NHS: modernisation or privatisation by stealth?

[mint]

[url]https://www.theguardian.com/society/2017/dec/08/stephen-hawking-lawsuit-foiling-jeremy-hunt-nhs-shake-up[/url]

[woolybanana]

Does anyone have the facts? These things are all in the fine print.

Given that the NHS wastes a fortune some areas of procurement it would seem that anything which encourages value for money is good as is an integrated service.

[richard51]

Its obvious to anybody who has the slightest connection with health care that privatisation is being pushed by the tories.

Richard Branson is even getting in on the act in a big way.

[andyh4]

So what will he call the maternity wards?

Virgin Birth?

[woolybanana]

richard, where is the evidence for this?

[richard51]

Don't be so naive. Google virgin healthcare.

There is ample evidence if you care to look. My personal experiences are very much seeing privatisation.

Pharmacies in hospitals.

Scanning and Imaging companies

Pathology companies

Only recently the whole cancer services in our area was put up for tender.

Private hospitals galore where NHS patients requiring straightforward operations are sent.

Estate services, procurement - look at the private fiascos there. PFI, staffing services.

Name a NHS service sector and there is privatisation.

Remember we are talking about money going to the NHS but being spent by them on non- NHS providers. Not the money from out of the pockets of patients being spent on private services which is extra. The Kings Fund stated that the money spent on non-NHS providers is slowly creeping up and is now just over 7%. They do point out it was also going up under labour. ( but Bliar was really a tory!! )

Anyway, perhaps the right wing mob will be happy to line the pockets of a few more private company executives.

[woolybanana]

Thank you, Richard, most informative.

There are ancilliary and central services in the list you provide; probably only cancer services whould not be outsourced which is a step too far, but most of the others could be.

Surely, the aim is to provide quality services for a sensible cost; if a private provider can do that then there is no reason for them not to do it. Of course all precautions must be taken.

to ensure that there are no shortcuts, excess profiteering etc.

In fact it might save the NHS money all round.

Three or four years ago I discussed this with the manager of a French blood testing centre. You probably know that there is one in almost every town. He told me that the relevant Government negotiating body was very tough at setting terms and the costs of all their blood tests and that they were inspected regularly. Whether their costs are lower than the NHS I cannot say but this approach could be as good as the NHS on of doing everything in-house, surely?

The trick is to maintain control, inspection standards.

PFI, by the way, started very badly with inappropriate terms and controls; since this was realised and rectified the system is working well. The stories of £150 to change a light bulb which took two years are, as I understand it, long gone.

[andyh4]

Wooly wrote:

The trick is to maintain control, inspection standards.

Something that successive British Governments and their civil servants have proven to be especially inept at doing.

Anyone remember Railtrack and its demise? Do we have to wait for NHS patients to die before it is seen as a less than good idea to outsource life critical systems?

[mint]

When Trump says he is going to give the UK a very, very good trade deal, I shudder at all the American medical businesses just waiting to grab their share of our health services market.

Be in no doubt, it's all happening.......

[DraytonBoy]

Surely the NHS is there to provide 'free at point of entry' healthcare for everyone. If it does that by outsourcing some of the care to private companies without affecting the quality of the care is it really that important an issue?

Funding of the NHS is a completely different matter though.

[AnOther]

It's beyond any rational argument that in it's current form the NHS is unsustainable and until the politicians and the public collectively grasp that nettle it cannot but continue its decline.

Rants about the Tories may relieve the spleen but serve no other purpose as it's an issue governments of all complexions have consistently swept under the carpet.

It's no coincidence that the French system is consistently ranked as the best in the world and I think it's true to say that while the UK may not have the NHS service it wants it does have the service it deserves.

[andyh4]

DraytonBoy wrote:

Surely the NHS is there to provide 'free at point of entry' healthcare for everyone. If it does that by outsourcing some of the care to private companies without affecting the quality of the care is it really that important an issue?

In principle I cannot disagree, but as I indicated earlier the ability of the UK systems to manage such outsourced operations is derisory.

Railtrack - which I alluded to above - went into voluntary liquidation following the Hatfield accident - 4 dead 70 injured - and their inability to deliver the upgrade of the West Coast Main Line, which was so far over budget that some small countries were glad that their debt was less.

Outsourcing of care home - leading to some appalling cases of poor care, spiralling costs, liquidation of a number of suppliers and ultimately bed blocking in NHS hospitals.

Not every privatisation has been a disaster, but as wooly said the controls have to be there and the track record is not good. Failing that you have to have fall backs - which would mean duplication which will probably mean massive inefficiency.

ANO is right that the UK has got the service it deserves. All the while the electorate are tempted by another few pounds in their pockets promised at election time but rarely delivered, rather than a realistic view of I will need to pay a little extra to get those services I want and need.

[YCCMB]

Exactly. And even with the whole "free" thing, someone has to pay. And taxpayers basically aren't.

As retirees in France, most people are paying very little towards the French health service, but add up the cost of mutuelles ..and deductions from salary for those that earn one.. and you're comparing apples with tomatoes.

Anyone in the UK with private medical insurance is likely experiencing a very similar level of service at a very similar level of cost to someone in France.

As someone pointed out ( and I'm not saying I agree with this, but it's food for thought) if the NHS is such a brilliant model, why has no other country ever adopted it?

[alittlebitfrench]

If I had the choice between paying 25 euros/pounds on a 30 min doctors appointment the same/next day or a free one in two weeks....I would pay. I do want them to be English speaking though if I am paying. Not some half arséd mix of English. Proper English.

I am happy to pay 30 euros for a clean and polish at my dentist every year.

People who can pay should pay. It is your health at the end of the day.

Also, stop health tourism. Make them pay. That winds me up.

Lastly, drunken idiots who end up in casualty on a Fri/Sat have to pay 500 pounds for treatment. Simples !!!

Look, ALBF has just solved the NHS.

[DraytonBoy]

As with most things these days it all boils down to funding -

Tories - just enough to keep services functioning.

Labour - happy to spend billions more as long as no one asks where the money comes from.

Taxes need to go up rather than increased borrowing IMO.

[mint]

[quote user="andyh4"]DraytonBoy wrote:

Surely the NHS is there to provide 'free at point of entry' healthcare for everyone. If it does that by outsourcing some of the care to private companies without affecting the quality of the care is it really that important an issue?

In principle I cannot disagree, but as I indicated earlier the ability of the UK systems to manage such outsourced operations is derisory.

Railtrack - which I alluded to above - went into voluntary liquidation following the Hatfield accident - 4 dead 70 injured - and their inability to deliver the upgrade of the West Coast Main Line, which was so far over budget that some small countries were glad that their debt was less.

Outsourcing of care home - leading to some appalling cases of poor care, spiralling costs, liquidation of a number of suppliers and ultimately bed blocking in NHS hospitals.

Not every privatisation has been a disaster, but as wooly said the controls have to be there and the track record is not good. Failing that you have to have fall backs - which would mean duplication which will probably mean massive inefficiency.

ANO is right that the UK has got the service it deserves. All the while the electorate are tempted by another few pounds in their pockets promised at election time but rarely delivered, rather than a realistic view of I will need to pay a little extra to get those services I want and need.[/quote]

YES!  Some services need to be run for the benefit of the public and not from a profit motive.  Why else would private companies be interested other than to make money?

There are other areas besides public transport that have not benefited from privatisation. Energy providers notably and, most shameful of all, the complete dereliction of responsibility for affordable housing.

Of course, we are not talking about waste or bad management here (of which there are numerous examples), but we do want health care and social services and we could afford them as the fifth largest (maybe more like sixth these days) economy in the world!

[richard51]

Mint , you are so correct.

Unfortunately its all to do with politics.

Brexit is leading to the UK getting into private insurance as in the US situation and medics etc not doing anything without the money being forthcoming ( though its becoming more like that already). The US spends about 17% of GDP on healthcare - way above any other country.

My experience and what is happening in the UK at the moment is minimal compared to what will happen to the NHS with the current direction of politics!!

[woolybanana]

By and large the State does not run things well, wastes money, does not use personnel well whereas the private sector does otherwise; the money wasted by the State is the profit of private managers. The publiic good can only be achieved by the two working together; private runs, the State oversees.

And we need a permanent financial management body to spot and eliminate waste, such as NHS procurement. ~No civil servants to do it, then train them.

[richard51]

Twaddle again. Wasn't a recent privatised personnel recruitment company chastised and closed down for wasting money.

As stated it is politics - in wooleys terms, imho the money "wasted" by the NHS (debateable) will actually feed its way back into the system and hence prevent government funds paying social security to working people in the NHS.

With private firms the money goes to overpaid execs/investors and additionally the underpaid private workers need to claim social topups.

I know which I prefer.

[woolybanana]

Inefficient, unresponsive State run enterprises like the old British Railways, PTO, Coal Industry, Steel Industry ....

You old school socialists talk so much rollox, Richard.

Oh and how much are the heads of unions paid plus grace and favour homes and handouts, Scargill's flat and house for life ..... How is that different from private industry?

The State is an open plughole for taxpayers money

[richard51]

We will have to beg to disagree.

Just answering one point in your post regarding the coal industry - history has confirmed that Scargill was right that the tories were determined to close down the coal industry even though it was viable.

Your other examples can likewise be argued from the other angle.

Agreed that union leaders are paid too much - but certainly a magnitude or more less than private industry managers.

NB - I really do find it quite amazing that some people can be so good as to become massive established company CEOs at the age of 30 or less.

[woolybanana]

as regards very young CEOs, they are often young entrepreneurs who take a chance and often fail but sometimes make companies that employ thousands eg Dyson.

[DraytonBoy]

More public spending is needed for essential services in the UK, whilst budgets have been increased in line with inflation no account has been made of the leap in the population.

Bringing back the railways etc into public ownership on the other hand is mad and will not lead to an instant improvement.

[richard51]

Not relevant to the UK, but as an example, Wooly, did Mr Trump Jnr get to CEO by his own brilliance?? Please don't say yes.

[woolybanana]

No idea, Richard, no doubt daddy pushed him there. But there is no way your politics will change that. There are some sharks in every ocean.

The CEOs I know of are young, dedicated and very talented, trying to get innovation off the ground from zero. As a non UK example, look at Steve Jobs.