The Evidence Against Commercialisation
The privatisation and commercialisation of the NHS has already started to divide the service, waste precious public money and undermine safety.
It is against this backdrop that the White Paper plans become so potentially destructive. While there may indeed be one or two benign proposals in the government's plans, as long as the NHS continues to be a divided marketplace, the reorganisation outlined in the White Paper will only make the service more fragmented, less comprehensive and less fair.
Markets don't necessarily produce excellent services. What they do is produce relative levels of service dependent on local economies. So you may be able to find excellence in affluent areas, but you'll only find cut-price basics (or no service) in less affluent areas. Which is perhaps acceptable if you're shopping for baked beans, but not if you need life-saving heart surgery.
More than half the larger PFI hospitals are in financial trouble
There are 149 PFI hospitals in Britain and according to
research by Professor Allyson Pollock over half are in financial difficulties - compared with a quarter of non-PFI hospitals. PFI currently costs 8.3% of a hospital's budget, compared to 5.8% for conventionally-built hospitals - that's
40% higher. The NHS will ultimately play
£70bn for PFI hospitals valued at £12bn - nearly
six times their building cost. PFI does not offer value for money and it's continued use will only create more huge debts that will threaten the future of the NHS.
Private clinics have been paid millions for doing nothing
Pollock also estimates that
£927m - almost two thirds - of the £1.5bn spent on private centre contracts in England could have been paid out for operations that did not take place. Recent figures from a centre run by Care UK in Nottingham support her findings. Over the last five years, almost £10m was paid to the
Barlborough Treatment Centre, but only £4m worth of procedures have been carried out.
Private treatment centres have been paid above the odds
The Department of Health has also admitted that across the first 20 private treatment centres the cost of procedures was
12% more expensive than the same work in the NHS. Health industry website Pulse has reported that the cost of privately-run GP-led health centres are averaging as much as
seven times more per patient than standard NHS centres.
Fees for external consultants have tripled since 2007
The burden of creating and maintaining an internal market has let to spending on management consultants more than tripling since 2007. An investigation by
Pulse revealed that each PCT is now spending an average of
£1.2m on external companies - primarily on 'business advice'. The cost of legal and professional fees has also risen dramatically.
The weight of opinion is against NHS market reforms
Commercialisation of the NHS may have taken place by stealth, but the public are at least aware of the burdens that the internal market is creating. According to a YouGov poll in March,
63% of the public feels that the money wasted on target-setting is
the biggest problem the NHS faces. This follows another YouGov poll in 2008 which revealed that
73% disagreed with more competition in the NHS. Last December a survey on behalf of the BMA and Doctors.net.uk, showed that
80% of doctors were also concerned about large multinational companies making profits out of NHS services. And the BMA, along with UNISON and UNITE, have formed a coalition of
major health unions in opposition to NHS commercialisation.
