NHS reform falters as Labour ministers pull advert
The sense that the Labour government is losing its grip on plans to reform the National Health Service gathered momentum yesterday as ministers pulled a procurement notice inviting the private sector to bid to purchase NHS services in the face of all-out opposition from unions. Patricia Hewitt, the health secretary, and Lord Warner, minister for NHS reform, said there had been "drafting errors" in the advertisement.
Their comments followed condemnation by Unison, which said it was calling on the Trades Union Congress to organise a campaign of opposition to the move to involve private sector companies in the purchasing of hospital, primary and community care.
Karen Jennings, head of health for Unison, described it as a "contract to privatise the whole of primary care across the UK". The union's opposition came on top of comments earlier this week by James Johnson, chairman of the British Medical Association, which said the involvement of the private sector in purchasing NHS care as well as in its provision was a "line in the sand" that the NHS should not cross.
Steve Webb, Liberal Democrat health spokesman, added to the furore, saying that the move involved a "fundamental shift in the NHS"; one that had been taken "without any consultation with parliament, the public or the professions".
The procurement notice, which was disclosed in the Financial Times and mentioned by Health Direct last week, offered bidders a framework contract that would allow them to undertake anything from the data analysis that underlay commissioning to the actual "purchasing of hospital and community care" on behalf of primary care trusts. These commission care on behalf of their local population.
Companies, from the the UK-based Bupa to the American United Health, could potentially be involved.
Ms Hewitt stressed that primary care trusts would remain the statutory body responsible for commissioning care. "They are can never outsource this responsibility or ask others to make decisions for them," she said.
But Ms Jennings said that this could still leave private sector commissioners buying services from private sector suppliers. Even if commissioners were prevented from buying directly from themselves "there will be a natural preference for the private sector to look after itself and buy from other private sector providers. There is huge scope for corruption and fraud," she said.
The row exploded at a meeting between health ministers and the unions on Thursday. The unions denounced the increased involvement of the private sector and accused ministers of reneging on a pledge made last year not to force primary care trusts to divest themselves of the direct provision of services such as district nursing, community hospitals and, in some cases, family doctor care.
Lord Warner accepted that the procurement notice mighty have given a "false impression". As a result, he said, the advertisement had been withdrawn because of "drafting errors". However, the department was unable to spell those out yesterday.
He added that the government remained determined to give PCTs access to "expert help" from the private and voluntary sectors with their commissioning role. A revised procurement notice would be issued shortly he said.
The extent to which that will restrict the role the private sector can take in commissioning remains to be seen.
David Hunter, professor of health services management at Durham University, said part of the problem was that ministers appeared to be disingenuous about the direction of policy.
Last year they said there was "no requirement or timetable" for primary care trusts to get out of the direct provision of services.
However, said Professor Hunter, this was the clear thrust of policy, with the department itself being divided into commissioning and providing arms, while also setting up a "social enterprise" unit to encourage staff to leave direct NHS employment and sell their services back.
Equally, although ministers had halted plans last year for the private sector to take over commissioning in Oxfordshire, they were now seeking tenders for it to be able to do precisely that.
Frank Dobson, Labour former health secretary, said: "The government's approach seems to be to take one step forward, deny it, take one step back and then move forward again.
"But this is the final confirmation that the government wants the private sector involved at every level of the NHS" - an approach he said would lead to fragmentation and mounting administrative costs.
Ms Hewitt insisted there was "no question whatsoever" of privatising the NHS. Care would remain free at the point of use and available to all, regardless of who was providing it.
http://www.ft.com/cms/s/2e66e6de-089d-11db-b9b2-0000779e2340.html
Health Direct first raised on Tuesday, June 20, 2006 in Last brick in the wall for the new look NHS health insurance Their comments followed condemnation by Unison, which said it was calling on the Trades Union Congress to organise a campaign of opposition to the move to involve private sector companies in the purchasing of hospital, primary and community care.
Karen Jennings, head of health for Unison, described it as a "contract to privatise the whole of primary care across the UK". The union's opposition came on top of comments earlier this week by James Johnson, chairman of the British Medical Association, which said the involvement of the private sector in purchasing NHS care as well as in its provision was a "line in the sand" that the NHS should not cross.
Steve Webb, Liberal Democrat health spokesman, added to the furore, saying that the move involved a "fundamental shift in the NHS"; one that had been taken "without any consultation with parliament, the public or the professions".
The procurement notice, which was disclosed in the Financial Times and mentioned by Health Direct last week, offered bidders a framework contract that would allow them to undertake anything from the data analysis that underlay commissioning to the actual "purchasing of hospital and community care" on behalf of primary care trusts. These commission care on behalf of their local population.
Companies, from the the UK-based Bupa to the American United Health, could potentially be involved.
Ms Hewitt stressed that primary care trusts would remain the statutory body responsible for commissioning care. "They are can never outsource this responsibility or ask others to make decisions for them," she said.
But Ms Jennings said that this could still leave private sector commissioners buying services from private sector suppliers. Even if commissioners were prevented from buying directly from themselves "there will be a natural preference for the private sector to look after itself and buy from other private sector providers. There is huge scope for corruption and fraud," she said.
The row exploded at a meeting between health ministers and the unions on Thursday. The unions denounced the increased involvement of the private sector and accused ministers of reneging on a pledge made last year not to force primary care trusts to divest themselves of the direct provision of services such as district nursing, community hospitals and, in some cases, family doctor care.
Lord Warner accepted that the procurement notice mighty have given a "false impression". As a result, he said, the advertisement had been withdrawn because of "drafting errors". However, the department was unable to spell those out yesterday.
He added that the government remained determined to give PCTs access to "expert help" from the private and voluntary sectors with their commissioning role. A revised procurement notice would be issued shortly he said.
The extent to which that will restrict the role the private sector can take in commissioning remains to be seen.
David Hunter, professor of health services management at Durham University, said part of the problem was that ministers appeared to be disingenuous about the direction of policy.
Last year they said there was "no requirement or timetable" for primary care trusts to get out of the direct provision of services.
However, said Professor Hunter, this was the clear thrust of policy, with the department itself being divided into commissioning and providing arms, while also setting up a "social enterprise" unit to encourage staff to leave direct NHS employment and sell their services back.
Equally, although ministers had halted plans last year for the private sector to take over commissioning in Oxfordshire, they were now seeking tenders for it to be able to do precisely that.
Frank Dobson, Labour former health secretary, said: "The government's approach seems to be to take one step forward, deny it, take one step back and then move forward again.
"But this is the final confirmation that the government wants the private sector involved at every level of the NHS" - an approach he said would lead to fragmentation and mounting administrative costs.
Ms Hewitt insisted there was "no question whatsoever" of privatising the NHS. Care would remain free at the point of use and available to all, regardless of who was providing it.
http://www.ft.com/cms/s/2e66e6de-089d-11db-b9b2-0000779e2340.html
And warned that a new health insurance tax was not too far behind.
Lord Warner’s "false impression" and "drafting errors"- even though the department was unable to spell those out yesterday, is nothing more than another screeching Labour U Turn.
It is also the first sign that the Unions have woken up to the threat of the final fragmentation of the NHS.
As Frank Dobson, Labour’s former health secretary, said: "The government's approach seems to be to take one step forward, deny it, take one step back and then move forward again.
"But this is the final confirmation that the government wants the private sector involved at every level of the NHS" - an approach he said would lead to fragmentation and mounting administrative costs. “
The difference that this system would make would be that it would not be NHS staff, directly employed by a PCT, who would be choosing which services - including GP services - provide the best available choice.
That would be undertaken by a privately-owned manager, operating on contract to the PCT's board and charged with obtaining the best value for money.
This new iniative is part of what the health department calls a "step change" that is shifting the NHS from being "a services provider to a commissioning-led organisation" - one that operates in effect as a giant, tax-funded health insurance scheme with no ideological view remaining about who should provide the service: the publicly- owned NHS, the private sector, or the third sector made up of voluntary organisations and charities.
This new iniative is part of what the health department calls a "step change" that is shifting the NHS from being "a services provider to a commissioning-led organisation" - one that operates in effect as a giant, tax-funded health insurance scheme with no ideological view remaining about who should provide the service: the publicly- owned NHS, the private sector, or the third sector made up of voluntary organisations and charities.
posted by Dr Search- Principal Consultant at the Search Clinic at
9:55 AM
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