NHS update

Nick Davidson highlights several significant developments in recent weeks.

Centene/Operose

There is some arguably good news concerning the Centene/Operose takeover of GP surgeries. The North Central London  Clinical Commissioning Group – covering Islington, Camden, Haringey, Enfield and Barnet – has renewed the contract for the two Islington Operose surgeries, and the one Operose sugary in Haringey, for only one year as opposed to the normal four or five years, while they review how the surgeries are working.  This is being seen as a victory for campaigners, among them local authorities, who have been asking difficult questions about the original decision to allow Centene/Operose to buy 49 GP surgeries across London and South East England.

The Health and Social Care Bill

The Health and Social Care bill continues to trundle through Parliament. It is currently in the Committee stage and likely to come back to the Commons in November. One of the big worries is that it will increase the role of the private sector in the NHS.

One significant development is that the government now appears to have conceded that ‘individuals with significant interests in private healthcare’ should not be allowed to sit on NHS boards. In other words, the private sector will not have a direct input into Integrated Care Systems decision making. (ICSs are the new look CCGs.)

However the Bill still explicitly provides for private sector involvement in other areas of the NHS. For example:

  • The private sector will be allowed to sit on ICS advisory boards which will not be required to meet in public or publish their minutes and papers.
  • There has not yet been any discussion of the regulations governing NHS procurement, or Labour Party amendments proposing the NHS should become the default provider when contracts come to an end.

So don’t celebrate too soon.

Health and Social Care Funding

The government recently agreed to put in an extra £36 billion into health and social care over the next three years paid for by a hike in National Insurance tax. There are a huge number of issues here.

  • An increase in NI will only increase inequalities. The now forgotten 2019 Labour Party manifesto came up with a much fairer way of doing this. It proposed an increase in income tax on salaries over £80,000, an increase in corporation tax and a  new tax on capital gains and dividends that would raise £14 billion annually. Sadly this has been forgotten.
  • To put the extra £36 billion in context, the government handed £37 billionto  Serco and Sitel’s privatised Test and Trace operation in May last year without a  blink –  let alone a new tax to pay for it.
  • The new provisions for social care funding are a con: they do not cover so-called ‘hotel costs’ – in other words, you have to continue to pay for the accommodation – and they will fund only the most basic care.
  • NHS trusts say they need a one-off payment of £10 billion this year to tackle waiting lists and Covid costs. The government has given them £5.4 billion, not available until April next year.
  • Finally it’s worth remembering we have fewer hospital beds and doctors per head of population than any other western European economy. Since 2010 the  NHS has lost 20,000 beds, more than 100 A&Es and is short of 90,000 staff.

Creeping privatisation

Meanwhile the private sector continues to creep into the NHS, often virtually out of sight. The most recent  example is at Kings College Hospital in south London where NHS staff at an urgent treatment centre have been told they will soon transfer to the private company Greenbrook Healthcare who are taking over the running of the centre on 4th October after winning a three-year contract worth £10million. Staff are dismayed and upset, according to trade union sources who say there has been “no proper consultation” or information with many staff finding out by text message.

Nick Davidson is a proud member of Haringey Keep Our NHS Public and Islington North Labour Party.

Image: anti-Centene demonstration outside the Dept of Health and Social Care on July 5th, taken by the author.

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