The governments NHS choice agenda sounds appetising, at least until you look at the ingredients. I like my consumer choice as much as anyone and spend lots of supermarket time deciding how to get my daily dose of Sudan 1. It seems the government operates very similarly, turning to the retail industry to help it fulfil its objectives. Stephen OBrien, formerly a marketing director at Kingfisher, the parent company of electrical retailer Comet and DIY store B&Q, now runs the Department of Healths marketing intelligence unit, helping hospitals sell their services in the new, competitive NHS.
The first step in the proposals is choose and book: GPs will offer patients a choice of four different providers for their treatment via a desktop computer system. The government plans that at least one choice will be from the private sector. The British Medical Association (BMA) described this as creeping privatisation, but thanks to a computer cock-up it is creeping very slowly. The National Audit Office found that only 63 bookings were made through the computer system instead of the 205,000 the government had projected.
The company originally hired to provide the computer system was SchlumbergerSema, which also supplied the Labour Partys membership system, donated money to the party and paid for meetings with government ministers at Labours annual conference. But after business failures SchlumbergerSema was sold at a huge loss to another firm, Atos Origin, which now runs (or fails to run) the choose-and-book computer system. Atos also has good political contacts: former Labour cabinet minister Lord Barnett is chair of its UK operations.
The Department of Health is currently selecting the private firms that GPs will be able to choose and book from. It intends to invest in private clinics and hospitals, helping ensure healthy returns for their executives and shareholders.
Thus, Netcare, South Africas largest private hospital group, was contracted to provide eye operations. South West Oxfordshire Primary Care Trust was bullied into buying Netcares eye operations even though it already had a well-respected NHS eye hospital in Oxford. A management consultants report commissioned by the Thames Valley Strategic Health Authority, but kept secret until after the Oxfordshire contract was signed, said the NHS hospital might be destabilised by the deal; Netcare would cream off the more simple operations the hospital traditionally supplied, starving it of money and training opportunities.
The consultants also said that the Oxfordshire contract would lead to fewer developmental opportunities for NHS trusts because of reduced investment, and that this would lead to poorer services for patients. But the consultants came up with some brilliant recommendations for obviating these problems: public sector health staff could gain experience working with Netcare for free; and the NHS should hawk surplus services in Wales and Scotland.
To tempt private companies into this new market, they get higher fees per operation than the NHS, to the inevitable detriment of the latter. To take just one example, in 1999 Tony Blair opened an ambulatory care and diagnostic centre at Londons Central Middlesex Hospital, hailing the walk-in clinic as amazing and the embodiment of the new NHS. The centre is now running at half capacity and with the threat of closure hanging over its collective head. This is simply because patients are being siphoned away by the private sector.
One of the private firms to have benefited from the governments reforms is Alliance Medical. The company sells MRI scans to the health service. As a result, the NHSs own scanners are lying idle and unused. Alliance secured the £95m contract after one of the companies that part owns it, Bridgepoint Capital, hired former health secretary Alan Milburn as an adviser (Healthy lucre, Know Your Enemy, July 2004). The contract has since been widely criticised by figures within the medical establishment.
Using the Freedom of Information Act, Red Pepper uncovered papers showing that the original idea for the MRI scan contract had come not from the government but Alliance itself. The only difference between the deal that Alliance finally secured and what it had at first proposed is that the company had also wanted to provide endoscopies, and ultrasound and PET/CT scans. But good things come to those who wait: now health secretary John Reid has announced plans for a £1 billion contract that would result in Alliance carrying out these services for the NHS as well.
The governments NHS choice agenda sounds appetising, at least until you look at the ingredients. I like my consumer choice as much as anyone and spend lots of supermarket time deciding how to get my daily dose of Sudan 1. It seems the government operates very similarly, turning to the retail industry to help it fulfil its objectives. Stephen OBrien, formerly a marketing director at Kingfisher, the parent company of electrical retailer Comet and DIY store B&Q, now runs the Department of Healths marketing intelligence unit, helping hospitals sell their services in the new, competitive NHS.
The first step in the proposals is choose and book: GPs will offer patients a choice of four different providers for their treatment via a desktop computer system. The government plans that at least one choice will be from the private sector. The British Medical Association (BMA) described this as creeping privatisation, but thanks to a computer cock-up it is creeping very slowly. The National Audit Office found that only 63 bookings were made through the computer system instead of the 205,000 the government had projected.
The company originally hired to provide the computer system was SchlumbergerSema, which also supplied the Labour Partys membership system, donated money to the party and paid for meetings with government ministers at Labours annual conference. But after business failures SchlumbergerSema was sold at a huge loss to another firm, Atos Origin, which now runs (or fails to run) the choose-and-book computer system. Atos also has good political contacts: former Labour cabinet minister Lord Barnett is chair of its UK operations.
The Department of Health is currently selecting the private firms that GPs will be able to choose and book from. It intends to invest in private clinics and hospitals, helping ensure healthy returns for their executives and shareholders.
Thus, Netcare, South Africas largest private hospital group, was contracted to provide eye operations. South West Oxfordshire Primary Care Trust was bullied into buying Netcares eye operations even though it already had a well-respected NHS eye hospital in Oxford. A management consultants report commissioned by the Thames Valley Strategic Health Authority, but kept secret until after the Oxfordshire contract was signed, said the NHS hospital might be destabilised by the deal; Netcare would cream off the more simple operations the hospital traditionally supplied, starving it of money and training opportunities.
The consultants also said that the Oxfordshire contract would lead to fewer developmental opportunities for NHS trusts because of reduced investment, and that this would lead to poorer services for patients. But the consultants came up with some brilliant recommendations for obviating these problems: public sector health staff could gain experience working with Netcare for free; and the NHS should hawk surplus services in Wales and Scotland.
To tempt private companies into this new market, they get higher fees per operation than the NHS, to the inevitable detriment of the latter. To take just one example, in 1999 Tony Blair opened an ambulatory care and diagnostic centre at Londons Central Middlesex Hospital, hailing the walk-in clinic as amazing and the embodiment of the new NHS. The centre is now running at half capacity and with the threat of closure hanging over its collective head. This is simply because patients are being siphoned away by the private sector.
One of the private firms to have benefited from the governments reforms is Alliance Medical. The company sells MRI scans to the health service. As a result, the NHSs own scanners are lying idle and unused. Alliance secured the £95m contract after one of the companies that part owns it, Bridgepoint Capital, hired former health secretary Alan Milburn as an adviser (Healthy lucre, Know Your Enemy, July 2004). The contract has since been widely criticised by figures within the medical establishment.
Using the Freedom of Information Act, Red Pepper uncovered papers showing that the original idea for the MRI scan contract had come not from the government but Alliance itself. The only difference between the deal that Alliance finally secured and what it had at first proposed is that the company had also wanted to provide endoscopies, and ultrasound and PET/CT scans. But good things come to those who wait: now health secretary John Reid has announced plans for a £1 billion contract that would result in Alliance carrying out these services for the NHS as well.