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Health privatisation failed, why does it keep coming back?

HELEN O'CONNOR reviews the very recent disasters from attempts to use private companies and private finance instead of a publicly funded NHS — now this discredited approach is back to 'drive down waiting lists'

THERE can be no doubt that the pandemic is putting unprecedented strain on the NHS — but decades of cuts and privatisation have also contributed to the current chaos.

Far from ensuring that the NHS retains experienced staff or allocating adequate funding to provide care, this government is still demanding that NHS trusts stick to rigorous financial targets and false performance indicators in order to avoid having further funding removed.

As NHS trusts struggle to balance the books, public money is being funnelled to the private sector to solve a crisis that is deliberately being created by this government and further exacerbated by the pandemic.

A deal has been struck with a consortium of private companies which has been hailed as the solution to reduce waiting lists that are now running in excess of five million for routine procedures. The cost of this deal is undisclosed but a previous deal with the private sector cost £400 million per month.

The introduction of privatisation inside the NHS has been a disaster and has led to cleaning and nutrition standards falling inside hospitals.

During the pandemic, cleaning provision has been cut in several London hospitals when enhanced cleaning is necessary. The abuse and exploitation of the outsourced staff continues as they are reliant on statutory sick pay even if they get infected with the virus.

As a result of serious shortage protocols, many workers are left with no choice but to come into hospitals when they are sick — which is a cross-infection risk for patients.

Private health companies cherry-pick the profitable short term health treatments and push the complex and more expensive work back onto the NHS.

Even though private hospitals look luxurious and offer fancy food and a higher standard of accommodation, many are reliant on agency staff and do not have the staffing, expertise or technology to provide life-saving emergency care. When complications develop, the patient will be returned to the NHS for specialist treatment.

History tells us that privatisation will not provide the solutions to the NHS crisis.

In 2012 Hinchingbrooke hospital in Cambridgeshire was struggling with 40 million debt when the coalition government was in power. Section 75 of the Health and Care Bill was introduced by Andrew Lansley and this allowed a company called Circle Health to be offered a 10-year deal to take over the management of the hospital.

The ambition was for Circle Health to turn the failing hospital around and reduce the debt while the staff and the assets remained under state control.

A year later the Daily Mail ran a feature hailing the enterprise and claiming that privately managed Hinchingbrooke hospital had the highest rates of “patient happiness” and the best waiting times in the country.

However within three years Circle Health had pulled out of the contract leaving the hospital in an even worse state — and the taxpayer to pick up the bill.

The management team of Circle Health, some of whom had backgrounds in private companies like Argos, embarked on a brutal regime of cuts in order to reduce the financial deficit in the trust. They cut staffing, training and excluded senior nurses from any decision making. Patient stays in hospital were reduced as were nurse-to-patient ratios, which meant that patient care and supervision deteriorated.

Senior Nurse Patricia Flanagan went on public record to say that she was unable to meet stringent financial targets and ensure that patients would receive good care — and she spoke of how she was pressurised into discharging patients before they were ready.

Co-operation between departments broke down inside HInchingbrooke hospital as they were forced to compete with each other to meet financial targets to get cash rewards put back into their allocated budgets.

A culture of fear developed and staff were unable to report concerns and the hospital struggled to retain permanent staff which led to an over-reliance on agency workers.

Over a quarter of staffing posts remained unfilled in the A&E department and patients ended up waiting up to 12 hours in ambulances.

In 2014 the CQC found that patients at Hinchingbrooke hospital were being treated in an undignified and abusive manner due to a lack of staff training.

Sloppy procedures developed as care plans were not updated and notes went missing. Health and safety standards plummeted and hand washing was not rigorously enforced in spite of a C. difficile outbreak on the wards.

Staff were unable to provide the most basic care like feeding and toileting of patients who were left dirty and distressed. There was an increase in Do Not Resuscitate orders and patients without mental capacity to consent were sedated.

The CQC also found that drugs were not locked away properly and that patients were moved between wards in the middle of the night.

The privatisation of Hinchingbrooke is not the only privatisation disaster that has occurred.

In 2015 London Bridge hospital paid out £2.1 million in compensation to the family of a patient who had died in an intensive care unit.

In October 2021 the health and safety investigation branch launched a probe into another private hospital that performed a bowel operation on a cancer patient who later died from sepsis. The report concluded that the capability and capacity of the provision of surgical care in private hospitals varied around that country and the main issues were safety risks and unclear roles and responsibilities of staff.

In spite of the documented failings in the private sector a myth prevails that the private is better than public. This false belief is being resurrected even by those who should know better as they publicly declare that it’s fine to use the private sector to bring waiting lists down.

No-one in the Labour Party or the trade union movement should be advocating use of private companies or private finance to provide healthcare — it does not work and it never will.

Experience tells us that not only is private healthcare costly but privately run hospitals often prove to be incapable of providing safe and fully comprehensive care for patients.

If there are billions available to pump cash into the private sector there is money for the NHS and for experienced NHS staff to get a decent pay rise that would stop them leaving in droves.

We don’t need to keep relearning the same old lessons over and over again. Public ownership, democratic accountability, adequate funding and properly trained and paid staff will efficiently deliver the healthcare we need — and this can be provided by the National Health Service if the political will is there.


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