In a letter in today’s Guardian, the Chief Executive of Macmillan Cancer Support defends the organisation’s leading role in the proposed privatisation of NHS cancer services in Staffordshire and Stoke-on Trent.
As a cancer patient, I know Macmillan makes all kinds of wonderful contributions, but this initiative raises the most serious questions about its approach.
The biggest threat to cancer patients in England is the attritional break-up of the NHS. In that context, the comprehensive privatisation of cancer services across a region is an alarming step in the wrong direction.
Charities like Macmillan are reluctant for a number of reasons to engage in politics, and that has blunted their ability to represent and fight for the interests of those they’re supposed to serve. But here we see Macmillan wholeheartedly embracing a highly political initiative, closely identified with a particular ideology.
It’s about more than naivete. Macmillan have taken this plunge partly because of the way they tend to define cancer support: as a managerial issue to be resolved without reference to political or economic policy. But it’s a classic lesson in how politics comes back to bite when you think you’ve left it behind.
Macmillan claims that the new programme will offer “an integrated approach”: “By appointing one organisation to take responsibility for managing the whole cancer care journey, we can demand truly seamless care.”
But this integrated, seamless care is what the NHS itself already provides, without assistance from the private sector, as I know from my experience at Barts and the Royal London. And where it fails to do that, as it sometimes does (and did in Staffs), there’s not a whit of evidence to suggest that private capital and its managerial prerogatives have anything to add to the solution. What we’re seeing, not for the first time, is a weakness in public provision being exploited to rush through a self-interested corporate privatisation with long term damaging impact.
Previous experience of health care privatisation suggests strongly that this latest scheme will increase costs, create new inefficiencies and undermine coordination. Given the recent history of NHS contracts with large corporations, Macmillan’s sweeping assertion that whoever wins the contract “will be subject to rigorous oversight and scrutiny for quality, patient safety and outcomes” is mere wishful thinking, and in the context, irresponsible. They owe the cancer patients they serve much better than this kind of complacency.
For the private healthcare industry, the Staffordshire contract is just the beginning of a potential gold rush. The numbers of people living with cancer are expected to increase massively in coming years: from about two million in Britain today to four million in less than twenty years time. Cancer care, in all its many forms, is an irresistible opportunity for private capital, a growing market that promises vast profits in an austerity-shaped future where individual patients can no longer rely on the support of collective provision like the NHS.
Mike Marqusee is the author of ‘The Price of Experience: Writings on Living with Cancer’ (OR Books)