Professor Peter Bradshaw on the Coalition’s visionary, free-market approach to health care in the UK.“The private hospital provider, Circle has finalised its long awaited deal to run Hinchingbrooke NHS hospital in Huntingdon, becoming the first non-state, privatised hospital in NHS history. The company’s pietism holds that profits will be ‘reinvested into services’ in a groundbreaking £1bn, 10-year deal for the firm to run a struggling NHS hospital. Noble though its sentiments seem, though shareholders will think differently.
The Circle deal brings to fruition a long standing Tory dogma to privatise the NHS. Put simply, private hospitals treat predictable conditions that make profit. If anything goes wrong, the patient is passed to the NHS. No private hospital is ever built more than 10 minutes away from a ‘blue light admission’ to its local NHS hospital. In contrast, the NHS takes on all-comers, irrespective of their clinical complexity or their perceived ‘economic worth’.
Hinchingbrooke was never a viable economic proposition, built to serve 160,000 people through its then sitting MP John Major who gave it to his electorate as a treat to save them from having to travel elsewhere.
The Government advance the contentious premise that Circle will stay in the NHS because the deal assumes financial risks of making the hospital more efficient and paying off its £40m of debts. The company chants the Coalition mantra that its success will be achieved through cutting bureaucracy and improving efficiency. But the contract heralds the wholesale transfer of hospitals to the private sector. Ministers inevitably deny this and deflect attention from the destruction of the NHS. But Circle intends to maintain standards of care at Hinchingbrooke, cuts costs and provide an exemplar for other profit making organisations. Twenty NHS hospitals face similar ruin with private companies itching to pounce.
The people of Huntingdon do not like this at all. They suspect impairment to the quality of care through the savage staff reductions necessary to achieve the financial targets of Circle.
Circle conveys a messianic message that it will increase the influence of doctors and nurses to create a John Lewis-style model. Everyone who works there will be, ‘owning the problems and solving them’. Yet the sceptics contend that Circle, has experience of providing planned care, but none of running a full range of services including emergency and maternity care. They contend Circle’s ability to deliver comprehensive services and predict it ‘an accident waiting to happen’. Clearly, despite the smokescreen of paying off the current debt, profits will go to shareholders not to patients who face inevitable reductions to services. To succeed, the hospital will need to attract patients from elsewhere, a risky consideration that raises the fundamental question of why should Hinchingbrooke continue to exist? But it will, because Mr Cameron, Mr Osborne, and Mr Lansley will see that it does and that Circle becomes an exemplary profit-generating beacon of success. Sorry Mr Clegg, your tongue is tied on this one.”
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