Get Red Pepper's email newsletter. Enter your email address to receive our latest articles, updates and news.

×

Nye’s nightmare

Health secretary Alan Johnson maintains that in backing centralised GP 'super-surgeries' he is staying true to the dream of the founder of the NHS. Tom Foot says the reality is more like Nye's nightmare

April 22, 2009
4 min read

At a celebration of the 60th anniversary of the National Health Service last year, Alan Johnson revealed his inspiration for introducing the polyclinic. ‘Nye Bevan did not want lots of isolated GPs,’ said the health secretary. ‘With the introduction of polyclinics I am trying to create Nye’s dream.’

The super-sized surgeries, where GPs work alongside a range of other health care professionals in centralised health centres, are set to replace thousands of ‘single handed’ practices across the country. But Nye’s dream has become rather warped along the way. What Labour is now proposing is fast becoming a recurring nightmare for those who prize the NHS – and it’s not just the Bevanites who are losing sleep.

In stark contrast to the public health centres Bevan sought to establish, the government is bending over backwards to ensure that these health centres are run by a strange clique of private companies.

Last April (2008), UnitedHealth was awarded contracts to run three surgeries in Camden, north London. The American health giant – recently indicted with defrauding American patients out of $1.3 billion of health insurance claims – was easily able to under-cut bids from local doctors by 25 per cent.

Within weeks, two popular locums – including one who had been at the Camden Road surgery for 18 years – were sacked, a popular baby clinic was closed and patient assessment times were cut by five minutes. In May, two directors from the IT firm Ingenix, a subsidiary of the Minnesota-based UnitedHealth Group that was responsible for wrongly calculating US patient insurance claims, were dispatched over the Atlantic to run operations here.

In a parliamentary debate following the takeover, former health secretary Frank Dobson asked: ‘UnitedHealth have been indicted for swindling taxpayers and patients – would you employ a company that had a record like that?’ But UnitedHealth’s raid on the NHS is not altogether surprising: the former Downing Street advisor Simon Stevens is chairman of its UK board.

When Camden PCT (primary care trust) announced in June it was planning to bundle Bloomsbury practices into a polyclinic in the University College London Hospital, patients feared UnitedHealth would again be first choice for the privatised project. It turned out to be Virgin Healthcare, but Richard Branson’s empire pulled out of the project because the scheme would not be profitable enough.

The multinational software firm Atos Origin, another of the Department of Health’s ‘preferred suppliers’ of polyclinics in London, recently announced it was pulling out of its contract to run local doctors’ services in Tower Hamlets. After just seven months, patients were told that a reduced service would be operating until the split.

It is no wonder that doctors and patients in Haringey fear the worst when the contracts to run five polyclinics are put out for tender in April.

Patient campaigner Janet Shapiro speaks for thousands when she says: ‘There is no democracy in the NHS. There’s no way of forcing the PCT to listen to us and that’s why these problems arise. We have been trying to get them to engage meaningfully with us from the start, with little success.’

No PCT has consulted the public, meaningfully or otherwise, on whether private firms should be allowed to bid for health contracts – because EU tendering rules mean private firms cannot be excluded from the bidding process.

There remain, in these uncertain economic times, question marks over who will pay to build these vast privatisation-domes. Department of Health rules state that all new health centres must be built and owned by a consortium of private contractors that rakes in a huge profit by renting the facilities back to PCTs for periods up to 35 years. Until the banking crash, these contractors had secured loans with ease – but getting credit isn’t so easy these days.

The entirely avoidable process of committing to costly Private Finance Initiative schemes has not gone unnoticed in Islington. In January, that borough’s PCT agreed to sell the Finsbury health centre. The Grade I listed building was designed by the Russian architect Berthold Lubetkin in 1938 and commissioned by the radical Labour council of the day to redress chronic deprivation. For the first time, health professionals including podiatrists, physiotherapists and children’s specialists and doctors worked alongside each other under one roof.

The model, which archive documents show informed Bevan on founding the NHS in 1948, was London’s first publicly-owned health centre and a precursor to what today are known as polyclinics. On the building’s opening, Lubetkin proudly proclaimed that ‘nothing is too good for ordinary people’. But according to PCT chief executive Rachel Tyndall, PFI means maintaining that vision is simply ‘not worth the money’. And so, in Islington, Nye’s dream has been cynically abandoned. Alan Johnson has yet to wake-up to that one.

Red Pepper is an independent, non-profit magazine that puts left politics and culture at the heart of its stories. We think publications should embrace the values of a movement that is unafraid to take a stand, radical yet not dogmatic, and focus on amplifying the voices of the people and activists that make up our movement. If you think so too, please support Red Pepper in continuing our work by becoming a subscriber today.
Why not try our new pay as you feel subscription? You decide how much to pay.

Working class theatre: Save Our Steel takes the stage
A new play inspired by Port Talbot’s ‘Save Our Steel’ campaign asks questions about the working class leaders of today. Adam Johannes talks to co-director Rhiannon White about the project, the people and the politics behind it

The dawn of commons politics
As supporters of the new 'commons politics' win office in a variety of European cities, Stacco Troncoso and Ann Marie Utratel chart where this movement came from – and where it may be going

A very social economist
Hilary Wainwright says the ideas of Robin Murray, who died in June, offer a practical alternative to neoliberalism

Art the Arms Fair: making art not war
Amy Corcoran on organising artistic resistance to the weapons dealers’ London showcase

Beware the automated landlord
Tenants of the automated landlord are effectively paying two rents: one in money, the other in information for data harvesting, writes Desiree Fields

Black Journalism Fund – Open Editorial Meeting
3-5pm Saturday 23rd September at The World Transformed in Brighton

Immigration detention: How the government is breaking its own rules
Detention is being used to punish ex-prisoners all over again, writes Annahita Moradi

A better way to regenerate a community
Gilbert Jassey describes a pioneering project that is bringing migrants and local people together to repopulate a village in rural Spain

Fast food workers stand up for themselves and #McStrike – we’re loving it!
McDonald's workers are striking for the first time ever in Britain, reports Michael Calderbank

Two years of broken promises: how the UK has failed refugees
Stefan Schmid investigates the ways Syrian refugees have been treated since the media spotlight faded

West Papua’s silent genocide
The brutal occupation of West Papua is under-reported - but UK and US corporations are profiting from the violence, write Eliza Egret and Tom Anderson

Activate, the new ‘Tory Momentum’, is 100% astroturf
The Conservatives’ effort at a grassroots youth movement is embarrassingly inept, writes Samantha Stevens

Peer-to-peer production and the partner state
Michel Bauwens and Vasilis Kostakis argue that we need to move to a commons-centric society – with a state fit for the digital age

Imagining a future free of oppression
Writer, artist and organiser Ama Josephine Budge says holding on to our imagination of tomorrow helps create a different understanding today

The ‘alt-right’ is an unstable coalition – with one thing holding it together
Mike Isaacson argues that efforts to define the alt-right are in danger of missing its central component: eugenics

Fighting for Peace: the battles that inspired generations of anti-war campaigners
Now the threat of nuclear war looms nearer again, we share the experience of eighty-year-old activist Ernest Rodker, whose work is displayed at The Imperial War Museum. With Jane Shallice and Jenny Nelson he discussed a recent history of the anti-war movement.

Put public purpose at the heart of government
Victoria Chick stresses the need to restore the public good to economic decision-making

Don’t let the world’s biggest arms fair turn 20
Eliza Egret talks to activists involved in almost two decades of protest against London’s DSEI arms show

The new municipalism is part of a proud radical history
Molly Conisbee reflects on the history of citizens taking collective control of local services

With the rise of Corbyn, is there still a place for the Green Party?
Former Green principal speaker Derek Wall says the party may struggle in the battle for votes, but can still be important in the battle of ideas

Fearless Cities: the new urban movements
A wave of new municipalist movements has been experimenting with how to take – and transform – power in cities large and small. Bertie Russell and Oscar Reyes report on the growing success of radical urban politics around the world

A musical fightback against school arts cuts
Elliot Clay on why his new musical turns the spotlight on the damage austerity has done to arts education, through the story of one school band's battle

Neoliberalism: the break-up tour
Sarah Woods and Andrew Simms ask why, given the trail of destruction it has left, we are still dancing to the neoliberal tune

Cat Smith MP: ‘Jeremy Corbyn has authenticity. You can’t fake that’
Cat Smith, shadow minister for voter engagement and youth affairs and one of the original parliamentary backers of Corbyn’s leadership, speaks to Ashish Ghadiali

To stop the BBC interviewing climate deniers, we need to make climate change less boring
To stop cranks like Lord Lawson getting airtime, we need to provoke more interesting debates around climate change than whether it's real or not, writes Leo Barasi

Tory Glastonbury? Money can’t buy you cultural relevance
Adam Peggs on why the left has more fun

Essay: After neoliberalism, what next?
There are economically-viable, socially-desirable alternatives to the failed neoliberal economic model, writes Jayati Ghosh

With the new nuclear ban treaty, it’s time to scrap Trident – and spend the money on our NHS
As a doctor, I want to see money spent on healthcare not warfare, writes David McCoy - Britain should join the growing international movement for disarmament

Inglorious Empire: What the British Did to India
Inglorious Empire: What the British Did to India, by Shashi Tharoor, reviewed by Ian Sinclair

A Death Retold in Truth and Rumour
A Death Retold in Truth and Rumour: Kenya, Britain and the Julie Ward Murder, by Grace A Musila, reviewed by Allen Oarbrook