Forum - Handing over your health service - Judy Davis on white paper (Liberating the NHS) - GP commissioning and an increased role for the private sector.

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Published: 16 July, 2010

NOW private companies are finally to get their hands on billions of pounds of the National Health Service budget to buy care from …other private companies, warns Dr Jacky Davis (above)

Change, change, change… aren’t things bad enough already? Clearly health secretary Andrew Lansley doesn’t think so.

While in opposition he criticised Labour for repeated and pointless reorganisations of the NHS and promised that he would leave it alone.

But on Monday he launched a White Paper (Liberating the NHS) proposing the most profound reorganisation of the service since its inception in 1948.

Either the coalition document failed to tell the truth or this massive shake-up has been concocted in less than six weeks.

At the heart of the proposals are GP commissioning and an increased role for the private sector.

This has predictably been dressed up in fine words, with talk of putting patients and GPs in the driving seat of the service and improving outcomes through increased “choice” and “contestability”.

But what lies behind the rhetoric?

GP commissioning entails handing over £80billion of the NHS budget to family doctors to buy healthcare for their patients.

Many GPs have already indicated that they have no interest in the massive and complex challenge of commissioning.

They have neither the time nor the expertise to supervise the management, accountancy and data analysis involved in buying healthcare for their local population.

Fortunately the last government had already set up FESC (Framework for External Support for Commissioners) which consists of commercial companies who will do this work for them.

Thus private companies will finally get their hands on billions of pounds of the NHS budget to buy care from other private companies, who will increasingly be involved in delivering NHS clinical care under the government’s “any willing provider” policy.

Has anyone noticed a possible conflict of interest here?

Hospitals must all become foundation trusts and, along with their staff, will lie outside the NHS.

Those who fail – both hospitals and GP commissioning bodies – will be eliminated, as “there will be no bail-outs of organisations which overspend public budgets”.

These proposals amount to nothing less than an accelerating privatisation of the NHS to the point where it becomes nothing more than an organisation buying care from a hotchpotch of competing and unaccountable private companies.

Labour, of course, did the ground-work by dismantling the safeguards that protected the service but the new white paper will lead to a legislated stampede of the private sector into the service.

One private sector director has already predicted that this could lead to “the denationalisation of healthcare services in England”.

Others have described it as an “evisceration of the NHS”.

Those who can’t see what all the fuss is about need look no further than the USA.

President Barack Obama, supported by the two-thirds of Americans who wanted a public option, wanted to push through much-needed healthcare reforms.

He and they were thwarted by the massive US

medical industrial complex, which spent a million dollars a day to resist change.

Those same companies, many of whom have been successfully indicted for fraud, are now being shown the red carpet to come and run our NHS.

There was no electoral mandate for the changes proposed in this white paper.

There is no evidence for them and despite the rhetoric there has been no consultation.

There will be no pilot.

They will allow the government to distance themselves from unpopular decisions on cuts and closures of local services, open wide the door to the private sector and divide the profession.

This is a dangerous ideological experiment which puts at risk the NHS and those who depend on it.

• Dr Jacky Davis is a north London radiologist and a member of the British Medical Association consultants’ committee and writes here in a personal capacity