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.


✹ Try our new pay-as-you-feel subscription — you choose how much to pay.

Red Pepper’s race section: open editorial meeting 19 April
On April 19th, we’ll be holding the second of Red Pepper’s Race Section Open Editorial Meetings.

Changing our attitude to Climate Change
Paul Allen of the Centre for Alternative Technology spells out what we need to do to break through the inaction over climate change

Introducing Trump’s Inner Circle
Donald Trump’s key allies are as alarming as the man himself

Secrets and spies of Scotland Yard
A new Espionage Act threatens whistleblowers and journalists, writes Sarah Kavanagh

#AndABlackWomanAtThat – part II: a discussion of power and privilege
In the second article of a three-part series, Sheri Carr reflects on the silencing of black women and the flaws in safe spaces

How progressive is the ‘progressive alliance’?
We need an anti-austerity alliance, not a vaguely progressive alliance, argues Michael Calderbank

The YPJ: Fighting Isis on the frontline
Rahila Gupta talks to Kimmie Taylor about life on the frontline in Rojava

Joint statement on George Osborne’s appointment to the Evening Standard
'We have come together to denounce this brazen conflict of interest and to champion the growing need for independent, truthful and representative media'

Confronting Brexit
Paul O’Connell and Michael Calderbank consider the conditions that led to the Brexit vote, and how the left in Britain should respond

On the right side of history: an interview with Mijente
Marienna Pope-Weidemann speaks to Reyna Wences, co-founder of Mijente, a radical Latinx and Chincanx organising network

Disrupting the City of London Corporation elections
The City of London Corporation is one of the most secretive and least understood institutions in the world, writes Luke Walter

#AndABlackWomanAtThat: a discussion of power and privilege
In the first article of a three-part series, Sheri Carr reflects on the oppression of her early life and how we must fight it, even in our own movement

Corbyn understands the needs of our communities
Ian Hodson reflects on the Copeland by-election and explains why Corbyn has the full support of The Bakers Food and Allied Workers Union

Red Pepper’s race section: open editorial meeting 15 March
On 15 March, we’ll be holding the first of Red Pepper’s Race Section open editorial meetings.

Social Workers Without Borders
Jenny Nelson speaks to Lauren Wroe about a group combining activism and social work with refugees

Growing up married
Laura Nicholson interviews Dr Eylem Atakav about her new film, Growing Up Married, which tells the stories of Turkey’s child brides

The Migrant Connections Festival: solidarity needs meaningful relationships
On March 4 & 5 Bethnal Green will host a migrant-led festival fostering community and solidarity for people of all backgrounds, writes Sohail Jannesari

Reclaiming Holloway Homes
The government is closing old, inner-city jails. Rebecca Roberts looks at what happens next

Intensification of state violence in the Kurdish provinces of Turkey
Oppression increases in the run up to Turkey’s constitutional referendum, writes Mehmet Ugur from Academics for Peace

Pass the domestic violence bill
Emma Snaith reports on the significance of the new anti-domestic violence bill

Report from the second Citizen’s Assembly of Podemos
Sol Trumbo Vila says the mandate from the Podemos Assembly is to go forwards in unity and with humility

Protect our public lands
Last summer Indigenous people travelled thousands of miles around the USA to tell their stories and build a movement. Julie Maldonado reports

From the frontlines
Red Pepper’s new race editor, Ashish Ghadiali, introduces a new space for black and minority progressive voices

How can we make the left sexy?
Jenny Nelson reports on a session at The World Transformed

In pictures: designing for change
Sana Iqbal, the designer behind the identity of The World Transformed festival and the accompanying cover of Red Pepper, talks about the importance of good design

Angry about the #MuslimBan? Here are 5 things to do
As well as protesting against Trump we have a lot of work to get on with here in the UK. Here's a list started by Platform

Who owns our land?
Guy Shrubsole gives some tips for finding out

Don’t delay – ditch coal
Take action this month with the Coal Action Network. By Anne Harris

Utopia: Work less play more
A shorter working week would benefit everyone, writes Madeleine Ellis-Petersen

Mum’s Colombian mine protest comes to London
Anne Harris reports on one woman’s fight against a multinational coal giant