaks up the universal system that has served us for over sixty years, and reduces the NHS to a stream of taxpayer funds and a logo for the use of a range of public and corporate providers of services.”
The implementation of the Act will be overseen by none other than Jeremy Hunt. The MP who last year was found in an unreasonably cosy relationship with the Murdoch Empire while heading up Culture, Media and Sport and overseeing the BSkyB bid.
A man with a history of extreme mateyness with corporations in charge of the NHS at a time when it is being laid out like a banquet for the private sector…what could possibly go wrong?
Vultures at the Carcass
The Director of Nursing of the Surrey Primary Health Care Trust found out first hand. The Primary Care Trust was facing a £650m takeover bid by Virgin Care. Yes: first the trains, now the NHS. While the Trust tackled Virgin on a number of issues, seeking assurances from the provider that it would put in place safeguards protecting patient care and employee terms and conditions, Hunt personally intervened to ensure swift signing of the deal. Surrey now has a Virgin run health service.
And this is but one of the things that has kept Hunt busy since taking up his undeserved promotion. Hunt has been in talks with a range of private health care providers to line up the PFI and privatisation deals up and down the country that can start in April. Our confidential medical histories are to be opened up to private providers across the country. Every act of the incoming Minister for Health seems determined to sell out the service, not even necessarily to the highest bidder.
Meanwhile, as in tax avoidance there appears to be a revolving door between the Department of Health and the private health care sector. One such example would be Christine Lineen. Lineen spent two years working as an aide to Health Secretary Andrew Lansley, during the period he made the decision to hand over Hinchingbrooke hospital to private provider Circle. She then became Head of Communications for Circle. Now she is back in the heart of government advising Jeremy Hunt on the NHS carve up.
It’s Time to Wake up Britain
The fact that members of a Leicester hospital trust took a £40k trip to the US to study its healthcare system can be taken as a sign of things to come.
There are many people who have woken to the real dangers of what’s afoot in the NHS and you can join them. It is not enough for us simply to shrug our shoulders and bemoan this situation. We owe it to the efforts taken to grant us our NHS, to at least match their efforts to retain it for the benefit of generations to come. Lord Owen as put forward a Bill to Reinstate the NHS, if approved, this will come to life in April 2015 and call to a close the worst elements of the current Act and reveres those which have already occurred. It is on us to get involved, and put an end to this shameless privatisation of our most treasured and essential public service.
Sign the 38 Degrees Petition – More than 200,000 people have signed this petition. Join them and make your opposition known.
National Health Action Party – are standing candidates in elections up and down the country. Check out their website and see if you can support.
Keep Our NHS Public – a great campaign with latest figures, facts and information. Follow them to find out where and how you can demonstrate and take part in other actions to stem the flow.