[A-List] UK corporate state: unhealthy accumulation

["Michael Keaney" <michael.keaney@xxxxxx>]

Blair puts NHS out to tender

John Carvel, social affairs editor
Wednesday May 14, 2003
The Guardian

Tony Blair told private-sector healthcare executives at breakfast in Downing
Street yesterday that he wanted to open the whole of the NHS to outside
competition.

Sharply accelerating NHS reform after defeating the Labour backbench
rebellion against foundation hospitals last week, he floated a proposal for
the state to regulate NHS services without necessarily running them.

The breakfast was attended by representatives of private companies bidding
to run 11 diagnostic and treatment centres (DTCs) due to open in December to
provide fast-track hip replacement and cataract surgery for NHS patients.

They are expected to perform about 100,000 operations a year.

South African companies were in the list of bidders released by the
Department of Health last night, provoking a fear that the scheme may rely
on poaching staff from developing countries which can ill afford to lose
them.

Mr Blair told the private sector executives and managers of NHS-run DTCs:
"We are anxious to ensure that this is the start of opening up the whole of
the NHS supply system so that we end up with a situation where the state is
the enabler, it is the regulator, but it is not always the provider.

"The basic principles of the NHS will remain but we will operate them and
implement them in a different way."

Alan Milburn, the health secretary, added: "With more resources going into
the NHS this is not the time to slow down on reform. It is the time to speed
it up to get a better service for NHS patients."

The breakfast guests got the impression that they were being encouraged to
bid to run DTCs as a means of entering an expanding market for treating NHS
patients.

The health department said the NHS was running 15 DTCs and had plans for
another 30. Eventually NHS and private DTCs would perform 250,000 operations
a year on patients from the NHS waiting list.

The private bidders included Netcare, the biggest integrated healthcare body
in South Africa, and consortia involving companies from the US, Canada,
Germany, France and Switzerland, some in partnership with UK firms.

For example, Interhealth Canada, a Canadian hospital operator, has joined
forces with the PFI provider Jarvis.

The department said the companies would bring their own clinical staff with
them to avoid exacerbating NHS staff shortages, but this would not breach
its commitment to avoid poaching doctors and nurses from developing
countries. It promised that the scheme would not go ahead without the
blessing of the South African government.

Last night Mr Milburn was preparing to name the NHS hospitals which have
passed the first selection round for foundation status.

It is understood that he will declare 29 of the 32 applicants eligible.

David Hinchliffe, Labour chairman of the Commons health select committee,
said half of them had applied for foundation status "to win brownie points
from the government", and had no intention of proceeding.

Committee members could find no substantial evidence that private companies
offered the NHS anything that could not be achieved by the public sector.