I’m proud to have presented the cross-party NHS Reinstatement Bill in Parliament. The creeping marketization of our NHS began in 1990 when trusts were created as atomised accounting centres, every trust to operate as if it were a separate business. This was then developed by Alan Milburn (the Labour Health Secretary) in 2003, who took the model even further with foundation trusts and Independent Sector Treatment Centres. The 2012 Health and Social Care Act went still further by handing the private sector unprecedented access to NHS markets.
In an excellent article for this website Paul Evans revealed, just before the election, that over the last year private firms have won £3.5bn worth of new clinical contracts – an increase of 500% on the previous year. Each year, more and more NHS contracts are forced out to tender and the private sector hoover up the profitable stuff. Why wouldn’t they. Cherry picking might make good business sense for private firms but it is very bad news for our NHS. Private firms grab the predictable and lucrative work, thus depriving the NHS of vital income and training opportunities. Orthopaedics departments in the NHS are a good case in point. They have traditionally had surgeons who carry out both emergency operations, on a broken leg, for example, and at other times they do elective work, such as hip or knee replacements.
But recent research by Professor Tim Briggs, a consultant orthopaedic surgeon shows that NHS trusts in England are typically losing between 10-40 per cent of their elective workload to other providers – while keeping the more expensive emergency work. Not only that, the corporate lawyers have been through the contracts to make it clear that when there are complications in an elective procedure, the NHS sorts it out. “The private providers don’t readmit their emergencies, and that is putting all the risk on the trust,” says Briggs.
The loss of expertise means people with shoulder fractures may have to wait for treatment at another centre because the surgeon in trauma hasn’t had enough experience of elective shoulder replacement to give them the confidence they need to deal with the problem locally. That is worse for the patient and more expensive for the NHS. So private sector involvement does not magically create greater efficiency – quite the opposite.
On top of the inefficiency created by private sector involvement in healthcare we face the looming threat of the services the NHS must provide being cut. Under the 2012 Act, the list of services that foundation trusts must provide after April 2016 will be reduced compared with the list they must provide now – that is the expectation of Monitor (the expensive regulator that marketization of the NHS demands). There is a serious danger that the NHS in England will be whittled down to a core service.
Critically, in reinstating the NHS, from the bottom up and without imposing yet another top-down reorganisation, the Bill tackles the waste of administering the artificial internal market that has been created over the last 25 years and the situation post-2012 which forces NHS contracts out to tender.
Our Bill, guided by the principles of the 1946 Act, would both reverse the costly marketisation we’ve seen and re-instate the Secretary of State’s duty to provide services.
Now, more than ever, faced with five years of a Tory Government, we must stand together and fight for the NHS we believe in.
Just last week we saw local people in Cornwall stop the privatisation of pathology services at their local hospital-and these fights are happening up and down the country.
People fighting in local communities need a response from those of us in Parliament. Labour, known for so long as the party of the NHS, now has a real opportunity to go beyond political tribalism and back this cross-party bill to save our NHS. Already one of the leadership candidates for Labour, Jeremy Corbyn, has backed the bill: I hope the others will show the same vision and follow suit.
Since its inception our NHS has never been in greater danger. MPs in Parliament who believe in a truly public NHS must now do all we can to save our health service by backing this bill.