News from the Frontline 06.05.20

THE GOVERNMENT’S DUTY TO KEEP THE PUBLIC SAFE OUTSOURCED TO THE PRIVATE SECTOR

HANCOCK INCREASES PRIVATISATION BY STEALTH

On Monday, the news broke that contact tracking and tracing (the next stage in managing the pandemic) will be outsourced to the private sector in the form of at least two private call-centre operators, one of which is Serco. They are providing 15,000 or more staff who, after one day of training, will be given a script to follow in conversations with people who have been in contact with confirmed cases of Covid-19.

Ministers have been using the pandemic as an excuse to by-pass “normal” procedures for awarding Government contracts which involve invitations to tender and have been awarding contracts to a string of private companies and management consultants with no open competition.

Even these “normal procedures” are a way the Tories privatise the NHS – the way they first began to do it – by insisting services which had previously been provided in-house by NHS employees, be “put out to tender”. Which is how firms like Carillion which went bust in Jan 2018 leaving debts of £7 billion, G4S, ISS, Sodexo, Bouygues and others came to be the employers of hospital porters, cleaners and catering services. A privatisation process dating back to 1979 and the Thatcher government and including more recently the Private Finance Initiative supported by the Labour Government of Tony Blair, but accepted as a disastrous debt-generator by subsequent Labour leaders.

The Government has proved itself totally inept at managing the health crisis caused by the Coronavirus. It ignored the findings of Exercise Cygnus in 2016 which forecast the need – in the event of a pandemic – for ventilators, PPE and all the equipment which the NHS now faces a dangerous shortage of. The Government did not want to spend the money. In fact it has been cutting the NHS to the bone instead.

Worse than cutting the funding, it has also been cherry-picking lucrative bits of the NHS and offering them to private investors for private gain at the expense of service to patients.

When Johnson said “The NHS saved my life”, voters may have concluded “the NHS is safe in his hands. The Government understands how important it is now.” They do, but ten years of deconstructing the national service, outsourcing and privatising have gathered momentum and still retain their ideological grip on this government with its zero experience of worry about where the rent is coming from, or the next meal. The NHS has been viewed by the Tories as a potential cash cow for private investors and their already-rich Tory-supporting friends and it still is as these contracts for testing and tracing illustrate.

At the beginning of the Covid Crisis, the SHA said, as did most of the medical profession and its journals, a range of statisticians, forecasters, epidemiologists and other scientists, that the dismissive and over-confident decisions of Johnson and Trump were seriously ill-founded; that pursuing the idea of “Herd Immunity” would mean that the NHS would be overwhelmed, and that the Government should accept the hand of friendship from the EU and other countries which offered to share sourcing of needed equipment (despite the “we can do better on our own” series of snubs to the rest of Europe, emanating from the UK Tory Government since 2016).

These commentators urged the adoption of effective measures.

  1. To slow down the spread so the emergency services could cope, hence the lockdown, though the UK Government was slow to introduce it compared to other countries.

 

  1. To test for the virus and trace the contacts of those infected, so the lockdown could be relaxed without a second wave of the epidemic. Again the UK Government was slow to implement this. SHA President and Prof. of Public Health, Allyson Pollock said that tasks including testing, contact tracing and purchasing should be handled through regional authorities rather than central government.

This was delayed while a private sector plan was cobbled together presumably to pre-empt the NHS, local authorities and other public sector bodies being asked to do the same, though they have a greater range of contacts, experience and expertise in spite of the relentless down-grading of the public health infrastructure and the budgetary strangulation of local councils.

  1. This would give time for a longer-term solution, and the development of a vaccine to reduce the numbers likely to get Covid-19 again, or reduce its severity.

Firms such as Serco, Mitie, Boots, Deloitte, KPMG, and a US “data-mining” group called Palantir, have already acquired the rights to manage Covid-19 drive-in test centres, the building of the Nightingale Hospitals, and the purchasing of PPE. Deloitte, for example, is a multinational “professional services network” and one of the largest accounting organisations in the world, managed to acquire a contract to advise the Government on PPE purchases a few weeks ago. It thus took more decision-making authority from the NHS and local authorities, and shifted more power from the frontline. “It’s a power grab”, said Rosie Cooper MP, and we must protest in the strongest possible terms.

Deloitte has had a poor track record in delivering PPE to the front line since the pandemic began, and taking more decision-making from NHS managers and local authorities shifts power further from the frontline and money for services into private pockets  The tax-payer pays for declining service.

The Guardian said that NHS Trusts have now been instructed by the DHSC to stop buying their own PPE and ventilators or high value equipment for more general use in hospitals such as mobile X-ray machines, CT scanners and ultrasound machines.

The system of tracking and tracing will be enabled by an NHS app on smart phones that alerts people that they have been near someone known to have the virus, or if they come into contact with an infected person in the future. Calling it an “NHS app” is no doubt intended to reassure people who might not want to use a Serco or Deloitte app for fear of what might happen to data on where they have been and to whom they might have been close. However, most of the contact tracing work will be contracted out to Serco and at least one other private-sector firm.

The app goes on trial on the Isle of Wight this week. Supporters of the SHA on the Island (currently busy in a cooperative project of people with sewing machines, recycling donated duvet covers and sheets into scrubs for the frontline) tell us that it went live yesterday with NHS and Council staff, and will reach the rest of the Island by Thursday.

The Isle of Wight was chosen as an area relatively cut off from the rest of the country during the lockdown, so a good place to study the spread of a virus. Currently there are limited ferry services for lorries transporting food and medicine and for ambulances to transfer serious medical cases to Southampton or Portsmouth. In addition the population is older than the UK average and fewer people have smart phones, so if it works reasonably well in those circumstances it should work even better nationally, says Hancock.

South Korea did not go into lockdown. It adopted a strategy of widespread tracing and mass testing. Take-up would have to be very extensive for this to work here. There will be resistance to detailed personal data being collected by a multinational company. David Blunkett tried to get us to all have ID cards after 9/11 and met strong opposition from civil rights lawyers, trade unions and, indeed, Tories.

The government is using the pandemic to transfer key public health activities from the NHS and other state bodies to the private sector. In 1977, Nicholas Ridley wrote a pre-Thatcher plan for the Tory Research Department in which he outlined a strategy of “privatisation of the NHS by stealth”.  “Managing” Covid 19 presents a good opportunity for taking this  further, building on the destructive intent of the 2012 Health & Social Care Act enabling a Tory government to give even more taxpayers money to the private sector.

Testing and tracing is to be given to the public limited company Serco and others as yet undisclosed, but likely to include the security services firm G4S. Serco became infamous   for having tagged thousands of criminals who either did not exist or were dead and “other botched government contracts”, reported The Financial Times in 2015. The chief executive is Rupert Soames, appointed to turn around the business (whose shares had dropped 50%) who in turn recruited Sir Roy Gardner as Chair and replaced almost the entire board.

Now, Serco has been appointed by the Johnson Administration to perform public health tasks in England for which it has little experience and little credibility with the general public. This tells you all you need to know about the current Government. Forget all the PR post Covid survival thanks to the NHS and the protestations of undying love for it.

The real values of the Government are revealed in this move to spread public largesse to its own, although it will rely on public support for the NHS to get people to allow data on their every movement to be collected by a spy on their phone

The reason why the NHS gets such massive support is because the general public use it, see it first-hand, recognise its skill and, crucially, know – in some imprecise way – that it is “theirs”.  It exists to look after all who come to it for its skills, whether Prime Ministers,  homeless veterans, newly born babies, or those beyond cure but never beyond care. And free at the point of use.

In contrast, however well run Serco might be, and however well it learns in three weeks what it has taken local government and the NHS decades to absorb, its first duty is to its share holders and the need to pay a dividend.   In this century it will never get the trust that the NHS acquired in the last. Trust and values matter, especially where using personal information and getting the co-operation of millions of the public is concerned. The Times  reported Grant Shapps, the Transport Secretary, as saying the Government would have to make downloading the app “a duty to the NHS”.

Further, at a time when it is abundantly clear that the NHS, local government, and bits of the already part privatised social care system cannot continue with the pre-Covid-19 settlement, the Serco option is as old fashioned as it is unwise.

This is one part of the Government’s plan that Labour has to expose and oppose. Now!

Vivien Walsh & Tony Beddow