The reinvention of failure (NHS article)

[Briar]

The reinvention of failure

Existing health services are being deliberately destabilised to pave the way for an ideologically driven privatisation programme

John Lister

How is it that with spending on the NHS now running at double the level of 1997, the service is running into an autumn crisis, with debts totalling at least £750m, bed closures, theatres closed, services cut and estimates of 8,000 or more redundancies?
The answer lies in the breakneck process of "modernisation", under which existing services are being deliberately destabilised to establish a competitive market system incorporating for-profit private providers, in place of a planned system of public healthcare.

Under John Major the NHS was buying less than £200m worth of treatment from private hospitals a year. This will have increased 10-fold by 2007. Up to 15% of elective surgery will be hived off to private hospitals, leaving NHS trusts to cover the remainder.
Hospital buildings have also been privatised: private finance initiative schemes worth more than £5bn have been completed since 1997 or are being built, and another £12bn of projects are under negotiation - all of them locking trusts into costly, long-term leasehold deals.

But while New Labour ministers press relentlessly on, opposition is starting to coalesce. Last week in London a group of consultants, academics, MPs and trade-union officials met to plan a "save our NHS" coalition against these "stealth reforms", which have little public support - a recent poll showed 89% against private provision of NHS care - and are little reported or discussed.

That is likely to change in the autumn as huge, unprecedented budget deficits - and cuts in services - begin to take shape alongside the new competitive health market.

...

http://www.guardian.co.uk/comment/story/0,3604,1531998,00.html

[muriel_volestrangler]

1. Here's a bit of astounding cheek from Labour

Second wave of treatment centres in England will have guaranteed payment but not referrals

In the run up to the election John Reid said that treatment centres would not have guaranteed referrals. In the preceding months, PCTs had been told to refer a certain percentage to ITCs. Now this will no longer be the case, but post-election the government say they will guarantee the income levels from NHS contracts.

This means treatment centres will be paid for x amount of operations even if local patients choose not to be referred there. It is a clear sign the government is prepared to pay the costs of market entry and an infrastructure for competition.

The DH say this policy will not lead to them directing patients to ITCs (to ensure the money is not wasted) and won't need to because ITCs will only be deployed in areas where extra capacity is needed. The government could waste a good deal of money if this assumption is wrong.

While Nigel Crisp told Hospital Doctor that ‘we will not be forcing patients to go to private providers’. The money held centrally to guarantee income will be withheld from NHS patients and the Choose and Book system favours these centres.

http://www.bma.org.uk/ap.nsf/Content/hpdmay2005~plurality

How to break your promises: you don't guarantee the referrals, just teh money for them. And if they get paid for, then of course the referrals will end up going to the private sector. But, oh no, it's not guaranteed. My arse.

[PaulaFarrell]

2. another effect of this

I've been told that as a result of all the 'easy' eye operations being outsourced to private, there is almost no training available for new eye surgeons who would normally cut their teeth on these operations. Private hospitals don't want to do the difficult operations. In the long-term, what happens to the standard of surgey availble in this country?