The NHS Support Federation has claimed that almost 70% of contracts for NHS services in England from April to December 2013 have been won by private firms. Thirty-nine out of fifty-seven contracts have gone their way. They include contracts for mental health, GP and out of hours services and diagnostics.
In money terms this has meant £510 million worth of contracts were advertised of which £450 million have gone outside the NHS (2 went to charities and one was shared between a private supplier and the NHS).
Much bigger contracts are coming up. Lord Howe, an Under Secretary of Health, has assured private firms that a procurement exercise to outsource the NHS Choices website, which had to be ‘insourced’ after the Cabinet was forced to veto the Dept of Health’s plans to give it to Capita, will go ahead. Capital IT has been awarded a £2.7 million contract to supply IT networks in the new S. Glasgow Adult and Children’s hospitals.
Privatisation invariably means cuts. When Blue Circle won the contract for the country’s first privatised hospital at Hinchinbrooke they proposed staff cuts of up to 320 full time equivalents over 3 years out of 1,600 staff in total. Blue Circle posted a £4.1 million deficit in 2012.
Now that the NHS Reforms have come in staff in the Commissioning groups are spending a lot of time on tendering. Commissioning often involves enormous sums. Cambridge has invited tenders for end of life care worth £140 to £160 million over 5 years, to replace six separate contracts with NHS organisations – 4 hospital Trusts, a Mental Health Trust and a Community Services Trust.
Organisations not normally involved in healthcare are also leaping on the bandwagon. Arriva, known for its bus and train services, has won a bid to run the amublance service for Greater Manchester. According to Unison this was won on the basis of lowest price rather than best quality.
Some contracts have already gone disasterously wrong. The Commons public accounts committee criticised Serco for providing “short-staffed and substandard” out-of-hours GP services in Cornwall, falsifying data about its performance on 252 occasions and inadequate quality of service. Yet Serco is still able to bid for contracts. This debacle demonstrated how unaccountable private companies are and how difficult to monitor.
Allyson Pollock’s recent excellent article in the Guardian (see link below), demonstrates that many hospitals and A&E departments have had to close because of the high costs of that other privatisation issue – PFI (Private Finance Initiative) This has put pressure on remaining hospitals and A&E departments.
The public expresses worry about privatisation, but does not always understand that the more parts of the NHS are privatised, the less economically viable they become and the more vulnerable to closure. Big US companies are eyeing up the possibility of taking on huge contracts, and the way may well be paved to an American system of charges and insurance.