The view from the ‘burning platform’ - Medicine Balls, Private Eye Issue 1439 10th March 2017
- Published: Monday, 13 March 2017 12:08
- Written by Una
ACCORDING to Professor Sir Mike Richards, chief inspector of hospitals, the NHS stands on a “burning platform” with 11 percent of trusts rated inadequate by the Care Quality Commission (CQC) and 70 percent requiring improvement. Understaffing and overcrowding put patients and staff at risk every day.
Meanwhile, private providers lead by Virgin Care are busy “conquering the community care space”, says HealthInvestor magazine. “A market worth around £10bn has suddenly become a private affair.” Virgin has already hoovered up more than 400 health, social care and local authority services’ contracts, worth more than £1bn. It’s “quite the portfolio”, according to HealthInvestor, and other companies are lining up to conquer what’s left. “The chance to drink in a £9bn pool is tantalising.”
There is a clear underfunding and privatising trend in NHS and local authority services. Between April 2013 and April 2016, 45 percent of the community health services that were put out to tender went to non-NHS providers. Private operators now run the following:
- GP and out-of-hours services
- Walk-in centres and minor injury units
- District nursing
- Diabetes, musculoskeletal, audiology, dermatology, physiotherapy, podiatry, rheumatology, mental health and other chronic disease services
- Not to mention urgent care, phlebotomy, anti-coagulation, sexual health, wheelchair services, prison healthcare, community hospitals, neuro-rehabilitation, frail and elderly care, health visiting, services for children with complex mental, physical and sensory learning difficulties, social care for adults and children, and end-of-life care.
The whole range of community healthcare has now been privatised while Theresa May and Jeremy Hunt – and Tony Blair and Alan Milburn before them – have the gall to repeat the lie that the NHS is not for sale. The NHS has outsourced its very essence – much of the complex, difficult care that requires close collaboration and team working has been contracted out. Virgin argues that such care was fragmented when the NHS offered it and that it has a much better chance of joining it up under one organisation. The more it hoovers up, the more it can join up.
Former health secretary Andrew Lansley’s Health and Social Care Act has allowed companies like Virgin to aggressively tender for any service they want, and to legally challenge the award of any contract that doesn’t allow them to make a pitch. That pitch is deceptively simple. “Our aim is to make a real difference to people’s lives by offering NHS and social care services that are better than what went before, a great experience for everyone and better value for the public and the NHS.”
When the NHS pitches for services it tends to be far more downbeat, citing the reality of trying to keep an underfunded, understaffed service afloat in the face of rising public demand and expectation. It’s easy to see how the clinical commissioning groups and local authorities who award the contracts fall for the optimistic swagger of Virgin. The company generally employs the NHS staff who were providing the services previously, and gives them smart phones, colour printers and other gadgets you have to fight for in the NHS. It claims that 93 percent of customers recommend its services to friends and family. If it can provide better services than the NHS for the same cost or less, then why not?
NHS commissioners are often naïve (remember PFI?), and get turned over in contracts, which companies stick to aggressively. “If it’s not in the contract, we’re not doing it” rarely equates with universal healthcare. Yet despite some tough negotiating, Virgin Care has yet to make a profit in seven years doing business. In the year ending 31 March 2015, turnover was reported as £40.38m leading to a gross profit of £5.2m, but with administrative expenses of more than £20m, the company made a loss of £9.1m. When will shareholders start demanding it balances the books and cuts back on smart phones?
Virgin recently lost its community services contract for children in Surrey. As a whistleblower told the Eye: “Virgin Care are now concentrating on recouping as much money as possible […] threatening removal of laptops and mobile phones with little thought for safe transfer of care. They have been restricting information sharing with the new provider and talking about intellectual property rights. Many staff are feeling anxious about being able to carry on with ‘business as usual’ on 1 April.” Meanwhile, the government is launching 10-year multi-specialty community provider contracts to take the pressure off hospitals. “It’s another lucrative opportunity for the private sector,” says HealthInvestor.
PS - from the same Private Eye issue: "Sorry is the hardest word... PwC Oscars"
Best milking of the taxpayer award:
PwC has been the most active of all financial advisers on private finance initiative schemes, including some of the most ruinously expensive. It advised Barts NHS trust (which runs St Bartholomew and the Royal London hospitals) in signing up to a £1bn deal that now costs the hospital £120m a year as it runs up annual deficits of a similar amount based on flawed value-for-money calculations. The trust’s chairman at the time said: “This is what got Enron into trouble. It’s all off the balance sheet. It’s cloud cuckoo land, Alice in Wonderland stuff.” Asked by MPs a few years ago if he would reveal how much his firm had made on its hundreds of contracts, the firm’s PFI supremo Richard Abadie replied: “Probably not. I believe that is commercially confidential.”