NHS plc?

Sicko.

As Andrew Lansley's 'brave new world' of GP Commissioning takes shape, I would like to examine the substance of that which will prevail in the future, and the effect it will have on all of our lives, yes, even the rich!

I have made no secret, of my view that, this is a covert plan, to 'privatise' the majority of services that are provided by the NHS, although a surprising number already are, such as Care UK and others, who almost exclusively contract for Prison Healthcare in the UK. There in fact, seems to be a 'model' forged to an extent by the last Government and continued by this one but at a more accelerated pace. It is the US Healthcare model.

Numerous consultations took place between the 'last lot', 'this lot' and US Healthcare giant Kaiser, to provide advice on the structure of the NHS. The concept of making Hospitals into Trusts especially Foundation Trusts, is a construct largely inspired by them, together with the enforced change upon all Hospitals to become the latter by 2014. As such these bodies will have to be in surplus, or fold. So the prospect of a Hospital closing because it is bankrupt moves ever closer, with Lansley clearly stating that there will be no 'bailouts' (don't remember him saying that about the Banks). This makes them a 'ripe fruit' to pluck, at rock bottom price for an aspiring Private provider.

 Primary in this role will be the FESC (Framework for procuring External Support for Commissioning), who will be ideally placed to design the procurement 'tools' for the GP cohort, flung into the maelstrom of designing a system about which they have little knowledge, or even desire to engineer.In this body we have a list of Private providers, including BUPA, Dr. Foster, KPMG, McKinsey, Tribal, United Health and others, all poised to take a slice of the cake. Close on their heels is the Cambridge Health Network, fronted by Dr. Penny Dash, which provides " Health Leadership and Enterprise", which is a euphemism for promoting the sponsors, which include; Halliburton (of Gulf Oil fame), General Electric, Virgin, BUPA, GlaxoSmithKline and of course, Carillion, to the DofH. Dr. Dash is of course, a McKinsey partner, and ex Head of Strategy and Planning at DofH, and now enjoys the ear of many in Government. Copperfield has this view about her in Pulse in 2009.

Many ex-Government politicians and advisers will be found within this organisations companies, including Patricia Hewitt (BUPA), former Blair adviser Simon Stevens (United Health), Mark Britnell, former DofH, head of commissioning (KPMG), Penny Dash (McKinsey), the list is almost endless, of those employed in Healthcare who have exited by the revolving door between, Public and Private Healthcare Providers. Is it likely that these and others, will be able to exercise influence in directing commissioning toward the 'private' model. Well do bears s**t in the woods?

Would this exercise to bring Private Medicine into the NHS be a bad thing? Well if we are to judge it by simple maths then let's work on Healthcare costs as a percentage of GDP, because the US has a larger population than do we, but is used by many as the model for Western Medicines excellence. It cost slightly more than 15% of US GDP in 2008, but only 9.2% in the UK to provide healthcare universally, but of course healthcare is not available to all in the US, only those who pay, so that comparison is even more favourable than it seems. In world terms we are 20th for life expectancy, yet the US, for all this expenditure, only ranks 36th and whilst we ought to be higher, if the belief that privatising the NHS is to bring benefits, then surely these figures must explode that myth.

The likely result is that cost savings will be heralded, certainly at Commissioning stage,  as it was with ISTC's, but the results a little further down the line will be one of reduced services, 'cheap' operations, based on dumbing down the staff cohort, and doing production line procedures, such as Arthroplasty, and leaving the NHS to take care of Trauma, until it goes broke, because it cannot compete. The end result will be, without doubt, less for the same, or eventually, as in the US, less for more.