Tuesday, March 13, 2012

Empress' New Clothes

It is amazing how the few things we picked up from early childhood serve us well into our adult life.

Politicians continue to want us to believe that they have new clothes on.

©2012 Am Ang Zhang 

This time the child is called Polly.

Whatever convinced Shirley Williams to U-turn, it was a shame that she put herself on the line in so bad a cause: "I would not be standing here, and I would not have stuck with the bill, if I believed for one moment it would undermine the NHS." But virtually every royal college says it will.

Doctors will make more money if they do not object to the HSCB!
There is no self-interest in the professions' opposition: GPs are supposed to rule the roost in this bill. What they see clearly on legal scrutiny is that competition and commercialisation will now drive the NHS, not collaboration.

The Lords' last chance to amend and delay it is next Monday, while the government resists legal orders to publish its Risk Register. If anyone doubts the scale of change, a second NHS hospital this week put itself up for takeover or private sale, after Hinchingbrookewas called a "one-off". That's just the start..

In the new world order of our NHS, private provider (AQP)for commercial reasons need not let the public have access to information about their activities etc, and even the doctors they provide.

Just look at one of the OOH, one doctor for 950,000 population!  As they say, be very afraid.

Even as we like our NHS as much as our woods: looks like private providers for public services is in the PM's mind. Sometimes it is public (taxpayer) money for private failures: catastrophic failures when it is someone's life.

Wait, most of the time they are the same doctors so introducing competition is not going to improve anything.

Under the agreement, King's College Hospital NHS Foundation Trust (King's) has joined GSTS Pathology, the joint venture between Guy's & St Thomas' NHS Foundation Trust (Guy's and St Thomas') and Serco GSTS Pathology has been awarded a ten-year contract valued at around £300m, starting October 2010, as the principal provider of pathology for King's.  It is anticipated that the agreement will result in incremental revenue to Serco over the term of the King's contract of approximately £110m.

The other way is to refer to Any Qualified Provider, the new NHS speak for Private Providers. Better still if these are owned by the same organisations that own some of the GP practices. Believe me, it is already happening and it will spread.

How could this be done? Simple, NHS Foundation Hospitals will not stand a chance if they have to continue with the expensive and unprofitable conditions or expensive dialysis and Intensive Care that many private insurers will not touch. In the new world order, they will fail and be closed or be bought by private companies. We have the regulator called Monitor that will see to it.

Again it will not be the politician’s fault: just bad management.

In 2009 the total value of the market for PH(Private Healthcare) in the UK was estimated at just over £5.8 billion. Private hospitals and clinics account for the largest part of the overall PH market, generating an estimated £3.75 billion in revenue during 2009. Fees to surgeons, anaesthetists and physicians generated an estimated £1.6 billion in 2009.

The total number of UK citizens with Private Insurance is estimated to be around 90,000. It is not difficult to work out what good value the NHS has always been.

The greatest threat to the NHS is perversely that of its regulator and in turn it is a threat to our democracy as the regulator is not elected and therefore not accountable to the electorate.

“……Tom Clark our leader writer says the real problem with the bill is the fact that the new regulator has a duty to promote competition where appropriate. He points out that in a previous life as a special adviser the regulator used his powers to squeeze state bodies in order to open up the space for private providers. It's why he is so against competition.”

We must not overlook the fact that Monitor is headed by someone from McKinsey and my reading is that one way or another the private providers are coming in.

I don’t care about my hospital’s use of resources, I want to know if it is going to deal with my particular problem on the day that it has to see me. We have a market with huge barriers to both entry and exit, and little or no idea on how either can be achieved. We have a regulator with little or no ability to get involved and deal with systemic problems like under-provision or to censure collusion.

In short, it’s a shambles. This isn’t a marketplace, it’s a distorted opportunity for private providers to make profits and undermine comprehensive public provision at the same time –  the very antithesis of a competitive environment. I fear for the future of health services in the NHS.

The Department seems to have been foolishly duped by commercial companies that promised the sun, cost the earth, and delivered not much more than hot air. Damningly, PAC's report states: “The Department could have avoided some of the pitfalls and waste if they had consulted at the start of the process with health professionals.”    

Emperor's New Clothes: Under One Roof

1 comment:

Jenny Woolf said...

Fullfact.org worked out that Polly is more likely to be accurate than Shirley Williams.

I'm grateful for her for keeping the flag flying.