Sunday 13 December 2015

A threat to the NHS too dangerous to be kicked into the long grass.


The City Independents have made their first political mistake since taking control of Stoke-on-Trent City Council in May. As is the way with such things it is a biggie; perhaps the biggest and most dangerous one they could have made.

This week Labour tabled a motion calling on the council to oppose plans by Stoke-on-Trent NHS Clinical Commissioning Group to allow private companies to tender for a contract to provide cancer and end of lifer services worth £1.2 billion.

Thanks to a successful intervention by Independent cabinet member Ann James the motion was amended so that the issue will simply be referred to the relevant overview and scrutiny committee. A small victory for her, a bis mistake for everyone else; positively huge in fact.

The threat this thinly veiled assault on the existence of a free at the point of delivery health service are many and various. Introducing competition to NHS contracts will have a huge impact on how decisions are made, visiting upon the health service 'predatory pricing', where companies underbid to win a contract, shutting out small local companies and charities who cannot afford to take the short term losses and leaving the field open to the big outsourcing companies. Capita, Virgin, and all the other usual suspects who have brought us countless disasters involving public services that have been sold off.

This freeze out happened to the Douglas Macmillan Hospice and St Giles Hospice when they tried to make a joint bis to deliver cancer and end of life services, they were ejected at the first stage without explanation. Prompting Dougie Mac chief executive Michelle Roberts to say the plan was 'undoubtedly a privatisation of a service and we cannot support such as move due to the serious damage it could inflict on the care we are able to provide.'

The clinical commissioning group has defended the plan on the grounds it will consolidate cancer and end of life services, improving how they are delivered. Possibly, but if it turns out to be a mistake, and the omens aren't good, we're stuck with it because the contract would be essentially unbreakable.

The cancer care contract has yet to be awarded due to ongoing difficulties, at present only the Royal Wolverhampton NHS Trust still in the frame. No shortlisted bidders have been announced for the end of life services contracts, although at least seven companies may be in the race.

An answer is expected over the Christmas period, a fact that should set a fire station filled with alarm bells ringing. Politicians like nothing better than announcing burying bad news whilst we the voters are all busy jingling bells under the Christmas tree.

It is hard to disassociate the plans to sell off cancer services with another and even more serious threat to the survival of the NHS as we know it, the silent approach of the Transatlantic Trade and investment Partnership (TTIP). This shadowy deal between the US and the EU hasn't registered on the domestic political radar, but could radically change our public services and not for the better.

Under the provisions of TTIP large corporations, just the sort of businesses who will be bidding for this contract and the others that will follow, will be able to sue anyone, councils, the NHS even the government, they feel has damaged their profits.

You can all too easily imagine a scenario where an NHS trust trying to protect services from cost cutting that may be good for the corporate balance sheet; but a disaster for the staff who work their and the patients who depend on it finding itself in court. Even is a trust won its case in the wonderful world of TTIP they would have no recourse to damages or ability to recoup their legal costs.

This could tie the hands of cash strapped public services, erode the employment rights of their staff and, in the case of the NHS, result in a debacle that makes the sorry events in South Staffs look minor. The big beasts of the corporate jungle would have power without responsibility or accountability; that never ends well.

Councils, trades unions and anyone else who can make a noise need to send a clear message to the decision makers in Brussels that they are not going to stand by and see vital services sold off to corporate asset strippers. By not doing so and instead kicking the issue into the long grass the Independents have done themselves and the people of this city few favours.

Since May they have managed, more by luck perhaps than design, to retain a surprising amount of public good will, mostly by not being Labour. That will dissolve entirely if they persist in ignoring a dangerous policy backed by a government that pours honeyed words over the NHS, then deprives it of money and puts its continued existence in danger.

1 comment:

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