2 more NHS hospitals already considering private ownership

The SKWAWKBOX blog last month covered the betrayal of the country by LibDem peers who voted through the government’s ‘section 75‘ measures designed to parcel up the NHS for privatisation by forcing Clinical Commissioning Groups (CCGs) to put all NHS services out to tender and include private bidders.

This process was foreshadowed, by a few weeks, by the decision by the supposedly ‘independent’ team appointed to review the decision to break up Mid Staffs NHS services in spite of massive opposition from the local people. These ‘independent’ reviewers (who were the same people who made the original decision!) have put out an invitation to private providers to express their interest in taking over the broken-up services.

But this is not the only ‘example in microcosm’ of the government’s vision of how health services should look in the all-too-imminent future.

There has been very little coverage of this in the mainstream media, so you may not be aware of it, but (at least) two NHS hospitals are already considering what amounts to handing themselves over to private ownership in response to the war of financial attrition and ‘marketisation’ to which they are being subjected.

Weston

Weston Area Health NHS Trust has announced that, as a small DGH (district general hospital), it is unable to achieve the Foundation Trust status that the Health and Social Care Act 2012 (HSCA) mandates that all NHS acute (hospital) Trusts must achieve by April next year. As a result, it is inviting ’expressions of interest’ from the ‘health market’:

Midlands and East Strategic Projects Team (SPT) on behalf of NHS South, the NHS Trust Development Authority and Weston Area Hospital NHS Trust, is sounding the market providers for expressions of interest to engage in a competitive tendering process to find a partner organisation to deliver its requirements by either i) an acquisition by another NHS Acute Trust, Foundation Trust or other NHS Health Body; or (ii) an operating franchise.
..
NHS South commissioners and Weston Hospital NHS Trust agreed that a market procurement solution should be sought for Weston Area Health NHS Trust.

In other words, the hospital is offering private providers a ‘franchise’ to use its name and its NHS ‘brand’ to provide services for profit – perhaps by buying another hospital to run alongside it. The hospital board insists that

the Trust must and will continue to provide NHS services for NHS patients, and that whatever option is finally selected, all staff and assets will remain within the NHS

But if it walks like a private franchise.. you know how it goes. This measure merely illustrates the innate deception in the government’s plans (already well underway) to allow private providers to ‘badge’ themselves as NHS institutions, even while they are taking profits that could be spent in providing front-line services.

George Eliot

The George Eliot Hospital (GEH) NHS Trust’s website carries the following statement, under a headline of “Trust given green light for future plans“:

The Trust has announced they are moving forward with their plans to seek a strategic partner to secure a sustainable future for its services and the care it provides to local people after receiving agreement to proceed.

George Eliot’s Board has agreed that it is in the best interests of the hospital, its patients and staff to seek a partner via a competitive procurement process.  This enables both NHS and non-NHS healthcare providers to make proposals and for the Trust to ensure that it can choose the best solution to achieve clinical and financial sustainability.

The phrasing here, by including ‘both NHS and non-NHS‘, is extremely deceptive. All NHS Trusts are under severe financial pressures at the moment, especially because the Treasury routinely ‘claws back’ any financial surplus from those Trusts who manage to balance their books. In this context, it is extremely unlikely that any other NHS Trust is going to express any interest.

This means that GEH is the latest in what is likely to become an extremely long list of NHS hospitals and under services coming up for grabs by private health operators.

Does it work?

A key question in all of this is, ‘Does it work?’. Are ‘franchising’ or other forms of privatisation likely to resolve financial problems and lead to better, more secure health services for patients?

There is one case study that we can already refer to: Hinchinbrooke. This hospital was handed over to private health company Circle from late 2011 into early 2012, amid much fanfare about how a private operator would run the hospital more efficiently than the ‘bureaucracy-ridden’ NHS.

However, in November last year the National Audit Office (NAO) published its audit report of the hospital and raised serious concerns:

Circle plans to achieve £311 million in projected savings over the ten-year life of the franchise, which is unprecedented as a percentage of annual turnover in the NHS..on an annual income of around £73 million

£311 million over 10 years means an average saving of £31.1 million per year – compared to a previous annual income of £73m – so around 43% of the Hinchingbrooke’s annual income before its privatisation. Even compared to the enhanced income of £107m that was granted to Circle to take over the hospital, the cuts targeted by Circle represent 29%.

Under no circumstances can cuts of 29-43% be made without adverse impact on services and on the patients who rely on them.

The NAO calls these savings ‘unprecedented’. They also appear to be unachievable. According to the NAO

the Trust had generated an in-year deficit of £4.1 million by September 2012, which was £2.2 million higher than planned

So, according to the NAO, Circle promised an ‘unprecedented’ level of cuts – and has been unable to deliver them. If it succeeds in its plan, the people who depend on Hinchingbrooke face massive reductions in their services – and if it fails, a hospital has been handed over to a private company for supposed ‘inefficiency’ and financial failings – for it to then fail to deliver promised efficiencies.

This is just common sense (though apparently not that common). If a non-profit company needs a certain level of funding to deliver services, a company that needs to take out money to deliver profits to shareholders is not realistically going to be able to deliver the same services at lower costs – even if it was true that private companies are more efficient, which last years G4S Olympic security debacle showed to be anything but the case.

When the government is obviously bent on a drastic increase in NHS privatisation, this can only be bad news for patients – and for their local economies, as less money will circulate into them via wages etc as private companies look to maximise profits in every possible way.

The plans mooted by the boards of these two hospitals are not directly linked to the recent ‘secondary legislation’ forced through under section 75 of the HSCA, but they do give a glimpse into the inexorable direction of travel that has been initiated in the NHS by the government’s Tory component, aided and abetted by large elements of the LibDems in the Commons and the Lords.

This constant and accelerating movement toward ever-increasing privatisation that will be difficult and expensive, if not impossible, to reverse by the next government, shows clearly how essential it is to carry the fight to the government and its agencies such as Monitor. The NHS Constitution is one of the last remaining – and perhaps most difficult for the government to remove – repositories of rights for ordinary people to insist on a truly national, truly public NHS.

CCGWatch has been set up to enable local communities to harness those rights to defend the NHS, and to prevent many more Hinchingbrookes, Westons and GEHs. If you are able to do so, please use the PayPal link on the right of this page to make a one-off or regular donation to help make it possible to conduct this fight in as many areas as need it.

Urgent: Mid Staffs NHS administrators pushing privatisation

On Saturday, over 50,000 people marched through Stafford in support of their local hospital, which has been put into administration by regulator Monitor on behalf of the Department of Health. As the SKWAWKBOX blog pointed out, the ‘independent’ administrators appointed by the government to review the provisional decisions made by the original CPT team are none other than… the same original team.

As a commenter on the SKWAWKBOX blog pointed out, the speeches given by those addressing the marchers on Saturday were impassioned and plain-spoken – in stark contrast to the twisted, opaque statements made by the so-called ‘independent’ administrators about their plans. Here is an excerpt from the speech made by Support Stafford Hospital campaigner Cheryl Porter:

Nye Bevan said ‘The NHS will last as long as there are folks left to fight for it!’ 
Well I can see that there are many people willing to stand up and fight for the best national health service in the world! This is just the beginning of the fight, not only for our hospital but for lots of hospitals throughout Britain.

I have been privileged to meet some truly wonderful, dedicated people recently and they haven’t had a voice! Today I hope we have given them a voice.

We all need to shout loud, be proud and let the GP’s. the administrators and the government know that we want OUR hospital.
Please, Please….. please
I ask each and everyone of you to ask your GP whether they are in favour of closing services at Stafford, I want you to write to the administrators and tell them,……tell them we want A&E,
Tell them we want critical care….
Tell them we want paediatrics…..
Tell them we want ICU….
Tell them we demand Maternity…..
Tell them we want our hospital!

Now, compare that with this, from the ‘independent’ administrators’ website:

The TSAs will also be undertaking a market engagement exercise to understand the appetite of other healthcare providers to deliver services in the local community. This engagement forms part of the TSAs’ work to develop potential solutions to ensure the sustainability of services and it will contribute to the development of the recommendations in the draft report which will form the basis of the formal consultation.

Convoluted, detached, opaque – and as serious as a heart attack if, like those 50,000+ marchers, you care about real NHS services in Stafford or anywhere else. The ‘market engagement exercise to understand the appetite of other healthcare providers to deliver services in the local community’ – if put as plainly as the language used by the speakers on Saturday afternoon – would read something like this:

We want to privatise Stafford’s services, and we are going to talk to any and all private providers to see who fancies a piece of the pie.

The people of Stafford have said loudly and clearly what they want – they want to keep their NHS hospital, which is now among the best in England. But the government, for all its talk of ‘choice’ and ‘localism’, has no intention of missing the opportunity it sees, not only to close Stafford hospital and farm services out to private companies, but to set a precedent that it can apply to other hospitals as well – and it has targeted 36% of England’s hospitals just for the first phase.

The people of Stafford deserve to keep their hospital, in spite of the ‘smear-job’ that has been done on it by the media and by government. But they’re going to have to continue fighting if they’re going to do so.

The NHS Constitution gives every single person in and around Stafford the legal right not only to be ‘consulted’ about which of a pre-decided list of options they have to put up with, but

to be involved, directly or through representatives, in the planning of healthcare services, the development and consideration of proposals for changes in the way those services are provided, and in decisions to be made affecting the operation of those services.

These legal rights are not being respected by the government’s ‘hatchet men’, the Trust Special Administrators. CCGWatch urges the people of Stafford to engage legal assistance and demand their right – the right to be right at the heart of the deliberations and decision-making. Not just one or two representatives that might be railroaded by the ‘hit squad’, but an overwhelming presence.

Every person who relies on Stafford hospital has that legal right individually. If the TSAs do not acquiesce, they could quite conceivably be tied up in legal wrangling while the hospital remains open until the country has a chance to change its government, if each person insists on their right to participate – the rights of the Constitution apply to patients and public alike.

Given the high-profile, career-making nature of the case, it might be possible to find barristers who would represent the townspeople free of charge. If not, then the people of Stafford are going to need funds urgently for the fight.

Just as CCGWatch urges the people of Stafford to ‘fight the good fight’ for all our sakes, we urge every person who reads this to contact Support Stafford Hospital to offer a donation to create a fighting fund – not just for the sake of Staffordians, but for your own self-interest. If the government gets away with its plan to pull apart Stafford hospital and throw the pieces to its private health supporters, your own local hospital is likely to be on the list sooner rather than later.

(And, if you can afford to do so, please consider using the Paypal link on the right of the screen to make a small one-off or repeat donation to CCGWatch for the wider fight to preserve the NHS).

Thank you.