Public Health Sector being privatised

by Patricia Campbell

Tony Blair insists that “Foundation Hospitals are the way forward for delivering health care”. The vote in the House of Commons on 7th May indicated that a majority of Labour MPs backed him as the Government got the green light to forge ahead with the plan. However a large number of MPs voted against the proposed changes to the NHS.

The Secretary of State for Health Alan Milburn, apparently found the idea for Foundation Hospitals when he travelled to the privately run Fundacion Alcorcon in Madrid to find nurses to work in Britain’s clapped-out Victorian hospitals. Milburn was so impressed by what he saw and even more enchanted by the idea that hospitals would be able to borrow money from big banks rather than rely on public borrowing limits. Dr David Green, head of the free-market think-tank Civitas, backs him, So enthused is the Civitas health policy consensus group that they recommend all hospitals should get Foundation status.

Milburn then produced a blueprint which envisaged hospitals freed from the ‘diktat of Whitehall’, able to raise unlimited money on the open market and to negotiate local pay deals. Claiming to be attuned to local needs, locally elected governors would run each Foundation hospital, they would make the decision to raise extra revenue by treating private patients. Yet Milburn was unable to sell his idea to the Chancellor, Gordon Brown, who it seems doesn’t like the idea of NHS hospitals acting like businesses and asked, “who would pick up the bill if the enterprise failed? He also raised concerns that the most profitable customers would be private patients and would therefore take precedence over NHS patients leading to a ‘two-tier system’ of health care. The Chancellor fought his corner on this one and in the end reached a compromise.

Foundation hospitals will face tougher limits than originally envisaged on how much they can borrow and how many private patients they can treat.
However, despite Browns argument that a two-tier health system would be the upshot, Blair backs Milburn on the over-all principle that the best hospitals should be rewarded with certain freedoms. Milburn heralds his new idea as radical and innovative. In his bid to sell the grand idea he concedes that the NHS has profound weaknesses, that health inequalities have widened and that staff and local communities have too often felt disempowered by top-down control in the NHS.
One might ask would all this change in the new Foundation hospitals?

Not so says Bill Morris of the Transport and General Workers’ Union. Morris told BBC radio 4 Today Programme that the Foundation hospital plans were a “distraction that will put a dagger through the heart of the NHS. Foundation hospitals will be concentrating on running a business, not private health care”. Labour MP, Des Turner, commented to a Sunday newspaper that, “Tony Blair is proposing something which even Maggie Thatcher did not have the bottle to do and that is to partially privatise the health service. We regard the Foundation trust idea a betrayal of the NHS ethos that we have all fought for”. The pressure group Reform added its voice to the dissent. They expressed concerns that Foundation hospitals do not represent a move towards public service reform. They argue that Foundation hospitals will gain limited financial freedoms but they will not have the extent of self-government that hospitals in other countries take for granted.

London based professor of public health policy and critic of Private Finance Initiatives (PFI), Allyson Pollock argues that the proposed changes “will enable the Labour government to privatise our NHS hospitals”. Pollock warned that the public doesn’t seem to be aware that the bill MPs voted on “allows any private sector body – from Tesco to Sainsbury to Boots – to apply to be a Foundation trust and run our NHS services”. Milburn remains confident nevertheless that his vision, based on the Spanish idea will win through, guarantee fast delivery and cut waiting lists. However Spanish trade unions assert that the Foundation hospital Milburn derived his idea from, has cut waiting lists by increasing staff working hours and sending difficult cases to publicly run hospitals. In this new dispensation the lesson seems to be; don’t get sick, if you’re not rich.

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