It is a common practice for politicians to ignore professional advice. Sometimes they might get away with it; sometimes it led to failure, gross failure as in the case of the French attempt at building the
So, please don’t cry!
© Am Ang Zhang 2012
Lith Style Photographic work.
Lith Style Photographic work.
No Public Accountability:
………As for public
accountability, there is none. Commercial contracts are redacted so that
crucial financial information is not in the public domain. Government
departments and companies refuse to release the necessary information on the
grounds of commercial confidentiality and allow companies to sequester their
profits in offshore tax havens. NHS staff transferred from the public to the
private sector see their wages and benefits eroded. But all this is nothing
compared with what is in store for patients.
In the new world it will
no longer be possible to measure coverage or fairness. Former NHS hospitals,
free to generate half their income from private patients, will dedicate their
staff and facilities to that end, making it impossible to monitor what is public and what people are paying for.
Market Concept:
The belief that markets
distribute resources more efficiently is the basis of regional economic
agreements like the European Union as well as policies imposed on developing
countries by the World Bank and IMF. Britain led the way, starting with gas,
water, telecoms and railways. By 2004, the whole of Whitehall was committed to
putting corporations in control of what had formerly been publicly administered
services. This year it is the turn of the NHS.
Loss of public control
means higher cost and fewer services, as we have learned from the toxic record
of the US corporations which are now part of England's new healthcare market
and helped design it. Billing, invoicing, marketing and advertising will add
between 30% and 50% to costs compared with 6% in the former NHS bureaucracy.
Fraudulent Billing & Embezzlement:
Patient charges will
become commonplace. Fraudulent billing and embezzlement will become endemic.
Take HCA, one of the largest and most profitable US chains and controlled by
private equity firms including Mitt Romney's Bain Capital. In 2006 HCA
International described its first joint venture with the NHS, the PFI
University College London Hospital (UCLH), as "the establishment of Harley
Street at UCLH".
HCA-UCLH provides cancer
treatment to those who can pay from the 15th floor of the hospital. But
currently some of HCA's American hospitals are under investigation for refusing
care and performing unnecessary investigations and treatment, including cardiac
surgery. A decade ago it paid the federal government $1.7bn to settle fraud
charges, while former chief executive Rick Scott – now the Republican governor
of Florida – managed to avoid prosecution.
This is the pattern
elsewhere. Unitedhealth, which is currently providing services to the NHS, paid
hundreds of millions of dollars in settlement of mischarging allegations in the
US; Medtronic paid $23.5m for paying illegal kickbacks to physicians to induce
them to implant the company's pacemakers and defibrillators; GlaxoSmithKline
and Abbott paid $4.5bn in fines relating to improper marketing and coercion of
physicians to prescribe antidepressants and antidementia drugs respectively.
Novartis, AstraZeneca, Pfizer and Eli Lilly have all paid large fines for
regulatory breaches.
The list is not
exhaustive. In the absence of information and strong laws to prevent corporate
crime and tax evasion, England's business-friendly environment is rapidly
becoming a banana republic. Franchising is not an easy win for the public. It
is a profit opportunity for big business in whose interests healthcare is
increasingly being run both at home and abroad.
On PFI:
Strangled by PFI debts and funding cuts, NHS foundation trusts compound their problems by entering into joint ventures. The great NHS divestiture, which began in 1990 with the introduction of the internal market and accelerated under the PFI programme, now takes the form of franchising, management buyout and corporate takeovers of our public hospitals.
Virgin has been awarded £630m to provide services to vulnerable people and children in Surrey and Devon.
Circle has been given the franchise for NHS hospital Hinchingbrooke and is now struggling to contain its debts. London teaching hospitals are merging to give them greater leverage for borrowing and cuts.
First Emperor, Animal Farm & Allyson Pollock
Strangled by PFI debts and funding cuts, NHS foundation trusts compound their problems by entering into joint ventures. The great NHS divestiture, which began in 1990 with the introduction of the internal market and accelerated under the PFI programme, now takes the form of franchising, management buyout and corporate takeovers of our public hospitals.
Virgin has been awarded £630m to provide services to vulnerable people and children in Surrey and Devon.
Circle has been given the franchise for NHS hospital Hinchingbrooke and is now struggling to contain its debts. London teaching hospitals are merging to give them greater leverage for borrowing and cuts.
First Emperor, Animal Farm & Allyson Pollock
"Since it was Pollock's views on the PFI that so upset its proponents, it is worth summarising them briefly. Costs are now intrinsically higher, because of capital borrowing at higher rates than those available to government, because of cash hungry consultancies and the vast transactional and monitoring costs of countless contracts, and because—for the first time on a large scale in the NHS—commercial profits must be made. To accommodate all these new costs clinical services have been scaled down, while matching assumptions about increased efficiency are only variably delivered. All this, along with the rigidity of a trust based strategy for building hospitals and the locking in effect of contracts fixed for decades, seems to Pollock and many others at best a bad bargain, at worst a naive betrayal that opens the NHS to piecemeal destruction and the eventual abandonment of its founding principles. And all over the country PFIs—greedy, noisy, alien cuckoos in the NHS nest—gobble up its finances and will do so for the next 30 years.”
Next 30 years!
Ernst & Young was paid £33m for handling the administration of Metronet, the company which left the maintenance of two thirds of the London Underground in limbo when it collapsed.
The failure cost the taxpayer up to £410m, the National Audit Office also disclosed in a highly-critical report released today.
'The taxpayer has borne some of the direct costs of Metronet’s failure, including the unexpected upfront payment of £1.7bn. We estimate there has been a direct loss to the taxpayer of between £170m and £410m,' the NAO said.
The government had to shell out the £1.7bn to cover Metronet's debt obligations to its lenders, which would have been paid back over the course
of the 30-year contract if the company had not collapsed.
of the 30-year contract if the company had not collapsed.
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