ARTICLE UPDATED 9th April 2019
In a move seen as the ‘Americanisation of our NHS’ doctors are being pressured into signing new contracts by May 9th.
Good traditional family practice and long-term relationships with doctors have been the cornerstone of community healthcare in the NHS since its inception in 1948. But this efficient continuity of care and a GP’s ongoing relationship with (especially elderly) patients are both under threat in the Government’s plans for Primary Care Networks (PCNs), being forced through while all attention is on Brexit.
The ‘integrated care system’, rolling out across the country over the next two years, is directly modelled on the odious American private healthcare arrangement, and sets up the NHS Family Doctor as a commercial venture ready to be packaged and sold to vulture capitalists.
Dr Gill describes a three stage process:
First, privatisation needs to control NHS budgets. Currently GPs are allocated budgets based on their patient lists. The enticement, recommended uncritically by the BMA, is for doctors to sign up as PCNs. This begins the capture of those lists.
Next, secondary legislation was passed in February which allow the creation of ‘Integrated Care Providers (ICPs)’ (highly reminiscent of American-style private Health Maintenance Organisations). The PCNs will come under scrutiny from ICPs, with targets and cost controls, which will effectively incentivise denial of care, as market forces have done across the US.
And finally, there’s the infamous Section 75 of the 2012 Health and Social Care Act, which gives private companies the right to compete with doctors as service providers, with the added protection of compensation schemes based on competition law. And as public bidders lose contracts, money for them will dry up and the workers will have to go through private companies for their work. Meanwhile administration charges will continue to soar (between 1980 and 2013, these rose from 5% to 16%).
So, as Dr Gill puts it, the private sector first grabs the patient records, then grabs the budgets, and finally grabs the workforce.
While the promise of extra funding sounds good, much of this will go towards hiring lower-skilled non-medical staff who will do some of the work of doctors, involving more risk for patients.
There used to be more than 8000 local practices across the country in 2010, but the new scheme shrinks these down to just 1500 network hubs.
Where the new architecture is already in place, for example in Cornwall, it is already becoming increasingly difficult to get to see your doctor, with lower-skilled staff acting as cheaper gatekeepers.
In return for the promise of new funds, doctors will be enticed to give away their autonomy, with network managers controlling targets. There are fears that this will in time lead directly to the American model where doctors are incentivised to deny care, with obvious dangerous results.
In this film by Dr Bob Gill and Dr Paul Hobday, they run through their understanding of how serious these changes are.
Both doctors, joined by retired consultant Anne Athow, will be holding a public meeting in south London on Thursday (April 11th) organised by Greenwich Keep Out NHS Public.
Dr Bob Gill is a family doctor who has campaigned tirelessly to save the NHS by exposing the true nature of progressive-sounding government plans, and analysing the ways in which privatisation is being stealthily introduced at every level of NHS care without democractic scrutiny, and with little media attention. Real Media interviewed him back in 2016,when he described the ongoing plans introduced by Simon Stevens , head of NHS England, who had arrived at the job from his executive post at UnitedHealth, the massive American private healthcare insurance corporation which is poised to enter the UK market with a massive asset grab using the three stage system described above..