Not so healthy

An interesting article on the Health Committee’s recent report suggests that privatisation is not as simple as we’re encouraged to believe by this and previous government’s.

In an earlier blog I suggested that donors were unduly influencing our ‘democracy’ and here is an instance – the Tory Party has received donations, it is suggested, from private health providers of about £20m.  But it really doesn’t matter if it were only 200k – such donations and the influence they yield are still highly likely to skew policy making and thus the systemic change that stems from it.

The article I refer to notes that the Health Committee thinks:

‘Notions about the Americanization of the NHS were misplaced, due in part to the terminology surrounding Accountable Care Organizations, while the somewhat less than transparent introduction of this new phrase – and new phase in the development of the NHS – has added to the confusion. Such problems could however be remedied by a “clear and compelling narrative” developed by the Department of Health, NHS England and other associated bodies, which would reassure both patients and taxpayers that the path of transformation was sound, sustainable, and in their best interests.’

The Committee also argued that clarity could be more readily achieved by developing this narrative from a patients perspective, rather than focusing on systemic transformation.

The author goes on to suggest that:

‘The World Economic Forum’s (WEF) year long deliberations on healthcare followed the announcement by Standard & Poors in January 2012 that national healthcare systems must demonstrate sustainability in order for their economies to maintain credit ratings. Workshops held in New York, Berlin, Istanbul, Tianjin, Madrid, Basel, the Hague, and London that year, were, according to the WEF, “remarkable in their consistency of vision”, advocating, for example, delivery from “capital-light settings” using “leveraged talent models” and “low-cost channels, such as home-based models”.’

In other words, what’s happening to the NHS is being reproduced on a global scale.

In this context it’s perhaps no accident that prior to his appointment as Chief Executive of NHSE, Simon Stevens led the Global Health Division of the US’s largest insurer, UnitedHealth, and was also chair of the WEF’s Steering Group on system sustainability (Steven’s had also been one of Tony Blair’s special advisers). The interoperability of transnational and US ambitions isn’t always so clearly evident!

The article’s author continues, summarising from his focus on Yeovil, which he suggests is the most ‘advanced’ in private provision:

‘The range of private healthcare provision in Somerset is remarkably extensive, so much so in fact that the vanguard can no longer be considered a public entity. US companies it would appear are not simply offering services, but providing capital investment, acting as brokers for other private providers, and also acting as de facto commissioners of care at a county-wide level. It would appear that the ‘engine room’ of change for the English NHS is firmly transatlantic.’

As the marvellous Alyson Pollock shows, Cameron lied (no surprise there then) about changes to the NHS in England, which he promised never to undertake. He went ahead regardless and from her simple planograms we can see how little Conservatives say when in opposition can be taken at face value once they reach government. Confusion, turmoil and overblown bureaucracy is the result. Goodness only knows how much more inefficient this has rendered the delivery of care to actual patients.

And looking at the flip side of the coin, goodness only knows how much more efficiently this has rendered the delivery of profits to private sector providers.

By contrast, this was the straightforward system that applied to the NHS prior to Blair’s New Labour becoming obsessed with choice and so-called internal markets:

And now ask yourself a simple question: why would a complex system be more efficient? And who exactly benefits from it?