1. KEEP OUR NHS PUBLIC Fight the White Paper Wendy Savage MBBCh(Cantab) FRCOG MSc (Public Health) Hon DSc Co-chair KONP Haringey 22.11.10

2. Keep Our NHS Public Launched September 2005 by NHS Consultants Association NHS Support Federation and Health Emergency and Health EmergencyWebsite www.keepournhspublic.com www.keepournhspublic.comwww.keepournhspublic.com

3. Aims of KONP To build a broad non-party political coalition which will campaign to protect the NHS from further privatisation and fragmentation To inform the media, public and MPs about the government ‘reforms’ To keep our NHS public which means publicly provided as well as funded

4. ‘Equity and Excellence: Liberating the NHS’ ? Transfer the responsibility for the NHS from the Secretary of State for Health to a new NHS Commissioning Board Abolish Strategic Health Authorities (SHAs) Abolish PCTs Create 500-600 groups of GPs called consortia which would take on the commissioning (purchasing) of services. They would replace 152 PCTs. They would be responsible for 80% of NHS budget – and have not been trained for this job ?half don’t want it

5. ‘ Liberating the NHS’ ?? Force all hospitals to become Foundation Trusts (FTs) and encourage them to become employee led social enterprises. Encourage ‘any willing provider’ Increase the powers of Monitor (who oversees FTs) as sole economic regulator Reduce NHS management costs by 45% over the next 4 years. Estimated cost of re-organisation is £1.7bn in the first year alone (government figures ) up to £3bn (Kings Fund)

6. ‘ Liberating the NHS ’ ??? Strengthen CQC -become effective regulator ‘We will give every patient the power to choose any health care provider that meets NHS standards withiin NHS prices. This includes independent, voluntary and community sector providers’ Comment from Tribal a private health care firm ‘ This white paper could amount to the denationalisation of healthcare services in England and is the most important redirection of the NHS in more than a generation, going further than any Secretary of State has gone before

7. The effect of the White Paper Managers will be demoralized, lose their jobs and some, after hefty redundancy, are likely to be re-hired to work for consortia Consortia must use any willing provider so private companies bid for services cheaply Consortia fail, taken over by private companies NHS fragmented reduced to basic backup

8. Government tactics Reassuring language-ie liberating, clinicians in charge, patient choice, positive spin ‘Consultation’ is about ‘how ‘not ‘what’ Directing PCTs and SHAs to start process of getting rid of managers Getting their message across as if changes have already happened although no electoral mandate or debate in Parliament

9. Useful points to remember & use Remember that FT survey found that 75% of population did not want private sector in NHS Private companies primary duty is to their shareholders Cooperation not competition needed in health care Market costs at least 10 bn a year to operate Exploit differences between Con Dems

10. The fight must continue Efficiency savings can be made by abolishing the market Evidence is that health care is an unsuitable service for market mechanisms Increases inequity Affects the elderly and other most vulnerable Why should ordinary people pay for the bankers excesses and failure of government regulation of the financial markets?

11. Lansley’s stated aims Patient centred approach ‘no decision about me without me’ Clinicians in charge not managers Reduced bureaucracy Improved outcomes measure by PROMs not targets All could be achieved without this massive upheaval

12. What can we do? Let MPs know in every constituency that another ‘re-disorganisation’ is the last thing we as citizens or the NHS staff want Point out that abolishing the market and the purchaser-provider split introduced in 1989 by Kenneth Clarke would save at least £10 billion a year Join &/or donate to KONP so we can mobilize people via meetings website etc

13. Market-driven politics 1. Real markets are deeply political-state omnipresent-national politics and the state always targets-businesses want to enter NHS 2. Convert services into commodities and workforce into one orientated to profit and get government to underwrite risk. 3. Market competition transforms commodities 4. Consequences, inequality of provision, high costs and corruption (eg US health system)

14. Further reading Colin Leys Market-driven politics (2001) Verso Allyson Pollock NHS-plc (2005) Verso John Lister Health Policy Reform (2005) The NHS after 60:for patients or profits? (2008) Stewart Player & Colin Leys Confuse and Conceal Merlin Press 2008 Merlin Press 2008 On the Brink Report for BMA London Regional Council by John Lister January 2009 House of Commons Health Committee (2010) Commissioning. Fourth Report of session 2009-10 An NHS beyond the Market report of a round table discussion download from www.bma.org.uk