NHS Overhaul - Privatisation by the back door
July 16, 2010
Posted by:Suzanne Trask
The Guardian reports that, in reality, Andrew Lansley's health white paper opens the door to the comprehensive privatisation of healthcare and the end of the NHS as a national service. It will have become a central fund with a minimal workforce, commissioning services from private companies.
Self-employed GPs will be forced to form consortiums, which are then expected to be run by the private firms. Will the creation of GP consortiums to replace primary care trusts be any different? All hospitals are to become foundation trusts and move towards "social enterprise" status. What does this mean in terms of ownership? Could hospitals be bought up and integrated with local GP consortiums to create US-style "health maintenance organisations"?
Only two months ago, the coalition parties solemnly pledged no more "top-down reorganisations of the NHS", and elections to primary care trusts. Both promises have been scrapped (the trusts will be abolished).
The proposed shakeup of the NHS once again requires an enormous management effort to redesign organisational structures, and this at a time when management costs are to be reduced by 45%.
There is a belief that changes in the structure of the NHS will lead to improvements in care processes and thus to better patient outcomes. After several major NHS reorganisations there is no evidence of such links. What happens when hospitals and GP consortiums go into deficit, as surely some will? Where are the details of how such problems will be handled by regulators?
There is no reason to believe that patients and taxpayers will get a better deal. The NHS commissioning board will set national standards, and the National Institute of Health and Clinical Excellence is to produce a package of good-practice protocols. However, will they be mandatory or voluntary? At present, the coverage of clinical audits is incomplete and contributing to them is often voluntary.