Nicola Biggerstaff – 16 June 2022
The True Cost of Our Health: how to protect Scotland from privatisation
On Monday night, BBC’s Panorama centred on a privately-owned GP practice in England, and how the larger company’s profit-driven model was both harming staff morale and risking patient outcomes. An undercover reporter saw first-hand the impact of cost-cutting measures, such as delegation of face-to-face appointments to cheaper and less experienced Physician Assistants (PA’s), and other measures undertaken by the wider group in an attempt to tackle the post-lockdown backlog of patients needing care. It makes us in Scotland thankful that we still value the locality of our doctors and practices, and will do anything to keep them as close to their original intents and purposes as we can in the twenty-first century. However, in the years following Covid and the long-term impact it will have on our healthcare system, we must be laser-focussed on this now more than ever. There are still risks and loopholes we must address to prevent the privatisation of our services and the consequences of this, as was laid bare on our TV screens.
The half hour documentary packs a punch for those unfamiliar with GP practices in England. Just last week I was complaining to my friends about how, when phoning my own GP, it took me over a dozen attempts to get through before waiting in a queue of four other callers, only redeemed when I was able to book an appointment for that afternoon. I watched in horror as the undercover journalist, posing as the GP receptionist for the privately owned practice, was unable to book in new appointments for days on end as a result of staff shortages, dealing with a queue of thirty-four callers. Other unscrupulous working practices were resulting in the overloading of inexperienced employees across the surgery, right down to the administrative staff, tasked with dealing with a document backlog through the unrealistic target of actioning 200 of them per day, including patient test results, diagnoses, and prescription changes. The risks posed to staff and patients is highlighted by sector professionals throughout, insisting that a full investigation should be conducted by the Care Quality Commission (CQC). How did they get to such an unsafe place?
In 2007, the New Labour government at Westminster changed the laws in England and Wales around GP ownership, allowing larger businesses to buy into practices in order to drive competition, using the health service, and therefore the collective nation’s health, to boost the economy. The company highlighted in Panorama has been buying into GP surgeries in England since 2016, and now owns 70 surgeries, overseeing over 600,000 NHS patients. Thankfully, our devolved health service meant we were protected from this attempt to profit from our collective health. However, a pattern is emerging in which some of our services are beginning to be influenced by private companies. Reporting on this has been warning of the increasing use of NHS funds to pay for services, such as medication reviews in Boots pharmacies, for years now. In this way, companies such as Boots can claim back, and profit from, the costs of providing services for NHS treatments. At best, an overly exploited loophole, at worst, a licence to print money from a service created to keep the nation healthy. No one, in my opinion, with an iota of morality should feel comfortable with this practice.
While it’s good to see that these pseudo-private contracts do not appear to be in the picture of the Scottish Government’s current NHS recovery plan (in fact it makes no reference to privatisation whatsoever), there is a real concern that this could become the case through these pharmaceutical inroads currently being explored. While the government have, rather sensibly, allowed for this five-year plan to be reviewed on an annual basis and adjust accordingly, this means there is nothing stopping enough tweaks year on year for gradual privatisation to become a real possibility. Worryingly, it talks of investing certain amounts into certain services, with no mention of where this funding will actually come from. It plans for over £1 billion of public money going into ‘targeted investments’, but no talk of tax increases, or financial redirection. So where exactly do they plan to come up with the financing for this? We are vulnerable, sitting ducks, waiting for the right company to approach the government with the right offer at the right time, and we will be surely led down the same path as our neighbours. We cannot allow this to happen. The Scottish Government needs to provide a more transparent overview of the origins of its planned funding for the NHS Recovery Plan over the next 4-5 years. It also needs to provide cast-iron guarantees that it will not sell the health of their people for the purposes of private profit, whether written into policy through legislation or a clarification on the Recovery Plan itself, or through a manifesto promise at the party conference in Aberdeen this October.
Here at Common Weal, we want to prevent these issues happening in our future. We believe the best way to do this is through a complete overhaul of our nationalised healthcare system, in an independent Scotland which would give us the space and financial freedom to do so. We are actively looking for healthcare professionals with experience working in the NHS to assist us in designing the practical and financial framework for this through our own healthcare working group, which meets on Tuesday evenings. In our first meeting last week we discussed how to approach such issues as NHS recovery, putting the Common Weal spin on potential solutions. For more details, or if you would be interested in participating, please get in touch with me at firstname.lastname@example.org.