Oppose privatisation, rethink commissioning

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2016 Health Care Service Group Conference
11 December 2015

Conference believes that the way NHS services are commissioned in England has to change.

Conference reiterates its opposition to NHS privatisation and notes that since the Health and Social Care Act 2012 came into force it is far easier for clinical and support services to be sold off, and increasingly even the actual commissioning itself.

Conference is dismayed by the spate of privatisations since the May 2015 general election. These include clinical commissioning groups in Staffordshire effectively passing responsibility for commissioning cancer services to a consortium led by Interserve, and Capita being handed the contract for Primary Care Support services by NHS England.

Conference is particularly alarmed that organisations such as Optum, part of American healthcare company United Health, have been selected to provide commissioning advice and support to CCGs. Conference is concerned about the potential for conflicts of interest these type of deals create and the fact that this only makes the privatisation of clinical services more likely.

Conference notes the confusion created within the wider commissioning support world, where some commissioning support units have been forced to close as a result of not making it onto NHS England’s “lead provider network”, and where CSUs are still threatened with being broken completely away from the public sector.

Conference is alarmed that such decisions endanger the jobs of healthcare staff working on both the commissioning and provision sides of the NHS, and also that the pay, terms and conditions of workers may come under threat where services are transferred out of the public sector.

Moreover, Conference asserts that clinical commissioning groups are in danger of becoming merely the local agents of the government’s cuts agenda, responsible for little more than skimming funding from local services.

Conference in no way blames those staff working at CCGs, but notes the differences from the era of primary care trusts where the local NHS at least had the ability to plan strategically and where commissioning meant more than just tendering processes and rationing.

At a time when the big concerns within the English NHS have become focused on the new care models of the Five Year Forward View and on the devolution agenda, Conference believes that the current commissioning system is not fit for purpose.

Similarly, Conference notes that the maintenance of the purchaser-provider split that has driven the development of the NHS market in the 21st century has become increasingly inappropriate and may actually be undermined by other NHS England initiatives, such as acute care collaborations.

Instead of the obsession with localised market-making that the Lansley overhaul aimed to foster, Conference believes that the time has come to rebuild a better integrated, better planned national system in which the NHS can more easily make those strategic decisions to improve services.

Conference therefore calls upon the Health SGE to work with other parts of the union to:

1)continue to oppose NHS privatisation in all its forms;

2)work to protect the jobs, pay, terms and conditions of staff working on both the commissioning and provision sides of the NHS; and

3)argue for a more progressive system for the English NHS based on strategic national planning rather than local marketeering.