Thursday, 18 February 2010

Hinchingbrook disgrace and PFI nonsense

Apparently the struggling District General Hospital in Hinchingbrook is to be taken over and run by a private company, according to the government and politicians this is not 'privatisation', it is about providing high quality services by using a leading provider. Interestingly Hinchingbrook's trouble must have nothing to do with various PFI schemes in which it was involved. It was also nothing to do with the PCT staving the hospital of funds because it was committed to throwing money at various private providers like a new treatment centre, as ordered by central government. These are the real reasons for the debt of poor Hinchingbrook:

· the Trust had lost out under Payment By Results;
· its NHS Treatment Centre had been starved of referrals by its own PCT;
· its caseload had been further squeezed by Foundation Trusts seeking
surpluses and by PCTs seeking economies and redirecting patients away
from hospital care;
· its budget had been further cut, and the cash used to send NHS patients
to private hospitals;
· and the merger of Cambridgeshire’s PCTs lumbered Huntingdonshire’s
health services with new deficits from elsewhere in the county.

The companies in the running include Circle Health, a company that specialises in 'John Lewis-style employee partnerships to boost productivity'. From their website regarding share ownership '50.1% is owned by Circle International plc'. This is the investment vehicle that blue chip City institutional investors have subscribed to for shares by providing the capital for Circle. So the controlling majority are not working 'partners' like John Lewis but sleeping 'partners' like banks. Care UK are also bidding, they are the firm that has been paying Andrew Lansley off for something that he can hopefully do when he steps into office later this year.

The perverse nature of this selling off of NHS contracts is there for all to see. Hospitals only get into debt because they are forced to comply with the top down market based reforms enforced by Whitehall, essentially they are being underfunded for doing the work that they have to do for patients. The market and payment systems are artificial, patients' illnesses are not, so when the system's error results in hospital debts, it is only the patients that will end up suffering.

Ironically these private firms will not give their money to improve the service, they will reduce the quality of the service and asset strip in order to generate profit for shareholders, this is the world of the short termist in business. Even more perverse is the fact that many of the scandalous PFI deals that are forcing numerous NHS trusts into massive debt are run by some of the big banks that were recently bailed out by billions of taxpayer pounds. The government is corrupt, foolish and acting against the interests of the public.

The likes of RBS and Lloyds are making shed loads of easy cash from numerous poorly thought out public service PFI schemes, and having been bailed out by the taxpayer, they are now partly owned by the taxpayer. Yet the government insists that these PFI schemes are good value and will not renegotiate them, meanwhile NHS trusts go into debt and are bought by big private firms that may even be partly owned by the very same banks. The banks cannot lose, the taxpayer and the patient simply cannot win, this game is rigged and it is a complete and utter disgrace.
Hinchingbrook is not an exception or an aberration, it is the inevitability of the destructive market based reforms that this corrupt government has indulged in. The top down market and privatisation agenda makes the like of Hinchingbrook's failure an absolute inevitability, the government knew this when it set about introducing the ghastly NHS Plan in 2000. Hinchingbrook will not be the last, it will be the first of many, the market based reforms have enriched many private firms for providing low quality services for a lot of money, the market is now set to bankrupt a lot of NHS hospitals, these hospitals will now be sold off and be used as yet another money making vehicle for the private sector. It is enough to make one weep.


Demetrius said...

How many hospitals are close to financial collapse for these reasons? A good many?

Garth Marenghi said...

I think there are many who are a long way gone and in large amounts of debt.

Personally speaking I have seen Trusts struggle for exactly the same reasons as Hichingbrook, the debt is nothing to do with mismanegement or bad hospitals, it is the government's fault entirely.

As a result of market based reforms, PCTs have starved hospitals of cash as they have farmed out loads of their work to other providers, often private ones who do the work to a lower quality for more money. Payment by results is also a badly thought out way of paying hospitals, it doesn't fairly reward hospitals for what they actually do, it's very artificial.

It is a farce and the market based reforms have been the most inefficient and expensive waste of our money.

As Dr Crippen points out on his blog today, the NHS SHOULD NOT be ring fenced, they should scrap the market, scrap PFI schemes, get rid of PCTs and the extra managerial layers, and go back to paying hospitals lump fees for for their populations. This would massively increase efficiency.