The private sector is not only providing NHS services, but now commissioning them as well

It had always been the Thatcherite/Blairite dogma of service provision that the big private companies – whether the likes of Capita, G4S, Serco, A 4E, Atos or the huge US healthcare multinationals – wouold provide all the health services, but the commissioning would be done by the independent public sector.   Now even that split, with the public sector confined to a relatively marginal role, is being done away with and the carving up of the NHS in all its various roles by these private behemoths is now all but complete.   For the first time the NHS under Tory ideological control is asking the private sector to undertake the buying of billions of pounds worth of services for hospitals and GPs.   NHS England has just advertised for companies to compete (or share out the booty) for £5bn or more of work advising the new GP-led clinical commissioning groups (CCGs) which spend more than two-third of the NHS budget (some £70bn) buying care for patients.

They will advise on patient care ‘reforms’, finances, drug purchasing, negotiating hospital contracts, handling NHS patient care data, and outsourcing services to private care providers.   Apart from the last, these were of course all functions provided by the Primary Care Trusts up till 2010, but they were disbanded in order to hand the responsibility to the CCGs ostensibly on the grounds that “they knew best what was in their patients’ interests”.   As we can now see, this was just a cover partly because many CCGs didn’t want this administrative commissioning role in the first place, but mainly because the Tory intention all along was to close the circle of private sector control by by giving the big private companies the commissioning role on the grounds that the CCGs didn’t have the expertise (so why were they given this role in the first place?).

Even more remarkable there are already 17 commissioning support units which were set up in 2012 to provide services to CCGs, so why are new bidders like Serco and the US United Health needed at all?   Obviously there has been a concerted lobbying effort by the big behemoth providers to take full control of the whole process without having to negotiate with other parties.   But the costs of this stitch-up will be enormous.   There will be huge new transaction costs which, it is well to remember, take up at least 30% of total health care costs in the US.   It will obviously fragment the service further, which is clearly the Tories’ intention.   Above all it will produce monstrous conflicts of interest as the big private healthcare providers advise on the commissioning of services of which they are themselves major providers.   There is also the very sensitive issue of handing over the handling of NHS patient care data into private hands.   Much of this, it can be said with assurance, will certainly backfire on the Tory machinators and come back to haunt them.

7 thoughts on “The private sector is not only providing NHS services, but now commissioning them as well

  1. Do you think it is Labour ineptitude or BBC bias or both that are responsible for the fact that what is happening to the NHS is not better known. There again, newspapers like the Independent and the Guardian have not been leading any campaign to bring it to our attention. Given the private sector’s dismal and/or corrupt involvement in providing public services you would fondly imagine that the public would be up in arms about the privatisation of the NHS if only they knew about it. The fact that they are not is one of the mysteries of our time.

  2. cut its monies then they sack staff nhs looks terrible ops peoples we have to makeit better for one you got it a complete sell off to American company don’t forget Unum in all this waiting for that day yes sir or mam we have the exact policy fot one to protect against hospitalisation yes the cunning gits are going to take you down this road privitisation I feel sorry for the young uns they sleep allowing this lot of lying buggers to getaway with it jw forget the bbc channel 4 and 5 they all get monies from the tv licence fee so being a tory mouth piece this is another piece of government saying do hawse say yet we pay they don’t for that licence funny world jeff3

  3. These are actually polices that were, (apparently they were devised by the US consulting firm McKinsey,) first introduced in nascent form under Blair, (to be facilitated by first effectively bankrupting the NHS with private debt through the PFI initiatives and such.)

    But then escalated and accelerated opportunistically by Cameron and this vile coalition for purely ideological reasons and probably also for personal gain; Jeremy Hunt’s personal relationship with former health secretary Virginia Bottomley, (they’re cousins,) and therefore with BUPA, is as inappropriate as it’s notorious.

    The real reason there has been no real outcry about all this is because on this as on so much else as well there is no clear water between the 2 major parties, (also Labour like the conservatives have a far from spotless record on MP’s accepting payment in cash or kind for services rendered to the commercial sector,) and as someone who’s followed all this fairly carefully I find Andy Burnham’s recent assurances both unconvincing and somewhat disingenuous.

    Almost Cameron’s very first act as our unelected PM , (of so many others,)of gratuitous and vindictive social vandalism was to quietly abolish, (in practice to facilitate selling off,) the NHS to the inefficient, often corrupt and almost always corrupting private sector on the dysfunctional and massively deficient American model.

    But a world where David Nicholson still remains in his job despite having being responsible for, perhaps as many as 1200 deaths, needless and premature at Mid Staff and the conditions and the regime of neglect and abuse that occurred there under his management and despite the NHS accepting liability for them amounting to almost 1 million pounds as result, “Huston, we have a problem,” so to speak.

    His successor looks even more dodgy.

    I’ll still definitely be voting Labour at the next general election, (for our sitting MP, but I still have very serious reservations about many of colleagues.

  4. This is bad enough in itself, but why has Ed Miliband vetoed Andy Burnham’s plan to hand NHS cash to local councils?

    Why isn’t Labour attacking TTIP, which would make it impossible to reverse the NHS privatisation?

    Andy Burnham is going to Brussels to get the NHS exempted from TTIP, but why is Labour not shouting from the roof tops what is at stake with TTIP, regarding the NHS? Also, the total loss of democracy in all other areas with TTIP?

    Why does the “Party of the People” appear to support a Treaty in the house which gives corporations powers to write laws, by being able to sue government for regulating them on behalf of the people?

  5. @John Wilson: It might be partly Labour’s timidity (or complete uselessness, take your pick, though Ed Miliband seems as in thrall to the market as Blair)but there is a very definite bias in the BBC’s news coverage, or more accurately, lack of coverage. But seeing as the BBC is crawling with Tories, the chairman of the BBC Trust is Chris Patten, ffs, it’s no coincidence that the NHS (and the Atos/benefit scandals) don’t get reported often or in any depth.

    The lack of coverage in The Guardian and Independent would be more of a puzzle til you consider one thing: they are businesses. The corporate media rely on advertisers so they don’t want to upset big business, they might lose advertising revenue. For instance, Virgin have a major contract from the NHS (in Surrey, I think) and no newspaper is going to risk losing Dickie Branson’s money.

    The public isn’t up in arms because of the almost total media blackout. If they knew the extent to which the NHS was being sold off, it might be a different story.

    Maybe the author of this blog could use his influence as an MP ask Miliband to be a bit more vocal about this issue and come up with some decent, non-market driven alternatives, because he’s giving no indication of having any ideas about anything these days…

  6. @Sandra Crawford. I find TTIP really very sinister, I also find Labour’s silence sinister as well as the news media’s non-reporting of this. It’s enough to turn people into conspiracy theorists 🙂

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