Going…
This is a short series of Blogs on privatisation in the NHS
and it’s based on some really useful research by The Observer, and written by
Daniel Boffey their Policy Editor. It was published on 7th April
2013, I don’t have the link, I’m afraid.
I’ve written a lot about the obvious threat to the NHS –
closing hospitals down and selling off the land. This is worse, more subtle,
more insidious. It’s not just the financial consequences, it nibbles away at
the ideals of the NHS and divides patients against patients and staff against
staff.
There are now 146 Foundation Trusts, soon all trusts will
have that status. They have been given freedom from Government control or,
another way of looking at it is they have been taken out of our democratically
elected control.
The Boards are now business people, running an independent
business. Except we are still paying for it all.
The regulations have been changed – ‘Trusts’ can now earn up
to 49% of their income from treating private patients. And boy, are they going
to take advantage of that. Here are a few choice examples from the article;
Great Ormond Street Hospital for Children.
A much loved charity as well as ‘GOSH’, featured in the
Olympic Opening Ceremony.
+34% or +£11 million
from private patients for year ending 2013 compared to 2010.
Imperial College Healthcare
+ 42% or + £9Million
Royal Marsden
+ 28% or + £12.7 million
NHS Overall +8%
40 trusts plan new Private patient units.
Then it gets really frightening – Moorfields Eye Hospital is
opening a unit in Dubai, to gain work from the Middle and Far East. Want to see
your Doctor? – he’s in Dubai.
Going
Going…
So much for the world famous hospitals, what about the boring
local ones, those are the ones we really care about because they are the ones
we need?
Ealing Hospital in West London is under real threat – it
faces losing its Accident and Emergency and Maternity. Things flow from that –
if maternity goes what future does Gynaecology have? The Stroke unit has
closed. If A and E goes, what about cardiac?
Well, they have plans of their own – plans to increase
Private Patient income in 2013 by + 231% compared to 2010.
Surrey and Sussex plans an increase of +186% and that
includes 11 new private rooms.
Their spokesman summed it up;
“As with other trusts, many of our consultants run private
practises outside of their NHS work. Many of these consultants prefer to
operate in NHS Hospitals where there is 24/7 backup of intensive care
facilities, etc, so that they can operate on high-risk patients. These
operations are carried out outside NHS sessions, at weekends or out of hours.”
No one voted for any of this, although we will be paying for
it. In return we get a first and second class service, which divides us up
between those who can pay and those who have to wait.
Tomorrow, I’ll have a look at how insidious it all really is.
Going
Going
Gone…..
Right now, if you go to a private hospital as a private
patient, you normally go to see a consultant who is hiring a room or basic
equipment. They do simple operations on healthy people. They do complicated
operations or operations on high risk people, but it takes planning and they
have to hire subcontracted staff as well. Medical procedures don’t follow
plans. Those private hospitals are rarely capable of dealing with intensive
care (ICU), resuscitation, or emergency work. They don’t have 24 hour back up.
Doctors and Nurses only come in when they are hired to do so. That’s why private hospitals are often near
NHS ones – it’s easier to get hold of staff at short notice.
When things go wrong, it doesn’t go so well. If there’s an
emergency, private patients use the NHS.
At the moment we are paying consultants £120,000 to £250,000
a year. They do work at weekends or at night but don’t like it (understandable)
but as we’ve seen, they are quite keen to take on private work at those times.
They don’t want to use private hospitals because they don’t
like their patients dying – they would prefer to do those operations in NHS
hospitals, then if there is a problem rush the patient into ICU or A and E.
So, the private patients jump the queue to start with (it’s
the same consultants as in the NHS and they only have so much time) then when
it all goes wrong they jump another queue into Intensive care etc., leaving the
rest of us to wait. (No beds, I’m afraid).
Consultants can only be at one place at a time – if they are
sloping off to have a look at their private patients in the ‘special wing’,
who’s to know? Who will be their priority?
One of the perks of being the manager of a ‘Foundation trust’
is the ability to set your own salary, to write yourself a cheque. Now we can
see where it comes from – it’s a business.
The private patients jump the queue but only have to pay for
those services they need, when they need them. Meanwhile the stupid taxpayer
picks up all the rest of the bills for the really expensive permanent costs
that never go away (buildings, equipment, staff costs 365 days a year 24/7).
And the NHS gets to sort out all those really expensive
emergencies.
Milo
Minderbinder
Remember Milo Minderbinder in Catch-22? Milo who?
People forget him or don’t understand what that part of the
book was about.
Catch-22, the best-selling book and later film is a satire on
an American WW2 bomber base in Sicily. The fliers bombing tourss keep getting
extended, each time just as they are about to go home. Each mission is
suicidally dangerous but if you apply to be excused due to mental illness you
will be deemed fit to fly as no sane person would want to fly suicidal
missions. Only the insane would actually do it – but they don’t apply - the
moment they make the application they are deemed fit to fly.
“That’s a good catch
that Catch-22.”
In the background, Milo Minderbinder offers to supply the
squadron’s mess with food and the men with supplies, bought from the black
market. His business ventures grow and grow and become more intrusive. He buys
up the entire Egyptian cotton supply in a giant speculation and then when he
can’t sell the cotton, covers it in chocolate to try to sell it to the fliers
as a snack.
It turns out he sold the silk from their parachutes to pay
for the cotton, then when they need the chutes, the fliers find they’ve gone,
replaced with a share certificate in Minderbinder’s company.
That’s the end result of this creeping privatisation. As the
private part grows, the NHS shrinks and the patients who thought they owned the
NHS, find they don’t.
Casual jobs replace full-time careers which came with
pensions and holidays.
NHS patients get stuck in second class.
Just when you needed the parachute, there’s nothing there.
Neil Harris
(a don’t stop till you drop production)
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