{"id":6607,"date":"2015-03-16T20:45:15","date_gmt":"2015-03-16T20:45:15","guid":{"rendered":"http:\/\/www.glass-cage.com\/dianas_blog\/?p=6607"},"modified":"2021-01-13T10:41:57","modified_gmt":"2021-01-13T10:41:57","slug":"the-biggest-privatisation-in-nhs-history-why-we-had-to-blow-the-whistle","status":"publish","type":"post","link":"https:\/\/glass-cage.com\/dianas_blog\/2015\/03\/16\/the-biggest-privatisation-in-nhs-history-why-we-had-to-blow-the-whistle\/","title":{"rendered":"The biggest privatisation in NHS history: why we had to blow the whistle"},"content":{"rendered":"<p><b><i>Another reason why we should all keep our eye on the ball<\/i><\/b><\/p>\n<hr \/>\n<p><!-- GUARDIAN WATERMARK --><a href=\"https:\/\/www.theguardian.com\/commentisfree\/2015\/mar\/16\/nhs-privatisation-biggest-history-staffordshire-cancer\"><img data-recalc-dims=\"1\" loading=\"lazy\" decoding=\"async\" class=\"alignright\" src=\"https:\/\/i0.wp.com\/image.guardian.co.uk\/sys-images\/Guardian\/Pix\/pictures\/2010\/03\/01\/poweredbyguardianBLACK.png?resize=140%2C45\" alt=\"Powered by Guardian.co.uk\" width=\"140\" height=\"45\" \/>This article titled &#8220;The biggest privatisation in NHS history: why we had to blow the whistle&#8221; was written by Kate Godfrey, for theguardian.com on Monday 16th March 2015 12.16 UTC<\/a><\/p>\n<p>I\u2019m not a journalist, but as of this morning I know what it feels like to be part of the biggest leak in NHS history.<\/p>\n<p>Published on openDemocracy, <a href=\"https:\/\/opendemocracy.net\/ournhs\/caroline-molloy\/details-of-staffordshire-cancer-privatisation-leaked\">the memorandum of information for the \u00a3700m sell-off of Staffordshire cancer services is now available<\/a> for the 800,000 directly affected and 3 million indirectly affected patients to read online.<\/p>\n<p><a href=\"https:\/\/opendemocracy.net\/files\/CCAREDO005%20MOI%20FINAL%20(2).pdf\">That document<\/a>, together with others relating to the joint \u00a31.2bn privatisation of cancer and end-of-life services in Staffordshire, was sent to me. They are commercially confidential, secret agreements that will rebuild NHS services for hundreds of thousands of people, but are for the eyes of the bidding companies only.<\/p>\n<p>Not only is this the first billion-pound NHS privatisation, it is the first time that it has been deemed acceptable to put care designed to meet the needs of our most vulnerable patients on sale.<\/p>\n<p>Uniquely for a privatisation on anything of this scale, there has been no public consultation, simply a series of weak \u201cengagement\u201d events led by paid \u201cpatient champions\u201d. For the past year unpaid patients have not been able to have their say. Thanks to the brave person who shared the documents, now they can.<\/p>\n<p>The background is this: Staffordshire commissioners want to hand the management of all care for cancer and end-of-life patients to a private company, a \u201cprime provider\u201d that will take responsibility for the delivery of care, subcontracting and performance management.<\/p>\n<aside class=\"element element-pullquote\">\n<blockquote><p> Time and time again we have seen Staffordshire used as the proving ground for the 2012 Health and Social Care Act<\/p>\n<\/blockquote>\n<\/aside>\n<p>There are lots of firsts here. It is the first time that cancer or end-of-life care has been contracted out. The first use of the prime provider model on anything like this scale. The first privatisation without formal consultation. The first huge international NHS contract that could fall under <a href=\"http:\/\/www.theguardian.com\/business\/2015\/jan\/15\/corporate-wolves-warning-ttip--trade-deal\">TTIP<\/a>. Transfer these services out of the NHS now, and we may never get them back.<\/p>\n<p>The leading bidders are all US private healthcare companies, some of them implicated in failures of care elsewhere. One is Optum, the US brand facing allegations over the American <a href=\"http:\/\/us.newscodex.com\/nhs-private-health-provider-accused-of-us-hospice-fraud-9cefc65543694031847c758fe3164da7\">hospice-packing scandal<\/a>. (Optum is defending itself against the allegations.) It is the first time that the commissioning responsibility held by local clinical commissioning groups (CCGs) \u2013 the right to spend a billion pounds on behalf of the NHS \u2013 will simply be gifted to a private company.<\/p>\n<p>And it looks like it will be a private company. There are clauses in the published document that simply have no place in a project that will stay within the NHS. Bidders are encouraged to explore a \u201cVAT efficient model\u201d. Not only is this disturbing in its own right, but NHS bodies don\u2019t pay VAT. This is a strange level of detail to find in a document that is otherwise so imprecise.<\/p>\n<p>There is no plan here, no benchmarks against which a bidder could be selected; just a hope that the shape of the contract will resolve itself as bidders make their own suggestions and time goes on.<\/p>\n<p>To me, it looks as though local commissioners simply got bored, and decided they didn\u2019t want to be responsible for cancer care any more. To the health expert <a href=\"http:\/\/wwwm.coventry.ac.uk\/researchnet\/cucv\/Pages\/Profile.aspx?profileID=688\">John Lister<\/a>, it looks worse. He says the contract is \u201cno more than a blank cheque for whichever private firm is the most ruthlessly willing to cut services to shore up their own profits\u201d.<\/p>\n<p>The winning bidder will be free to decommission or disinvest as they like \u2013 cutting contracts with local hospices, therapeutic providers or even frontline healthcare such as radiotherapy and surgery. The bidder could simply replace them, delivering services such as radiotherapy themselves, further fragmenting the services that mean most to patients. Or they could just squeeze existing contracts. No payment structure is specified. Bidding companies can decide for themselves what they are worth, as long as their fees are self-funding within the current budget. Based on similar health privatisation contracts, \u00a3100m in fees is the minimum that a private provider will accept. This money will be diverted straight from funds currently spent on frontline care.<\/p>\n<p>Those hospices and providers will be told that they can still provide care \u2013 it just has to be for 20% less, with the remainder meeting the fees of the winning bidder. They might just reduce costs, or they might cut services that cancer patients depend on. It is the postcode lottery written into an NHS contract.<\/p>\n<p>The question the document doesn\u2019t even try to answer is why. Commissioners\u2019 own figures show cancer care in Staffordshire to be above national average. Only one of the four CCGs backing the change list cancer as an area where they could make significant improvement. There is no clear case for change, but there is an opportunity.<\/p>\n<aside class=\"element element-rich-link element--thumbnail\">  <span>Related: <\/span><a href=\"http:\/\/www.theguardian.com\/society\/2015\/mar\/16\/privatisating-nhs-staffordshire-cancer-care-harm-patients-campaigners-say\">Privatising cancer care in Staffordshire could harm patients, campaigners say<\/a> <\/p>\n<\/aside>\n<p>Time and time again we have seen Staffordshire used as the proving ground for the <a href=\"http:\/\/www.legislation.gov.uk\/ukpga\/2012\/7\/contents\/enacted\">2012 Health and Social Care Act<\/a>. Cancer and end-of-life privatisation has been introduced here because it was politically convenient. Our history is used against us; our patients pay the price again.<\/p>\n<p>Not only was there no formal consultation, but local patients were meant to get no say on this contract at all. The original plan was to sign the deal in March \u2013 before people could have their say at the polls. Labour has said it will not let the project go ahead.<\/p>\n<p>The campaign group I work with \u2013 <a href=\"https:\/\/www.facebook.com\/cancernotforprofit\">Cancer Not For Profit<\/a> \u2013 fought for more time. When the awarding of the contract was put back until June, we thought that we had won a small victory.<\/p>\n<p>Our source heard differently. The project wasn\u2019t delayed, they were told, but simply hushed up. The political implications of pushing through the biggest privatisation in NHS history two months before a general election were too serious. It had to move forward with speed, and if the contract lacked benchmarks or risk management, forget it. It could all be resolved later. (It is the essence of contract law that weaknesses are generally not resolved later.) The only thing being delayed until after May was the announcement, which would now be made in June. And then a gamble that a new government couldn\u2019t go back on a contract already awarded.<\/p>\n<p>\u201cI\u2019m going to publish,\u201d I told the source. \u201cTell me if you don\u2019t want me to publish.\u201d I never heard from them again.<\/p>\n<p>guardian.co.uk &#169; Guardian News &amp; Media Limited 2010<\/p>\n<p>Published via the <a href=\"http:\/\/www.guardian.co.uk\/open-platform\/news-feed-wordpress-plugin\" target=\"_blank\" title=\"Guardian plugin page\" rel=\"noopener\">Guardian News Feed<\/a> <a href=\"http:\/\/wordpress.org\/extend\/plugins\/the-guardian-news-feed\/\" target=\"_blank\" title=\"Wordress plugin page\" rel=\"noopener\">plugin<\/a> for WordPress.<\/p>\n<p><!-- END GUARDIAN WATERMARK --><\/p>\n","protected":false},"excerpt":{"rendered":"<p>Staffordshire was planning a \u00a31.2bn sell-off of cancer and end-of-life care without proper patient consultation. But now a key leaked document reveals all<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"advanced_seo_description":"","jetpack_seo_html_title":"","jetpack_seo_noindex":false,"jetpack_post_was_ever_published":false,"_jetpack_newsletter_access":"","_jetpack_dont_email_post_to_subs":true,"_jetpack_newsletter_tier_id":0,"_jetpack_memberships_contains_paywalled_content":false,"_jetpack_memberships_contains_paid_content":false,"footnotes":"","jetpack_publicize_message":"","jetpack_publicize_feature_enabled":true,"jetpack_social_post_already_shared":false,"jetpack_social_options":{"image_generator_settings":{"template":"highway","default_image_id":0,"font":"","enabled":false},"version":2}},"categories":[3],"tags":[59,48,63,173,175,98,174,281,66,46],"class_list":["post-6607","post","type-post","status-publish","format-standard","hentry","category-musings","tag-article","tag-comment","tag-health","tag-hospitals","tag-kate-godfrey","tag-nhs","tag-older-people","tag-opinion","tag-society","tag-uk-news"],"jetpack_publicize_connections":[],"jetpack_featured_media_url":"","jetpack_sharing_enabled":true,"jetpack_shortlink":"https:\/\/wp.me\/p6NRDR-1Iz","jetpack-related-posts":[{"id":142734,"url":"https:\/\/glass-cage.com\/dianas_blog\/2019\/06\/04\/dont-put-our-nhs-up-for-negotiation\/","url_meta":{"origin":6607,"position":0},"title":"Don&#8217;t put our NHS up for negotiation","author":"diana Stone","date":"June 4, 2019","format":false,"excerpt":"Don't put our NHS up for negotiation Please introduce concrete safeguards that will make sure our NHS is kept out of any future trade deals after Brexit. Words aren't enough - we want watertight protections that will keep our NHS off the negotiating table. Why is this important? When done\u2026","rel":"","context":"In &quot;Musings&quot;","block_context":{"text":"Musings","link":"https:\/\/glass-cage.com\/dianas_blog\/category\/musings\/"},"img":{"alt_text":"","src":"","width":0,"height":0},"classes":[]},{"id":5807,"url":"https:\/\/glass-cage.com\/dianas_blog\/2014\/11\/20\/stop-privatising-the-nhs\/","url_meta":{"origin":6607,"position":1},"title":"Stop privatising the NHS","author":"diana Stone","date":"November 20, 2014","format":false,"excerpt":"There are less than 24 hours until a crucial vote in Parliament that could determine the future of the NHS. Sign the petition telling the government to vote the right way and rein back NHS privatisation >> http:\/\/action.labour.org.uk\/future-of-our-nhs Post by The Labour Party.","rel":"","context":"In &quot;Musings&quot;","block_context":{"text":"Musings","link":"https:\/\/glass-cage.com\/dianas_blog\/category\/musings\/"},"img":{"alt_text":"","src":"","width":0,"height":0},"classes":[]},{"id":152739,"url":"https:\/\/glass-cage.com\/dianas_blog\/2019\/12\/02\/risks-to-the-nhs\/","url_meta":{"origin":6607,"position":2},"title":"Risks to the NHS","author":"diana Stone","date":"December 2, 2019","format":false,"excerpt":"","rel":"","context":"In &quot;Musings&quot;","block_context":{"text":"Musings","link":"https:\/\/glass-cage.com\/dianas_blog\/category\/musings\/"},"img":{"alt_text":"","src":"","width":0,"height":0},"classes":[]},{"id":151742,"url":"https:\/\/glass-cage.com\/dianas_blog\/2019\/11\/13\/tories-insist-the-nhs-is-not-for-sale\/","url_meta":{"origin":6607,"position":3},"title":"Tories insist the NHS is not for sale?","author":"diana Stone","date":"November 13, 2019","format":false,"excerpt":"Tories insist the NHS is not for sale - which must disappoint Conservative co-chair Ben Elliot, whose firm Hawthorn Advisers lobbies for foreign-owned private health firms, including one which took 25% of the UK's adult social care market. Full story in new Private Eye, out now. \u2014 Private Eye Magazine\u2026","rel":"","context":"In &quot;Musings&quot;","block_context":{"text":"Musings","link":"https:\/\/glass-cage.com\/dianas_blog\/category\/musings\/"},"img":{"alt_text":"","src":"","width":0,"height":0},"classes":[]},{"id":151072,"url":"https:\/\/glass-cage.com\/dianas_blog\/2019\/11\/01\/matt-hancock-received-32000-in-donations-from-chair-of-think-tank-that-wants-nhs-abolished\/","url_meta":{"origin":6607,"position":4},"title":"Matt Hancock received \u00a332,000 in donations from chair of think tank that wants NHS &#8216;abolished&#8217;","author":"diana Stone","date":"November 1, 2019","format":false,"excerpt":"This basically the face of evil. Nothing less. What it means is that this person would rather see people like you and I die for profit. Make no mistake about this. \"Newly appointed health secretary Matt Hancock received \u00a332,000 in donations from the chairman of a think tank which critics\u2026","rel":"","context":"In &quot;Musings&quot;","block_context":{"text":"Musings","link":"https:\/\/glass-cage.com\/dianas_blog\/category\/musings\/"},"img":{"alt_text":"","src":"","width":0,"height":0},"classes":[]},{"id":125525,"url":"https:\/\/glass-cage.com\/dianas_blog\/2018\/08\/04\/check-your-weight\/","url_meta":{"origin":6607,"position":5},"title":"Check your weight","author":"diana Stone","date":"August 4, 2018","format":false,"excerpt":"Mines Ok how's is yours? Healthy or not?","rel":"","context":"In &quot;Musings&quot;","block_context":{"text":"Musings","link":"https:\/\/glass-cage.com\/dianas_blog\/category\/musings\/"},"img":{"alt_text":"content provided by NHS Choices","src":"https:\/\/i0.wp.com\/media.nhschoices.nhs.uk\/tools\/documents\/self_assessments_js\/images\/syndication.png?resize=350%2C200","width":350,"height":200},"classes":[]}],"jetpack_likes_enabled":true,"_links":{"self":[{"href":"https:\/\/glass-cage.com\/dianas_blog\/wp-json\/wp\/v2\/posts\/6607","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/glass-cage.com\/dianas_blog\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/glass-cage.com\/dianas_blog\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/glass-cage.com\/dianas_blog\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/glass-cage.com\/dianas_blog\/wp-json\/wp\/v2\/comments?post=6607"}],"version-history":[{"count":0,"href":"https:\/\/glass-cage.com\/dianas_blog\/wp-json\/wp\/v2\/posts\/6607\/revisions"}],"wp:attachment":[{"href":"https:\/\/glass-cage.com\/dianas_blog\/wp-json\/wp\/v2\/media?parent=6607"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/glass-cage.com\/dianas_blog\/wp-json\/wp\/v2\/categories?post=6607"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/glass-cage.com\/dianas_blog\/wp-json\/wp\/v2\/tags?post=6607"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}