More than 50 GP practices have recently been transferred into private hands across the UK with little or no scrutiny or oversight, and campaigners fear it is the thin end of the wedge and another step towards wholesale privatisation of the NHS.
In 2004, APMS Contracts (Alternative Provider of Medical Services) allowed practices to effectively form private companies, and 15 years later when the largest of these, AT Medics, was due for renewal, it was bought by Operose Health.
As part of an ongoing campaign, several groups organised a protest outside the central London office of Operose Health in New Cavendish Street recently to voice their concerns over NHS practices being operated by this health-for-profit company.
Operose is a wholly-owned subsidiary of the American giant health insurance corporation Centene which trades on the stock exchange and has been involved in numerous legal wrangles over acquisitions, lack of medical access, underpaying doctors, and aggressive treatment of whistleblowers. They are currently facing allegations from the Ohio state that they fleeced millions of dollars from the taxpayer through an elaborate overcharging plot.
Centene’s fiduciary duty is of course to its shareholders and its main aim is to increase profits and cut costs, so patient care becomes a necessary expense to minimise rather than the core aim of the provider. A public healthcare provision is likely to suffer in the hands of a corporation, but not only that, it also ends up being more expensive. The US spends more than 16% of GDP on so-called health care, but delivers a lower life expectancy than the UK and most of western Europe. Its infant mortality rate is higher than many countries that used to be classified as ‘third world’.
In North East London, eleven AT Medics practices changed hands at the end of last year in circumstances mired in controversy. Campaigners claim there was a very short online meeting during which the chair of the North East London Clinical Commissioning Group approved the transfer with absolutely no mention of Centene. There was also an undertaking that the AT Medics board of directors would stay on, but within a couple of months they all resigned and the board was taken over by Operose.
One of the newly installed directors was Samantha Jones, who was previously NHS England’s Director of New Care Models from 2015. Another of the new Centene directors is Tim de Winter, but he is also deputy director at the Department of Health of the utterly discredited Test and Trace project which wasted a staggering £37 billion of public money. Tim de Winter previously held a senior position at Carillion which went bust, and also worked at a private health group Clinicenta which had to be rescued by the NHS.
Centene acquired a network of GP practices in 2017 when it took over The Practice Group, where Tim de Winter worked for two years. He was also Director of Operations at Simplify Health when they were taken over by Centene in 2018. Operose was born out of these two companies in January 2020, comprising around 20 GP surgeries along with an urgent treatment centre, various ophthalmology clinics and a dermatology clinic. The takeover of AT Medics extends their grip to nearly 70 GP practices covering more than half a million UK NHS patients.
Centene also has a £41 million stake in the Babylon GP at Hand app, which restricts face-to-face access to GPs under the guise of convenience and online diagnosis. Public funding of Babylon caused controversy when it was revealed Dominic Cummings advised them on strategy prior to Matt Hancock publicly backing them.
The concept of being able to see a local regular GP face-to-face is seen as expensive and unprofitable by private interests who prefer American models of pre-screening. GPs have already raised concerns over the dangers of Babylon diagnosis. The pandemic provided a perfect excuse to erode direct patient access to GPs with inadequate alternatives such as the 111 phone line and the GP at Hand app being offered as a first port of call.
Campaigners are also concerned that private companies intend to obtain and financialise patient data. Obviously if a health insurance model evolves, then insurers would love to get hold of your medical history in order to set their premiums. Although this kind of use is protected for the moment, Babylon has already suffered a major data breach and there is extreme concern over the government NHS data contract with US intelligence firm Palantir.
The recent announcement of yet another NHS reorganisation introduces Integrated Care Systems which are very much based on US models. The new plan concentrates power in the hands of the Health Secretary with even less scrutiny of procurement contracts, including NHS data management.
At the rally outside Operose, Phil Edwards from Newham Save Our NHS raised another issue around the Integrated Care Systems plan – that of accountability:
“We regularly go to Trust meetings which are publicly held, we go to Health & Well-being meetings which are open to the public, we go to Clinical Commissioning Groups (CCGs) open to public, but Integrated Care Systems are held behind closed doors and they make decisions like this one behind everyone’s back. No-one was consulted, it was a nod and a wink, Chair’s decision, and even the CCGs didn’t know about it.”
The protest outside Operose HQ attracted a wide range of activists and included speeches by Dr. Jackie Applebee (Doctors in Unite), Phil Edwards (Newham Save Our NHS), Apsana Begum (MP for Poplar & Limehouse), Jeremy Corbyn (MP for Islington), George Binette (Camden Trades Council), and Paul Summers (Unite Community) among others. Their unified call was for a reversal of the insidious privatisation by stealth, and a return to a health service that is publicly funded, publicly owned, and free at the point of delivery.
The last year has shown how important our health service is. Health workers are aware that when their work gets privatised and for-profit models are introduced, the pay and conditions inevitably go down, the hours get longer, and the service gets poorer. In Real Media’s interview with Bob Gill nearly four years ago, he outlined the steps towards privatising the NHS and explained how the plan had unfolded slowly over many years. Its still not wholly inevitable, but time is getting short for people to wake up and fight back against this stealthy takeover.
We Own It have an ongoing petition against NHS privatisation.