"Creeping privatisation" of services could be bad for patients
At an open meeting in Crown Street Surgery recently, Drs Michael Kenny, Sarah Bull, Naz Pambakian and Practice Manager Jacqui Hawkins talked to their patients about current changes in the NHS. They called the meeting to discuss important issues which they say are "less publicized facts" about what the changes mean to the NHS.
Dr Michael Kenny said that the current changes are being made with little consultation or piloting. He said: "The government's confrontation with doctors over extended hours is being used as a smokescreen for creeping privatisation of the NHS."
He talked about how the Government was unhappy with aspects of the 2004 contract for GPs. "We already have onerous daytime responsibilities. Yes, GPs are fairly paid - there's no question about that and I'm not complaining, though reports of GPs driving around in Ferraris are wildly exaggerated.
"We have invested extra money in the practice, for example, employing new doctors or by making improvements to the appointments system, and increasing nurse hours. We aim to provide better care for the Community and continuity of care. However, the Government PR machine is much cleverer at manipulating public opinion.
"It is generally true of GPs that the people who provide the service now put patient care before everything else."
He described how Primary Care Trusts (PCTs) are putting practices out to tender which are then being taken over by privately run companies including United Health, an American company.
Dr Kenny told us about Lord Ara Darzi, Junior Health Minister and a respected surgeon, who is advising the Government on NHS changes. "But he issued his recommendations for London before he ran a consultation. His recommendation is for Polyclinics to be set up - large buildings with large numbers of staff. But are Polyclinics what patients want? Where is the evidence that they provide a better service for patients? What will it mean for our patients if Ealing PCT is pumping huge amounts of NHS funding into new Polyclinics?
"My belief is that the Government knows that it can't afford the NHS any more. But to admit to that would be a vote loser. So they are trying to address the problem by creeping privatisation. Before the 2004 contract, private sector companies were not allowed to own NHS bodies, but that has been changed.
"I believe the public should be extremely wary of private sector companies running NHS bodies. If they fail, the Government will be able to say 'it's not our fault, it's theirs.'"
However, the Government's point of view is that the NHS should respond to patient need and cites Cabinet reports which state "nine out of ten" people want GPs to be available for longer hours, "even if that means they would sometimes be shut during the working week."
Dr Kenny added: "if patients decide that what they really want is a new sort of general practice, then we as their doctors should provide that. The key is that patients are not really being given the information to even know that there may be a lot of change in the way general practice is provided locally."
Dr Pambakian emphasized that Polyclinics and surgeries run by private companies would employ junior doctors and may give them strict protocols about how to treat patients. "We are disturbed by what we hear about established practices being taken over by private companies. Dr Sam Everington, a well-respected GP whose practice has won numerous awards, and who is deputy chairman of the British Medical Association put forward a management proposal with a GP colleague for a long-established surgery where three GPs had recently retired. Instead, the local PCT handed over the surgery to US-based private company ATOS healthcare.
"What really concerns us is that inevitably, the private sector will put profits before the needs of patients. As reported in the Guardian recently (see link), on the strength of a 'bare-faced lie', GPs are being bludgeoned into extending the opening hours of their surgeries when 'health supermarkets, open all hours' represent extremely poor value for money."
We consulted a GP who will have a Polyclinic opening in his area later this year. Dr Stephen Amiel, who is Chair of Camden and Islington Local Medical Committee and a partner in Caversham Group Practice in Kentish Town, told me that University College Hospital is opening a Polyclinic on site.
"They have found some surplus space in which to put the Polyclinic. This will doubtless be taken over by a private health company, such as United Health or Virgin. United Health, a US-based company, has already taken over three practices in the area. These were formerly run by a group of doctors who bid to continue running the practices. Despite the fact that the GPs' bid was generally regarded to provide the highest quality healthcare, the business plan of United Health was cheaper and they were awarded the contract. However, this is soon to be up for judicial review."
Returning to the issue of the proposed University College Hospital Polyclinic, Dr Amiel said: "The people who will lose out are patients and GPs who will be herded into Polyclinics on a hospital site rather than their local GP practice.
"It's interesting that Professor Darzi's consultation finished only on March 7th but Polyclinics are already being rushed through. This points to the complete futility and cynicism of a consultation which, in London alone, has cost £11 million.
"This Government is committed to privatising health care. They are doing this by freeing up the whole process of healthcare provision."
Drs Pambakian, Kenny and Bull are worried that they could be facing a similar situation to the one which is already giving Dr Amiel huge cause for concern.
March 27, 2008