An interview with, Dr Bob Gill NHS GP of 22 years @drbobgill
By Victoria Egerton @VictoriaEgerto2
“The NHS is being transformed into an American style, private insurance dominated system”.
Profit extraction is dismantling cost effective healthcare.
In 1968 Arthur Seldon (later Thatcher’s privatisation policy adviser) in his document ‘ After the NHS’ , said that to improve the NHS, we need to abolish it and provide profit opportunities in health insurance. In 1988, there were similar suggestions made by Conservative MPs Oliver Letwin and John Redwood.
But, admitting NHS privatisation on any agenda is electoral, democratic and therefore political suicide. As a result, over the past 30 years, the government has embarked on a covert and gradual operation, distracting the public from the reality of privatisation.
The legal duty for the Secretary of State to provide healthcare has been abolished. Every step consecutive governments have taken was intended to dismantle your NHS and leave you so dissatisfied that you turn to private insurance.
“An American style healthcare system”
Simon Stevens is an ex-executive at UnitedHealth, a global American health insurance company. Ironically, Stevens is now the kingpin at NHS England, bringing with him his ‘ Five Year Forward plan’ .
This is a coded document, stating the changes required to deliver NHS corporate interests by, amongst others, reducing NHS beds by 17,000, 34 hospital closures and cutting the wage bill.
Hunt aims to increase profitability and destroy public trust and confidence in the NHS, driving people towards private heath insurance.
“Politicians took their time, 30 years on average. They made it complicated… created a plausible cover narrative”
No politician will admit that privatisation is on the agenda. A cover up story was created. We were told that the private sector is used to temporarily help out the NHS, to cut waiting lists. In reality, it is mainstream, covert corruption. Many parliamentarians (over 200) will benefit financially from privatisation and the public are preoccupied with their own life, distracted by trivia. But, it is the patients that will lose out.
Privatisation has been creeping up on us. It started in the 1980’s where we saw the replacement of medical leadership with a corporate structure. Our public health service started transformation into a business (foundation trusts).
The key stages of the rip off were outsourcing non-clinical services, the introduction of market bureaucracy and splitting the hospital network into independent trusts.
The trusts were burdened with the Private Finance Initiative (PFI); deals designed to bankrupt them. Clinical control and oversight was removed, “stripping out medical ethics and NHS culture”.
Vital, non-clinical services such as IT, ancillary, financial and audit functions were outsourced. This removed public oversight on budgets and enabled a mass cover up over the amounts squandered on commercialisation.
“The PFI saddled the NHS with expensive debt”
The 2009 Unsustainable Provider Regime enabled PFI debts from one hospital to be used to justify closure of neighbouring publicly owned hospitals. 101 of 135 hospitals were built using PFI loans. The cost is so exorbitant that for every 1 PFI hospital, 3 publicly funded hospitals could have been built.
Extortionate repayments are required to destabilise the NHS. Billions of public funds are wasted on unaffordable interest rates and costs NHS Trusts £2 billion a year. This is the ideal cover to shut down publicly owned hospitals, flog off public assets and ultimately drive the private insurance conversion.
Since 2013, NHS services have been funded by Clinical Commissioning Groups (CCG’s). Commissioning decisions are regulated by incentives of outsourcing to private companies.
“The Health and Social Care Act 2012 forces services to be put out to commercial tender”
The HSCA has seen large-scale outsourcing of clinical services such as, out of hours and ambulance services. The list goes on. There have been so many examples of provision failure due to cheap, dangerous service provision; Serco in Cornwall, Virgin in Croydon and Vanguard in Musgrove Park Hospital.
The Act removes the Secretary of Health’s legal duty to provide health care. It locks all services under the HSCA into competition law, allowing private companies legal rights to have services opened up for profit extraction. This will become permanent if the Translantic Trade and Investment Partnership (TTIP) is adopted. If TTIP goes ahead the corporate will be on par with the government. This is dangerous.
“We are in the final stages of privatisation”
Currently, junior doctors are the ones under attack; deskilling is part of the privatisation agenda . However, key services such as cleaning, porters and catering have already been outsourced and downsized. Student nurses also face cuts to bursaries. Effectively they will be delivering a service, which is a compulsory part of their training, for free.
Highly skilled medics will inevitably leave the NHS, but not through choice. This would not be a problem for a privatised system, as it will rely mainly on lower skilled staff, assistants and volunteers.
What’s left to do?
Enact the Stevens Five Year Forward Plan by down skilling, cutting the wage bill and closing more hospitals. Then the merge of social and health budgets and the devolution of NHS budgets to local councils.
For privatisation to be complete, there will be a complete hand over of budget control via Commissioning Support Units to private companies such as United Health, a lift of the PFI debts and a complete sell off the remaining hospitals.
Personal Health Budgets will be introduced which will effectively transfer to private insurance companies. Patient records will be handed over and valuable data will be used to deny insurance claims and for marketing by drug companies.
The NHS offer will be reduced. Services will no longer be available on the NHS. The remaining NHS services will be delivered by under qualified staff in fewer hospitals. People will be driven towards taking out private health insurance. People will believe insurance will cover their health needs but in reality insurers will look for any reason to deny cover when claims are made.
“Nobody is safe with privatisation”
Bob explained that already, his local services have also been cut. Access to health services is harder, and casualty care is dangerous.
Many of his patients have suffered avoidable harm. There is not enough capacity and staff morale is low. Casualties cannot retain high calibre staff. Hospitals are dumping work onto overstretched GPs. Recruitment and retention is currently a problem across the board.
Unprofitable care will be neglected. Mental Health patients are most vulnerable and least vocal. They are easy targets of a profit-making take over. Elderly patients will also be neglected in their own homes rather than being admitted to non-existent hospital beds.
“Not even the wealthy patients with the top-of-the-range health insurance are safe”
There is a risk that expensive medical bills are rejected on flimsy grounds after medical records have been scrutinised. The goal of any insurance company is not to pay out and to retain, as many premiums are possible. This will be the same for health care insurance. This is dangerous and takes away NHS culture.
“This race to the bottom will erode quality of care and kill, or harm patients”
A privatised system diverts money away from patient care. Incentives to deny care will damage the trust and confidence between doctors and patients. Unsafe, low quality care will be delivered and the cheapest staff will be employed. This burdens medics with risk to patients and themselves. Privatisation leads to corporate pressure to conform and collude with fraud, covering up patient harm.
“We are living in the greatest betrayal of public interest”
Politicians have gradually and covertly introduced privatisation but the media has a role to play too. Full and balanced reporting would expose the scam. All we hear is superficial comment or often, simple repetition of political spin. “ A process that amounts to censorship by omission.”
We accept think tanks such as the King’s fund as independent, despite a clear conflict of interest. They receive significant funding from the Government. Other think tanks funded by accountancy firms and management consultants profit from the program.
What can be done?
Unfortunately, pleading with corrupt corporate sponsored politicians has failed.
“The most important action, is to get the word out”
Tell everyone you know about the scandal
Watch and hold screenings of the ‘sell off’
Use local media -balanced reporting
Protest against TTIP
Boycott those profiting from the carve-up. Particularly those with other interests such as Virgin and Boots
Join local campaign groups and support NHS staff in industrial action
Renationalise our NHS