The Darzi report into the future of the NHS published last week restated the government’s commitment to the privatisation of the health service.
It also revealed Gordon Brown’s plans to push privatisation into more areas of the NHS than ever before.
Lord Darzi, the health minister who wrote the Our NHS, Our Future report, estimates that the NHS is two thirds of the way through a “reform programme”.
He claims that independent health providers – private companies – have helped to “extend choice, add capacity and spur innovation”.
Therefore new general practices should be set up by independent contractors or “new private providers”.
His vision is of a health care system run by private companies.
Darzi argues for greater regulation and testing of hospitals with fines for hospitals deemed to be deficient in areas such as hygiene and safety.
Hospitals run by “autonomous” service providers will then compete against each other, providing “choice” for patients.
Darzi’s report has created anger among health service workers and campaigners.
Kambiz Boomla, a GP in Tower Hamlets, east London, told Socialist Worker, “The main point of the report is to create a wider opening for the private sector in healthcare.
“The report talks a lot about ‘polyclinics’, which are large health clinics that will be privately run. The aim is to get GPs working within these centres – meaning that GPs would then be under private control.
“Currently GPs’ surgeries are run by partnerships of GPs. They have a contract with the NHS, but they also have some autonomy.
“If GPs become privatised in the new polyclinics then that means that both the provision and the purchasing of healthcare is handed over to the private sector.
“The competitive market is not run on the basis of health needs or social equity. It runs on the quest for surpluses and the elimination of services that cannot pay their way.”
Allyson Pollock, the director of the Centre for International Public Health Policy at Edinburgh university, has also criticised the Darzi report.
She said that it “reveals a return to pre-1940s thinking and the launch of US-style healthcare – deserts of poor quality or no healthcare for the many millions (primary care polyclinics) and a few little islands of excellence for the lucky few.”
US health companies are now licking their lips at the prospect of the market opening up for them in Britain.
Kambiz said, “Healthcare is the most profitable industry in the US, and now the United Healthcare company is targeting the British health service.”
A lot of the media coverage of the report has focused on the plans for increasing the opening hours of GP surgeries.
The CBI bosses’ organisation attacks “outdated” services that mean workers having to go to their GP during working hours.
But 24-hour GP surgeries are not the main concern of most people – they just want to be able to get an appointment with a GP within a reasonable amount of time.
Kambiz says that the focus on such issues shows that “the government is trying to create a problem that it can then ‘solve’ with privatisation”.
Increased privatisation will not only lead to a worse service for patients and worse conditions for staff – it will see NHS debt soar.
“Privatisation is expensive,” said Kambiz.
“A polyclinic pilot in Newham in east London had building costs of £5 million, and the rental cost for the NHS is £1 million a year – a 20 percent rate of return.
“The pilot on the Isle of Dogs cost £10 million to build and £1 million a year to rent back – a 10 percent rate of return.
“In contrast to the private sector, the treasury borrows at an interest rate of 5 or 6 percent.”
Kambiz argues that any good ideas in the report will be lost within the framework of privatisation.
He said, “There are some progressive aspects, for example giving people the option to be cared for in their own homes and sending people to specialised ‘stroke centres’ or ‘cancer centres’.
“But the issue is – what else is organised around that?
“It’s no good if there are specialised centres, but no properly funded local hospitals – there are transport implications for patients.
“Providing care at home will have transport implications for NHS and social care staff, and no solution is offered to deal with this.
“There’s a danger that local hospitals will be run down and then become ‘unviable’ in the eyes of the government – and that further privatisation will then become the solution.”