Report on Keep Our NHS Public (KONP) 2008
KONP was founded about three years ago with the aims of keeping the NHS in the public domain, to build a broad based non-party political campaign to this end, to keep the media and public informed of the effects of the government’s reform programme and to ensure a public debate on these issues. KONP has been supported by the NHS Consultants Association (NHSCA), a body set up to defend Bevan’s vision for the NHS, NHS Support Federation, set up originally to resist the internal market, and Health Emergency together with Unison and Unite and a few MPs. There are good links also to the BMA. So a number of consultants, public health experts and academics are participating. For the last two years I have represented the SHA on the KONP steering group following our decision to affiliate.
Members will be aware of the publication ‘Patchwork Privatisation’ produced by KONP just over a year ago. This set out the effects of the marketisation of healthcare, a process begun under the Tories in the 1990’s and developed by Labour this century. It began with the purchaser/provider split and, inter alia, spread to the introduction of competition between hospitals, the establishment of private sector involvement in secondary care by Independent Sector Treatment Centres (ISTCs) and Assessment and Treatment Centres (ICATS &CATS) ( the latter sometimes private, sometimes public), the introduction of Payment by Results (PbR) and, in primary care, the privatisation of GP practices and the commissioning role of PCTs, together with Practice Based Commissioning (PBC).
This year KONP has produced a leaflet, copy attached, setting out an analysis of the Darzi proposals for England and London and showing how the reforms being pursued by government (which they are continuing) are incompatible with the approach he is taking, much of which we welcome. The continuation of competition, particularly the involvement of private companies, undermines the approach Darzi sets out in his reports which requires cooperation across the different health sectors and with social care.
More recently, KONP has prepared a leaflet on the latest developments whereby private corporations such as United Health and Virgin are being given the opportunity to take over GP practices. Its latest version, which is attached, sets out the difference between the current independent contractor status of GPs working to a well-defined NHS contract and GPs working to the requirements of a private company which is likely to undermine professional autonomy. This is shortly to be circulated to MPs and to a selection of GPs with the aim of getting them to inform patients and ensure public debate. In addition, KONP is sending this to the chairs of Local Authority Health Scrutiny Committees to inform them of this development and KONP’s views on the Darzi proposals. KONP’s particular concern is the effect the private takeover of GP practices could have on the important relationship between health and social care, asking their committees to examine and report on the matter should a PCT in their area be contemplating such a measure.
I have been involved in the drafting of this year’s documents. It has not been my role to reflect SHA views formally. However, I have reported on a regular basis to central council.
KONP has a large number of local groups over which it does not maintain close control. I spent some time working with colleagues on the steering group adjusting the constitution to ensure that while local groups obtain regular reports on what the steering group is doing and have the opportunity to input suggestions they do not have voting power. This avoids the risk of bodies such as the SWP taking any form of control at national level. As colleagues are aware these organisations always attempt to leech onto bodies such as KONP and use public demos to exert their influence but this has been generally well controlled. Local groups are involved in a mixture of fighting cuts and closures and resisting private involvement in the NHS.
I believe it is essential that the SHA remains affiliated to KONP. It is not necessary for all members to agree with everything KONP does. It is certainly an organisation that reflects many of the principles on which our socialist ideas are based. Central Council has membership from within the NHS and therefore access to those putting many of the government measures into effect. It also needs to retain links with those who find that the effects of these measures put at risk the service provided to patients. Just because labour is in power that does not mean we should not maintain our critical stance where appropriate whilst being broadly supportive.
John Lipetz
March 2008