The CBI says ‘Jump’; Brown says ‘How high?’

This story is a bit complicated, but worth following. I worked this one out while doing some reading around Lord Darzi’s proposals for the NHS, in preparation for a union meeting. Thanks also to Dr Rant for pointers to the Hollick-Alliance Boots connection.

During the course of Darzi’s review, he met with the CBI, and with an enormous number of private sector companies hoping to make a load of money out of the NHS. One of the companies he met was Alliance Boots (popularly known still as ‘Boots the Chemists’).

The involvement of both the CBI and Alliance Boots is significant, and highlights the role of the private sector in making healthcare policy.

In August 2007, the CBI and Alliance Boots published an ‘analysis’ that showed that businesses lose 28 million working hours and £1 bn a year because employees schedule GP visits in working hours. They highlighted the same dodgy figures again in September 2007. Secretary of State for Health Alan Johnson said they had a point, proclaiming, ‘This has to change’.

GP opening hours became a positive fixation of the Government, with Gordon Brown announcing that this was one of his personal priorities. For several months, from September 2007 onwards, it was almost impossible to turn on the TV without hearing a Government spokesperson lambasting GPs for refusing to work 12 hours a day.

Darzi, on Johnson’s instructions, looked at GP opening hours and recommended in his interim report of October 2007 that there should be 150 new GP-led health centres  – with a ‘guiding principle’ that they should be open seven days a week from 8am to 8pm.

Alliance Boots immediately announced its willingness to host all 150.

Alliance Boots is arguably no longer the chain of local pharmacies that we all know and love. Alliance Boots was taken over by leading private equity company KKR in a deal agreed in May last year. Interestingly, Labour peer Lord Hollick is managing director of KKR.

Do patients want extended opening hours? No. In July 2007, the Department of Health published the results of a poll of more than 2 million patients. The poll showed that 84% did not feel the need for extended morning or evening surgeries, and were satisfied with the opening times of their GP. There has been no call for extended hours from GPs, or other health workers, or trade unions. For ordinary workers, it means we can forget asking for time off during the working day to go to a medical appointment – we’ll have to see the GP in the evening or at the weekend, whether we want to or not. Where’s the gain for us? Nothing at all. It’s big business setting the agenda here. The CBI says ‘Jump’; Gordon Brown replies ‘How high?’

The final bit of Government duplicity is on the ‘GP-led health centres’ themselves. The Government lost the argument around polyclinics. Did they back down? No – they just changed their language. ‘GP-led health centre’ is the new name for ‘polyclinic’. Every Primary Care Trust in England has been instructed to set up a GP-led health centre, irrespective of whether it is needed or wanted by local people. These will be ‘APMS’ health centres, with ‘APMS’ standing for ‘Alternative Provider of Medical Services’. It’s overwhelmingly likely that all or most of these will be run by the private sector. The money to be made here is immense.

The BMA, representing doctors, recently collected over a million signatures in a petition to protect conventional GP services against the predatory polyclinics. Did the Government listen to a million voters? Nope. The NHS gets to be dismantled anyway.

It’s maybe not so surprising that Labour keeps losing elections.

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