The ghosts of “NHS privatisation” past, present and future
“Privatising the NHS” has become the all purpose political denunciation of the moment. No matter how much one’s own party has, is or will involve private providers in the system, the mere accusation seems to shut down any meaningful discussion about health reform.
Labour accuse the Conservatives and LibDems of doing it, and wanting to do more. The Conservatives run US-style video attack ads and leaflets against Ukip. Ukip say the Westminster elite plan it via an EU trade deal. The SNP accuse all the Unionists parties of allowing it for the devolved Scottish health system. In turn the SNP is accused of having done it in Scotland. And today at PMQs the LibDems launched a fierce attack on Labour for its record on the subject in Government too.
In an otherwise drab deputy PMQs, it was the one notable spat. Nick Clegg stared across the aisle at Andy Burnham and accused him of undertaking the only actual privatisation of an NHS hospital. “Rubbish” cried the shadow and former Health Secretary. The hospital in question was Hinchingbrooke, a small district general hospital in Cambridgeshire.
In a point of order, Mr Burnham called for the DPM to return to the House after PMQs to correct his “misstatement”. Mr Burnham pointed out that the contracts were signed by the Coalition. The DPM returned fire with a letter saying that Mr Burnham was “stretching accuracy to its limits”.
Luckily for us, the NAO did issue a report on the franchise award for Hinchingbrooke in 2012. On the one hand it does show that final contract was signed off in 2011, under the Coalition. So this is the most sensible definition of actual “privatisation”.
However the NAO also confirm that the decision to shortlist only private sector bidders for the “invitation to participate in dialogue” occurred in December 2009, at a time when Andy Burnham was Health Secretary.
When I pointed this out, the shadow Health Secretary tweeted to me that it was wrong, and indeed that there was still NHS involvement in the bidding process, when the Coalition took over. Indeed Hansard does seem to bear this out.
But if you look at the press announcements at the time… then it appears that the “NHS bidder” referred to by Labour is none other than “Serco Health, which is working with Peterborough and Stamford Hospitals NHS Foundation Trust”.
In the end, under the Coalition, the purely private company, Circle, won the contract. So yes the Coalition privatised the hospital. But Andy Burnham’s health department left it inevitable, notwithstanding the fact that another NHS trust was working with one of the remaining private sector bidders.
But the story gets much more interesting than this. The NHS trust involved in helping Serco’s bid, was, itself, heading to the dogs (“heading towards a financial meltdown”) requiring at least £26 million a year. Read a small part of the Public Accounts Committee’s devastating report from last year. The reason? A terrible, botched PFI, combined with, yes, the privatisation of the Hinchingbrooke hospital.
Basically the hospitals are 24 miles apart and are competing with each other for the same patients, spending millions on management consultants to advise them on fake forms of NHS competition. The end result: “neither Trust is financially sustainable in current form”. This is in fact a damning indictment of a total lack of healthcare planning and multiple failures of different types of NHS privatisation, interacting with each other to form a type of NHS supernova.
So Labour should be more willing to self-reflect on, for example PFI. I asked Ed Miliband, at his post-conference interviews in the Salford Royal Hospital (itself a Labour-signed PFI which will not be repaid until 2042) about what he was saving the NHS from, and whether that included PFI payments:
This subject area is going to play very big ahead of the election. There are many many more stories like this. It just so happens that Hichingbrooke arose at PMQs. Conservative figures already regret the political damage of the Health and Social Care Act. It is complex. But no party can really shy away from their own complicity.
UPDATE 1923: DPM and Shadow Health Sec swap annoyed letters:
