A story on the BBC website starts:
“Health bosses have provoked uproar among family doctors over plans to franchise out services along the lines of fast food outlets or estate agents.”
It goes on to say:
“They have told the existing doctors unless they move into the buildings they will bring in the private sector.
Bosses said they could learn from the likes of supermarkets Tesco and Asda on improving customer service.”
This is Heart of Birmingham tPCT. This is not just a quirk of one PCT, though. It closely follows the plans outlined in the Darzi report for London for the setting up massive Polyclinics and closing down smaller GP practices. Plenty of Primary Care Trusts are already going down a similar route. Birmingham makes it clear what this direction is all about. Who believes that the bosses in Tesco really care about their customers? ‘Customer service’ is just another way of maximising profit. So it fits right in to the Government strategy of bringing in the private sector to promote competition in health care provision.
Hasn’t the Government strategy changed though? Thursday saw an announcement by Alan Johnson proposing to slash future ISTC contracts worth around £3bn. The press is talking about this being a reversal of Blair’s NHS strategy by the Brown Government. I think is something different. Brown is slowing down the rate of privatisation in the acute sector – although even there the number of NHS patients treated in private hospitals has doubled in the last month – in order to push ahead faster in primary care.
The ‘commissioner provider split’ is about ending the role of PCTs as providers of community health care. ‘Plurality of provision’ is Labour’s vision for community services. We’re heading for a future where health visiting, district nursing, physiotherapy and the like are provided by private sector companies with little interest in patient care and an overwhelming priority of making money. Last week, I met as a stakeholder (that’s a Union rep to readers of this blog) with a consultant brought in to my Trust to map out the future of service provision. Favoured options include services being moved out of the NHS into the private sector, or to the half-way house of social enterprises. The same process is underway in most PCTs. It is not as dramatic as a £3bn contract for ISTCs, but the overall effect will be even greater.
I think the BMA have had the right response in Birmingham:
“Over the 600 years that there have been GPs no one has come up with this model, and people feel uncomfortable with it because they don’t think it will work. And nobody has asked us whether we’re prepared to work that way.”
The BMA is also worried about private firms coming in to run the franchises, and putting shareholders before patients. We need our Unions to oppose all privatisation of our NHS, and to respond with united opposition. We cannot afford, as some of our Union leaders do, to believe that the Alan Johnson announcement represents a reversal of Government policy. Clutching at straws has never been a good starting point for defending members’ jobs and a fully public health service.