Staffordshire could be facing the biggest privatisation in the history of the NHS as cancer care and end-of-life care are put out to private companies in a contract worth £1.2bn – butl it doesn’t have to be so
Staffordshire could be facing the biggest privatisation in the history of the NHS.
Caring for patients with cancer and providing end-of-life care for people with terminal illnesses is at the heart of what the National Health Service should be about as a public service.
But in Staffordshire, those two key services could be handed over to private companies in what is potentially the biggest privatisation in the history of the NHS – a 10-year contract worth more than £1.2bn.
UNISON needs your help to highlight the issue and put a stop to the sell-off.
Key care offered to private companies
Under the government’s Health and Social Care Act, bodies called clinical commissioning groups, or CCGs, decide how NHS money is spent locally.
In Staffordshire, four of these CCGs – Cannock Chase, North Staffordshire, Stafford and Surrounds and Stoke on Trent – have joined forces to offer two 10-year contracts to a company or companies to manage the provision of end-of-life care and adults’ and children’s cancer care.
The contracts, worth more than £1.2bn over 10 years, are for a “prime contractor” to manage existing contracts for two years and then to take full responsibility for the management of the provision of care – sub-contracting services to others providers as they see fit.
This is potentially the biggest ever privatisation in the history of the NHS.
Profiting from cancer care and end-of-life care
If these contracts are awarded to private companies, it will place the management of £1.2bn of fundamental NHS services – cancer care and end-of-life care – into the hands of profit-driven companies.
UNISON believes that all NHS services should be protected from profit-driven companies, but the idea of making a profit from cancer care -especially for children – and end-of-life care is particularly hard to stomach.
At least three companies interested
At least three companies – Virgin Care, Care UK and Ramsay Health – have expressed an interest in the contracts so far.
All of these companies have taken on NHS work, but none has experience of running healthcare services on this scale.
The advertisements for these contracts state that potential bidders “may bring skills and experience derived from other sectors (eg supply chain management and logistics, business process management, change management…).”
This means the government’s stated aim of putting healthcare into the hands of clinicians would be thrown out of the window, with healthcare being handed over to private companies.
Could the contract go to an NHS organisation?
Possibly, and UNISON would much prefer an NHS organisation to take the role of prime contractor, but there is still a problem with the model of contracts and tendering. Whoever the winning bidder is, a huge amount of money will have been spent on the procurement process.
Some estimates suggest that 30% to 40% of the contract value will go towards management costs and fees.
The prime contractor will need to be paid for managing the contracts: a payment that wouldn’t have been necessary if the CCGs were doing this work themselves.
This is vital money that should be spent on patient care.
What about the clinical commissioning groups?
The commissioners are effectively outsourcing their basic commissioning responsibilities. It is their job to arrange for necessary services to be provided in the manner which best meets local needs, but they will be handing over those decisions to another organisation or private company.
This is a move away from contracts for individual services and a shift towards contracts for the provision of an entire service area, and the CCGs will be tied in for years: the contracts are for 10 years.
The prime contractor model breaks the direct link between the clinical commissioning groups and those actually providing care.
The CCGs will only have a contract with the prime contractor. The sub contractors will only be responsible to the prime contractor.
If the care provided by sub-contractor is unsatisfactory, the CCGs will have no direct means to hold them to account. The CCGs must look to the prime contractor to try to hold the sub-contractors to account.
That potentially means one big game of pass-the-blame.
So what can you do?
It’s not too late to stop this. Help us to lobby all those who can make a difference.
If you live in the area or are likely to be affected by this change, write to your MP or local councillor and ask them if they know what’s happening – and ask them to intervene.
If you don’t know who your MP or councillor is, use the links below to find out.
The Work for You – find out who your MP is.
Write to Them – email your MP or councillor, just enter your post code.
Write to your clinical commissioning group and ask them why you’ve not been consulted.
UNISON is supporting the local campaign group NHS “Cancer not for profit” – sign their online petition.
UNISON members can stop this
Although the consultation with patients and the public has been scarce, UNISON has made sure people know what’s happening.
It was thanks to UNISON’s work that the story was on the front page of The Guardian.
The union has also written to the four clinical commissioning groups to ask how they have met their legal obligation to consult, which is part of the Health and Social Care Act.
If that hasn’t happened, then the process should be halted to allow time for patients and the public to have their say.
UNISON believes that patients and the public should have been consulted over the decision to use the prime contractor model, which hasn’t been done before.
We believe that patients and the public will be shocked to know what is happening to their local health services without any proper consultation taking place.