Sunday, 21 September 2014

GPs are NOT private companies - and this is why...

‘All you GPs are private providers anyway’
I often have this charge thrown at me when I speak at NHS campaign meetings. Those who level this charge at me are often those arguing in favour of a privatised NHS.
They will say that ever since 1948 GPs have been private companies, so not much is changing.
Nothing could be further from the truth.
It is true that GPs are self employed and have been since 1948. They often own the GP surgery that they work from and the NHS pays the GPs to allow them to employ the staff, pay for the electricity and lighting in the surgery and take home their own income too. GPs do earn a good income.
But the vast majority earn nowhere near the telephone number salaries the Daily Mail talk about. But GPs cannot sell or advertise our surgeries or set up a practice wherever we like. 
And GPs stay at their surgery through thick and thin. They invest in a community. Even during the bad times they stay with their patients and ensure their surgery is the best it can be. We are not answerable to shareholders wishing to maximise return on their investment by increasing profit margins.
The private sector will hand the keys back and move on when the profits begin to fall – they don’t want to hang around if their profit margin suffers or the shareholders start to complain at their AGMs.
These points are glossed over by those misleadingly claiming GPs are an example of how NHS privatisation is nothing new.
But the false claim that ‘GP practices are just businesses’  has just been given a massive push towards reality.   
Last month, it emerged that NHS England has said that, because of competition law, all new GP contracts will have to be opened up to bids from the profit-making, private corporate sector. And - whilst struggling under funding cuts - they will have to fight off the private sector to keep their practice every 5 years. They will all be forced into contracts as ‘Alternative Providers of Medical Services’. This was a new concept introduced by New Labour in 2004. It allowed contracts to be held by the private sector, including by non-GPs. It  gave companies like Virgin and Care UK a foothold in general practice, though hiding behind the NHS logo. It was a defining moment for general practice and many feel the BMA GP Committee should have resisted it harder. 
But last month’s announcement is a step change towards the rapid corporatisation of General Practice. 
The Chair of the British Medical Association GP Committee has said this would “spell the death knell of the whole ethos of long-term, continuity of care in the way general practice operates”.
The BMA have taken legal advice and believe NHS England’s policy is flawed because it focuses only on competition but ignores the need to consider “securing the needs of patients” that is supposedly written into the law and guidance. They have written to NHS England calling on it to reverse this policy.
The Health and Social Care Act opened up the English NHS to many more private providers. Tory and Lib Dem ministers repeatedly promised us that the NHS would not be forced to tender services to the private sector. Yet this is what is happening now, to the cornerstone of the NHS, your local GP.
Lord Howe should be made to answer the question ‘Can the NHS offer a contract to a non commercial provider (such as a family GP) without going out to tender, without fear of legal challenge from the private sector?’
It is a very dangerous time for the English NHS. Competition is the name of the game now and billions of our taxpayers pounds will be wasted on legal fees, accountancy fees, management consultancy fees and complex tendering exercises – all in order to satisfy the demands of the Tory led coalition.
No wonder only 1 in 5 GP practices think their partnership will survive in 10 years time, and 85% think it will be fully privatised by then - and what a worrying state of affairs for the cornerstone of the English NHS.

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This article first appeared on Open Democracy website and can be found here