Sixty years after its birth, the process of auctioning off the most profitable sections of the NHS is now well and truly underway. GPs who have traditionally run their own small, locally-based surgeries are now being forced to compete with huge international companies as a result of legislative changes introduced in 2003.
Primary Care Trusts who manage and oversee local healthcare budgets are increasingly being swayed by a new Alternative Provider of Medical Services (APMS) contract model which enables GP surgeries to be sold off to big profit-making companies like Virgin, Boots and the US corporation, United Healthcare Europe. The latter body is the British section of the largest healthcare provider in the United States – which is under investigation there for allegedly using subsidiary company Ingenix to defraud patients by manipulating benefits below the usual costs.
In the London Boroughs of Tower Hamlets and Camden, local GPs lost out in the tendering process, and practices were duly transferred into private hands. Commercial contractors, needless to say, are not bound by NHS terms and conditions and pension schemes, which allows them to undercut wage costs and offer vastly reduced tender prices. Commercial bodies are also more preoccupied with making profits than making sure that patients get optimum care.
The Darzi Report in 2007 introduced the concept of polyclininics, large impersonal GP-led health centres designed to replace traditional, more intimate surgeries. However, groups like Stop Haringey Health Cuts Coalition have sprung up in opposition. In the last 3 years coordinated protest and resistance to £15-20 million worth of local cuts, closures and threats of privatisation has occurred. One activist describes how:
Our main tactics have included extensive e-mailing through affiliates, mass leafleting, regular presentations backed by lobbies and protests at PCT Board meetings and Council Scrutiny Committees. In the last 4 months there has been uproar over local plans to force GPs into polyclinics which would result in the closure of 45 out of 60 surgeries. The eyes of the country are on Haringey which appears to have been chosen as a guinea-pig for a highly controversial “slash and burn” approach to this reform.
We have publicised and joined protests organised by campaigners in neighbouring boroughs such as the recent anti-privatisation protest at the Whittington Hospital in Camden, and last year’s 5,000 strong march to save Chase Farm hospital in Enfield.
We’ve also sent delegations to [campaign group] Keep Our NHS Public meetings because we know that it is vital to link up all the many grass-roots struggles and campaigns into a countrywide movement capable of ensuring the free, comprehensive and world class public health services our communities are entitled to.
For more information on grass-roots struggles against NHS privatisation, cuts and closures, see: www.keepournhspublic.com
These 3 articles demonstrate New Labour’s unflinching commitment to privatisation, deregulation and cutbacks in vital public health and social care services. At a time when the economy is on the downturn, with the government firmly committed to neo-liberal policies, workers and communities are bearing the brunt. We have already seen the devastating effects with the nationwide hospital superbug epidemic. (Incidentally, figures published by the Office for National Statistics in August confirmed a 28% annual rise in the number of patients dying while infected with superbug C-Difficile). Pinpointing the underlying cause, Karen Jennings of UNISON said:
We are losing any sense of collective responsibility or equity in the NHS. The super bug phenomenon can be directly attributed to the contracting out process: hospitals had 50% more cleaners in 1982 than in 2007.
Anyone unconvinced of the dire consequences of privatisation should see Michael Moore’s Sicko, which chronicles the abysmal state of the fully privatised US system.
In order to combat these wholesale attacks on our services and working conditions, positive action-based solidarity between workers and local communities is needed. We cannot rely on the politicians and bureaucrats, who, for all their silver-tongued spin, are working towards their own clear long term agenda.
In the final analysis, under capitalism health and social care provision will always be seen as a disposable, dispensable commodity, playing very much second fiddle to the bosses’ drive to make profits. So while we expose and resist cutbacks in the here and now, we work towards a time when the services we use and provide are directly shaped, organised and controlled by the workers and local communities who know them best.