The tragedy of a market based NHS

The 2012 Health & Social Act created a new NHS framework. Clinical Commissioning Groups have been set up to commission health services to any bidder (“any qualified provider”). I remember campaigning against the 2012 bill with the relentless Leeds Keep Our NHS Public. The bill encourages privatisation of the NHS. Yet bizarrely, Conservatives (and the odd Lib-Dem) claim that paying the private sector to run a service is not privatisation!! In fact nearly any NHS service can now be privatised, even services involved with the commissioning itself. We all knew that introducing a ‘market’ into the NHS would add extra costs.

Leeds & York Partnership Foundation Trust (LYPFT) runs mental health services in Leeds, North Yorkshire and York. It recently lost the majority of its contracts in York to another public sector Foundation Trust called Tees, Esk and Wear Valleys NHS Trust (TEWV). LYPFT still runs a few services in York and North Yorkshire via an NHS England contract. The decision to award the existing contract to TEWV over LYPFT was decided by the Vale of York Clinical Commissioning Group (CCG).

CCGs are made up of groups of General Practices and commission the following:
• Planned hospital care
• Urgent and emergency care
• Rehabilitation care
• Community health services
• Mental health and learning disability services

A CCG board is made up of GPs and a few other specialists. Currently we have a shortage of GPs and many are working long hours. From a laymans view it appears the government wants the GPs to run the accounting and the Accountants the NHS!

On the 11th May LYPFT learned they had not been selected as the “preferred provider” by the Vale of York CCG. LYPFT was surprised, since they believed the contract would be awarded on quality not cost. LYPFT were also in the middle of doing-up an important medical centre in York. It then turned out there was a conflict of interest. A Doctor on the judging panel for the Vale of York contract had a partner who worked in TEWV (1).

LYPFT then asked Monitor (the NHS regulator) to investigate these issues. Monitor refused….. yet another watchdog which is not fit for purpose. The 2012 Health & Social Act created more bureaucracy than prior to 2010. Tellingly the government has plans to merge Monitor and the NHS Development Authority into “NHS Improvement”. But no amount of ‘creative’ renaming can hide the cuts in money and staff shortages within the NHS. This grim graph shows the amount of Foundation Trusts now in deficit. Do we want our NHS to rack up debt and even go ‘bust’?



The tendering cost for LYPFT for the Vale of York contract cost at least £250000. The combined costs to both LYPFT & TEWV from tendering and any transfer costs could be over £1m. This money would better spent on patient care, not expensive, wasteful tendering processes. Yet the government will continue with their empty double-speak. I can only assume many MPs will eventually be rewarded by positions on private health company boards (2).



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