"The NHS will last as long as there are folk left with the faith to fight for it"
Aneurin Bevan

Thursday, 31 March 2011

Bring and buy sale of the NHS

Yes it it privatisation, don't let the phrases "mutual" and "social enterprise" make you think that the government's plan are anything but privatisation. (I'll cover that issue in my next blog post) The government have just released their master plan for their initial IPO of the NHS, the PDF is here.

The government is not going for all out privatisation, instead they will do it piecemeal. The idea is that willing workers will buy up a service from a hospital and then provide it cut price back to the hospital. This is, of course, the best business plan since Enron thought "I wonder how we can make accounting a bit more exciting?" So in the future your local hospital will be a bit like a franchised department store: your blood taken by PhlebotomistRUs ("we promise only to wear fangs at Halloween!"), analysed by OneHourPathLabs ("three for two offer every Thursday") and then your Virgin Healthcare consultant will tell you what's wrong with you before flicking through his luxury yacht catalogue. What possibly can go wrong with that?

The interesting thing is that Foundation Trusts are largely immune to this initial IPO, and NHS trusts can turn down your get-rich-quick idea if taking over a service from them is likely to affect their application to be a Foundation Trust. To be frank, if your plan to take over a service will not affect the trust's FT application then you shouldn't touch it: NHS trusts are cash strapped, so they will only want to lose loss making services.

However, I found it interesting to see what they say about FTs:

If you work in a Foundation Trust, you will have to talk through your proposals with your manager and decide on the best approach to take. As Foundation Trusts are independent organisations, their boards are not obliged to support proposals to develop staff led enterprises. However, Foundation Trusts may well be interested in innovative proposals that will improve patient care.
So FTs don't have to do everything the government tells them to do. The phrase "boards are not obliged to support proposals to develop staff led enterprises" actually means "the government wants to force FTs to do this, but we can't". Revenge of Milburn?

However, whoever wrote it does not know much about FTs because significant policy decisions like outsourcing or privatising services should be approved rubberstamped by FT governors, but there is nowt there about FT governors. Why governors? Well FTs are public benefit corporations which means they are publicly owned and have a public membership. The membership elect governors who oversee the board's actions. So something as significant as selling off a service should be reviewed by the FT's governors. I bet that no FT council of governors have yet challenged a board's decision.

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