In April the NHS will be privatised

Submitted by Matthew on 20 February, 2013 - 6:56

From this April, 80% of the NHS budget — around £70 billion — will be handed over to 211 GP-led Clinical Commissioning Groups (CCGs). CCGs replace Primary Care Trusts, once the local arm of the Department of Health.

The CCGs’ budget will be spent in a competitive market subject to competition laws designed for commerce not public health. The private sector will cherry-pick the services where they can make the most profit. Hospitals will be left with the most difficult and most expensive cases; their finances will be destabilised. For many Trusts, laden with PFI debts, the financial crisis will deepen.

Under regulations to Section 75 of the Health and Social Care Act (not voted on by MPs) it will be almost impossible to award a contract without competitive tendering from “Any Qualified Provider”. The “Qualified” bit means financially sound with certain policies in place, not medically qualified!

CCGs are not accountable to the electorate. They answer to the NHS Commissioning Board (Sir David Nicholson) and to Monitor, the market regulator.

The new regulations grant Monitor sweeping statutory powers to intervene and enforce competition. Monitor will be able to decide when commissioners have breached competition regulations, and have powers to issue fines, set aside contracts, stop arrangements that they deem flawed and to impose competitive tendering and the offer of “Any Qualified Provider”.

The spin for CCGs has been that GPs are best placed to know about patients’ needs. But very few GPs have the time or knowledge to do the commissioning. It will in fact be done for them by private companies employing around two thirds of the commissioning workforce. Commissioning is being taken from PCTs and given to the private profit making sector.

Built into CCGs’ constitutions are gagging clauses forbidding GPs to speak out about contracts awarded and any other CCG business without prior permission from the CCG board. GPs will be more accountable to the shareholders of private business than to the public.

This system is created for the private sector to compete for any NHS funding that is spent on purchasing services for patients. With massive cuts in real terms to NHS funding, CCGs will choose private providers who are cutting corners, at the expense of patient care.

NHS hospitals will be forced to close services that cannot make a profit or, worse, close altogether.

What’s happening in Lewisham and South London Health Trust will happen all over the country — the closure of well-functioning A&Es, replacing them with first aid posts, selling off land where hospital services sit and outsourcing to the private sector.

The whole procedure is set up to favour big businesses and corporations who have teams of lawyers and accountants to put together their tenders, and heavily stacked against co-operatives, social enterprises and the voluntary sector not-for-profit providers that are clinically led.

The NHS, beyond the reassuring logo that will be used by all private providers, is disappearing in front of our collective eyes.

The regulations to Section 75 going through Statutory Instrument Committees over the next 30 odd days firmly place competition laws central, putting fear into any future government that might consider renationalisation of the NHS because of the astronomical costs attached to breaking billions of pounds worth of contracts under competition law. Yet this has got to be fought for and won. There is no alternative. We demand the renationalisation of the NHS. Leaders of the labour movement gormlessly stood by as the Health and Social Care Bill became law. Not one national demonstration was called in defence of the NHS, not one piece of industrial action, and not one demand on the Labour leadership to commit to repealing the entire Act and rebuilding the NHS when it comes to power. Not so much as a whisper.

Yet could there be a better, more uniting issue on which to mobilise millions of people? The fight to repeal the Health and Social Care Act and to rebuild the NHS paid for by taxing the rich and big business is now the job of everyone who considers themselves a socialist. It is the job of every trade unionist, and should be the job of every Labour Party member.

We must take the argument for rebuilding the NHS into the labour movement. It should be on every Labour Party agenda and discussed in trade union meetings across the land.

An equal right to life is as basic as it gets. To fight for it raises fundamental questions about how the world works. It is a starting point from which the idea of transforming society, creating a better world for the whole of humanity, begins.

We are living through a crisis in capitalism that has laid bare the barbaric nature of the system. Banks are bailed out to the tune of hundreds of billions of pounds, dollars and euros and the rich collect properties, works of art and fast cars, while the poor collect food parcels in community and church halls.

We have just sacrificed health care for all free at the point of need so the rich can accumulate more wealth that they will greedily hoard and stupidly spend.

We live in a deeply sick system that just got sicker with the implementation of the Health and Social Care Act. We have to organise and fight to get it back.

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