2021-09-18 19:15

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Can We Expect Labour To Oppose The Americanisation And Privatisation Of The NHS?

As previously reported by Unionsafety, supported by the evidence from the media, healthcare pressure groups, the BMA, BMJ, HSJ, Tory and Labour MPs, NHS England and Government policy papers; the NHS is already splitting up into 42 Americanised Integrated Care Systems that currently have no legal standing and is contrary to the universal and national service of healthcare that the NHS constitution is based upon.

This will vanish following the introduction of the NHS Bill; it’s passing into law by April 2022 and the abolition of the existing NHS Constitution, along with the handing over of healthcare in England to a locally controlled ICS and administered by the private sector with no accountability to patients.

But to date, little in rejection of these plans has been uttered by the Labour Party opposition in Parliament, and what little has been said does not attack the basic principle that the NHS is being privatised.

The usual bland Blair-coined statement that the NHS should be ‘publically funded and free at the point of delivery‘ is once again repeated, but what does it actually say about Labour’s NHS policy in opposing the Tory Integrated Care Systems? Absolutely zilch!

In fact using it as a statement opposing changes to the NHS, is merely joining in on the Tory ‘Smoke and Mirrors’ claims that the NHS is not being privatised.

The attitude from many politicians on the opposition benches seems to mirror those of the Tory government – that the public don’t care who provides healthcare; as long as it is free!

Of course healthcare provided by the NHS is NOT free because our taxes in the form of National Insurance Contributions and Income Tax, goes towards paying for it.

Whilst Labour leadership has failed to get into the nitty gritty of just what the Tory plans are, they know that the Government itself is not telling the truth!

It is clear that many Labour MPs and Andy Burnham, a previous Shadow Health Secretary support the idea of integrated care.

The Lowdown website reports that the notes published by the House of Commons Library in advance of the Speech anticipated legislation along the lines of the White Paper, including proposals previously set out by NHS England:

  • “To establish Integrated Care Systems as statutory bodies and other measures to support integration of health and care
  • “To formally merge NHS England and NHS Improvement
  • “Changes to procurement and competition rules relating to health services,”

In addition to giving additional powers for the Secretary of State “including powers over NHS England, Arm’s Length Bodies and health service reconfigurations, and powers to create new Trusts.”

The Queen’s Speech Briefing Notes give little in  the way of detail, other than to providing a breathe glimpse into the main elements of the Bill as being along these lines:

  • “Driving integration of health and care through the delivery of an Integrated Care System in every part of the country.
  • “Ensuring NHS England, in a new combined form, is accountable to Government, Parliament and taxpayers while maintaining the NHS’s clinical and day-to-day operational independence.
  • “Banning junk food adverts pre-9pm watershed on TV and a total ban online.
  • “Putting the Healthcare Safety Investigation Branch on a statutory footing to deliver a fully independent national body to investigate healthcare incidents, with the right powers to investigate the most serious patient safety risks to support system learning.”

A deliberately (but denied) leaked document version of the entitled, ‘Department of Health and Social Care's legislative proposals for a Health and Care Bill, made no mention of the falsely reported and headlined BBC, Sky and ITV news outlets claims that Section 75 of the 2012 Health and Social Care Act which effectively required Clinical Commissioning Groups to carve up an ever-increasing range of services into contracts and put them out to tender, inviting private as well as NHS providers.

The reality, as always, of Tory Government policy announcements is that do exactly the opposite of what they publically claim they intend to do. In the case of the transformation (or rather abolition) of the NHS, the private sector is embedded in not only service provision but in the administration and decision making of exactly which healthcare services will be provided within a geographic and independent care system; but within the ICS board itself.

Again the reality is that billions of pounds of profit to the private sector has been created by the Government, as it granted public funding from the NHS budgets to private sector healthcare, manufacturing, and data collection and storage companies and providers.

The Lowdown news article continues:

The Covid pandemic has been used to increase dramatically the profits of these private organisations and providers.
Missing completely from this bland summary is the much-vaunted proposal from NHS England, echoed in the White Paper, to scrap the controversial, and the associated regulations

This reading of the proposals was especially inappropriate after a year of pandemic measures had massively increased the level and proportion of health spending on private providers – with billions spent on privatised test and trace, huge sums spent on private management consultants, and billions more on the use of private hospitals to treat NHS patients, with plans to continue and increase this over the next four years at a cost of up to £10 billion.

Focusing on the tiny percentage of contracts subjected to competitive tender is also a misleading way of assessing the level of outsourcing of NHS services to private providers, since the bulk of this is now done through ‘framework contracts’ established by NHS England that list a range of pre-approved private and other providers, from which CCGs and trusts can choose without any competitive process.

And more recently NHS England itself is now promoting the idea of handing new contracts to run imaging networks in each Integrated Care System to commercial companies as one of two possible ways forward.

But if the Bill, now expected to be published next month and debated into the autumn, turns out to be as vacuous as the Speech and Briefing Notes suggest, then much of the debate over this aspect of the White Paper will turn out to have been misdirected.

However in preparation for the likelihood of the Bill being based more substantially on the White Paper, and given the Johnson government’s 80-strong majority, campaigners wanting to fight any of its damaging proposals will need to focus on issues and demands for amendments that might win broad enough popular support to split some Tory MPs and secure amendments.

Shadow Health Secretary Jonathan Ashworth MP told The Lowdown:

“We need to see what is included in the Bill. We obviously want to see genuine integrated, coordinated care for the patient, but that must be delivered by well-funded, publicly-provided, properly qualified primary care, working in partnership with community and secondary care.

“What is being proposed in the White Paper is a new confusing bureaucracy, with opaque decision making and little accountability to the public, allowing contracts to be handed out to private interests with no challenge. We’ve already seen what that means with a string of GP practices disgracefully handed to a US health insurance company. Labour will not be supporting anything that allows this or any other extension of private provision of the NHS.

“Moreover with waiting lists at record levels risking a middle class flight to the private sector the response must surely be a properly funded and staffed NHS with decent pay and conditions, not imposing financial straightjackets that can only lead to more rationing locally.

“Labour will be fighting in Parliament and the across the country for a publicly provided, fully funded comprehensive NHS.”
Demands for amendments which might draw wide support include:

  • Barring the new statutory Integrated Care Systems from including any private sector representatives on their Boards.  Instead independently appointed or elected representatives of public, patients and trade unions should have a place on every Board.
  • Requiring all ICS Boards to meet in public, offer online access, publish their minutes and Board papers and be subject to the Freedom of Information Act.
  • A clear and statutory requirement for accountability and scrutiny by local government at the most local “place” level within each ICS.
  • Maintaining the right of local authorities to refer controversial changes to the Secretary of State, and the Independent Reconfiguration Panel, which must be made more representative, not abolished.
  • Establishing NHS as the default provider when existing contracts expire. ICSs must be required to consult publicly before awarding a contract for any existing services to a private provider.
  • Requiring any ICS to publish fully without any claim to commercial confidentiality all proposals for contracts, the contracts themselves and the outcomes of regular contract monitoring.
  • No private provider should be approved for any NHS contract who does not pay staff at least the equivalent of NHS terms and conditions

Further news items regarding the abolition of the NHS appear on this website and can be found in the NHS Privatisation News Archive here

Source: The Lowdown / unionsafety

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