The Government has forced through their Health & Care Bill. This Bill risks the core principles of the NHS; opening up privatisation and risking a postcode lottery for healthcare. It now falls to the House of Lords to force the Government to rethink the Bill.
When the NHS was founded, it was on the three core principles that it would (i) meet the needs of everyone; (ii) be free at the point of delivery; and (iii) be based on clinical need, not the ability to pay.
Those principles have slowly been eroded over the years and there are fears that the new Health & Care Bill is a further nail in the coffin of the NHS.
Regional Integrated Care
Particular concerns relate to the breakup of the NHS to a regional level, with CCGs (Clinical Commissioning Groups) replaced by ICSs (Integrated Care Systems).
This means that our local North Tyneside CCG will be integrated into a Regional ICS, representing the North East and Cumbria.
The new ICS will cover the area from Whitehaven and Carlisle in Cumbria, up to Berwick in Northumberland, and down to Darlington and Redcar.
The new ICS will be granted a regional budget and discretion as to what services are provided at a local level.
This risks the creation of a postcode lottery for care, losing the NHS’s core principle of meeting the needs of everyone and removing the commitment to meet clinical need.
Privatisation
Although many fear that privatisation will threaten the principle that the NHS should be free at the point of delivery, the truth is that privatisation has been used to deliver taxpayer money to private companies.
We have already seen local services privatised in North Tyneside, for example:
- Urgent Care at Rake Lane hospital is delivered by Vocare (a private company owned by Totally plc). Totally plc own healthcare services around the UK and this year reported gross profits of £11.6m. These profits arise from taxpayer money and we understand that a dividend is proposed which is worth over £100,000 to the principal shareholder alone.
- Virtual GP consultations are offered in North Tyneside by Livi. This app was developed by a Swedish company, which is owned by Private Equity investors. The company reported revenues of $90m in 2020.
The Health & Care Bill enables further privatisation of services and removes the need to open these services to tender.
The Bill also allows private companies to sit on the board of regional ICSs. Thereby influencing decisions to outsource NHS services,in a clear conflict of interest.
Political Agenda
There are many who feel that the NHS is used as a political football – and that politicians should step away and allow the NHS to be run according to the needs of patients.
The Health & Care Bill instead increases the risk that politicians will use the NHS to further their own political agenda.
The Bill grants the right for the Secretary of State to intervene at a local level. This gives the Government direct influence on local decisions and what services are provided in our Region.
Conclusions
In the wake of the global pandemic, many would agree that Covid-19 exposed weaknesses in the NHS and action is needed to safeguard for the future.
However, the British Medical Association has highlighted concerns about the failure of the Bill to address the problems faced by the NHS.
There is no thought as to the staffing shortages, the funding crisis or the provision of social care. Instead, the focus is on restructuring and removing red tape when outsourcing.
It is clear that the Health & Care Bill is driven by political ideology rather than a desire to protect our NHS.
This is not the end of the NHS, but the Bill leaves the NHS weakened and – after the effects of the pandemic – still in need of life support.