Tony Blair has promised that Labour’s election manifesto will “drive through the market based reforms in the health service”. But the privatisation of our NHS isn’t simply a threat for the future—it’s happening now.
Billions of pounds of NHS money is being diverted into the private sector, healthworkers’ jobs are being privatised and crucial services are entrusted to profit-hungry firms.
Experts warn the conversion of the health service into a huge marketplace could threaten cuts and closures of NHS hospitals, already facing an estimated end of year deficit of more than £224 million. Ministers have declared that up to 15 percent of elective surgery—planned operations—and increasing amounts of diagnostic tests will be carried out in the private sector by 2008.
Everything from the MRI scans used to help diagnose cancers and other serious conditions to the admin staff handling finances for dozens of hospitals is being handed to the private sector. About a third of NHS cleaning contracts are already in private hands. Giant consortiums of private firms will be making a fortune from private finance initiative hospital building schemes for decades to come.
The new wave of privatisation comes as the government introduces a system called “payment by results” into the NHS, where hospitals are paid a set sum of money per patient treated.
Under this scheme hospitals will compete against each other for patients. Hospitals that cannot compete effectively will face severe consequences including possible closure. The new scheme goes even further than the discredited NHS “internal market” introduced by the Tories.
Professor Allyson Pollock, who heads University College London’s public health policy unit, says, “Labour is doing what the Conservatives wouldn’t have dreamed of doing—and they’re doing it without opposition. The government has a problem distinguishing between what are commercial goods and what is a public service. Areas that were never open to trade are now open.”
Labour’s enthusiasm for handing the NHS over to the private sector is boundless. Blairite MP Alan Milburn, now in charge of New Labour’s election manifesto, began the process when he was health secretary, urging NHS hospitals to buy operations for NHS patients from the private sector.
But the numbers of patients whose operations were “outsourced” in this way will be dwarfed by the government’s £2 billion “independent sector treatment centre” programme, the latest stage of which was announced by health secretary John Reid last week.
This has allowed private firms to set up the centres, sometimes dubbed “surgery factories”, that will carry out hundreds of thousands of routine hip, knee and cataract operations for the NHS.
Pollock says the private firms are being allowed to “cherry-pick” the high-volume, less complicated routine work, leaving the NHS destabilised.
The biggest scandal has surrounded the farming out of thousands of cataract operations from the NHS’s Oxford Eye Hospital to units run by South African company Netcare.
Loss of patients threatens redundancies and loss of the hospital’s teaching status, with a possible financial shortfall of up to £2 million. The local primary care trust, which holds the NHS budget for the area, said it would rather “opt out” of using the Netcare facilities, but was ordered by the Department of Health to go ahead—to avoid jeopardising the private deal.
Another crucial area of work being handed to the private sector is MRI scanning. MRI scans are important for diagnosing a range of serious conditions—and there is a waiting list of up to 18 months in some areas. But rather than invest in more scanners for the NHS, the government is intent on using those provided by private firms, either through the treatment centre deals or under separate contracts for scanning services.
The BMA’s Paul Miller says: “We have heard of MRI scanners in NHS hospitals sitting unused while patients are scanned in mobile units in car parks outside.”
The hidden privatisation of our NHS is marching on apace. But Allyson Pollock says it would be “a tragedy if staff working in the NHS or patients got cynical” about the health service. Healthcare is an important right that people have fought for for generations, she says.
“People need to be informed and educated and mobilise more at a local level, questioning and calling for greater transparency.”