At the 2010 election we were assured by all the main political parties that there would be no top-down reorganisation and no privatisation of the NHS. However after four years of the Conservative-Liberal Democrat coalition, we’ve got both!
Readers of the West Sussex County Times will be aware of the debate that is taking place over the privatisation of the existing NHS ‘musculoskeletal’ (MSK) services for the Sussex coastal region (which will affect patients in the Horsham area).
So despite the constant reassurances, the denials, all the promises by the Coalition, the privatisation of NHS services under the Government’s Health and Social Care Act of 2012 is proceeding steadily.
In this particular instance - the award of the contract for musculoskeletal services for the Sussex coastal region - we have a blatant example of ‘cherry-picking’ by the private sector - as opponents of the 2012 Act predicted would happen at the time of the passing of the Act!
The private corporate interests involved have chosen to bid for the NHS south coast hospitals’ most lucrative sector of health care provision, so the financial attraction to the private sector of making money out of a profitable sector of NHS hospital provision is self-evident.
The decision of the NHS Coastal West Sussex Clinical Commissioning Group (CCG) to award the £235m contract for the provision of MSK services in this region to BupaCSH Ltd raises a number of critical issues: firstly, we need to know what the consequences will be for MSK patients; and so far we have been told very little except that the new providers have put patients at the heart of their proposals (whatever this might mean?).
At present experienced and highly qualified MSK medical teams established over many years treat over 150 MSK diseases and syndromes in NHS hospitals across the region.
So how will this current provision be changed under the new privately-run dispensation except for the imposition of yet another tier of management in this instance provided by the private sector?
We also need to assess how this detachment of MSK services, from their integral place in existing NHS provision, will affect the continued operation of all the other sectors of the health service.
Many health care professionals are indeed questioning the continuing viability of an integrated health service for the Sussex coastal region with the loss of the hospital service’s best earner. In commercial terms the removal of any business’ most profitable activity would gravely weaken that business and threaten its entire future.
What is seen to be at particular risk is the continued provision of Accident and Emergency services by the three hospitals likely to be most affected (Worthing Chichester and St Richard’s) in the region.
It has been claimed it will bleed away £30m from Western (Sussex) Hospital Trust which runs Worthing and St Richard’s and put severe pressure on maintaining existing orthopaedic and trauma services.
A third issue concerns the public’s right to have more information about the private recipients of public money. Bupa claims to have no shareholders, but it would be nice to know to whom exactly does its annual profits go (£638.5m before tax for 2013)? And who exactly is behind Bupa’s partner ‘CSH Surrey’?
As the large sums involved are public money we surely have the right to know more about this money’s ultimate destinations and about the private interests involved! As we have seen with other privatisations the resources involved could end up being foreign owned with the profits deposited in offshore tax havens.
Clearly, this particular privatisation has a number of potentially very damaging consequences for local NHS services. If we wish to maintain a comprehensive and integrated NHS we cannot at the same time allow the most profitable bits and pieces of the service to be hived off to the private sector.
The sooner the 2012 Act is repealed, the better it will be for maintaining a coherent NHS in the future.
Secretary, Horsham Labour Party, Pondtail Road, Horsham