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David Wrigley: Privatisation behind an invisibility cloak

26 Jun, 14 | by BMJ

david_wrigleyI was a guest speaker recently at a packed meeting in central Newcastle, where we discussed and debated the changes to the NHS. Everyone in the room was very concerned and indeed very angry at what they heard. A lot were unaware of the scale of the issue over privatisation in the English NHS.

Time and again I hear, “We didn’t vote for this at the last election—it wasn’t in any manifesto,” or “The coalition have no mandate to make such huge changes to our NHS—no single party won the election.” And I agree with them. The coalition has been very clever in making out that GPs were on board with the NHS changes (they weren’t), that it was what the NHS needed (it wasn’t), that the NHS is in a massive hole (it isn’t), and their coup de grace is that they are selling off many services to the private sector hidden behind the well trusted and well respected NHS logo. It is privatisation behind an invisibility cloak.

One story at this meeting hit home to me though, and explains perfectly why the coalition’s privatisation of the NHS is disastrous for patients and the taxpayer. It also illustrates the difference between NHS GPs and the private sector. Time and again when I debate NHS changes, I hear the allegation “You GPs are just like the private sector.” Well, this story explains why we are not . . .

A few years ago, the local NHS managers in Newcastle decided to put out to tender a large GP practice in Newcastle. The bidding process (as I have written on this before) is hugely in favour of large corporate companies, who have the back office staff available to fill out the masses of forms and paperwork. They also have the ability to put in a “low bid” as a loss leader in order to get a foot in the door. Local GPs bid for the contract, but the upshot was that Care UK won the contract, despite local opposition. Here is a news report from 2012 on the outcome of the bidding process. Please take special note of the reassurances by Care UK that they would meet “the high standards which the NHS expects of us and which patients deserve.”

Move the clocks forward two years, and last month a shock announcement was made by Care UK that they would be handing the keys back to the surgery they took over in 2012. An alternative provider will now need to be found for the 7000 patients whose care has been disrupted, while Care UK will walk away without (so far) giving any reasons as to why it’s leaving a service it had committed to run until August 2017.

To me, this short story explains why we should not be selling off our English NHS and why the private sector cannot be trusted with NHS contracts. It also explains the difference between the private sector and GPs. GPs often stay with a practice for their whole career, including when times are bad. The private sector does not do this. Private companies can just walk away and move on to the next contract. They lack the same affinity to the patients, or the desire to maintain that longitudinal and ever so important doctor/patient relationship.

I hope this explains why many of us are campaigning to stop the privatisation of the NHS under the Health and Social Care Act, and why we oppose the private sector moving in and winning NHS contracts. The Health Act needs repealing. We need a complete halt to the market in the NHS, and for the NHS to be a preferred provider of services to stop scenarios like the one above from happening.

P.S. One interesting point to note is that Care UK is backed by the huge global private equity firm Bridgepoint Capital. One of Bridgepoint’s advisers is Alan Milburn, Labour MP for Darlington from 1992 to 2010. He was the architect of New Labour opening up the NHS to the private sector, and much has been written elsewhere about this. He is now advising those who seek to profit from the NHS, after he helped make it possible for them to bid for such contracts. I will leave that sobering thought with you.

David Wrigley is a GP in Lancashire and a member of the BMA GP Committee. He also speaks for the campaigning group Keep Our NHS Public, which is an apolitical organisation seeking to bring about a publicly funded, publicly provided, and publicly accountable NHS. He contributed to the recent book “NHS SOS.”

Competing interests: I declare that I have read and understood the BMJ Group policy on declaration of interests and I have no relevant interests to declare.

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