The privatisation of the NHS

[Rhiannon]

https://www.theguardian.com/society/2018/aug/05/virgin-awarded-almost-2bn-of-nhs-contracts-in-the-past-five-years

I have had dealings with Virgin Care via the NHS. Not only are they inefficient, their mission seems to be to refuse to actually see any patients. The report says ‘doing less for more’ and from what I’ve seen I’d agree.

[jeremyp]

their mission seems to be to refuse to actually see any patients.

Treating patients is an expense. If they treat patients, it eats into the profits (or if Richard Branson is correct, it makes their loss worse).

[Rhiannon]

Treating patients is an expense. If they treat patients, it eats into the profits (or if Richard Branson is correct, it makes their loss worse).

Indeed. So given that the service is worse (contrary to Branson's claims) and patients don't get seen in spite of being referred (something I know first hand is actually happening), why is Virgin Care anywhere near providing public services on the NHS?

[jeremyp]

Indeed. So given that the service is worse (contrary to Branson's claims) and patients don't get seen in spite of being referred (something I know first hand is actually happening), why is Virgin Care anywhere near providing public services on the NHS?

I really don’t know. If I were in charge of managing these contracts, the remuneration would not be structured in such a way that it is beneficial to not treat patients. There would also be standards with respect to making it easy to contact the health provider and penalties for failing to meet the standards.

I speak as somebody who has to subcontract aspects of the work I do and it seems to me that the managers of the NHS miss certain obvious things they should be doing to stop their subcontractors from taking the piss.

It’s not unique to the NHS btw, pretty much all government organisations fail to deal with contractors effectively and a lot of commercial organisations too.

[Rhiannon]

I really don’t know. If I were in charge of managing these contracts, the remuneration would not be structured in such a way that it is beneficial to not treat patients. There would also be standards with respect to making it easy to contact the health provider and penalties for failing to meet the standards.

I speak as somebody who has to subcontract aspects of the work I do and it seems to me that the managers of the NHS miss certain obvious things they should be doing to stop their subcontractors from taking the piss.

It’s not unique to the NHS btw, pretty much all government organisations fail to deal with contractors effectively and a lot of commercial organisations too.

What is happening in this case is that the referral is being passed onto other NHS departments for them to carry out assessments first. Eventually it will end up back with Virgin and they will have to deal with it. But in the meantime it is costing the NHS for other assessments that aren't necessary.

Taking the piss is right, but this is the NHS, and somebody's future health and wellbeing is at stake. It isn't the firm contracted to clean the town hall.

[Harrowby Hall]

There is a belief locked in the hearts of government ministers - of whatever party - that the presence of a profit motive will always result in a more efficient operation than one managed by Whitehall alone.

One would have thought that the catastrophic failure of Carillion, questions raised recently about Capita and the black hole of PFI would lead to ... at least ... the reconsideration of the involvement of private enterprise in public sector activity.

[Aruntraveller]

really don’t know. If I were in charge of managing these contracts, the remuneration would not be structured in such a way that it is beneficial to not treat patients. There would also be standards with respect to making it easy to contact the health provider and penalties for failing to meet the standards.

I was, until I retired, involved in some of this in a small way. Where I worked in PHysio/OT/Dietetics various contracts come up for renewal.

We tender as per the spec provided and our costs lately have always come in higher than Virgin/Circle/etc. We lose the contracts. The choice is made by the commissioners at CCG level. As a Trust the hospital holds little sway as the CCG's are being squeezed by central government. Our tenders are based on the knowledge that goes back years over how complex some patients needs are. This is not factored in by private healthcare and very often they will tender on the basis of one new appt then 2 follow ups. Then you are done. Clearly ridiculous for a lot of conditions. This then leads to the situation where we lose income and therefore staff who end up working for Virgin doing a job that they know is not the standard it should be. Furthermore it is not unknown for the hospital to have to pick up more complex cases when patients who have seen Virgin etc, end up as Inpatients and we then end up doing the work anyway.

That there are clearly inadequate checks built into the system is annoying and frustrating but it is the way of things - defund, demoralise, privatise.