privatisation | ukwatch.net

The Great City Academy Fraud

Ellie Keen — Wed, 16 Jul 2008 23:52:55 +0000

book Review

The Great City Academy Fraud, by Francis Beckett

It is impossible to commend this book highly enough. When the whole City Academy saga started Brent was chosen as one of the first 3 proposed in the country. As local NUT Secretary I was intimately involved from the start. We witnessed the deceit, the spin, the secrecy, the bribery and the downright dishonesty and lying. I collected the papers and the evidence and thought of writing a book. In common with most people I never got round to it. I’m glad I didn’t, I couldn’t have done the job a tenth as well.

It’s an elegantly written book packed with killer quotes and facts. I have the rather desecrating habit of turning the ears of pages down if they have a particularly important or germane fact or quote. By the end of the book almost every other page had been dog-eared.

I read the book whilst camping out at the occupation ‘tent city’ we have set up to oppose an Academy on the Wembley Park site. You can imagine that I and my colleagues have been absorbed in studying and finding out as much information as possible about the academy programme, yet still I found out so many things I didn’t know and gained more insights into the depth and perfidy of these would-be state education privatisers.

Amongst many things, the book shows how Primary schools will not escape and will be included in the academies’ increasing trend to be all-through 3-18 schools (the bigger the school, the cheaper the cost per unit – sorry – child); how private schools are being allowed to become academies; how academies are now being built entirely with public money with so-called sponsors only being expected to make annual revenue contributions to the academy trust; how Local Authorities, as being responsible for education, are to be ended; how democratic consultation and procedures have been trampled into the dust and the legal goalposts bent, ignored and moved with the regularity and speed of atomic clocks; and how there is a determined plan by religious groups to turn the clock back.

So, to quote two brief extracts from the book, the first regarding the role of religion in education, and the second regarding the role of charity, or rather the role it shouldn’t have, in education (but if you use them I want you to promise me that you won’t do it without buying the book, because you’ll miss so many other good ones).

He points out that long before the academies became the vehicle for it (1995) a booklet from a Mr Burn and Mr McQuoid, now involved with the Vardy foundation, said, “In Britain the Christian churches were active in the field of schooling long before the state took over….in retrospect it is a matter of regret that the churches so readily relinquished control of education to the state….”. And there you have it says Francis, “the state must be driven out of education and it should be handed back to the churches, our function as tax payers should be confined to providing the money with which people like McQuoid and Burn can make sure we can bring up a generation in their own image”.

He quotes Clement Atlee, who was later to become Labour prime Minister in 1945, writing in 1920. He said, “If the rich want to help the poor then they should pay their taxes gladly. A right established by law, such as that to an old age pension, is less galling than an allowance made by a rich man to a poor one depending on his view of the recipient’s character and terminable at his caprice”. He quotes Robert Louis Stevenson who called taxes “the true charity, impartial, impersonal, cumbering none with obligation, helping all”.

“ Charity” , Atlee wrote, “is always apt to be accompanied by a certain complacency and condescension on the part of the benefactor and by an expectation of gratitude from the recipient which cuts at the root of all true friendliness”

Francis then writes, “For these reasons, in the early part of the 20th century it became the view of the Labour Party – and broadly speaking remained so until 1997 – that the rich should aid the poor through the tax system, rather than by charitable gifts; and that education, health care, social security – all the elements of the 1945 Atlee settlement – should be paid for from taxation”.

“What city academies represent, therefore, is a return to the idea, condemned by Atlee, that the rich should contribute voluntarily, rather than through the tax system. But there is a new twist. The sponsor can get all the things a nineteenth-century philanthropist could get, and which Atlee grudged him: control of how the money is spent, a ‘monument’ to himself, the gratitude of the recipients. But unlike the nineteenth-century philanthropist, he does not have to pay the cost of the thing he is ‘giving’ – or even a substantial contribution towards the cost”.

Francis, you have done a service to all of us, full credit to you. As you point out, “Each funding agreement contains conditions upon which the Academy can be returned to the public sector”. We should repay you by defeating this attempt to end state education. This means all out war to stop new academies being built, and campaigning and fighting by any and all means to bring all existing academies back into a fully integrated state education system. Over to you, readers. A journey of a thousand miles begins with the first step. We have started and this is an excellent guide.

Profit and power: the privatisation of asylum control

Tim Holmes — Mon, 14 Jul 2008 16:18:50 +0000

In 2007, tucked away behind the headlines, a number of news stories quietly filtered through discussing the latest developments in the privatisation of asylum control and administration. Compared to the sensationalist rhetoric of asylum seekers as scroungers, cheats, liars, and criminals such developments rarely provoke much attention. Indeed, reading the Sydney Morning Herald in March discussing proposals by two businessmen to start-up ‘Asylum Airlines’; an airline exclusively running deportation flights, you could have been forgiven for believing the proposals were an early April Fools Day prank. The planned flights would have a human rights representative on board, but ‘no immediate news of plans for inflight entertainment or a frequent-flyer scheme’ the paper sardonically reported (Sydney Morning Herald, 2007).

The reality, however, is much more sombre. According to the Independent nine months later the key protagonist behind Asylum Airlines – Heinz Berger – has already set the company up, and has been closely involved with British airport security. An aviation consultant; Berger claimed that only bureaucracy was hindering his airline from beginning to negotiate the contracts for deportation transportations. He claimed to have had interest from a host of European countries, including Britain, and could save governments millions of pounds. One way in which these savings would be made, presumably, would be based in cutting the number of private security officers that are currently required to accompany those who are deported. Instead, the specially modified asylum airline planes will have seats with built in straps and restraining equipment for ‘disruptive’ passengers. Whilst those who persist in resisting their forced removal will be taken to padded rooms built into the aircraft (Verkaik, 2007).

The control and administration of the fate of asylum seekers has quite literally become big business. An entirely false and misleading discourse between ‘bogus’ and ‘genuine’ asylum seekers has underpinned a widespread shift in policy formation. And rather than seeking to offer safety and opportunity to those who are forced to migrate across the globe; opportunities are instead offered to those who wish to profit from such movement. In the first months of 2005 for example Daon (UK), a subsidiary of the secretive biometrics firm Daon, recorded pre-tax profits of €34, 114. Relatively speaking, such profits are not that remarkable. Yet a closer look behind the expansion activities of the company reveals that Daon, working with consulting firm Accenture and mobile phone company Motorola, is part of a consortium with an ‘€18 million contract to develop an electronic fingerprint system’ for immigration services within Europe. The first stage of this venture involves updating pre-existing fingerprint systems for asylum seekers. Moreover, in 2007 Daon was also believed to be working with Accenture to develop an EU-wide fingerprint matching database in a contract worth €157 million (Daly, 2007).

It is not wholly implausible to imagine a scenario where those seeking asylum could have almost their entire claim – a claim which is fundamentally a matter of life or death – processed in a way that ensures financial gain for companies ready to capitalise on those fleeing from death, torture, and misery. To offer a hypothetical scenario; albeit one entirely grounded in current reality, let’s imagine an asylum seeker arriving in the UK looking for sanctuary. She is housed by one of the nine companies who secured contracts worth roughly £135 million a year to provide NASS (National Asylum Support Service) accommodation in 2006 whilst her claim is processed (Home Office, 2006). Faster decision making procedures consolidated through a new asylum model (NAM) however means that her claim is unsuccessful as she does not have enough time to amass evidence and work with lawyers to present their case. In turn, massive reductions in legal and restrictions in appeal rights means that there is little opportunity for redress against this decision (Burnett, 2008a). Instead, she is forced to turn to private lawyers who can, and often do, charge extortionate fees. Yet as the claim has been rejected the individual is now destitute – homeless, hungry, and increasingly marginalised – and, like all asylum seekers, is not allowed to work. Consequently she becomes an undocumented worker in what are often dangerous and exploitative economies. After raising the money to pay for a private solicitor new representations are submitted to the state. But before these representations are processed she is picked up in one the increasing number of ‘dawn raids’ occurring across the UK – in 2006 running at an average of 22 raids a day (Ibid, 2008b). She is subsequently taken to a privately run detention centre – a likely event as most of the UK’s detention centres are contracted to the private sector – and held in, for example, Harmondsworth Detention Centre: built and run by ‘UK Detention Services’ (a subsidiary of Sodexho) in a contract worth £180 million over 8 years (Corporate Watch, 2004).

Now let’s imagine she tries to escape from detention but is caught in the process. Her solicitor ensures her release but, because of the unsuccessful escape attempt, she is electronically tagged by one of the many companies who have secured extremely lucrative electronic monitoring contracts in the UK.[1] In the meantime she is offered Section 4 (hard case) support whilst her representations are considered. Forced to reside in ‘no choice’ accommodation of which almost all is contracted to the private sector; she is given £35 per week in food vouchers that can only be used in the mainstream supermarkets such as, for example, Tesco, that have secured the contracts for their use. Section 4 support has proven to be an extremely profitable market and, for example, housing provider the ‘Angel Group’ recorded pre-tax profits of £4.8 million between 2000-2001. Its owner paid herself a salary of £458,000 (Pallister and Bowcott, 2005).

This scenario is not particularly unlikely, and emphasises just some of the contexts in which the harrowing ordeals that many asylum seekers are forced to endure in the UK have been turned into extremely profitable business opportunities. Indeed, if our hypothetical woman above has her fresh representations rejected then, if he gets his way, she could well become one of Heinz Berger’s first passengers on Asylum Airlines.

Of course, the above sounds wildly conspiratorial. Yet the privatisation of asylum control is already well advanced and developed. Campaigners must recognise this if effective challenges to the brutality that is embedded in the asylum process are to be posed. For as it stands, the wars, inequalities, famines, and dangers abroad that asylum seekers symbolise by their very presence here provide lucrative opportunities for those who wish to make money from misery.

Jon Burnett is Information and Communications Officer at Positive Action for Refugees and Asylum Seekers (PAFRAS).

Notes:

[1] The opportunity for businesses to branch out into the electronic monitoring of asylum seekers is increasingly likely. In 2006 the then Immigration Minister Tony Mcnulty announced plans to electronically tag almost all asylum seekers on arrival (Travis, 2006).

References:

* Burnett, J. (2008a) ‘No access to justice: legal aid and destitute asylum seekers’, PAFRAS Briefing Paper No. 3, Leeds: PAFRAS.
* Burnett, J. (2008b) ‘Dawn raids’, PAFRAS Briefing Paper No. 4, Leeds: PAFRAS.
* Corporate Watch (2004) ‘Sodexho: A Corporate Profile’, Corporate Watch UK.
* Daly, G. (2007) ‘Desmond firm reports profits in UK’, The Sunday Post Business Online, 14 January.
* Home Office (2006) ‘New Five Year Accommodation Contracts Signed’, Home Office Press Release, 24 March.
* Pallister, D. and Bowcott, O. (2005) ‘Inquiry into firm’s asylum contracts’, Guardian Unlimited, 3 August.
* Sydney Morning Herald (2007) ‘New airline for failed asylum seekers’, Sydney Morning Herald, 14 March.
* Travis, A. (2006) ‘Electronic tagging for asylum seekers’, Guardian Unlimited, 14 March.
* Verkaik, R. (2007) ‘Austrian company offers to remove UK’s “disruptive” migrants in adapted aircraft’, The Independent, 27 December.

Outsource till you drop

Ellie Keen — Sun, 13 Jul 2008 00:00:00 +0000

What exactly is the point of John Hutton? Every week seems to bring news of Labour’s dread political predicament: the loss of support not just in the supposedly affluent marginals, but also at the heart of Labour’s core constituency, as demonstrated by government shivers about the looming Glasgow East byelection.

For the business secretary, however, this is evidently no time to be moving away from the old Blairite behavioural tic of defining yourself against your own side. Having already counselled his party against any move on the mega-paid new olympians who are making Gordon Brown’s call for pay restraint all the more difficult (“Rather than questioning whether high salaries are morally justified, we should celebrate the fact that people can be enormously successful in this country,” he said back in March), today found him enthusiastically launching a report from his department’s public services industry review, a funny old document that amounts to a brazen call for New Labour’s privatisation drive to be accelerated.

Despite protests from such union leaders as Mark Serwotka, the old “ideological battle” over the relentless extension of the private sector is, Hutton claims, long over. In the report, the multitude of “service companies” who have sprung up to make the most of 30-ish years of outsourcing are grouped into a “public services industry” that now accounts for 6% of GDP, and is in the midst of what Hutton sees as an admirable export drive, advising foreign governments about how to break up and sell off their public services, and then reaping the benefits. In the UK, says the report, handing these firms all manner of contracts has led to cost savings of between 10% and 30%. It acknowledges that evidence on what outsourcing does to the actual quality of services is “weaker and more limited” than the financial stuff, but that doesn’t get in the way of the essential point: that “Government authorities need to reinforce and demonstrate their long-term commitment to open up public service markets” – whatever “public service markets” actually are.

On the ground, of course, it does not take much effort to discover how those miraculous savings come about, and what such cost-slashing causes. One thinks, for example, of the burgeoning private prison industry, in which average pay rates are a third lower than in the public sector, and staff turnover runs 10 times as high. In my home turf of Cheshire, there was a flurry of outrage a few years back about the grim reality of one of privatisation’s most mind-boggling aspects: its extension into police custody, and the replacement of scores of local holding cells with outsourced “custody suites”, often several miles from where people might be arrested.

You might also cite the experience of hospital caterers like the woman I once met at private finance initiative hospital in Carlisle, told by her new private sector employers that preparing food in the traditional way was now prohibitively expensive, and it was time for the staff to get with the “cook-chill” method: that reassuring cheap culinary technique whereby hospital patients are now served up a grim version of airplane food.

Under duress, the government has occasionally – and belatedly – tried to smooth over the worst effects of its privatising zeal, which has often only served to point up the near-lunacy of what’s been done: in 2005, for example, the Department of Health finally made moves to ensure that outsourced hospital staff would be employed on the same wages as their NHS counterparts, which involved local health trusts paying subsidies of £75m a year to the private companies who had taken over so-called “ancillary” services. Even with that wheeze, however, the essential problems remained. The best example, as demonstrated by loud noises from the Royal College of Nursing, is that of hospital cleaning, and a story that comes up time and again: that when you outsource, you fragment the workforce, standards tend to drop, and the wards get dirty and diseased.

Against an unbeatable combination of New Labour zeal and corporate lobbying, unfortunately, all that counts for precious little, and we continue our passage into a grim future – in which schools, hospitals and jobcentres are adorned with the flash logos of the aforementioned service companies (Serco, Capita, Sodexho, Interserve), accountability counts for very little at all, and the public service ethos is superseded by a dried-up combination of output-specified contracts and the profit motive.

Thinking about all this, my mind goes back to a trip I made in 2006 to the Adam Smith Institute (ASI), the free-market think tank where the ongoing privatisation drive of the last 30 years partly originated (“We propose things which people regard as being on the edge of lunacy”, its president, Madsen Pirie, once boasted. “The next thing you know, they’re on the edge of policy.”). While I was there, I spent a couple of hours talking to Dr Eamonn Butler, ASI’s co-founder and director, who exhibited the unflappable confidence of a man who reckoned that history was on his side.

“For many years,” he told me, “people have said to us, ‘Well, where does it all end? Would you privatise the army, or the police?’ And I say this. Mrs Thatcher did the easy ones first. It took her a long time to get on to health and education, which were difficult. There’s no such thing as an easy, simple privatisation. Every one has been a very complicated political process. And if you look at things like the police, Post Office, health, education, welfare services, all of those things – in theory, all of them could be outsourced. But how should it actually be delivered?”

His conclusion crisply proved what John Hutton will never tell us: that all this has less to do with anything “evidenced based”, than the most hare-brained kind of dogma. “All you can do is try,” he said, “and see what happens.”

Foreign Bodies

Ellie Keen — Sat, 12 Jul 2008 17:13:27 +0000

As Schnews Investigates Dictated Racism in the NHS

As the NHS sinks into a privatised pay-as-you-go American style health system, SchNEWS has decided to take an overdue look at the state of NHS Plcs’ treatment of foreigners who have the misfortune to get sick over here. They’re having their right to health taken away from underneath them by a swathe of new laws being passed.

Despite free healthcare for all being enshrined in the NHS charter, overseas visitors’ access to treatment has been systematically attacked since 1989, when the Tories brought in the first charges for foreigners. Neo-labour has (as always) smoothly stepped in where they left off, further tightening the noose. The latest piece of legislation was passed in 2007.

Thanks to the efforts of successive tightfisted and racist regimes, overseas visitors (anyone who’s been resident in the UK for less than a year) will only be treated when it’s absolutely necessary. For any treatment deemed not immediately necessary they must cough up or go home (not exactly an enticing offer for someone whose fled from persecution and poverty back home).

Whether it’s an attempt to save money or (more likely) pandering to tabloid induced fear of ‘health tourists’ comin’ over ‘ere and swamping ‘our’ NHS (not that foreigners would ever come over here to work in the NHS), the logic of the system simply doesn’t add up. If it’s ‘not immediately necessary’ to provide a patient with drugs to hold a heart condition at bay, before not too long it’ll be necessary to pay for open heart surgery to save his or her life, at a massively higher cost (about £10,000 for open heart surgery versus a few hundred quid for a GP visit and some drugs). It’s nice to know though that if a ‘chargeable’ foetus is delivered in a UK hospital, it is not charged, just its mother.

The latest Neo-Labour wheeze to squeeze the poor and the brown out of their fundamental rights is the new post of NHS Private and Overseas Patients Co-ordinator’. These staff are the attack dogs of this latest approach to maltreatment. They function as NHS debt collectors, who’s job it is to go bed to bed hunting down foreigners and making them pay or turfing them out of the country. These jobs are being advertised around the country- government diktat is that every NHS trust must have one.

Things are a little better in GP’s surgeries, where doctors can operate with a greater degree of freedom than within the over-bureaucratised NHS. Luckily as GPs are self employed it’s at their discretion to accept any person, including overseas visitors, to be fully registered as an NHS patient or as a temporary resident. Because nurses at a GP’s Practice are employed by them and not the NHS Trust, they’re exempt from the laws as well. Unfortunately not many of them seem to know this. However, GPs should know that any random generosity on their part will extend no further than their surgery. For example if the GP wanted to send them for an x-ray, the patient would have to pay up.

In a bizarre twist of government logic, the 65 page document detailing who is and isn’t eligible for free treatment is big on avoiding discrimination. The most important principle (according to the document) is all patients should treated as foreign until proven innocent, not just people who appear foreign (ie funny accents and dark skin). Theoretically, everyone who goes to hospital should be asked “Have you lived in the UK for the past 12 months?” and “Can you show you have the right to live here?” Anyone who has enough foresight to bring their proof they have lived legally in UK for 12 months before treatment should be OK. Of not expect a visit from the NHS debt chaser.

These new laws are compounding the lack of access to health of the poor, immigrant communities that are a micro third-world in large British cities, replete with developing country-style diseases such as tuberculosis and hepatitis. In Tower Hamlets (poor and multi-ethnic London borough) the rate of TB infection is eight times the national average.

Bucking the trend, the French-based NGO ‘Médecins du Monde’ set up a clinic, ‘Project London’ in Bethnal Green two years ago. MdM broke away from the more famous Medicine Sans Frontiers, and, like its larger parent organisation, is more used to working in slums and refugee camps than a scant few miles from one of the world’s financial centres.

Staffed entirely by volunteers, Project London aims to help the immigrant poor access medical services- assisting them to overcome language and cultural barriers. More than three quarters just needed help to register with a GP, and in 85% of cases they were able to get them registered. This suggests that if staff on the front desk aren’t deliberately excluding people are too scared to seek help or no-one can actually work out who is and who isn’t entitled to care.

The Médecins du Monde style is the basic ethos of health workers- good old fashioned humanistic philosophy. Inside hospitals doctors and nurses are having to lie, cheat and break rules in order to protect the rights of patients, having to work against what amounts to an NHS anti-immigrant secret police.

As the UN Special Rappotuer Paul Hunt puts it: “The right to health applies to everyone, regardless of Immigration status…Governments are required to ‘refrain from denying or limiting equal access’ to health services for all persons including ‘illegal immigrants’.”

The ‘Project:London’ clinic is found at:
Praxis, Pott Street, London E2 0EF.
Tube: Bethnal Green, Bus: D3, 8, 106, 254, 388
Tel: 0208 1236614/07974 616852

Open every Monday, Wednesday and Friday between 1pm – 5pm No appointment necessary. (No admission after 4.30pm)
www.medecinsdumonde.org.uk

Contempt for unions

JamieSW — Fri, 11 Jul 2008 00:58:32 +0000

IT is no secret that Business Secretary John Hutton was a Tory when he was at university. The only question is whether he has ever changed his politics.

Everyone knows that government ministers don’t commission a report unless they can be reasonably sure what conclusions it is likely to draw.

Putting DeAnne Julius, a former Bank of England monetary policy committee member, an ex-director of vulture capitalist conglomerate Serco and current director of BP and Roche, in charge of the commission makes it a pretty safe bet that the principle of publicly owned and operated services is not likely to be high up on the list of recommendations.

Not that this was a surprise. The fact that Mr Hutton announced this commission at last December’s CBI public services forum spoke volumes for the intent behind it.

It was intended to signal further opportunities for big business to dine out at the public expense and the subsequent invitations to, among others, Cap Gemini Consulting, Logica, Spire Healthcare, Babcock, KPMG and Serco conjured up images of troughs and slavering pigs.

The Julius commission’s priority is corporate profit, so it is axiomatic that she urges the government to open up even more public services to privatisation.

It is not enough that 6 per cent of the economy that was previously in the public sector is now part of the profits mainline for these dividend junkies.

As long as there is the capacity for privateers to milk the public purse, this parasitic sector will expand to take it up.

Mr Hutton borrows the overused and threadbare line of Tony Blair that “what matters to the public is not who provides but how well a service is provided,” as though government actions are dictated by pragmatism rather than dogma.

But, in fact, there is no practical assessment taking place. The government opts for private as a matter of course.

And Ms Julius does the same, referring to “clear benefits” to taxpayers in hiving off public services to the privateers.

If cutting costs and enabling private profits are the sole criteria, privatisation obviously makes sense, but it omits the key questions of value for money and quality of services.

So confident are the trade unions of the superiority of public over private that, at TUC congress and Labour Party conferences, they have successfully proposed in-depth examination of private finance initiatives and their comparison with government-financed schemes.

New Labour has refused to proceed with these evaluations because, as with Ms Julius’s commission, it knows the answer already.

Most bizarrely, in light of the tidal wave of fury expressed by trade unions, Mr Hutton claims that “the ideological battle over using private and third-sector providers is over.”

By this he means among the circles in which he moves and to which he listens and that doesn’t include trade unionists.

No-one should imagine that Mr Hutton is a maverick out of step with Gordon Brown. They are in step with each other and they couldn’t give a toss about the unions.

The point at issue is what the unions are prepared to do about a party that holds them and their members in contempt.

The true cost of privatised public services

JamieSW — Thu, 10 Jul 2008 16:25:27 +0000

Today’s report by the free market economist DeAnne Julius celebrates the multibillion pound profits private companies are now making from our privatised public services.

Proving what PCS has been saying for some time – that New Labour has privatised more than the last two Tory governments combined – the report joyfully proclaims that what is sinisterly referred to as the “public services industry” is now worth an eye-watering £79bn, a 130% growth since 1995.

These figures are the stuff of dreams to economists and business leaders; and, it would now appear, Labour cabinet ministers.

But it is worth reflecting on what it means. What it shows is the ideological drive to sell off the vital public services on which this country relies has now gathered such pace that we are in a position to parade contracts around the world as a shop window to attract yet more buyers.

Instead of commissioning an economist to investigate how much can be sold off, the government should ask itself, what is the essence of public service? Instead of privatising workers who have won awards for the services they provide, it should reverse its obsession with prioritising profits over people’s needs.

The report offers no reliable evidence for the assertion that public services are improved by privatisation and outsourcing. It is fitting that it is published in the same week as the Commons public administration select committee confirmed PCS’s long-held view that there is no compelling evidence to support the government’s claim that the third sector is “transforming” public services.

If she had wanted evidence, Dr Julius could have looked no further than the report, Water as a Public Service [.pdf], by David Hall and Emanuele Lobina of Greenwich University’s public services international research unit, which leaves no room for doubt about the need for public provision of this most vital resource.

She could also read Allyson Pollock’s devastating analysis of private involvement in healthcare, NHS plc, which exposes the damage done by PFI.

Dr Julius might have thought twice about citing welfare reform as an area of success of marketisation, if she had read the Department for Work and Pensions‘ [.pdf] own research, which shows that non-contracted out job centre teams outperform private-sector teams.

As Steve Davies, of Cardiff University, points out in Contracting Out Employment Services to the Third and Private Sectors: A Critique, the evidence of the success of outsourcing is just not there.

As I said on Radio 4’s Today programme this morning, the fact this review was commissioned, and has been endorsed, by business secretary John Hutton sums up all that is wrong with this Labour government; a government which is now more obsessed with putting profits in the pockets of millionaires, than caring about the lives of the millions of people who rely on public services.

We now face the horrifying prospect of a Labour secretary of state jetting off round the world to persuade developing countries that they should follow suit and privatise their services.

My union, through the Public Services Not Private Profit campaign, will continue to lead the fight against this trend at every possible turn. I believe we enjoy the support of the majority in our opposition to this programme of so-called “reform”, which is ideological in intent and devastating in impact.

Privatised Disasters

Ellie Keen — Thu, 12 Jun 2008 15:49:06 +0000

BACK in 1995, in the days of hope and expectation that a Labour government would represent a qualitative change from the Tories, Labour leader Tony Blair gave a solemn pledge.

He promised that, under Labour, there would be a “publicly owned and publicly accountable railway.”

Not only did Labour renege on that pledge but, these days, despite the obvious failure of the railways sell-off and the overwhelming popular opposition to privatisation, it has become a champion of this shabby Tory policy.

Rail Minister Tom Harris told a BBC Wales programme on Tuesday night: “Ideologically and practically speaking, a private railway has provided a level of investment, innovation and imagination that wouldn’t have happened if British Rail had stayed as it was.”

He seems unaware that the privatised railways attract around four times the subsidy that British Rail received and one of the touted benefits of privatisation was that the privateers would profit from their efficiencies and phase out subsidies.

We were fed lies then and we are still being fed lies. Privatisation is not a policy based on sober assessment of its benefits. It is a matter of neoliberal dogma.

No Labour government has ever announced its intention of abolishing council housing. Neither has Labour conference voted for such a benighted policy. But that is, in reality, the government’s policy, from which it will not be diverted.

It uses public finance to draw up plans for stock transfers of entire housing estates to the private sector, authorises public funds to put out slanted pro-private propaganda and refuses to allow refurbishment of local authority properties if tenants vote to remain with the council.

Nor has any Labour government ever announced its intention of privatising the NHS.

But the Gordon Brown government, like that of Tony Blair before him, is carving the heart out of the NHS, once again deploying public funds to make health care a commodity out of which the privateers can gouge profit.

Mr Brown’s flawed private finance initiative obsession is still used to replace NHS hospitals and clinics with new facilities that are privately owned and leased back to the NHS at extortionate rates.

Similar developments are taking place in other public services such as state education and the Prison Service, where the efficient, economic and democratically accountable public alternative is systematically undermined and discarded in favour of the sleazy, expensive but hugely profitable private option. And that’s without taking account of the plunder of the previously public utilities such as water, electricity and gas, which were milked of their assets for overseas investment.

Barely a week passes without another scandal in the private sector, with sky-high profits for banks, oil companies and other sectors and directors touching for multimillion-pound pay-offs for either success or failure.

The new TUC Touchstone pamphlet will add to public awareness of the scandals associated with privatisation, but we should not expect any acceptance by new Labour that it is wrong and that it will change course.

The case for public ownership has never been more pressing. It must become a major labour movement campaigning issue now, because our entire post-World War II gains are at risk.

NHS Whistleblower speaks out

tim — Tue, 27 May 2008 12:35:59 +0000

Senior mental health nurse Karen Reissmann was sacked last year after being found guilty of gross misconduct by Manchester Mental Health and Social Care Trust for speaking out against NHS cuts. Tom Haines-Doran catches up with her to ask about the latest in the campaign to have her reinstated.

Where are you at with the campaign to get you reinstated?

The campaign started when I was first suspended [June 2007] for bringing the Trust into disrepute. We had 700 people on strike for 14 days of action, followed by further action in November. My appeal was turned down and is now going to an employment tribunal. MPs will be asked to sign Early Day Motion 443 which calls for my reinstatement and there may be further days of strike action. We’re trying to persuade Alan Johnson to sign the motion. It’s ironic that I am being supported by Stephen O’Brien the Shadow Minister for Health, and not his opposite in the Labour government.

Is the return to work something that can keep the campaign alive?

The campaign is not going to fizzle out. I have received an incredible amount support from my colleagues and many others. People are worried about the Health Service; there is a fear of speaking out and a number of health workers are saying they’re glad that I did. One of the questions I was asked by the management was ‘what loyalty do you have to our organisation?’ I said I have plenty of loyalty to the patients, but what they wanted to know was what corporate loyalty I had to the individual trust. The aim of my suspension was to break our union, but now we have seven more Unison stewards than at the start. The fight to stop staff cuts in our service, the campaign that led to my suspension in the first place, has been won – the managers have conceded they will keep the original staffing levels.

During the campaign you brought in many activists from the Trade Union movement and the left. How was this achieved?

One of the first things we recognised was that we needed to mobilise political pressure from the outside. There was a deliberate strategy of including trade unionists and service user groups and networks. We have fought to get users heard. They overcame the stigma of mental illness and have been articulate in their defence of the service. We made an effort to write to every Unison branch to pass information on and particularly helpful were the CWU and RMT unions who made donations to the campaign and invited us to speak at their meetings.

Regarding the NHS in general what would you say are the key issues?

One of the key problems is the tendering process. It identifies areas of work, for example, hip replacement operations and parcels them off. The idea is to create a competitive market within the Health Service. South Manchester Psychiatric Unit is run by a Private Finance Initiative that uses a private contractor to clean the ward and it costs the NHS four times what it did when the work was in-house. Also more of the work is target-driven.

As an NHS employee how would you say working conditions have changed during your career?

When I started 25 years ago we provided a service to patients. Now targets are the be all and end all and we can no longer prioritise in terms of need. On the other hand 25 years ago nurses’ wages were worse because they were less unionised. But with this slight improvement in wages has come a greater workload. The pace is unrelenting. For example occupancy rates are much higher. Now there are 20 beds for 24 or 25 patients with occupancy rates at 120 per cent to 130 per cent. This leads to stress amongst the staff and patients.

Would you recommend a job in the Health Service to people?

I love the work and the people I work with are fantastic. If you do a job that is helpful to others it is generally more satisfying. But more time is spent filling out forms and battling bureaucracy. I would say ‘do it’ but you’ll have to fight your corner.

Michael Moore’s documentary Sicko gave an overview of what a privatised health system looks like in the US, is that something that could happen here?

Nothing is automatic about the NHS. People who fought in the Second World War weren’t prepared to go back to the provisions available in the 1930s. Unlike the Tories, this government dresses up privatisation in complicated proposals. They don’t say they will privatise it but they are in effect creating a market – they’re saying that 15 per cent of the Health Service should be outside the NHS. Not only has the NHS management chosen private operators to run aspects of the service but now private companies are set up to do this on their behalf.

Corporate cherry-picking isn't delivering the goods

JamieSW — Thu, 22 May 2008 23:09:26 +0000

As New Labour heads for humiliation in the Crewe byelection today, those who want to find a way out of the wreckage need to face up to the lessons of its ideological bankruptcy fast. For more than a decade, Tony Blair and, puffing slightly to keep up, Gordon Brown have always insisted that the only test for their policies is “what works”. That has been the theme tune of their ever more enthusiastic embrace of public service privatisation and commercialisation. Not for them the pickled nostrums of the past: if the corporate world could deliver the goods, it had to be given the freest of reins.

The farce of their claims couldn’t have been more clearly demonstrated than in the liberalisation and creeping privatisation of Britain’s postal service. Far from “working” or delivering the goods, the corporate-skewed opening up of the market is progressively destroying a publicly owned network at the heart of Britain’s social and business life. When New Labour came to power, the Post Office was an effective public monopoly handing over more than £100m profit a year to the public purse. Public and political support saw off successive attempts by the Tories and, more tentatively, Tony Blair to privatise what had become Royal Mail.

But eight years after New Labour began exposing the network to private competition and two years after Royal Mail’s 350-year-old monopoly was finally abandoned, the postal service is in crisis and the universal service which guarantees delivery of mail anywhere in the country at a single price is in peril. A devastating independent review for the government this month found that liberalisation had only benefited big business, brought “no significant benefits” to consumers or small businesses, and created a “substantial threat” both to the future of Royal Mail and the universal service.

Of course, few people needed to be told that the service was deteriorating, when the last five years have seen an end to Sunday collections and fewer and later daily deliveries. But the response of the postal regulator Postcomm, whose ideological passion for markets and unchained competition has been central to this sorry saga, was to demand an intensification of the private treatment: far from stepping back, it last week insisted that part-privatisation of Royal Mail was the only way to prevent a further decline in the service, including an end to Saturday deliveries.

Naturally, Royal Mail’s executives like the idea, from which they would stand to benefit richly. But it’s hard to see how it would help protect the unprofitable parts of the universal service or the threatened network of post offices on which it depends. What has really tipped Royal Mail over the edge are Postcomm’s rigged rules for access to Royal Mail deliveries, which have levered corporate operators into the most profitable parts of the business – they now handle 40% of the profitable bulk mail which previously underwrote remote deliveries – and turned an operating profit of £233m in 2006-7 into a £279m loss this year.

Of course, the growth of the internet and years of under-investment in mechanisation have also had an impact – though online transactions also generate mail. But it is this deliberately engineered leaching off the public sector which has been the decisive factor in delivering a worse service to most users and lower pay and conditions to those employed by the corporate cherry-pickers. Meanwhile the government’s continued drive to close thousands of unprofitable post offices, shutting off social lifelines for some of the country’s most vulnerable people, has directly fuelled the public rejection of New Labour which now appears to have passed the point of no return.

When one Labour rebel recently challenged Brown about the impact of postal liberalisation, the prime minister blamed the European Union. It’s true that EU directives require the opening up of postal and other public services to competition – and those neoliberal catechisms are now locked into the Lisbon treaty, due to face its first popular test in the Irish referendum next month. But Britain, ever more royal than the king, has gone much further, much faster than required to do by Brussels, and has failed to use the protective measures available to keep its “dominant provider” afloat.

Not that there’s much hope of either of the other two main parties taking a more sensible approach. David Cameron’s Tories may have opposed post office closures, but they have carefully avoided committing themselves even to the current level of government financial support and can be safely relied on to head off further down the privatisation and liberalisation path, while the Liberal Democrats now want to part-privatise Royal Mail to raise cash.

What’s needed instead is the debunking of the privatising dogma that has created this crisis, a halt to preferential pricing for private predators, a universal service charge for market entrants, and a broadening of Postcomm’s remit. At the same time there is a huge untapped potential to turn local post offices into far more viable hubs by, for example, making them centres of access to public services and reintroducing public banking facilities.

But then the gutting of the postal service isn’t the only part of the government’s corporate-driven market agenda that isn’t working. As Allan Asher, chief executive of Energywatch, told parliament this week, competition in the privatised energy market is a myth, and British gas and electricity consumers are being fleeced by the “tacit collusion” of a “comfortable oligopoly”.

There is clearly going to have to be a more far-reaching change of course. Tuesday’s compromise agreement between the government, CBI and TUC to give exploited contract and agency workers the same basic rights as permanent staff after 12 weeks is certainly a significant move in the right direction and was greeted with squeals of rage by business lobbyists. But there was also disappointment among Labour MPs and trade unionists: once again, Britain has signed up to less worker protection than most EU states wanted and is now likely to be able to continue opting out of long hours regulation as a result of the deal. It may be too late to avoid defeat, but if Labour is to reverse its haemorrhage of support and lay the ground for a better future, it will have to take more than these faltering steps.

Welfare Reform Act to force sick and vulnerable into work

tim — Sat, 10 May 2008 12:05:25 +0000

The draconian measures laid out in the Welfare Reform Act 2007 are now being implemented in Britain by the Labour government of Prime Minster Gordon Brown. The Act represents a wide-ranging attack on millions of the poorest and most vulnerable people who rely on Incapacity Benefit (IB). Recipients of the benefit are deemed unable to work due to poor physical or mental health.

Under the new legislation, their entitlement to financial support is being replaced with new, conditional Employment and Support Allowance (ESA). From November, those registering for the first time as too sick or unable to work will only be entitled to ESA, whereby payments are determined by national insurance contributions, and are subject to means testing. All existing IB claimants will then be transferred to the ESA.

The main aim is to force people into work under threat of poverty. The government has stated it intends to cut the number of Incapacity Benefit claimants by 20,000 each year.

Attacks on welfare have been a central plank of Labour’s policies since coming to power in 1997. Unemployment benefit has been restricted and Lone Parent Benefit reduced.

The government has stated that 2.4 million people currently receive Incapacity Benefit and that up to one million should not be entitled to it. This figure is actually a distortion as statistics from the Department for Work and Pensions (DWP) show that only 1.4 million of the 2.4 million unable to work due to illness actually receive any additional payment. The rest receive standard national insurance credits only.

Since the measures were first mooted in 2006, a campaign based on demonising Incapacity Benefit claimants has swung into operation. This has been fuelled by incessant media scare stories about Incapacity Benefit “scroungers”, “spongers” and “cheats” who claim the benefit “fraudulently” instead of working.

According to recently published research, the number of cases of Incapacity Benefit “fraud” is so low it is almost impossible to measure accurately. It is estimated to account for less than 0.3 percent of total Incapacity Benefit payments.

The tabloid press would have us believe that recipients of “generous” Incapacity Benefit live a life of luxury. But those who are on the benefit are among the poorest people in society. Basic Incapacity Benefit payment ranges from £63.75 on the “short-term lower late” to £84.50 on the “long-term higher rate.” Research conducted by the Joseph Rowntree Foundation in 2004 found that claimants on Incapacity Benefit and or Disability Living Allowance/Income Support met only 28 percent of the costs of people with low-medium needs, 30 percent of the costs of people with intermittent/fluctuating needs, 35 percent of the costs of deaf people and people with visual impairments and 50 percent of the costs of people with high-medium support needs.

On April 4, the Daily Express ran a sensationalist headline “Outrage At £8.5m A Week For Jobless Junkies And Winos,” claiming that “Taxpayers are forking out £8.5million a week in benefits to support jobless drink and drug addicts.”

The article cited statistics from the DWP revealing that 51,410 people whose medical record included a diagnosis of alcoholism received long-term Incapacity Benefits. The figures also showed that a further 49,890 on Incapacity Benefit were drug addicts.

That so many people, including young people, are victims of alcoholism and drug addiction is a societal problem—not only an issue of dependency, which constitutes a genuine illness that causes untold suffering. The turn to alcohol and drugs is exacerbated by the steady erosion of stable job opportunities, the decline of many industries, and decreasing access to quality education, health care, and to drug treatment programmes.

Most of those in receipt of Incapacity Benefit reside in inner city areas in London, the North-West, the North-East, Scotland and Wales. Many of these workers would have previously been in secure, relatively stable jobs in industries like mining, steel and shipbuilding. Over the past 25 years these jobs have been decimated, with millions forced into lives of poverty and the attendant problems such as debt and ill health.

Currently claimants have to pass a rigorous “personal capability assessment” (PCA) in order to quality for IB. A new “work capability assessment” is to target all Incapacity Benefit claimants, with only the terminally ill excluded from the requirement.

Under the remit to “focus on what people can do, not what they can not,” a distinction will be drawn between “being eligible for benefit and being capable for work.” If it is found that the claimant is capable of doing some sort of work, they can receive benefit only on the condition that they retrain and look for work. The penalty for not doing so will be the loss of benefit.

Under the new rules, eligibility for benefit will be decided on a DWP doctor’s evidence and “capability for work” could be assessed by other unspecified “health professionals”.

At present, the severely mentally impaired are exempt from being assessed. Under the new measures, these claimants are required to be assessed and have to agree to look for work in order to qualify for ESA. They are also obliged to attend courses to improve “employability.” They will also be compelled to “manage their health” in work and undertake therapy for their mental health problems.

In order to speed up the number of claimants denied benefit payments, doctors and “care teams” will be directly involved in ensuring that their patients are removed from IB and forced into employment. The Welfare Reform Act follows proposals made in 2005 to allow “employment advisors” from Job Centres to be based in doctors’ surgeries. The pilot schemes began in 2006 in six areas of the UK.

“A revolution in our welfare state”

The Conservative Party has proposed its own assault on Incapacity Benefit. In January, Shadow Work and Pensions Secretary Chris Grayling announced what he termed “revolutionary” welfare proposals.

Under a Tory government, anyone who failed a “work capability” test would automatically lose their entitlement to Incapacity Benefit. They would then be placed on Job Seekers Allowance, immediately resulting in a welfare payment cut of £20 a week.

The plans also specify that those on IB with the “potential to work” would be referred to “welfare to work” providers. These would include private-sector companies.

In preparation for their welfare announcement, the Tories studied welfare systems in a number of countries, and were particularly praiseworthy of measures taken in the American state of Wisconsin, which had cut the number of people on benefit rolls by 82 percent in three years.

Grayling said of the proposals, “For Britain such an approach marks a revolution in our welfare state. It marks an end to a situation where the receipt of incapacity benefit is an unconditional entitlement. In the future, it will carry with it the responsibility to do everything that you can to get back into work and help lift yourself out of the poverty trap that the benefit can represent for so many people.”

The response from the government was merely to complain that the Tory proposal would cost too much to implement. Peter Hain, the Work and Pensions Secretary, said, “The Conservative proposals could cost an extra £3 billion to £4 billion on top of planned spending in this area.”

Labour and the Tories agree that public spending must be slashed in order to make the British economy more competitive with its European and world rivals. When the initial bill was first proposed in 2006, Secretary of State for Work and Pensions John Hutton said the welfare state “must help UK companies succeed in the global economy.”

As well as forcing IB claimants into work, the government is also targeting 300,000 more lone parents and one million additional older workers, including those over retirement age.

Welfare and health provision and the private sector

A critical element in slashing access to benefits such as IB is to facilitate the privatisation of both welfare and employment service. Over the past decade, the private sector has been utilised to step up attacks on the welfare state and to profit from providing services.

A prime example is Atos Healthcare, a subsidiary of a French-based computer firm, which employs 50,000 people worldwide and has annual revenues of 5.4 billion euros. The new Employment and Support Allowance medical assessment system is to be run by Atos Healthcare.

Atos Healthcare was awarded a £500 million seven-year contract by the DWP in 2005 to provide medical advice and assessment services. These include Incapacity Benefit, Disability Living Allowance, and Industrial Injuries Disablement Benefits.

Employees of the company were recruited to be on the technical working groups which drew up the new harsher, Work Capability Assessment. The increased cost of examinations is expected to be in the region of £200 million up to August 2015.

The company also plays a direct role in the provision of medical services. Then known as Atos Origin, the firm won an £8 million contract to operate the first privately run walk-in NHS clinic for local residents and commuters near Manchester’s Piccadilly railway station in 2005.

In January this year, Atos won a 10-year contract to run St Paul’s Way Medical Centre in Tower Hamlets, East London. The former state-run surgery was one of the first to be taken over by a private company. The Tower Hamlets takeover prompted a demonstration by dozens of doctors, nurses and local residents. One doctor who has worked in the area since 1983 told the BBC, “This practice is in one of the poorest areas in the country. There is overcrowding, poverty and a lot of people who are having difficulties with English. There is a huge amount of ill health. The residents are very angry that their health care is going to be sold for profit rather than for personal care.”

In London alone, the government has identified a further 150 GP surgeries that could be taken over and run by private firms.

The Great Consolidation

Ellie Keen — Tue, 29 Apr 2008 20:49:50 +0000

Everything is getting bigger and further away. Hospitals, post offices, schools and prisons are being “rationalised” and “consolidated”. The government says that this process improves efficiency. Instead, it outsources inefficiency: we must travel further to use public services. This is bad for the environment, bad for community life, bad for universal provision. But we haven’t seen anything yet. We are about to be confronted with the biggest shutdown of all: the government has started the process of closing England’s network of doctors’ surgeries.

If you know nothing of this, don’t blame yourself. The announcement was buried in an interim report published last October by a health minister(1). The report was 52 pages long, and the policy was explained in a single paragraph on pages 25 and 26. Rather than being brought before parliament, it was released four days before MPs returned from their recess. Since then there has been no further public announcement. But in December the Department of Health sent a letter to all the strategic health authorities in England, demanding that the policy be implemented immediately(2). The greatest transformation in the history of the NHS is taking place without public debate, public consent or formal consultation.

The government’s policy is to consolidate doctors’ surgeries into a series of giant health centres or polyclinics. Thousands of small practices will be closed and patients will be processed in buildings containing up to 50 GPs. The new clinics will also house some services currently provided by hospitals, which allows the government to claim that it is bringing healthcare “closer to home”. The net effect will be a massive reduction in convenience.

The policy was launched by Ara Darzi, a colorectal surgeon who has been raised to the peerage and made under-secretary of state for health. He wrote his interim report in three months, during which he claims to have spoken to thousands of people. But it contains no record of who they are, how they were selected or what their answers were: he reveals only that “their views have helped shape this interim report.”(3) His final report will not be published until June, but the Department of Health has instructed England’s primary care trusts (PCTs) to advertise for bidders for the new polyclinics by May 2008(4): the first notices have already been posted in the Health Service Journal.

During a parliamentary debate launched by the Conservatives last week, Alan Johnson, the secretary of state for health, claimed three times that this policy is not being imposed on primary care trusts. “There is no national policy,” he said, “for replacing traditional GP surgeries with health centres or, indeed, polyclinics”; “we are not specifying polyclinics as any part of the exercise”; “[the Tories say] we are imposing a system of polyclinics throughout the country. We are not.”(5) Three times, in other words, he misled the House. The letter sent by the Department of Health in December ordered that “each PCT will be expected to complete procurements during 2008/09″(6). In a parliamentary answer in Febrary, the health minister Ben Bradshaw confirmed that “every PCT in the country will be procuring a new … health centre during 2008-09.”(7) A press release published by the Labour Party on April 15th confirmed that the new health centres would be built “in every town and city.”(8) I hope MPs demand that Alan Johnson apologise to parliament.

Lord Darzi insists that polyclinics will offer “a more personalised service”(9). This is nonsense: in the huge new centres we are less likely to be able to see the same GP and more likely to get lost in the system. A recent paper in the British Medical Journal reveals that “patients in small practices rate their care more highly in terms of both access and continuity” and that small practices “achieved slightly higher levels of clinical quality than larger practices”(10). The new centres will be built not where they are most convenient for patients but – as Darzi revealed to the Commons health committee – where the NHS happens to own land(11). If you live in a village or a distant suburb and depend on public transport – as many elderly and sick people do – visiting the doctor could take all day. Ara Darzi is the new Dr Beeching, shutting down the branch lines of our primary health service.

So why is this happening? In seeking surreptitiously to privatise healthcare, the government has a problem. Primary care is already in private hands: GPs run their own practices. But they are the wrong hands: the corporations demanding guaranteed streams of income from the taxpayer can’t play. Polyclinics are perfectly designed to let them in, while preventing doctors from competing.

It’s not just that GPs can’t raise the capital; because the contracts are much bigger than ordinary practices’ and involve many different services, the tendering process is expensive and fiendishly complex. The big service companies can produce the same bid for any number of clinics: they need spend their money only once. The Department of Health says that primary care trusts should use a type of contract called Alternative Provider Medical Services(12), which is designed to allow corporations to bid. This is not a public-private partnership: it is the outright privatisation of primary healthcare.

Do I need to explain the implications? The US health system, which the British government seems determined to emulate, is both more expensive and less efficient than ours; those who can’t afford to pay are either excluded or treated like battery pigs(13). The independent sector treatment centres (ISTCs) – private clinics performing routine operations for the NHS – that the government introduced in England in 2003 have been a costly disaster. Private companies receive their money whether or not they carry out the work they are contracted to do. The government refuses to release comparative figures, but the little evidence we have suggests that their costs are much higher than the public sector’s(14). The risks have been transferred back to the taxpayer and in some cases the standards of treatment are appalling. In 2006 Angus Wallace, professor of orthopaedic and accident surgery at Nottingham University, told the Guardian, “We expect failures of hip replacements at approximately 1% a year and knees at about 1.5% a year. But we have got some of the ISTCs that are looking at 20% failure rates.”(15) Because they put profits first, companies that run these centres have generated a stack of litigation claims and a huge NHS bill for repairing the damage they have caused(16). Far from reversing its policy in the light of this evidence, the government is setting up a competition panel, to ensure that the health service never discriminates in favour of the public sector when awarding contracts(17).

Did any of us ask for this? Are there crowds on the streets demanding the privatisation of the NHS? Even the Tories, for God’s sake, have come out against it: David Cameron’s speech last week placed them to the left of Labour(18). Why, after the 60-odd consecutive quarters of growth that Gordon Brown keeps boasting about, can he not maintain a public service founded in the midst of poverty and rationing? What mysterious hold on policy do the corporations possess, that they can persuade this government to wreck Labour’s finest achievement and damage its chances of re-election?

www.monbiot.com

References:

1. Ara Darzi, October 2007. Our NHS, Our Future. NHS Next Stage Review: Interim report. National Health Service. http://www.ournhs.nhs.uk/

2. Ben Dyson, Commissioning and System Management Directorate, Department of Health, 21st December 2007. Letter to SHA Directors of Commissioning.

3. Ara Darzi, ibid, p3.

4. Ben Dyson, ibid, para 14.

5. http://www.publications.parliament.uk/pa/cm200708/cmhansrd/cm080423/debt…

6. Ben Dyson, ibid, para 5.

7. http://www.publications.parliament.uk/pa/cm200708/cmhansrd/cm080229/text…

8. The Labour Party, 15th April 2008. NHS on your side. http://www.labour.org.uk/nhs_on_your_side,2008-04-15

9. Ara Darzi, ibid, p30.

10. Martin Roland, 22nd March 2008. Assessing the options available to Lord Darzi. British Medical Journal, vol 336, pp625-626. doi:10.1136/bmj.39510.702234.80

11. Professor Lord Darzi of Denham KBE, 25th October 2007. Minutes of Evidence taken before the House of Commons Health Committee. Answer to Q94. http://www.publications.parliament.uk/pa/cm200607/cmselect/cmhealth/uc11…

12. Ben Dyson, ibid, Annex A.

13. During the Commons debate last week, Richard Taylor MP cited two recent papers about the failures of the US medical system, published in the BMJ and the New England Journal of Medicine. http://www.publications.parliament.uk/pa/cm200708/cmhansrd/cm080423/debt…

14. Allyson M Pollock and Sylvia Godden, 23rd February 2008. Independent sector treatment centres: evidence so far. British Medical Journal, vol 336, pp421-424. doi:10.1136/bmj.39470.505556.80

15. Quoted by Sarah Boseley, 1oth March 2006. NHS forced to fix bungled private sector hip replacement operations. The Guardian.

16. See also Stewart Player and Colin Leys, April 2008. Under the knife. Red Pepper magazine.

17. Nicholas Timmins, 16th March 2008. NHS providers to win right of appeal. Financial Times.

18. David Cameron, 21st April 2008. Speech on Primary Care.
http://www.conservatives.com/tile.do?def=news.story.page&obj_id=143765&s…

Public Transport: How to Get Back on Track

Ellie Keen — Mon, 14 Apr 2008 12:42:56 +0000

The market has failed. The Tory privatisation of the railways has been a disaster. The Hatfield derailment exposed the failure of Railtrack and the fundamental flaw in the “separate the wheel from steel” strategy – in which railway operations are split from infrastructure. More rail disasters, from Ladbroke Grove to Potters Bar, further illustrated that public services left to the dictates of the market cost lives.

In July 1999 even the Economist magazine had to admit that “the Tories preferred to see the railways privatised badly than not at all. And that was what they got.” This was an important admission, but it merely shifted the debate from why privatisation doesn’t work to the problem of its implementation.

Thus, despite party manifesto pledges, New Labour continued with the privatisation agenda until, under intensified public pressure, then transport minister Stephen Byers was forced on 5 October 2001 to bring Railtrack into administration under a “not for profit company”, Network Rail.

Nevertheless, New Labour pressed full steam ahead, not only continuing Tory policies but actually extending the privatisation agenda. It was Gordon Brown who forced through the Public Private Partnership (PPP) on London Underground. This time “separating wheel from steel” has already witnessed five derailments, two in one weekend.

The East London Line extension, due to be finished in 2010, will be run by a complex hybrid of eight different companies. Two will be responsible for signalling, two for infrastructure maintenance, two for infrastructure renewals, one for train and station operations and one for train maintenance.

PPP really put the con in contract. Most spectacularly, Metronet, representing two thirds of the contract, was forced into administration on 18 July last year when it ran up debts of £2 billion – a debt that Gordon Brown has written off with public money.

The madness of the market and the sheer greed of the privateers were well illustrated during the Mayor of London’s Question Time on the day Metronet went into administration. Transport for London (TfL) managing director Tim O’Toole and TfL managing director of finance Steve Allen accompanied Ken Livingstone on the day.

When asked about the potential liability on either TfL or London Underground Ltd as its subsidiary, for a considerable chunk of Metronet’s debts, O’Toole confirmed that “the Metronet debt is guaranteed by us”. And again, when the mayor’s team was further pushed for answers to whether it was true that TfL or the subsidiary could be liable for up to 95 percent of the debt, Allen explained, “That is correct. That is a feature of the PPP contracts.”

Brown paid out over £500 million to accountancy firms to draw up the failed PPP contracts. One of the firms, Ernst & Young, took over as administrator, charging £750 per person per hour – and there are 45 of them. Just like the collapse of Northern Rock although the mess is not of our making, the rich are determined that we pay. The argument is simple: if it’s the public who pay, then it should be the public who own and control.

A fully integrated, publicly owned, democratically accountable and environmentally sustainable transport system is not only possible but necessary. Climate change is a major issue facing humanity. However, it is also a class issue. This was starkly exposed when a young delegate from the RMT union asked David Miliband, environment minister, the following question at the TUC Congress in 2006:

“If we are serious about greening Britain and reducing harmful emissions, then railways must be a key part of the solution. So is it not time that we took some serious steps towards making rail travel attractive, affordable and available to all?”

The minister’s shameful response was, “I was absolutely dreading a question about transport because I do not know anything about transport. Do we need to make the railways affordable and attractive? Yes. How do we do it? I do not know.”

Yet transport policy will play a major part in the Climate Change Bill’s target to reduce carbon emissions by 60 percent by 2050. Road transport currently contributes over 21 percent of Britain’s carbon emissions, with a predicted rise to 30 percent from 1990 to 2020. Moreover, in 2002 189 million passengers used Britain’s airports, with a projected increase of between 350 and 460 million by 2020. Just creating a high speed rail link between London and Scotland would cut demand for internal flights.

There is an alternative. The madness of the free market in transport must be ended to allow for a sustainable public transport system integrating principally rail, buses and shipping. There is a convergence of interest between transport workers and the public to achieve this. For the public, any modal shift from roads, private car use and aviation, must take the cost of travel into account. Figures since 1975 indicate that up to 2004 the cost of motoring fell by 11 percent, while during the same period rail fares rose by 70 percent – probably accounting for the fact that rail currently only accounts for 6 percent of all transport journeys.

In 2004 rail unions commissioned the labour movement thinktank Catalyst to investigate the financial structure and performance of the railway industry post-privatisation. One report concluded that receipts from fares increased from £2.94 billion to £4.39 billion in 2003. In the same year train-operating companies also received £1.2 billion in public subsidy. They then paid shareholders £160 million. The profits of the private companies are dependent on massive state handouts and expensive fares.

If the drive for profits was removed, the cost of travel by rail and bus could be slashed. Furthermore, tickets could be made interchangeable between rail, tube, light rail, buses and trams. A coordinated timetable between different modes of an integrated public transport system could then be created.

This would require massive investment in public transport to deal with the problems of overcrowding and to enhance safety equipment. For example, if 5 percent of people travelling by car turn to rail it would require a 50 percent increase in rail capacity.

For rail workers we expect decent terms and conditions and an end to attacks on health and safety. Privatisation and the fragmentation of the railways have led to a concerted and continual drive to casualise the workforce with the introduction of agency and security staff at minimum wage and often zero-hour contracts in place of licensed and qualified railway staff.

This economic race to the bottom lies behind the current dispute on London Underground. The privateers are continually seeking ways of skirting around, undermining and plain cutting corners when it comes to safety. Any mass transport system needs to be run to the highest safety standards with staff present at all locations with pay and conditions that reflect the important role they play.

For the planet, an integrated transport system is not only necessary for public use. It is also necessary environmentally for the passage of freight. The percentage of freight moved by road in Britain is higher than the European Union’s average. Carbon emissions in Britain from heavy goods vehicles increased from 6.3 million tonnes of carbon in 1994 to 7.6 in 2004. Freight volumes are projected to expand in the aviation sector from 2.2 million tonnes in 2003 to 14 million tonnes in 2030 (south east of England). In 2005, 585 million tonnes of foreign and domestic cargo were moved through British ports – the additional volume can be readily accommodated.

In 2005, 90,000 tonnes of domestic cargo and mail were uplifted at British airports. This could be moved by rail, inland waterway and coastwise traffic. All this is achievable. All it requires is the political will to shift from blind faith in the free market policies of successive Tory and Labour governments.

Transport workers and members of the public are best situated to determine what kind of transport system we want. Together we can run a system paid for by the public, democratically accountable to the public and served by public sector workers in our interest.

Unjum Mirza is the secretary of the RMT Stratford No.1 Branch. He writes in a personal capacity

Climate Change and the Public Sphere

Ellie Keen — Mon, 07 Apr 2008 22:38:53 +0000

It might seem a long way from public toilets to the politics of climate change, but there’s an important relationship between what is happening to such public spaces and what is happening to the climate. As so often, it is one of the “rich” countries where the notion of the public realm has been most corroded by individualist, marketised ideology – Britain – that provides a vivid illustration of a more general international trend.

In March 2008, the secretary of state for communities and local government noticed that as Britain’s urban areas were hosting ever-busier crowds of daytime shoppers and nighttime revellers, the number of “public conveniences” available to meet their needs was insufficient. Something had to be done.

The solution Hazel Blears proposed is instructive. Pubs, cafés, restaurants and shops are to be paid by local councils to allow the public in to use their toilets (or what other parts of the English-speaking world knows as “rest rooms”). This is a kind of private-finance initiative (PFI) in reverse: one in which public money is diverted to private enterprises so that they can provide what is indisputably a public service.

The alternative seems obvious: to spend the money on refurbishing and maintaining public toilets, without the private go-between. Why isn’t it the first option of a minister whose remit covers the health of “communities”? Because it is – according to a crude cost calculation – less expensive to pay the private sector than invest in the public sector. The problem here – and the insight it can generate – is that the notion of “cost” and “expense” being employed is an impoverished one that fails to recognise the value of the public sphere itself.

The wrong path

The environment is a classic example of a “common-pool resource”: no one can be effectively excluded from using it, but it is finite and diminishing. Common-pool resources are subject to the “free-rider problem”: namely, that people can’t be excluded from benefiting from the resource, and therefore have no self-interested reason for keeping it well-maintained. In fact their self-interest lies in relying on other people to maintain it, while they spend their time doing other things. The popular English phrase that captures this phenomenon is “having your cake and eating it”.

There are a number of possible solutions to the free-rider problem. Many focus on those who do free-ride, but it is less common – and may be more interesting – to attend more to those who don’t. Why would anyone work to maintain a public resource from which they could benefit equally well without doing so? The answer lies in the commitment of those people to the idea of the public realm where the common-pool resource is located.

This suggests a different type of solution to problems like climate change. The most familiar such solutions tend to be written in the language of commerce and contract, according to which self-interested people will only act for the common good when it’s in their interest to do so. So tradable permits combined with a cap on emissions, for example, are proposed as a way to guarantee lower overall emissions.

But from the point of view of the free-rider problem, tradable permits are part of the problem rather than part of the solution – because they reinforce the frame of mind that leads to the problem in the first place. It will always be in the free-rider interests of carbon-traders to set the cap too high and the price of carbon too low – which is exactly what happens all the time.

An alternative frame of mind is needed – one which seeks to maintain the integrity of the common-pool resource because of its public benefit, not because of some private, excludable benefit that might accrue to the individual. This is an explicitly non-contractual approach to collective social action, and one which runs counter to the popular and apparently unassailable “I will if you will” campaign for pro-environmental action.

When this formula is examined more closely, two flaws emerge. The first is that it assumes that the free-rider problem has been overcome – but it hasn’t, since it can’t ever really be known whether other people are fulfilling their side of the bargain. So the contract contains the permanent possibility of its own demise through internal corrosion.

The second problem with the formula is its logical corollary: “I won’t if you won’t”. This is obviously a recipe for inaction, yet in the free-rider world it is the most likely outcome of the contractual approach. Moreover, it becomes even more damaging where the relationship between the individual and government is concerned, since in conditions of widespread low levels of trust in government even in many democratic states, citizens often won’t fulfil their part of the contract because they don’t believe government will fulfil its.

So what is required is a different social logic: “I will even if you won’t”. This seems utterly illogical from the point of view of commerce and contract; but it is entirely rational when it comes to building the kind of social movement that climate-change mitigation requires.

The right shift

This is exactly where the idea of the public realm plays such an important role. The public sphere is where members of a society learn what a common-pool resource is and how to look after it. It is where people develop non-contractual habits, and learn how to cope with free-riders without falling into the trap of believing that the only solution is privatised “incentivisation” – which just makes the problem worse. Taxes, fines, exemptions, rewards and permits all point away from the public towards the private, which is precisely the wrong direction.

To solve the problem of climate change, a broader and wider frame of reference than seems currently on offer is essential. Technological solutions alone are not enough – but nor are political solutions, so long as they run along the same lines that caused the problem in the first place.

This is why Hazel Blears’s favouring of the privatised solution to the problem of public conveniences is bad news not just for late-night revellers but for the fight against climate change. It reinforces the brutal assault on the idea of the public realm which has been such a marked feature of life in Britain over the last thirty years. Yet without this idea, and a commitment to its protection and what it represents, a society’s ability to address key environmental challenges such as climate change is severely damaged.

The fight against climate change is at once technological, political, economic and cultural – and the biggest cultural change the government could effect would be to expand and defend the public sphere. In too many places, however, governments seem to be pushing their citizens in the opposite direction: private-finance initiatives, individual learning contracts, council-house sales, declining library budgets, and – yes – the demise of the public convenience. All these are potent indicators of the corrosion of the public realm and public interest.

The biggest casualty of the rush to privatisation, enclosure and the withering of the public sphere may well be the climate itself. It’s time for a change of outlook – one which will make so many other things, hitherto unimagined, suddenly possible.

Under the Knife

Ellie Keen — Sun, 06 Apr 2008 19:02:01 +0000

Tom Nairn recently described parliament as ‘a dry-rot infested ruin where one shame succeeds another’. Decay appears to be spreading rapidly. The speed with which former health secretary Patricia Hewitt, and the former health minister Lord Warner, have transferred their services to private healthcare companies appears less and less shocking. It’s not simply the snouts-at-the-trough aspect that is of concern. What their actions show is that the advance of private healthcare at the expense of formerly public provision is sufficiently entrenched to make them confident of a lucrative future.

It should make what is happening clearer to the public too. Since 2000, the year of the NHS Plan, a central feature of government policy for the NHS has been the concealment of its real trajectory. At the acute healthcare conferences organised annually by private healthcare analysts Laing and Buisson, for example, ministers and top civil servants have for several years given detailed policy briefings to companies on new private sector healthcare opportunities, while Hewitt was constantly assuring journalists that NHS privatisation was ‘out of the question’.

Creeping privatisation

Nowhere has concealment of the government’s real aims been more rigorously applied than in the independent sector treatment centre (ISTC) programme. Ostensibly designed primarily to harness additional capacity from the private sector to reduce waiting times for elective (non-emergency) operations such as knee replacements and cataract removals, privately owned ISTCs – 23 of them, spread across England, plus one in Scotland – have in reality served as a bridgehead for market penetration of the NHS, the first time that NHS surgical care has been systematically handed over to for-profit providers.

So far this has meant ensuring adequate and financially risk-free levels of clinical activity, encouraging companies to set up in business to compete with NHS hospitals and treatment centres. It also involves significant and ongoing transfers of NHS staff. But because the NHS remains one of the most popular institutions in the country, replacing public with private services involves enormous political risk. How many MPs – including Conservatives, at least in marginal seats – would be prepared to declare that NHS treatment should increasingly be handed over to private companies, like the railways? Managing and mitigating that risk involves a wide array of mechanisms.

A key example is an exercise in spin called ‘integration’. In reality the only way the private ISTCs can carry out the number of elective procedures they have contracted to provide is to have NHS staff transferred to them. Originally, because they were supposed to bring in ‘additional capacity’, they were not allowed to employ anyone who had worked for the NHS in the previous six months. This rule was repeatedly diluted, either through secondment of NHS staff, or by applying it to an ever-shrinking number of specialties.

By September 2007 ISTCs could use NHS consultants for almost all surgical procedures. A key method in enabling this change has been calls by various bodies, notably the BMA consultant committee leadership, and the Healthcare Commission, to integrate ISTC facilities with those of NHS hospitals in the interests of patients.

While the overall threat of NHS privatisation is denounced, measures to ensure that NHS staff are transferred to the new private employers are supported. For example, the BMA’s Dr Paul Miller told a 2005 BMA conference that ‘as things stand, I would not accept an MRI scan or elective surgery from these ISTCs’ – yet the leadership firmly resisted a motion opposing the centres, arguing that ISTCs could bring about ‘a sustainable expansion of capacity’ and that NHS consultants should be allowed to work in them. A year later, commenting on the health committee’s report, Miller stated: ‘For the last three years, the BMA has been shouting from the rooftops about its concerns regarding ISTCs. I am particularly pleased to see the committee agrees that the Department of Health needs to go further in enabling NHS doctors to work and train in ISTCs, as I believe this will benefit standards and integration of patient care.’

Revolving doors

Political risk has also been managed through the development of a ‘policy community’ of insiders committed to marketisation. The rapid interchange of personnel between government and the private sector – policy makers, management consultants, and healthcare company executives – has been particularly glaring in health policy circles.

The example of Tony Blair’s senior health policy adviser, Simon Stevens, who left to become president for Europe of the giant US company UnitedHealth, is well known. Another example is the former special adviser to both the prime minister and the health secretary, Darren Murphy, who became director of corporate lobbyists APCO UK. APCO’s clients rapidly came to include all the companies involved in the ISTC programme. By February 2006 these companies had formed an ‘NHS Partners Network’, under the aegis of APCO, and had a meeting with Tony Blair where they were warmly welcomed into ‘the NHS family’.

Tom Mann, formerly head of the Department of Health’s ‘national implementation team’ which imposed the first ISTC contracts on sometimes highly reluctant primary care trusts, subsequently became chief executive of Capio, which won a large number of these contracts. Patricia Hewitt’s defection to the healthcare venture capital group Cinven, which now owns Bupa’s former hospitals, and Lord Warner’s to the health insurer AXA PPP, are only the latest in a long line. And within the NHS itself a new ‘national leadership network’ has been formed, consisting of some 150 ‘clinicians and managers from partner organisations’ (i.e. including the private sector) to provide ‘collective leadership for the next phase of transformation, advise ministers on developing policies … and promote shared values and behaviours’. What these values and behaviours are is kept secret. Access to the network’s webpage is restricted to its members, and publications, resources and contacts are all password-protected.

Concealing data

These restrictions are a good example of another key means of limiting political risk – information control. Such control was particularly sensitive in relation to the quality of operations done in the private centres. The first official quality assessment of ISTCs, carried out in October 2005 by the National Centre for Health Outcome Development (NCHOD), found that poor data returns rendered ‘any attempts at commenting on trends and comparison between schemes and with any external benchmark futile’.

The one direct indicator of clinical outcomes at ISTCs had been completely ignored. This did not stop Lord Warner declaring that the NCHOD’s report provided ‘heartening’ evidence of a ‘robust and comprehensive quality assurance and reporting system’. A further study was undertaken by the Healthcare Commission, but in July 2007 it had to report that the necessary information was still lacking. Yet the data concerns NHS patients, whose health and lives are at risk.

Concealment would appear to have been essential, as many first-hand reports by NHS specialists on clinical quality in ISTCs have been highly critical. For example, the professor of orthopaedic surgery at Nottingham University, Angus Wallace, told the Guardian in March 2006 that: ‘We expect failure rates of hip replacements at approximately 1 per cent a year. But we have got some of the ISTCs that are looking at 20 per cent failure rates.’ A study by Dr Gordon Bannister, a leading orthopaedic surgeon in Avon, found that 9 per cent of hip and knee replacements carried out at a nearby ISTC had to be reoperated on, compared with 0.6 per cent in the local NHS hospital – in spite of ISTCs being able to select simpler cases. Notably the surgical repair work fell on the local NHS hospitals.

Such results are hardly surprising. Most of the surgeons originally involved in the first wave of ISTCs were brought in from overseas. They were often unfamiliar with NHS surgical techniques, sometimes had language problems, and were under pressure to achieve high levels of productivity. Release of information about their results therefore had to be kept to a minimum. Once sufficient numbers of NHS consultants have transferred to ISTCs the availability of outcome data will no doubt improve.

All these measures to limit political risk show that ministers and their advisers are acutely aware that the risk is real. The counterpart of this is that if the public clearly understood what is being planned, there is an excellent chance that this path to privatisation would have to be abandoned.

Stewart Player’s and Colin Leys’ new book, Confuse and Conceal: the NHS and Independent Sector Treatment Centres, is published by Merlin Press at £10.99

The Water Thieves

Ellie Keen — Thu, 03 Apr 2008 20:02:29 +0000

The Morning Star recently reported the outrage caused in Britain by the official regulator Ofwat’s approval of increased sewage and water bills. Averaging 5.8%, or over £300, they will hit pensioners and others on low incomes hard. Some areas, including North Wales – a region hardly famed for its arid climate – will see bills rise even more.

What people rightly angered by this profiteering may not have known was that this was far from being a purely British phenomenon. It is, in fact, part of a world-wide water-grab being conducted by major corporations, aided by the usual suspects, the International Monetary Fund and the European Union.

The IMF imposes privatisation of essential services on any country desperate enough to go to it for a loan, or seeking debt relief. The EU is attempting to force developing countries to open their services markets to European corporate investment as it negotiates trade deals.

Known as ‘Economic Partnership Agreements’ (EPAs) these seek to impose ‘free trade’ on poorer countries, making it impossible for them to develop manufacturing and processing industries in the face of foreign competition. In addition, the EU is determined to push countries into removing restrictions on foreign (for which read corporate) investment, including in service sectors. As is the case within Europe, publicly-owned service providers will simply be classed as monopolies, and any attempt to defend or improve them as supporting a restrictive monopoly practice.

Since the late 1980s, the European Commission has turned a jaundiced eye on publicly-owned companies of all kinds. In its ultra-liberalising view a public service which is owned by the people is no different to any other monopoly. The fact that Belgium, for example, has a legal bar on privatising water is, in this way of seeing things, merely a ‘restraint of trade’, as it prevents private companies from competing for contracts within the sector. Belgium can no longer claim that this is Belgium’s business and if any other country doesn’t like it they can lump it.

This is an exclusion whose days are numbered.

As a result of EU rules implicit in the 1957 Treaty of Rome, first made explicit thirty years later in the Single European Act and intensified with every new European treaty since, a foreign water privateer such as the French Vivendi has the right to muscle in on the Belgian ‘market’ for water, and it is only a matter of time before someone insists on exercising that right. The facts that privatisation of water does not deliver what it claims to, and that the Belgian people might like the current arrangements or want to decide for themselves how they might be improved, are, in the EU’s view, irrelevant.

Fortunately, reality is having its say. In France – the lair of the water privateers – around forty local authorities, including Paris, have taken water back into public ownership in the last decade. A rash of privatisations had followed the introduction of a new law in 1992. A few years of experience of rising prices and deteriorating levels of service were enough for most French people, however, and while French corporations scour the world looking for water to grab, France itself is turning away from this bogus “solution”.

As well as trade negotiations, the EU organises the theft of the people’s property outside Europe through the European Union Water Initiative (EUWI). This makes it clear that the EU sees its prime responsibility as being to EU-based corporations, rather than to people in developing countries lacking access to clean, usable water. The fact that water is a necessity makes it, in the Commission’s worldview, a great business opportunity, rather than a human right. The 1.4 billion people in the world who are without clean water and the 2.5 billion without even basic sanitation are potential sources of profit. The Millennium Development Goal of halving these numbers by 2015 becomes simply a commitment to line the pockets of corporate shareholders.

The fact is, in rich countries or poor, there is no way to make a service provider committed to delivering wholesome water and effective sanitation to every home into a profitable business. This is why, in common with other vital services such as public transport and postal delivery, it was in public ownership in the first place.

Privatisation is simply another way of transferring public wealth into private pockets. This is as true in Africa as it is in Accrington. Where a population is relatively wealthy, as in Britain, the money will come direct from the people’s pockets, in the form not only of raised prices but also in the taxes needed to cover the subsidies which are in reality the only source of ‘profit’ for the privateers.

Where the people are too poor to pay up, one of two things will happen. Services will improve, if at all, only for the rich. Or exceptions may be found in urban areas, but only if development monies which originate with those same taxpayers in Europe and other wealthier parts of the world cover the costs, and then some. The market can deliver only to those who can pay. The poor will not get water, being too poor to pay for it, unless someone else pays for them.

25 million people a year die as a result of water-related diseases. Most readers would, I hope, be only too happy to see some of their taxes go to addressing the stark inequalities which lie behind these wasted lives. Lining the pockets of Vivendi’s shareholders, however, is likely to be less popular.

The real solution is, of course, to use our development monies, our power as a trading bloc and our long experience and accumulated expertise to work with those communities and public utilities in developing countries which are really trying to solve this most fundamental of problems.

Partnerships between public utilities in Europe and developing countries – known as PUPs – to share expertise and improve service; innovative thinking such as the small solidarity levy paid by customers of Milan’s publicly-owned water company; and a concerted effort to achieve and go beyond the UN’s Millennium Development Goal are what will help to end the thirst, hunger and disease which are the results of inadequate water supply and sanitation.

Steve McGiffen is editor of Spectre and writes monthly column for the Morning Star, where this article first appeared.