PROTESTORS took the steps of Leamington Town Hall to demonstrate against government’s Test and Trace contract.
Supporters of South Warwickshire Keep our NHS Public (SWKONP) called on government to cancel its contract with Serco for running its contact tracing call centres.
The campaigners, who gathered on Tuesday (April 27) are calling for contact tracing to be run locally and given to Public Health Warwickshire instead of private companies.
SWKONP secretary Anna Pollert said: “Government renewed Serco’s contract last October, despite the public outcry at its poor performance.
“It has failed us in this pandemic. The government’s Scientific Advisory Group for Emergencies (SAGE) said 80 per cent of an infected person’s close contacts must be contacted and told to self-isolate within 48 to 72 hours. But Serco has consistently failed to reach this target.
“It’s great the vaccine programme is successful, but Covid is still here and with potentially resistant variants we need an effective testing, contact tracing and quarantine system. To be successful, contact tracing should be decentralised and run locally, with community knowledge, trust and support for those who are asked to self-isolate.
“We’re demanding government does not repeat its mistake and renew Serco’s contract.”
Supporters of South Warwickshire Keep our NHS Public want the Government to scrap its contract with outsourcing firm Serco for running its contact tracing call centres
Supporters of South Warwickshire Keep our NHS Public (SWKNOP) demonstrated outside Leamington Town Hall yesterday (Tuesday April 27) about Test and Trace.
Supporters of South Warwickshire Keep our NHS Public (SWKNOP) demonstrated outside Leamington Town Hall yesterday (Tuesday April 27) about Test and Trace.
The group gathered with placards in the morning.
Anna Pollert, SWKONP secretary, said: ‘We are here to tell the government to scrap its contract with Serco for running its contact tracing call centres.
“The government is obsessed with outsourcing lucrative contracts to private companies and sidelining public health and the NHS.
“It’s great that the vaccine programme is successful, but Covid is still here and with potentially resistant variants we need an effective testing, contact tracing and quarantine system.
“To be successful, contact tracing should be decentralised and run locally, with community knowledge, trust and support for those who are asked to self-isolate. The last thing it needs is remote call centres and corner-cutting companies.
Carolyn Pickering, another SWKONP member, added: “Test and trace has been proven in countries with a properly functioning system to be a successful strategy to manage and contain COVID. Numerous experts have repeated that, to be effective, testing and tracing needs to be managed and carried out at a local level
“However, instead of funding local bodies, which have the expertise, experience and vital local connections, this Government has squandered billions of pounds of public money on private companies dishonestly named ‘NHS Test & Trace’.
“In startling contrast, we have seen that the remarkable success of the vaccination programme is due to its being handled by a national public service but at local levels – namely the real NHS, providing vaccination at a local clinic which everyone can reach.
“Leamington people can be vaccinated in Leamington, instead of having to drive to Coventry to be tested.
Rupert Soames, Serco’s chief executive, has defended the scheme.
He told the BBC’s Today programme: “It [test-and-trace] is now a remarkable success and I acknowledge it has taken quite some time to get there.”
CLAIMS have been made some 150 staff are being forced to leave the NHS and work for South Warwickshire Foundation Trust’s private subsidiary company.
The public service union Unison says IT staff at South Warwickshire Foundation Trust (SWFT) and George Eliot Hospital – which both belong to the same foundation group led by chief executive Glen Burley – have been told they must accept the new contracts or could lose their jobs.
The union claims moving employees to SWFT’s wholly owned subsidiary – which was set up to sell IT services to other NHS organisations – amounts to backdoor privatisation.
West Midlands regional spokesman Mike Wilson said: “The employers have claimed that these dedicated IT staff lack commitment to the health service, but it’s simply not true.
“These workers are just as passionate about the NHS as any member of the frontline clinical staff. They are proud to be playing their part working for the health service and want to stay.
“The creation of companies like this is simply backdoor privatisation. The pandemic has shown how much the public cherish the NHS and all the staff who to deliver its services. The last thing they want to see is for the health service to be broken up.
“Employers must rethink these plans and respect the staff’s wishes to remain as NHS employees.”
SWFT chief executive Glen Burley said: “Non-clinical functions including IT play very important roles in supporting the delivery of NHS services, and these teams show great commitment and dedication.
“George Eliot Hospital NHS Trust and South Warwickshire NHS Foundation Trust, who are a part of a Foundation Group, wanted to bring these functions together to work collaboratively. One of the options that was looked into and subsequently approved was to bring the teams together through South Warwickshire NHS Foundation Trust’s wholly owned subsidiary company.
“As a Foundation Trust, we have the ability to set up wholly owned subsidiaries. These are organisations that NHS providers can legally adopt to manage part of their organisation and it helps us protect essential services from other future efficiency saving options – such as potential outsourcing to private contractors. IT services will remain ‘wholly owned’ by the trust and therefore be part of the NHS family. The company already manages a range of non-clinical estates and facilities services while generating profits to re-invest back into our local NHS.
“Both trusts recognise how important these teams are to the organisations and therefore the key reason for bringing them together under a wholly owned subsidiary is to enable us to take advantage of opportunities that would not be possible otherwise. It will enable us to invest in our teams and infrastructure and we will also look at growing the workforce to offer services to other public sector organisations and creating new income streams, all of which would be re-invested back in to the NHS.
“As a subsidiary company staff play a big part in shaping the future of the company and its services. All staff will be transferred on their existing terms and conditions.
‘This could lead to backdoor NHS privatisation’ – councillor raises concerns after claims that IT staff at Warwick Hospital have been ‘forced to leave the NHS against their will’
The hospital trust denies the claims and says the move has had the backing of staff and the management
A former employee of South Warwickshire NHS Foundation Trust (SWFT) who is now a Warwick town councillor has raised concerns about the trust ‘forcing staff at Warwick Hospital to leave working for the health service against their will’.
Cllr Noel Butler (Con, Aylesford) says that by 100 IT staff members being moved under transfer of undertakings protection of employment (TUPE) , SWFT is being unfair to those staff who have ‘proudly and loyally’ worked for the health service for years and could lead to ‘privatisation of part of the NHS by the backdoor’.
Cllr Butler said: “SWFT has set up a wholly owned subsidiary called ‘Innovate’ and intend to TUPE all the IT staff at SWFT (and George Elliot Hospital in Nuneaton) to it.
“The staff are in the IT, digital transformation and IG areas which support all the technology in the trust.
“This would have the effect that the staff would no longer work for the NHS.
“Innovate had been set up during the pandemic with SWFT personnel as directors and before any consultation with the staff concerned started.
“It would appear from this that the consultation was prejudged and was only going to have one outcome.
“In their response to the consultation, staff were almost unanimous that they didn’t want to leave the NHS but have now been sent a letter saying if they don’t sign new contacts with Innovate, they will have no job.
“Some of these staff have over 30 years’ service in the NHS and a number have been working for it for over half its existence.
“It is a dreadful way to treat such loyalty.
“They take great pride in working for the NHS and want to stay working for it.
Cllr Butler said he believes the move is being done for ‘tax purposes’.
He added: “Senior management at the trust have been quoted as saying that ‘IT staff don’t consider themselves part of the NHS’.
“As someone who worked in IT at Warwick Hospital for more than ten years this is simply not true.
I was extremely proud to work for the NHS as were my colleagues, many of whom are still working there.
“If senior management really believe this, then they are completely out of touch with their staff.
“I have a major concern that as a subsidiary, not part of the NHS, Innovate could be sold off and the scheme could the start of a journey that will lead to privatisation of part of the NHS by the backdoor.
“Just as important is the impact it could have on the quality of IT support to the trust.
“As I mentioned earlier this company will support all the technology in the trust and it could finish up being run by a profit-making company which has to answer to shareholders for the profits and dividends it generates.
“We have seen many times in recent years where this scenario ends up with poor quality service as costs are cut to improve profitability.
“You have to ask yourself why all this is being done with no publicity. I believe it is because if the general public got to know what is happening to the staff, they would oppose it on both counts i.e. dreadful treatment of loyal staff and the privatisation of part of the NHS.
“Considering what NHS staff have gone through over the past year this scheme is extremely insensitive to their feelings and in the longer term if the subsidiary was sold could lead to poor support for IT at the trust.
“As a local councillor I am concerned about this direction of travel and feel the scheme should come into the public domain and receive proper scrutiny.
In response, a spokeswoman for SWFT said the Trust denies the claims and that the move has had the backing of staff and the board.
They added: “At SWFT we are lucky to be in a position to work with our neighbour and fellow foundation group member, George Eliot Hospital NHS Trust.
“This close relationship helps us to overcome similar challenges and achieve a shared vision.
“Working together enables us to bring a range of skills together, share best practice and strengthen and develop our services.
“Non-clinical functions including ICT, play very important roles in supporting the delivery of NHS services so both trusts wanted to bring these functions together to work collaboratively.
“One of the options that was scoped and subsequently approved was to bring the teams together through the Trust’s wholly owned subsidiary company.
“As a Foundation Trust we have a wholly owned subsidiary company which manages a range of non-clinical estates and facilities services. SWFT Clinical Services Ltd enables us to deliver essential services in a flexible approach, whilst generating profits to re-invest back into our local NHS.
“The Trust is the parent company so this model provides protection from external providers and keeps staff within the NHS family.
“Before this process started, SWFT set up another subsidiary to explore options for providing more services externally, it was never specifically intended for ICT services.
“Staff engagement was a key element to this proposal and a series sessions to gather their feedback took place at the beginning of the process.
“Staff views were reflected in the proposals that were shared with both boards. The board approved the decision to transfer ICT teams to a wholly owned subsidiary, which staff voted to name the company Innovate Healthcare Services.
“Both Trust’s recognise how important these teams are to the organisations and therefore the key reason for bringing them together under a wholly owned subsidiary is to enable us to take advantage of opportunities that would not be possible otherwise.
“Staff engagement was a key element to this proposal and a series sessions to gather their feedback took place at the beginning of the process.
“Staff views were reflected in the proposals that were shared with both boards. The board approved the decision to transfer ICT teams to a wholly owned subsidiary, which staff voted to name the company Innovate Healthcare Services.
“Both Trust’s recognise how important these teams are to the organisations and therefore the key reason for bringing them together under a wholly owned subsidiary is to enable us to take advantage of opportunities that would not be possible otherwise.
A judicial inquiry will take years, but memories are already being collected
Michael Mansfield Thursday April 15 2021, 12.01am, The Times
There has been an increasing demand over the past 50 years by different communities throughout the world for a way to challenge the shortcomings of government and corporate bodies — especially where clear moral and legal obligations have been shirked in relation to systemic deficiencies.
This need has been met by voluntary inquiries variously described as citizen’s or people’s tribunals or commissions of inquiry. They perform a vital role where there is a significant democratic deficit.
And that is precisely the situation with the Johnson government in relation to its handling of the coronavirus pandemic — absent effective scrutiny in parliament or accountability through the courts. There is a consensus favouring a public inquiry to learn lessons and address the health emergency and to circumvent another.
This was readily picked up by the prime minister in July, followed by a studious silence until he was recently reminded. But nothing has been done, no timeline has been mooted — worse still, it has been booted into the long grass.
The fundamental problem facing a judge-led inquiry is logistical. It would involve an enormous amount of time and resources to establish, and even if Johnson were to announce its initiation tomorrow it would take at least a year, probably more, to determine the terms of reference, gather the research, the witnesses, the documentation, the High Court judge and panel, the venue and so on. All that before a word of evidence is heard.
Nevertheless, it has a crucial place in the annals of public health and is a categorical imperative for the longer term. However, a fast-track rapid response version is long overdue.
While memories are fresh and dilemmas arise on every front, they need to be addressed urgently and, most of all, independently, by evidence adduced from those with experience, expertise and commitment to public health.
In the forefront are the bereaved. The UK has one of the worst death rates in the world. How has this come about and how can it be redressed? What’s next?
These issues are being canvassed by the People’s Covid Inquiry. There have been four hearings and six more are to come.
Despite the restrictions, the semblance of an inquiry format has been achieved. Impressive and moving testimony has been presented by inquiry counsel to a prominent expert panel of adjudicators.
The next session on April 21 concerns the effect on frontline staff and key workers.
Michael Mansfield, QC, is the chairman of the People’s Covid Inquiry
Guy’s and St Thomas’ and King’s College Hospital pay Serco £15m to leave pathology partnership
Sum disclosed after “challenge” to £2.25bn tender process received
Two trusts have paid an outsourcing firm £15m to leave the joint venture which has provided their pathology services over the last 10 years, HSJ can reveal.
Guy’s and St Thomas’ and King’s College Hospitals foundation trusts have made a payment of £15m to Serco for it to leave the Viapath pathology partnership, Serco’s annual accounts disclose. Viapath was created in 2009, as a joint venture between GSTT and Serco, before KCH also joined the partnership.
But last year, the trusts oversaw a re-tendering process to award a £2.2bn contract to provide pathology services right across south east London for the next 15 years, in which a bid from German based company, Synlab, was preferred to that of Viapath.
Last summer, KCH confirmed there was an “ongoing challenge to the tender process” that would lead to “potential costs”.
Serco’s annual accounts now reveal it received £15m to exit the partnership, which comprised “£11m for its share in the net assets of the joint venture”, plus recovery of “a loan into the joint venture of £1.2m and £2.9m of profit share which was previously considered to be irrecoverable”.
Sources close to the deal told HSJ the sum reflected the cost of an IT system Serco had invested in on behalf of Viapath, although the annual accounts make no mention of this.
One source suggested the contract was badly drawn up at the start of the partnership, adding: “Any well written contract would have exit provisions which would have prevented the commercial partner holding the NHS to ransom at the end of the contract.”
Serco was approached for comment.
Ahead of the re-tendering process that saw Viapath lose the contract, the company appointed former Monitor chief executive David Bennett as chair. The trusts confirmed on Friday he remained chair, although earlier in the month three senior managers at Viapath, including the chief executive, stepped down.
They confirmed the buyout had been agreed by both trusts’ boards and that “external valuation support” had been consulted to decide what they should pay Serco. They would not say who provided the advice.
The trusts would also not disclose who was on the selection panel for the re-tendering process, or whether any of these were the same people who signed off the Serco buyout. NHS England and Improvement was notified of the transaction, a spokesman said.
It is also unclear if the procurement process was completed, and a new contract awarded, or whether the new arrangement means it was abandoned, with Synlab instead replacing Serco in the partnership.
Viapath’s annual accounts, published in November, said a buyout would allow the trusts “the freedom to finalise an agreement with Synlab, to buy into the Viapath Group and thus fulfil the delivery of the south east London STP contract through the Viapath Group”.
According to trust board reports from 2017 there had been some concerns around the “movement of blood” within the service, although details were unclear.
The papers added: “The chief medical officer would be attending a meeting of the Viapath board to emphasise the importance of it delivering a failsafe solution; it was likely to be of concern to the [Medicines and Healthcare products Regulatory Agency], the regulator for this area.”
Viapath also serves Bedford Hospital Trust and South London and Maudsley FT.
HSJ asked what it had cost Synlab to “buy into” the partnership but received no answer.
The tendering process started in 2018 and was originally supposed to include Lewisham and Greenwich Trust also, but LGT opted to partner with Barts Health Trust and Homerton University Hospital FT in east London instead.
A spokesman for the trusts said overall responsibility for the programme sat with the South East London sustainability and transformation partnership. Within GSTT, overall accountability sat with the chief executive. GSTT finance boss Martin Shaw was not involved in the tender exercise as he had a conflict of interest as a member of the Viapath Board, and his role as accountable financial officer on this tender was delegated to finance director Steven Davies.
NHS WHITE PAPER AND INTEGRATED CARE SYSTEMS (ICSs):
I am writing to you concerning the impending national rollout of 42 ICSs across England. The Keep Our NHS Public campaign is calling for a halt to the development of ICSs until there is a full consultation with the public, local authorities and Parliament.
In Warwickshire, Warwick County Council voted in favour of supporting Integrated Care Systems on 19th February 2019, WCC endorsed ICSs.
At the time, SWKONP made interventions at the public debate about this motion. We argued that behind the seemingly sensible idea of ‘better integration’ of health and social care, was a new model of health and social care, which would permit more privatisation of the NHS. The new term proposed by the government, ‘Integrated Care System’, had been introduced to obscure its original name, Accountable Care System, based on the American healthcare system.
Now, with the White Paper, the agenda of NHS privatisation in the ICS programme is much more obvious. But it is a long, convoluted paper, and hard to read. Such complexity is deliberate. Few members of the public understand what is happening. And hidden in there is a larger role for privatisation, giving out private contracts to private companies without even tendering, and the further marginalisation of Local Authority oversight and NHS accountability to the public.
The Government’s White Paper ‘Integration and Innovation: working together to improve health and social care for all’ sets out its proposals for the future structure and operation of the NHS. The proposals will provide a legal basis for the 42 ICSs across England that have been in development since 2014, and will hasten privatisation in both clinical services and management of the NHS through a new permissive procurement regime.
In the midst of a massive COVID-19 epidemic, the government is driving through a far-reaching top-down reorganisation, using a strategy set out by NHS England (NHSE) based on proposals in the Long Term Plan (2019). Far from being just another reorganisation of NHS bureaucracy, this is potentially one of the final steps in the fragmentation and privatisation of the NHS.
These proposals and related NHSE documents show the government’s intentions to:
embed the private sector throughout the NHS, for example, increasing dependence on firms accredited by NHSE to develop ICSs (the Health Systems Support Framework), including many global corporations. One such firm, Centene, is a US health insurance company which now owns GP surgeries across England.
enable the Boards of ICSs to include private companies, allowing them to influence which services are delivered and by whom.
remove Section 75 of the Health and Social Care Act and associated regulations, and remove the NHS from the Public Contracts Regulations. This will, in effect maintain the purchaser/provider split while replacing a regulated market with an unregulated one, without environmental, social and labour protections.
make ‘population health management’ the basis for deciding priorities and planning health services, shifting the focus of the NHS away from providing universal comprehensive health care. Using data to set targets for the health of the population of an ICS area prioritises demand-management over clinical need and may give firms access to the data.
tighten central control of the NHS, for example by removing Local Authority powers to refer reconfiguration proposals to the Secretary of State for Health and Social Care. The geographical size of ICSs, with mergers and ultimately abolition of CCGs, will concentrate decision-making at a level much more distant from local populations.
ensure the compliance of organisations within an ICS through a legal duty to collaborate on meeting the ICS’s financial objectives and “shared use of NHS resources”, binding providers to a plan written by the ICS Board and to financial controls linked to that plan.
bring local government resources under the control of the NHS in the name of addressing health inequalities and improving social care, public health and mental health – but there are still no plans covering these issues.
ignore the ‘democratic deficit’: neither the ICS proposals nor the White Paper mention making ICSs or the NHS as a whole democratically accountable. Elected local authorities could lose some control of a major part of their work, social care. In response to Local Government Association objections, the White Paper suggests a two tier system for ICSs, an NHS body responsible for day to day running of the ICS and the plan, commissioning and budgets, with representation from local authorities and unspecified others; and a Health and Care Partnership to support integration, including public health and social care, and representation including independent sector partners and social care providers. However, the relationship between decision-making at the ICS NHS Body and the Partnership is not explicit, and “will allow systems to decide how much or how little to do at these different levels and will also potentially allow them to vary these arrangements over time as the system matures and adapts.”
A letter from NHSE Chief Operating Officer Amanda Pritchard (11 February) states that “The composition of the board of the NHS ICS statutory body itself must however be sufficiently streamlined to support effective decision-making” and “the NHS ICS Board must include a chair and CEO and as a minimum also draw representation from (i) NHS trusts and Foundation Trusts, (ii) general practice, and (iii) a local authority.”. Thus a single local authority may suffice.
Local authorities will not be equal partners in this arrangement.
We therefore urge you to:
1. Demand an immediate halt to the rollout of ICSs.
2. Demand extended and meaningful consultation with the public, health service staff and their unions, local authorities and Parliament to decide how health and social care services are provided in England.
3. Promote the introduction of legislation to bring about a universal, comprehensive, publicly provided and publicly funded NHS, fit for the 21st century.
The best performing trusts and clinical commissioning groups are allowed to spend as much as they want on management and external consultancy, under proposals for a new regulation regime.
This surprising and interesting proposal is found buried in details of NHS England’s new system oversight framework — ie the way it plans to regulate the NHS in the brave new world being ushered in along with integration and system working.
The document states that trusts and clinical commissioning groups which find themselves in ”segment 1” (out of four) will “be exempt from the consultancy controls/relevant running cost limits”, and “streamlined business case approval”.
NHS England and Improvement and their predecessors have long promised “earned autonomy” for the best, and generally struggled to turn it into anything meaningful.
Yet scrapping management cost controls, and consultancy caps even more so, are unexpected moves, given the political will and operational pain which went into bringing down those costs in recent years (and with the government claiming its white paper proposals will reduce bureaucracy even further). One of Sir Simon Stevens’ favourite mottos, declared immediately on his return to the NHS in 2014, is “think like a patient, act like a taxpayer”.
The previous SOF said trusts in the top tier would be given “maximum autonomy and [the] lowest level of oversight appropriate” — but gave nothing away on what these would be.
The latest rules for approval of consultancy spend were introduced in 2016, with NHS providers needing to seek approval of any spend over £50,000. Anything over £1m also needs approval by a “central NHS consultancy panel”, with reviews taking at least six weeks to complete. That said, for foundation trusts, only those in breach of their licence or receiving financial support from the Department of Health and Social Care technically have to comply.
In practice, until covid-19 came along, ministers and central officials had exerted its influence to generally bring down consultancy spend. Administration spend is also strictly capped for CCGs.
The new framework continues with the ranking system set out in the 2019-20 SOF. ICSs, trusts and clinical commissioning groups are placed into one of four “support” tiers, with one being for the best organisations that are required to have no “support”, and four being the worst.
Segment one trusts will also be able to “request access to funding to provide peer support to other organisations”.
The framework does not offer ICS any respite from management or consultancy spend controls — perhaps because they are not yet statutory organisations — but the best systems can instead request ”devolution of programme funding”, and “greater control over the deployment of improvement resources made available through regional improvement hubs”.
Health and social care secretary Matt Hancock has been stressing in recent months that he wants the new NHSE to be an “improvement and transformation organisation”, rather than a regulator, so perhaps these regional hubs are a sign of the future for its regional outposts. How much transparency there will be on how these ‘improvement resources’ are spent, we’ll see.
The new SOF paper also suggests NHSE will be expanding the idea of peer support as far as it can, with ICSs asked to peer review other systems — a nice idea but one which runs up against practicalities like chief executives reviewing their former colleagues and bosses.
Compared to the previous SOF, it looks like the bar has been lowered as for trusts falling into “segment three”, under which they get “mandated support”. In the 2019-20 SOF, trusts that were “in actual or suspected breach of the licence (or equivalent for NHS trusts) but not in special measures” were put into segment three.
Now trusts are likely to be put into the third segment if it has experienced any of the following: performing very poorly against one or more oversight metrics [or] against its financial plan; has seen a dramatic drop in performance; is rated “requires improvement” by the Care Quality Commission overall and in the well-led domain; or is in the bottom quartile nationally in oversight metrics.
Using the latest trust ratings from 1 April 2021, based solely on the CQC requirement, 50 trusts would be segment three, with three in segment four.
The NHSE paper also begs questions about the CQC’s future role. Mr Hancock has said the CQC will rate ICSs as it does providers, and the inspectorate is keen to be inspecting more systems, yet there is no mention here of taking the CQC’s view of systems into account in this paper.
With this, plus NHSE’s view of how it should measure and rate ICSs, and its ideas about ICS peer review and regional improvement work, it’s clear that the relevance of the CQC in the new landscape will remain up for debate.
Around 90% of NHS transactions take place in primary care. If we are serious about saving our NHS, we can’t stand by while private companies, including US healthcorps, take over local GP surgeries and other primary care services.
Following the Operose Health takeover of 49 GP sites, we set up an ad hoc campaigning group. Our objectives are:
1. To reverse the Centene deal (Operose Health is its UK subsidiary).
2. To alert the country to the risks of Alternative Provider contracts.
3. To help inform opposition to the White Paper. 4. To show a link between Centene and other privatisation.
We are now calling on local campaigning groups to join us, to:
expose the scale of the problem at local level
challenge the award of contracts, and
campaign against the Alternative Provider contracts that make takeovers possible.
We have provided a campaign resources pack to get you started.
What has changed in general practice
We know that even seasoned NHS campaigners rarely understand how general practice works [link to Louise]. We think this urgently needs to change.
The key points are as follows.
On a traditional family doctor contract (a GMS or PMS contract*), GPs are sub-contracted to run primary care services, indefinitely, on behalf of the NHS. They aren’t true businesses, because there are strict controls on the services they provide, the ways they can spend their money and how they treat their staff.
When new Alternative Provider (APMS*) contracts were introduced in 2004, all that changed. GPs and private companies were offered the chance to run some surgeries differently on five-year rolling contracts. They were offered extra funding, encouraged to form chains and allowed to make profits for shareholders.
In practice, the first of these Alternative Provider contracts were mainly taken on by GP partners who swapped contracts to try out the new model. But now we are seeing the practices and chains they built being hoovered up by the insurance giants.
The key difference between the contracts is that GP partners running a surgery for decades have a commitment to their patients, families and local areas. A US health corporation, with a time-limited contract, has a commitment to profits.
US and other private companies have a poor record at running UK practices (for example: www.theguardian.com/society/2012/dec/19/when-privitisation-gp-practices-wrong. They often have a dire reputation back home too (the Find out more section of the Resource pack gives some damning facts about Centene’s record of fraud etc in the UK, US and Spain).
Since they can’t up their prices, these companies can only increase their profits by cutting back on staff costs and services.
When a private company like Operose Health becomes big in primary care, it will inevitably demand seats on the new NHS bodies that decide which services to commission and who to give contracts to.
There is serious potential for conflict of interest. Centene, for example, owns 40% of Circle Health, which in turn owns the huge chain of private BMI hospitals – which all make a significant amount of their income from treating NHS patients.
It is important to recognise that the takeover of GP surgeries by US healthcorps, as well as the cuts to beds and A&E services in hospitals, the restructuring of the NHS in England into 42 Integrated Care Systems, and the privatisation of areas such as pathology, test & trace, and back office functions, are ALL important elements of the ‘transformation’ of the NHS promised in the Health White Paper.
What your group can do
As a local group, you are in the best position to find out what is happening in your area and to involve local people, including affected patients, in any campaign. Our short guide to taking action and our campaign resource pack [link] are designed to help you get you started.
Who we are
This campaign has been launched by a concerned group of NHS campaigners and academics from around the country. It is backed by Keep Our NHS Public, 999 Call for the NHS, We Own IT, Doctors in Unite and EveryDoctor.
See the comprehensive online pack (password: CampaignPack] we have put together to help you kickstart a campaign locally and get involved nationally.
Keep Our NHS Public 