Please don’t let the NHS die

The health bill is capable of destroying the NHS. I wish this was hyperbole. It’s not.

I am in Scotland, where things are a bit more sensible. Markets were tried, with Independent Sector Treatment Sectors, but because our hospitals tend to be geographically distant, it’s not really feasible to have a competitive market based system of any quality. Even then, markets don’t work for healthcare; you can’t be mid-heart attack and shop around for the best interventional cardiologist in the country. Markets have been proven not to work, too; there is ample work showing harm with competition. Healthcare is  not like  a market because patients are not shoppers. People with severe mental illness or learning disability or dementia should be able to get good care whether or not they are finding and comparing services data. People who have expensive-to -treat cancers should not be reduced to finding a doctor prepared to take them on. Markets in healthcare just don’t work. Politicians are very slow to catch on.

The USA, with  rafts of unproven tests and overboard investigations in the rich, and lack of healthcare for the poor, is not a model to be chasing. Probably the most developed medical market in the UK is for cosmetic surgery. Here we see the uprising of ‘practitioners’ with varying qualifications, advertising in magazines to teenagers, and celebrities going on to approve or try the wares. Doctors can make a lot of money out of this market. Whether you think that the results – procedures of risk in people who looked fine to start with and who tend to have  more psychological problems than average – is a good thing, is another matter. I don’t think this lucrative market is good for patients or society more broadly.

The Guardian are reporting that independent legal advice suggests that the health bill will contain a ‘hands-off’ clause which will absolve the government of responsibility when it comes to commissioning healthcare. This means that the private companies or GP companies who will be bidding will be effectively unaccountable. We already have the problem with Atos, contracted to do all the DWP health assessments; if you ask the DWP for information relating to the minutia of their assessments you are told no, because it is a private company. They are allowed to be private, although they are contracted by the taxpayer. This feels wrong to me; it means that the care of the most vulnerable people in our society is determined in a non transparent way.

If the NHS is franchised out to a thousand competing companies, what then? I predict: the easiest to set up and most lucrative healthcare interventions will be advertised and creamed off. The most difficult disorders will be unpopular, underdeveloped, and if you are unfortunate enough to need care from several different places at once, all will place caps on what they are willing to do (what they are paid for) and what they won’t (where their contract stops. )

The NHS, for all it’s faults, is fuelled by people who care about their work and who will add extra in. These are the people who chase things up, will stay a bit late to help, who will take a phone call when offduty because it’s something they know about and can fix well. Numb us down to the level of contract salespeople, and we will all suffer. But some people, the sickest, you can bet will suffer far more than others.

4 Responses to “Please don’t let the NHS die”

  1. Paul Smith August 30, 2011 at 3:19 pm #

    This is extremely worrying, private companies getting taxpayers money should be totally transparent, open to any questioning.

    Private companies also don’t like anyone digging into their business as I have found out to my cost, only a couple of weeks ago I recieved a copy of a legal letter sent to my website hosts from Atos demanding I remove defamatory and Libelous material from my website, they do NOT stipulate which material falls into that category, a few hours after getting the email my website vanished.

    I nowhave another site up and running, “Register of Shame 2” it contains some of the personal accounts of how people have been treated by Atos and the DWP, what’s going on in this country is wrong, why do we always have to follow the USA in everything we do, it doesn’t work, or should I say it doesn’t work for the vulnerable and sick/disabled, God help this country and it’s impoverished….

  2. Derek Tunnicliffe August 31, 2011 at 5:00 pm #

    I cannot understand the supposed need for competition.

    Here in France we have private hospitals, clinics, etc. They are all registered with the government and subject to exactly the same rules and regulations (including allowable charges) as the publicly owned. They are not there because they won any competition but because their owners felt that, allowing for all the rules, etc, they could still offer a good public service. This is open to anyone with State insurance (private cover against any costs not fully covered by the State is not expensive).

    France is not unique in Europe in these matters. Why are UK governments’ (of all shades) always turned towards the US, rather than Europe when searching for ideas?

  3. Mo Stewart September 3, 2011 at 1:52 pm #

    The reason WHY is because the DWP are no longer in charge of UK welfare. The DWP invited Unum Provident Insurance to join us, as ‘advisers’ back in ’94. This American corporate insurance giant, with 25 million clients in the US alone, were to be banned from 15 states in the US until 2008 and were to be identified as the 2nd WORST insurance company in the US by the American Ass of Justice, so why were they permitted to be involved with the welfare of British citizens? Because, now that the DWP have terrified the British public into believing that there will be no welfare if they get sick or disabled, the newly named Unum Insurance are about to flood the UK market with their income protection disability insurance, they will clean up, and we will become the British version of American style healthcare, funded by insurance. Of course, Unum have removed all evidence of their past wrong doings from the Internet,including the transcript from the damning BBC news report, so finding the info is difficult unless of course you’d already found it and downloaded it… BUT, what the DWP and Unum Insurance will forget to mention is their diabolical record of REFUSING to pay out on the insurance policies when sick and disabled people made a claim. All relevant info can be found at: and just scroll down the front pages until you find the research report. Much more damning evidence will be published on that website – free from Atos attempts to close down the website – on 14th September, following the welfare reform debate in the House of Lords on 13th.

  4. stan September 5, 2011 at 9:12 pm #

    If the NHS goes down the same route as the Welfare examinations it will be a sad day.
    Atos Healthcare are a Private company contracted to do the ESA WCA for the DWP, a more uncaring company would be hard to find .
    Healthcare will always be a contentious subject but look at the old folks homes and what a disaster that has become in private hands.
    The unending need for these companies to make profit does not allow for moral values, as share prices fall, the care will naturally fall with them.
    Private companies will naturally only want the profit making parts of the NHS ,the tax payer could end up paying more and more to support the non lucrative parts of the system.
    Atos Healthcare in the welfare side of medicine answer to no one ,this would be the case with private companies in the NHS side.
    As a previous poster said “why is there a need for the NHS to make profit”