Why is Labour helping to privatise the NHS in Wirral?

update: you can watch my speech via this link starting at 2.37.50

At tonight's full council meeting, a Labour party motion opposes the current closure threat to walk-in health centres across Wirral and explicitly states: “This council is opposed to all forms of privatisation in the NHS”,
 

Tomorrow, October 16th, a meeting of the Joint Strategic Commissioning Board for Wirral will consider a proposal to approve an Integrated Commissioning Hub for Wirral.  This will be opening the door to an accountable care organisation and health privatisation in Wirral.

I've tabled an amendment to Labour's motion asking council to specifically reject plans for an Accountable Care Organisation. These are my reasons why:

I welcome the very clear statement in this motion which states: “This council is opposed to all forms of privatisation in the NHS” and earlier public statements by the Leader of the Council that he opposes the development of an accountable care system in Wirral. Accountable care is widely recognised as a means of facilitating privatisation within the NHS.

Sadly, if the proposals for an Integrated Commissioning Hub for Wirral Council and NHS Wirral in front of tomorrow’s meeting of the Joint Strategic Commissioning Board (agenda item 6) are adopted then this council will in fact be opening the door to an accountable care organisation and health privatisation in Wirral.

There can be no ambiguity about this.  Throughout the associated due diligence report from Price Waterhouse Coopers there is reference to the development of an Accountable Care System and that the Integrated Commissioning Hub is the first step towards this. Crucially, the report concludes by saying:

The introduction of an integrated commissioner with a single pool of funds will facilitate the introduction of a wider Accountable Care System / Accountable Care Organisation across the Wirral.

Significantly, the publication of this all-important due diligence report was repeatedly denied up until a few weeks or so ago. No meaningful and proper public consultation and engagement has taken place. The public has been locked out. This is unacceptable and undemocratic.

If this contract goes ahead, our Clinical Commissioning Group will be using it to procure a range of NHS services from April 2019. 

Currently, in most NHS contracts apart from mental health, a needs-based payment is made for each treatment provided to individual patients. But the new contract would pay the provider a fixed lump sum at the start of each year, to cover the costs of a range of treatments for the whole population.

This switch from a needs-based payment to a fixed contract is crucial. It means the introduction of demand management and rationing for health services. Fixed capital budgets will be allocated which are no longer based on clinical need and must not be overspent.

This is a clear route to new “care models” that are based on the USA’s Medicare/Medicaid system that provide limited health care for people who can’t afford private health insurance.

A new government would be powerless to stop and reverse this because the contracts would be locked in for a continuous period of up to 15 years or more. 

And, we already know how this model operates. In mental health, the introduction of fixed lump sum contracts means that it is now normal for there to be NO hospital beds for acute mental health patients in their own area. They are routinely taken by ambulance across the country to wherever there is a hospital bed. 

This is not a model we should be rolling out across the health service. A model that allows for price competition between providers when bidding for contracts leading inevitably to a reduction in the quality of care and, potentially, a Carillion type collapse.

And, even if an Accountable Care Organisation is initially kept within the public sector it would still decimate the founding principles of the NHS. ACOs represent the breaking up of a single national health service into sub-regional care packages with fixed budgets and rationed services. This means a loss of universalism, comprehensiveness, national terms and conditions and quality standards.

Let me finish by repeating the all-important concluding sentence from PWC’s due diligence report:

The introduction of an integrated commissioner with a single pool of funds will facilitate the introduction of a wider Accountable Care System / Accountable Care Organisation across the Wirral.

There is no legislation in place forcing these changes on Wirral. The changes are entirely voluntary. In fact, if the clear statement in this motion – “This council is opposed to all forms of privatisation in the NHS” means anything then we must say an emphatic and resolute no to Accountable Care in Wirral.

I therefore urge all councillors to support this amendment and send a clear message to the relevant cabinet members that they must not support the proposals for an Integrated Commissioning Hub in Wirral and must not sign this legally binding contract.