You’ve heard the stories: a minority group of people is draining our NHS of vital resources, bleeding it dry so it can no longer provide life-saving care to the rest of the nation. Those stories are all true. But the people sucking the lifeblood out of our National Health Service aren’t the folk-devils the Right wants you to believe in; the migrants and the benefit claimants sponging off frontline services. They are the super-rich elites and party donors using our National Health Service to as their own personal piggy bank.
The party I work for, the National Health Action Party, has been attempting to stop just this – to prevent a cornerstone of the welfare state being used to line the pockets of people with knighthoods and second homes in tax havens. Our aims are simple. We want to end the purchaser-provider split in the NHS by scrapping the Health and Social Care Act 2012. We want to put an end to the creation of parasitic internal markets in the health service, properly fund social care and bring it back under state control and reverse austerity. But now, as the NHS turns 70 years old, we are faced with another battle. We’re trying to raise awareness and fight against the roll-out of Accountable Care Organisations across England – if you don’t know what ACOs are, you should. And you should be worried.
The NHS as you know it could be coming to end
Accountable Care Organisations (ACOs) derive from the American healthcare system. The government is attempting to roll them out across the UK without a vote in Parliament, undemocratically importing policies from a country in which medical costs drive hundreds of thousands of people into bankruptcy each year. They would involve the creation of corporate and non-statutory bodies delivering combined health and social care across 44 regions of England with fixed budgets for 10-15 years a piece.
This means that, in theory, a single private company could be responsible delivering the entire provision of healthcare within a region. And as ACOs aren’t statutory bodies they won’t be subject to basic democratic checks, such as Freedom of Information requests or judicial reviews. Many commentators have also pointed out that case law indicates its likely to be difficult to hold ACOs to account, especially regarding social care, should they infringe upon human rights legislation.
On top of that, ACOs are not technically required to provide universal healthcare coverage. Rather, they’re required to provide healthcare for those who are already registered with a GP. The consequences for those without a fixed address or an irregular immigration status would be dire. And once we look through the smoke and mirrors of the government’s recent announcement of an increase in funding for the NHS, what we really see when it comes to ACOs, is that they’ll be managing a capped budget.
As the NHS is already cash-strapped, with demand increasing and the cost of treatment increasing due technological and medical advances, this means that the caps are likely to be reached before the 10-15-year mark.
Charges could be slowly phased in for a series of services in the same manner Thatcher salami sliced optical care out of the NHS. As a result of the corporate nature of ACOs other fundamental democratic mechanisms, such as a CCGs having to consult with the public should it wish to shut down or relocate a service, will no longer be in force. If an ACO wants to shutdown your local GP or sexual health clinic they won’t be required to consult you.
The real issues become apparent when we also learn that the funding follows per patient, i.e. ACOs can compete for patients. This means that should people register with GPs outside the area they live in the money will follow them (this is something that is already in its infancy and heaping costs on already struggling CCGs). The risk of exacerbating pre-existing geographic health disparities is colossal.
Now, we have to ask ourselves, why don’t more people know about ACOs? Why aren’t people who read the Daily Mail and who become incensed with rage at the thought of benefit cheats, aware of what is happening? Why aren’t Express or Sun readers as angry about the state of our NHS and the parasitic relation between the state and capital as they are when they believed the EU wanted to force us to only eat straight bananas?
It’s hard for the entire Left to get its message across when the most read papers are right-wing. But, bigger questions have to be raised when key figures in the Labour Party – such as the new mayor of Sheffield Dan Jarvis MP – have financial links to former hedge fund operators, such as Martin Taylor, who have given him just under £60,000 in donations in the past – and who have directly invested in ACOs. Incidentally, Sheffield is one of 8 regions where ACOs will be piloted, and Dan Jarvis’ election literature failed to make reference to them.
For too long, governments have created internal markets for parasitic companies to operate in the NHS. These companies repeatedly fail to deliver on their contracts but still pocket vast sums of tax payers’ money whilst most of the time having put patient safety at risk. If you think I’m exaggerating, then just look at the record.
Firstly, we have Virgin Care. A company which has set the record of taking over a GP surgery rated “outstanding” and managing in the space of two years to run it into the ground so that it is now deemed “inadequate”. They have a track record of suing the NHS when they’re not awarded contracts, despite the fact that in the past they’ve been caught allowing untrained receptionists with no medical experience to decide who does, and does not, get to go to Croydon’s A&E service. Unsurprisingly, and tragically, this led to deaths. And, as with all things Virgin related, the incompetence is also mixed with a healthy dose of tax dodging. Virgin Care repeatedly reports losses and is registered in the UKs worst offending tax haven, the British Virgin Islands (the clue’s in the name). Meaning that UK taxpayers have little to no power to scrutinise where their money is actually going. Despite this, towards the end of 2017 Virgin Care still managed to scoop £1bn’s worth of new contracts.
Then we have Serco. Run by the brother of Tory MP Nicholas Soames, Serco currently holds the record of having a £600m contract with the biggest NHS Trust in the UK, and in 2016 boasted a profit of £82 million and revenues of £3,048 million. This is in spite of the fact that Serco has the illustrious record of deliberately overcharging NHS hospitals. In a three-month period, Serco was found to have overcharged several hospitals to the tune of £283, 561. After an inspection of Serco’s billing processes, it was estimated that Serco probably overcharged to the tune of £1million plus. Not being content with just stealing money from the public, Serco also doesn’t mind seriously hampering the ability of the NHS to engage in the strategic planning of services, they tend to do this by falsifying performance data, so they can cling onto their grubby contracts.
Other illustrious feats include taking on a contract to deliver community health services in Suffolk, and then proceeding to cut 137 jobs in the process. Followed up by colossal underperformance and the selling off of the contract whilst still pocketing £140million. Oh, and if you’re wondering what Serco gets up to outside the NHS, well it tends to involve running detention centres where inmates are beaten, prisons where prisoners were deprived of water and electricity for two days, and being investigated by the Serious Fraud Office for overcharging the government £64.5m for the electronic tagging of offenders.
Last, but by no means least, is Capita. If the name rings a bell, it might be because Capita were recently in the news for being seriously rebuked by the National Audit Office. In 2015 Capita was awarded a contract worth £330 million over several years. They were given the task of centralising the NHS England’s Primary Care Support Service. This was a total failure leading to 9000 misplaced patient records, the aggressive slashing of staff to cut down on costs during a time where we currently have a recruitment crisis in general practice – there are 5000 unfilled GP vacancies in England alone – Capita managed to not update the “performers list” of GPs, dentists and opticians. This meant that up to 1000 GPs, dentists and opticians were unable to work for over a year. Unsurprisingly those GPs, dentists and opticians are now seeking damages for lost earnings, meaning the NHS will be shelling out more money in the near future as a result of private sector incompetence.
These companies are the tip of the iceberg – just a few of the players who are making a tidy profit from dismantling an institution once called the ‘envy of the world’ for its ability to deliver care to everyone – irrespective of how much you had in the bank account.
What is to be done?
A group formerly led by the late Prof. Stephen Hawking have taken Jeremy Hunt and NHS England to court over their attempt to roll-out ACOs, and we are awaiting the result. But the fight doesn’t stop at the courthouse steps – we need to draw attention to the parasites killing off the NHS for personal gain. We need to put faces and names to those who have interests in selling off our NHS, plenty of whom sit on the government benches in Westminster. The Tory party and some of its leading figures are bankrolled by those who would love nothing more than to carve up the NHS and flog it off to their mates. If your MP is on this list, you need to call them out on their position on ACOs – because they threaten to bring the NHS to an end.
#227 Democratic Dictators ● The psychology of authoritarianism ● Does national pride have a place on the left? ● Keep police out of schools ● Video games special ● The new left MPs ● Speaking to local organisers ● Simon Hedges’ column ● Book reviews ● And much more!
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