Stop these NHS changes now

YOUR health care is being privatised. Your body's ailments may be a source of concern for you but to someone else they will be soon be a commodity to be bartered for, bought and sold on the free market. How do I know?

I am a health professional employed in the NHS.

A short while back, my colleagues and I started to receive emails regarding changes to our employment.

One included a form offering voluntary redundancy and the others advising us that we had an 'opportunity' to become part of a 'social enterprise trust' (or SET). An SET is what is termed a third sector organisation – a non-profit, non-governmental sector. Other third sector organisations are charities and voluntary organisations.

With short notice, we were invited to hear what this entailed and to ask questions. As far as the term 'consultation' goes, I am unsure of the lengths managers are meant to go to but I am not sure they were met.

Anyway, the most affected staff in the primary care SET push seem to be the health professionals and administration staff sited all over the county.

My colleagues and I are clinicians whose clinics move around and the majority are not based in the place the meeting was to be held.

We have patients booked in advance for weeks ahead, we work through our lunch breaks, and we do not have the time and are too stressed during working hours to read the 11 government documents we were given a link to.

We certainly need a good few weeks notice of any meeting to attend. The managers know this.

Of course, the previous government set out a requirement that staff should 'buy in to' this change of setup if it were to take place anywhere.

The coalition altered this to a requirement only to show evidence of staff engagement.

They sent us a meeting invite and some downloadable leaflets – how very engaging.

This change in trust type is part of a number of big changes to our health service.

The SET system was something, non-mandatory, being introduced by the previous government, but now it is being implemented with some sense of urgency because PCTs are to be scrapped and, I feel, due the need for trusts to function on a more 'business-like' level in order to work with the proposals outlined in the Government's white paper (ie, the further privatisation).

As with the white paper there is a feeling that so-called proposed changes are being implemented with scant regard for the NHS Act 2006, which states: "These NHS organisations (strategic health authorities; primary care trusts; NHS trusts, and NHS foundation trusts) are required to make arrangements to involve and consult patients and the public in: planning of the provision of services; the development and consideration of proposals for changes in the way those services are provided, and decisions to be made by the NHS organisation affecting the operation of services." The public were meant to be consulted but if I don't know what's going on, how on earth would people outside of the NHS?

Change

The really big change that members of the public are more likely to have heard about is that GPs are to take responsibility for up to 80 per cent of the NHS budget.

This sounds good in theory. These are people who know what is needed locally and who see the patient as someone with lifelong needs, not just the time it takes from referral to discharge following a hip replacement.

However, GPs do not have the time or wherewithal to decide where the budget they are being given should be spent. Who should get the treatment, yes, but how it will be delivered, not so sure.

They are doctors – that's what they do – they doctor people. The job of choosing where the money will be spent may be contracted out – maybe to private companies that will be looking for a profit – profit drawn from the NHS's 'ring-fenced' funds.

There are already private health companies expressing interest in taking over the running of consortia from the GPs, before they have even started.

Amongst the jobs to be done by these companies are finding the legal people, doing the admin, billing etc – jobs already being done by PCTs.

These commissioning bodies, with their 80 per cent NHS budget, will look for a provider for a particular service for a particular patient need and, for example, my department will go up against non-public sector groups to provide the needed service.

If that group can provide it cheaper, then I fear that group will get the work.

The work I personally do has benefits which are cost-saving by tens of thousands of pounds over the rest of the patient's life, but a private company will look toward a cheap, quick-fix treatment with only short-term results – after all, shareholders will not want to wait 30 years for their dividend. This is where a lot of the ring-fenced money will end up. Not to mention your taxes.

These potential commissioning groups are big private health companies.

They have been collaborating a while already and the word 'cartel' has even been banded about recently on the radio. This, I suspect, is the reason PCT bosses feel they need to be running a SET – a business outside of the conventional public sector.

Later, the hospital trusts are to be converted to similar fates – they too will be moved outside of the traditional 'public' sector.

For us working in the SETs, the future will be uncertain, we may lose our pensions and other things we thought we had signed up to when we joined the NHS.

Every few years the SET contracts will be re-negotiated, leaving us wondering if we still have jobs.

We do not want this for our NHS and neither do the doctors; their own organisation, the British Medical Association, is actively campaigning against this privatisation, this slaughter of the NHS (www.lookafterournhs.org.uk)

Concerns

The third sector is non-governmental and is not classically 'public sector' – so who will scrutinise the performance of all the big players in this and ensure the public are safe in this new Health Service, if not the Government or public?

Who will ensure we are safe in our hospital beds or that we are getting the correct treatment? Apparently the Care Quality Commission will ensure the hospitals are up to standard.

The public think they are getting a raw deal now from the NHS, but I can tell you most of the issues people have with the NHS are with regard to sections long since put out to private contract – cleaning, agency nurses, staff on short-term contracts, call centres, NHS deliveries and many more departments.

Within the proper NHS, quantitative outcomes dominate most treatments – in some trusts nurses doing pre-operative assessments have their time to assess so reduced that they know unsuitable patients are being sent for anaesthetic and surgery. This will get worse with markets and competition being brought fully into the NHS. People will die as a result.

In a few years time I may not have a job if our service is under utilised.

Then my patients will have to be seen by the quick-fix private sector, and their long-term health will probably be affected negatively.

In a few years time our health service will no longer be 'national' as in 'public-owned' – it will be a collection of competing businesses. The Government says competition in health care will be a good thing, but there is no evidence of this.

There is no unbiased research undertaken that shows introducing competition into healthcare is a good thing.

Even in the USA studies show only a similarity of quality at best between free healthcare and insurance-provided. There are plenty of studies showing competition will produce greater inequity and lead to poorer quality of patient care.

I could say the private sector has created a crisis for which the public sector is being made to pay, that this is back-door cuts.

That is what it seems at first glance.

But it is actually an ideological change to our healthcare system. We know this as the reforms have no evidence to back them. So it clearly is not for the good of the public.

It is privatisation and is not only unnecessary, but deadly.