The legacy of PFI in the NHS

Submitted by Matthew on 29 June, 2012 - 12:00

South London Healthcare NHS Trust includes Queen Mary Hospital in Sidcup, Queen Elizabeth Hospital in Woolwich and Princess Royal Hospital in Bromley.

Its budget shortfall (£1 million a week) is the equivalent of employing 1,200 nurses or doing 200 hip operations a week.

It is the first NHS organisation to go into the "unsustainable providers regime" — a system set up by New Labour but never used. Under that regime an administrator is brought in to run the Trust's board and to recommend measures directly to the Health Secretary about how to put the Trust on a more sustainable footing.

The Trust's outgoing Chief Executive, Dr Christopher Streather, says that the administrators will succeed where he has failed. He believes they will be able to secure a subsidy to help with two PFI deals that bleed funds by £61 million a year. Maybe, but only if the government agrees to such a subsidy.

More to the point, Streather has said the administrators are likely to sell off parts of the hospital estate and shut down services, shifting them onto primary care and community providers.

This Trust was recently shortlisted for an award for its quality of care, management and innovation. It has one of the best mortality rates and infection control records in the country. But it costs money to deliver this level of care. These standards cannot be met whilst private sector parasites demand their risk-free returns on their PFI racket. In a situation where the government is demanding NHS Trusts slash their budgets, the burdens of PFI schemes — massively expanded under New Labour — may send many Trusts into bankruptcy.

According to the Daily Telegraph up to 22 NHS trusts are facing serious financial difficulties because of expensive PFI schemes, and six are thought to have taken on projects viewed by ministers as "unsustainable".

As you cannot run the NHS on the loose change that is left over once the millionaires who benefited from PFI have all taken their slice of the cake, the PFI "legacy" could threaten very future of the NHS as system of free quality healthcare.

Treatment rationing in the new NHS

If you are losing your sight, in chronic pain or need a wart removed, your chances of being treated in the NHS are greatly reduced under the new regime.

A survey commissioned by the Labour Party revealed that over 90% of Primary Care Trusts and shadow Clinical Commissioning Groups are restricting access to treatment due to financial pressure. 125 assorted treatments are no longer available or severely restricted on the NHS due to the cuts.

But as the NHS shrinks the private sector moves in.

Shadow Health Minister Andy Burnham described the experience of a patient in west Yorkshire who received a letter from his GP informing him that treatment for a skin condition was no longer available on the NHS and was given a menu complete with prices for treatments available at a private clinic.

When challenged about treatment rationing in the House of Commons, William Hague, deputising for the Prime Minister, claimed that this practice is illegal and any PCT/CCG that is denying treatment on financial grounds will be held to account by the government.

However, as health policy expert Allyson Pollock has pointed out, the legal power of the Secretary of State to ensure provision of a comprehensive health service was deliberately abolished as part of the Health and Social Care act. Any legal challenge to treatment rationing would probably fail as the Secretary of State absolved himself of the "duty to provide" free NHS care.

Powers to decide which treatments are included in the free NHS service was largely devolved to the Clinical Commissioning Groups.

These organisations have a direct financial incentive to deny their patients treatment. Their members, as illustrated by the west Yorkshire example, have multiple links to the private sector.

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