Edward Davies: The health service that cried wolf

Edward DaviesToo much hysteria is clouding reasonable criticism

If you watched Channel 4 news last night, you could only come away with the impression that the government is waging a secret war to privatise the entire NHS. You see, Channel 4 were “exclusively” “leaked” “proof” that “the government is planning to privatise the NHS.”

The proof was so exclusive and so leaked that a couple of weeks ago you could only read about it on dozens of websites including here, here, here, here, and here and you could only read the draft version over a month ago here after it was first published over a month ago…. here.

But this was a huge scoop and so other national media outlets are picking up the scent today and giving their own take – Government planning to privatise swathes of NHS, claim GPs, NHS bill is “privatisation by stealth” of healthcare.

And what is this leaked, exclusive smoking gun proving the imminent demise of a public NHS? It’s a document on commissioning support that will see private firms working for and with commissioners in primary care.

This development is so new and so exclusive and so dangerous that only more than a dozen firms have been government rubber stamped to do exactly this for only the last five years after Patricia Hewitt launched the Framework for procuring External Support for Commissioners in Feb 2007.

These long-running schemes are so clandestine and so underhand that you can only read boastful accounts of them on company websites here, here, here, here, here….. and so on and so forth ad infinitum. You get the point.

So why am I playing the irritating smart arse lawyer telling you to read the small print?

Because of the response of the department of health: “A spokesman for the Department of Health dismissed the concerns, saying the document was about back office functions.”

The word “dismissed” sounds somewhat aloof. Rather condescending. Ever so traditionally Tory. And yet, it’s utterly justified given the exclusive leaked proof is at best weeks-old well-documented conjecture and actually reflective of five year old and fully implemented public policy. And indeed in those five years an awful lot of contracts have not gone the way of the private sector anyway. And in fact on seeing the conservative plans many government rubber-stamped private firms scaled back their NHS involvement (“US healthcare giant and commissioning support organisation Humana to pull out of UK market,” and “UnitedHealth quits primary care and sells off surgeries to The Practice”).

Reform criticism is in danger of becoming reform hysteria and a classic case of crying wolf. This healthcare bill continues to have real problems that demand real consideration, but if the government gets too comfortable reasonably dismissing trumped-up concerns, when the real wolves come there’ll be no listening exercises left to save it.

Edward Davies is editor, BMJ Careers

  • Dave West

    Thanks Edward for making these points. I think it is also fair to say that, although current commissioning support plans do potentially lead to more staff in the commercial sector, the aim of the work was to give more certainty and security for current to staff. Following the past year of the opposite.

    So it's not clear that creating hysteria around it will give those staff any more certainty/security, at least not in the short term.

    Dave, HSJ

  • My concern is that the document does not list an “NHS solution” for CSOs. The document effectively says that where there currently is an NHS solution (in the local PCT), this will not exist after 2016. In fact, the FESC solutions you list are all multinational, centralised solutions which cocks a snook to the government's mantra of localism and more personalised care. As for pluralism in providers…

    (Please do not say “but there is the soc ent/voluntary route” since we all know that route is very limited, and so far it has proven to be a temporary solution before a transfer to the private sector.) And just because Hewitt introduced FESC does not make it right, does it?

    If the only solution is a private sector solution then you cannot avoid using the term privatisation.