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How our NHS is being privatised: what’s happened so far and what’s coming next!

Stage 1 (1991-2014): Preparing the ground for wholesale privatisation.  These steps have already been achieved! 

  • Reorganise NHS to prepare for privatisation:  create a purchaser-provider split (1991) starting with an internal NHS market and later opening the market to private healthcare. Start with non-clinical (cleaning and catering), moving to services like audiology.
  • PFI-funded hospitals with facilities management: 30-year contracts - providing massive year on year private profit from NHS funds
  • Start in the public ‘comfort zone’:  some NHS funding has always gone to voluntary sector services – hospices, voluntary groups and community-based innovative services. Most GPs are private contractors. Use these examples to provide reassurance and argue that privatisation is nothing new.
  • Require all NHS Clinical Commissioning Groups to tender services; start with routine procedures and tests; use the NHS brand to hide the reality of privatisation
  • Force and encourage NHS patients to use private providers; get patients used to it.
  • Pay a standard tariff for NHS procedures regardless of how complex the patient’s needs; allow the private sector to cherry pick and exclude patients with additional or complex needs who need more intensive and costly care. The NHS funds additional costs.  
  • Health & Social Care Act 2012, forces competitive tendering; 
  • Remove the Government’s legal duty to provide a comprehensive, free, health service
  • Remove commissioning support provided by NHS England, forcing CCG commissioners to seek external commissioning support – generally from the likes of KPMG and McKinsey
  • Impose massive real term cuts in funding and services; do not fund the extra cost of PFI
  • Criticise the NHS whenever possible; 
  • Cover up and ignore failures by private companies
  • Reassure the public: 
  • ·         Up to now, patients will experience few changes in their services
  • ·         Privately-owned services  masquerade under the familiar NHS logo
  • ·         Showcase the private deals for very high tech equipment & flash new buildings
  • ·         Health services remain ‘free at the point of delivery’
  • Agree EU and Atlantic trade treaties that mean in future all public services will have to be put out to tender (EU procurement regulations; TTIP Trans Atlantic Trade and Investment Partnership).
Everything above apart from TTIP is now in place. The UK is poised to move to the next stage.

Stage 2: 2014-2020

The next stage is wholesale privatisation of the NHS
  • All NHS services will be tendered to comply with international trade agreements; all tenders will be open to private healthcare companies
  • TTIP treaties make marketisation and privatisation changes irreversible by national governments
  • Government require that CCG contracts are tendered in smaller packages – supposedly to help the voluntary sector tender for contracts; in reality to facilitate cherry-picking of profitable services by private corporations
  • NHS is left responsible for unprofitable services: A&E and care of people with long-term & complex conditions
  • NHS starved of funds;  people who can pay for top-up insurance  (expect 95% by 2020)
 
Stage 3 The goal (2020 and beyond): US- style privatised healthcare
  • Hospitals, GPs and community services all openly run by private companies
  • A rump NHS provides a ‘safety-net’ delivering emergency and minimal care
  • Anyone who can is forced to buy private insurance
  • Massive profits for private healthcare providers
  • terrible health inequalities and private debt for individuals
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