From the New Statesman..
It emerged this morning that Labour MPs took the extraordinary step of blocking the publication of the Health Select Committee report into the NHS – because the conclusions backed up government reforms. I have just been handed details of this report, and it’s clear why Labour wanted it suppressed: it contradicts the party’s attack message. Here are the main points:

No sweeping privatisations: there has been little increase in private sector providers since 2010.
Nor has there been an extension of charges or top-ups during the current parliament, and that these are not planned.
Less red tape: a general trend of declining administration costs in the NHS.
No evidence that the Transatlantic Trade and Investment Partnership poses a threat to the NHS.
http://tinyurl.com/paamey4

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19 Comments

  1. Dear John you are truly deluded if you think that the privatisation programme is not having a detrimental affect on the NHS, Here where I live they tried unsuccessfully three times to outsource our Out Of Hours service.

    PTS has been outsourced to arriva, absolute disaster and a patient waited 24 hrs., to be collected for hospital appointment with continuing problems.

    111 service chaos reigns ambulance service regards them as a nightmare.

    Tonight the CCG is finalising new contracts for a private hospital that had prepayment sum of money for services it never carried out, we have protested about the waste of money and detrimental affect on the local NHS budget but of course will be ignored, because this is all part of the agenda.

  2. John Locke says:

    I am not deluded.. I am not the author of the report it was the health select committee .

  3. Steve Adshead says:

    A quick look at the article rather than the report suggests that it has concentrated on whether the % of commissioned services have gone to private or public providers since the inception of the CCGs. I am not surprised with the findings as the ‘free market’ will take more than one cycle of commissioning to increase its market share significantly. I think the ‘market’ as such at the moment is actually experiencing a transfer of services between NHS providers; the most ambitious Trusts are finding they have over-extended themselves financially in taking on services in other areas during the credit crunch. However, I am surprised by the Labour response. The narrative of NHS privatisation was always directed at the back door sale of hospitals because of the failure of PPI/PFI initiatives. The accusation levelled at the CCG system was that it would increase fragmentation rather than integration, which is an issue the health select committee seemed to have ignored.

  4. Watch this YouTube for the true and honest history of what has, is and WiLL happen to ‘OUR NHS’ :

    http://www.selloff.org.uk/default.html

    Why are these fraudsters not being prosecuted and shut down?

    http://www.bbc.co.uk/news/uk-england-bristol-31063973

  5. Irwin says:

    Facts. Since the mid noughties there has been an increase in the scope and value of services provided to the NHS by private providers from £5bn in 06/07 to £10bn in 13/14 or around 10% of total spend. Around 5% of non-elective and 2½% of all acute admissions were to non NHS providers. Small but significant.
    If the “franchised” services from GPs, Pharmacy, Dentists and Ophthalmologists are included as these too are non NHS then the total for non NHS provision is around 25% of NHS budget.
    There are direct outflows for drugs, IT, medical equipment, and property costs, outsourced services such as cleaning and facilities management or managed services and Trusts sub contract work and also pay out to agencies and employ staff on contract terms. If all this is taken into account then spending with the private sector is probably more than half of the total. So far as anyone can tell, and proper figures are not available, this percentage has always been around 50%.
    The full impact of the H&SC Act has yet to be felt and the pipeline for possible privatisation clearly anticiaptes further increases, Commissioners default to CCT which favours the private sector. Local campiagns continue to fight off the worst effects.
    These facts do not change the basic argument that markets and competition do not work in health and add costs to no great advantage. The market system needs to be scrapped so that there is democractic accountability not market forces and so that shared decsion making and collaberation can replace the market competition that is fragmeneting services.

  6. john locke says:

    So do you want the NHS to have no private provision, and GPs Ophthalmologist and Dentist must become public sector employees? what about drug companies and other suppliers, do you want the NHS to manufacture its own bandages ? The sooner people accept that public or private is immaterial and is just dogma and the only thing of importance is that the best care is available no matter what the source .The very fact that this is a “Socialist”Health Association is telling..lets take politics out of the NHS…

    1. Irwin says:

      No. The NHS has never been fully publicly provided.
      I agree with SHA policy that there is a role for the private sector in non clinical areas like IT as always; that there can be franchised services such as those from GPs; and that in some circumstances there can be non NHS provision of clinical services within a framework which is not a market and which does not force CCT.
      It is not dogma to ague that a market system does distort values and has proved in healthcare to be ineffective and expensive. Private providers may have a tactical role but market competition cannot be the driving force. Fundamentally key decisions about allocation of resources and priorities need to be taken through democratic strucures not left to the market. If the proportion of services delivered by private providers through contracts becomes too large then control over these key decisions and direction over the system locally and nationally is lost.

  7. Martin Rathfelder says:

    Uncertainty and the Welfare Economics of Medical Care – the paper that got Kenneth Arrow the Nobel Prize.

    The objections of the SHA (not all our contributors) are against marketisation, not private provision. Primary care in the UK is almost entirely private and is seen internationally as a big success.

  8. john locke says:

    If you think there is a role for the private sector, why is this limited to non clinical areas..?

    1. Irwin says:

      It isn’t. There can be a role and there are good examples but also bad ones. Also in area like diagnostics the borders are vague. Social care (which SHA always sees as part of care) is already mostly private though here the trend will be the other way – back to public.
      As is recognised for example in all EU Procurement Directives, Treaties etc there is a distinction to be made for some types of service which the state may choose to provide rather than create a market.
      The non NHS role in clinical services is tacical not strategic as the NHS is a national system not a market.
      I would personally be quite happy for some kind of Best Value system where services are properly evaluated and where the possibility of using other providers is accepted where they already have the necessary capabilities but that is not the samer as mandated CCT for all services within a market.
      Under anything like fair best value comparison which takes risk propelry into account and which allows the track record of non NHS providers to be properly evaluated the private sector cannot compete for most acute and tertiary services and much of primary care is already offered through “franchise” type non NHS anyway.

    2. Steve Adshead says:

      TBH John I think you and the Conservative Party are the only people thinking in the black and white terms of private good – public bad. UKIP are even supporting the Marxist principle of state-run healthcare; although I think they are as naive as the Conservatives when it comes to understanding healthcare in the UK economy. Comparing EU and US models, the state still provides far better healthcare insurance. This is partly because it can reign back the worst excesses of the free-market. Smoking would still be OK on the wards in the NHS hospitals had it not been for political leadership and legislation. The state still needs to do a lot more about regulating the free-market’s exploitation of consumers: covert marketing surveillance; the sale of confidential information; and the explosion of online technologies that are solely concerned with manipulating people’s minds for sales purposes. It could also do a lot more about the exploitation of workers: particularly in the financial services sector where ‘risks’ are exploited for financial gain ignoring the psychological, social or emotional (health and safety) costs that the UK taxpayer ends up paying. But that is not to say that the state provision of health and social care cannot be improved by the NHS becoming the preferred provider under a broader CQC regulatory mechanism. NICE guidance determines the standard of care demanded from any provider – if CCGs can buy more Quality Adjusted Life Years (QALYs) for less £s from any qualified provider then (I believe as a ‘democratic socialist’) that is not necessarily a bad thing!! But I also believe that what ends up as private or public provision cannot be left to the free-market simply because the basic assumptions of price theory, and so the normal ‘demand-supply’ economic models, do not apply to the health and social care market: a) those who are most in need are least able to pay; and b) the consumer does not make the informed decisions, the provider ultimately does.

  9. Martin Rathfelder says:

    I don’t think Irwin said that. We have no problem with primary care being private. Pharmacy is almost entirely private. But in both cases there is little competition. You get the same medication for the same money from every pharmacist.

  10. john locke says:

    you are right i misread the sentence….

  11. john locke says:

    Steve, nowhere have i said private good, public bad..i live in a socialist country that has a highly successful health system that is a total mix of public and private provision..And my criticism of Labour does not mean I am aligned to the Conservatives…both parties have let the country down where the NHS is concerned.

    1. Which socialist country might that be?

  12. John Locke says:

    France…..

  13. Steve Adshead says:

    Surely France is as much a Nationalist country (e.g. Joan of Arc, de Gaulle, Sarkozy, le Pen) as a Socialist one (e.g. Fourier, Foucault, Mitterrand, Hollande)? Unless your stuck in some enlightenment time-warp. lol x

  14. John Locke says:

    Compared to the UK even Sarkozy was socialist….and Le Pen has no chance of gaining power…that is like thinking Farage could become PM

  15. Steve Adshead says:

    I think it would be fairer to say Sarkozy was a republican whereas le Pen is a fascist; despite your rather ambitious logic I don’t think anyone would describe Sarkozy as a Socialist. For me Farage ([not] as in ‘garage’) is a descendent of the same French aristocracy that have ruled in this country since 1066. The only reason he is interested in politics in the UK now (rather than remaining as a City broker and exploiting his minions through the stock markets) is because he sees the new republican democracy of the EU as a threat to his privileged aristocratic inheritance. Thus, his political campaign is because he is trying not to lose power, not because he is trying to gain it. Farage is aligned with the UK monarchy in the same way that Le Pen is aligned with the French republic. Power is relative and leadership does not require qualifications.

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