So, as widely reported, on the day the Government thought they could bury bad news they decided to announce the privatisation of eight areas of mental and community health. By September 2012 choice of three providers will have to be offered in local areas in the following services; back and neck pain; adult hearing services in the community; continence services (adults and children); diagnostic testing; wheelchair services for children); leg ulcer and wound healing; ‘talking therapies’ for adults and podiatry services. This all amounts to the opening up of a £1billion market to the private sector to profit from.
This latest announcement comes before the passing of the Health and Social Care Bill, which sets in train the privatising of the whole of our NHS, and after repeated assertions from Ministers that there would be no ‘selling off’ of our NHS. This latest move has been introduced under what is called the ‘any qualified provider’ principle which doesn’t require legislation to enact. Under this vision patients and service users will act as consumers, choosing which service provider they will ‘buy’ from. Who they pick will receive a payment for the delivery of this service from what we can still call the NHS budget pot.
What will this mean in practice? Each service will be working as a business, generating its income stream as it attracts patients and service users – a service won’t be able to plan or invest in advance as it will have no guarantees on levels of income or number of patients. Sharing best practice and innovations with other service providers means losing a competitive advantage and possibly threatening the future of your business. It raises the spectre of health services who do not attract enough patients and users going bust – as Southern Care has done. Those most likely to attract more patients and users are those with advertising budgets, such as Serco, Capita, UnitedHealth, Bupa and others who will be taking a public payment and creaming off a profit. And to make this profit as big as possible, corners will be cut, services run on threadbare resources, staff numbers reduced and wages cut. This is before we turn to the transactional costs – contracting, invoicing, lawyers fees and so on – in running such a market.
It is useful to look around at what else the Government is up to if clarity, if any were needed, on their future plans for the NHS. The publication of the White Paper on the future of public services omits only the military, core policing, intelligence services and judges as the areas where ‘commissioning’ (contracting out) is not appropriate – though support and specialist functions in these areas are cited as potentials for privatisation. The universal, comprehensive principle of the NHS was fought for and won by generations of working people and now faces destruction. The privatisation of the NHS, through whichever route the Government opens up, needs to be clearly opposed. It is an ideological assault that sees health as a private commodity, not a public good and basic human right.