April 1st starts stealth privatisation of NHS – every day, things are getting worse

You can read an edited transcript of the video on the British Medical Journal website. Lucy Reynolds offers a clear, chilling analysis of how the Health and Social Care Act will work when it comes into force on April 1st.

Save Lewisham Hospital Campaign is calling on everyone to lobby Parliament and MPs on 26th March, and write to Lords to oppose  regulations that are the thin end of the wedge for stealth NHS privatisation.

We want to make sure that CCGs are not forced to use competition, but can decide for themselves whether they use NHS services or whether they choose to use private providers like Virgin or other international companies.”

Also, you can ask your MP to sign the EDM 1188 aiming to get a public debate on the new regulations.
If this last-ditch attempt to stop the competition regulations fails,  key points for those campaigning to save our NHS include:

Section 75 regulations will come into effect, so that

“everything has to be put out to competitive markets by CCGs [clinical commissioning groups] and the national commissioning board. That will create rights for private providers to supply which will not only allow them to take quite a lot of the share of the NHS budget for their business right now, it also potentially makes the privatisation irreversible in the future.”

“The rules are structured in such a way that there will be a gradual transition between those two groups. The public sector will shrink away, and the private sector will grow.But because there will never be an announcement in parliament that the NHS is privatised, and because the private providers will be allowed to use the NHS logo for anything that they are getting NHS funding for, it is very likely that the general public will not be aware that the private sector has in fact come in and taken over whatever bits of the NHS it finds profitable until probably service provision gets fairly bad.”

The Clinical Commissioning Groups (CCGs) are technically state-owned health insurance schemes. They are taking on around 80% of NHS funding and paying it out to health service providers.

Although the propaganda is that CCGs will be able to  have a lot of autonomy in deciding which health service providers to fund, in fact this is not the case, because they are bound to put out and award contracts according to competition law. If private health service providers don’t get the contract and don’t like the CCG’s decision, they will appeal to the sector regulator, Monitor, who has to enforce competition law.

This might not matter particularly, if private and public (NHS) providers were operating on a level playing field, but they won’t be. CCGs will have to put all aspects of health care out to tender,  and Lucy Reynolds points out that,

“the private contractors are considerably advantaged in winning those tenders… They designed the rules, and the tendering process [is] quite highly technical—legally, financially and operationally. Just having medical knowledge is not enough. You need people who are good on legal and financial stuff and are experts in bid preparation. Private companies have a dedicated bid team who do nothing but search for bids to apply for, prepare the bids, and pull in the external consultants to get exactly the right technical expertise in. There are some other reasons why it’s stacked.”

These include the “cherry picking” problem – which is that private health service providers will only want contracts for the profitable services. To allow this to happen, the Health and Social Care Act legislates for a special tariff facility.

This means that the CCG can say to the cherry picking provider, well the price for this contract is for the whole service, but you only want to deliver part of it, so we’ll lower the price to reflect that. This then allows private health care providers to systematically undercut the NHS on price, which the ConDems had said would be impossible under the Health and Social Care Act. The NHS, with its ethical commitment to providing a complete service, will not be able to compete on price with cherry picking private health service providers.

Every time an NHS provider loses a contract to a private health care provider, the NHS capacity is lost because there is no money to pay people’s wages. Lucy Reynolds says,

“What is plain is that this has been a long-term plan with things set up in a predictable way such that the outcome is likely to be privatisation of the NHS.”

It will happen by stealth, gradually. And when it does happen, everyone will blame the doctors – not the politicians who set up the stealth privatisation. Lucy Reynolds explains that the ConDem government has sold Clinical Commissioning Groups  to the public and to doctors on the grounds that they will empower GPs and patients. The reason for this

“… is firstly to lure the doctors into complying with this. They are belatedly starting to understand that this has been a trick.

The second reason GPs have been told that in CCGs they would have the chance to advance the interests of patients is because it’s very important for our politicians that nobody blames them. The public has been induced to believe that the GPs are taking over and will be in control so in five years when the whole thing is complete chaos and you can’t get decent care, it won’t be the politicians’ fault.”

Posted from here.