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Tories plan to wreck NHS

The Conservative whitepaper, “Equity and Excellence: liberating the NHS”, is designed to transfer control for £80 billion pounds of the NHS budget to the private health sector.

It means the end of the NHS as a publicly owned and operated service, and its transformation into little more than a brand name, which health corporations will operate their own clinics and services under.

Privatisation
The changes outlined in the whitepaper give GPs the role of commissioners (purchasers) of services. When it was founded, the provision of healthcare was controlled and funded by Health Authorities (HAs). These distributed funding to the services in their area, according to a needs-based formula.

Market mechanisms were eliminated, and healthcare was planned to meet human need based on the principle of equity, with funding needs met through redistribution from low-cost to high-cost services; risk pooling, which means sharing the cost of high-risk patients across a large funding pool; and risk planning.

This way, the NHS was able to provide comprehensive, universal and equitable healthcare at a lower cost and with greater efficiency than any other healthcare system. The NHS still costs less than half of the cost in terms of GDP than the privatised US healthcare system. The proposed whitepaper will allow the same greedy health corporations to provide healthcare in Britain, paid for by the taxpayer.

Currently, funding for the NHS is administered by Strategic Health Authorities (SHAs) and Primary Care Trusts (PCTs). These purchase services from the providers (hospitals and primary care services). While inefficient and bureaucratic, at least this means funding is administered by the government, so there is some accountability and oversight. Under the Tory proposals, the SHAs and PCTs are to be abolished and replaced with commissioning run by GPs.

GPs are to be grouped together in consortiums, which will then be given control of £80 billion of the NHS budget to be used to commission services from “any willing provider”. However, the GPs themselves won’t be commissioning services, as they will be busy seeing patients. This function will be carried out by private health corporations, which are already bidding for contracts to commission services on behalf of GP consortiums. KPMG, the global auditing firm, has been hired to group all of London’s GPs into consortiums.

Crucially, healthcare corporations are to be allowed to “compete” for contracts on an equal footing with already existing NHS services. The quango, Monitor, will be tasked with ensuring the already existing NHS services don’t use their “competitive advantage” to stop the health corporations getting contracts. Since those same health corporations will be administering the commissioning, it’s easy to see how they will be able to systematically direct contracts to private health providers, until existing publicly-owned NHS services close from lack of funding.

And under rules set out in the whitepaper, GPs will be legally bound to adhere to all of their consortium’s commissioning decisions, including policies on referral management. This means that even if some GPs wanted to continue referring patients to NHS services, they will be stopped from doing so.

This is wholesale privatisation and will lead to the dismantling and destruction of the NHS. The Lancet, a respected medical journal, stated in its editorial that the whitepaper means “the end of the NHS as we know it”.

Resistance
But there is opposition developing across the country. The British Medical Association (BMA) has called for a halt to the reform, and the chairman of its GPs committee has stated: “We will quite quickly see failed consortiums bought up on the cheap by foreign companies and see bits of the NHS run from abroad. This really is just the beginning. Parts of this government want to see all NHS management in private hands.”

These changes will lead to mass opposition in communities around the country as the inefficiencies and madness of the market begins to take hold. Anti-cuts campaigns need to reach out to GPs and patients groups, and seek to involve healthworkers and health union branches in campaigns.

When the NHS was created it was the jewel in the crown of the welfare state. We must ensure it remains so, and is not sold off to pay for the capitalist crisis.

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