Our NHS Belongs To U.S?

The future of the NHS is crucial to most of us, even more so now that we are leaving ths EU and the U.S. Healthcare companies are financial vultures hovering over our hospitals and NHS structures. Whether we voted to leave the EU or remain, the vast majority of us want to have our NHS to remain free at the point of delivery; whether we are visiting our doctor, having a hospital appointment or being admitted into hospital.

In leaving the EU, there is a threat that the NHS will be sold to one of the large US healthcare companies or broken up and the fragments sold to assorted private, mainly US, healthcare companies. We will not know if this will happen until negotiations with the U.S. for a Trade Agreement have been concluded. But there is an immediate threat even worse and more insidious.

The US companies want to be paid to create new contractual systems and commissioning arrangements that they call ‘Accountable Care’. There would be a cost for every individual part of a patient’s treatment that would be charged separately but then added together for payment by the NHS or a private medical insurance company.

To be able to do this the population will need to be broken down into neat contractual areas and, conveniently, those areas would be the patients registered with a GP practice or a group of practices. These groups of patients will be part of a pool that will be treated by registered providers, both NHS and private.

If this is going to happen it will mean installing new computerised systems. There will be a requirement for existing NHS staff and new staff to be trained to work with the new system and, obviously there will be the inevitable glitches in getting this new system working. This whole process can be described as digitalisation, contractualisation and commercialisation.

This itself is not privatisation but It can be said that what is being planned is creating the infrastructure for privatisation. There is also the question as whether such a large scheme can be built within budget and come on stream as planned. The indications are that very few complex schemes undertaken in the UK are within budget and they are also rarely up and running on time.

When it is up and running the system could be then used in the US or any other major first world country. But what are the possibilities of a Tory government agreeing to this?

Simon Stevens has been the Chief Executive of the NHS since 2014 and a Tory Government with a workable majority is just what Simon Stevens needs to open up the NHS to the American market. Is it coincidence that Johnson and Stevens were student politicians together at Oxford? And is it coincidence that before becoming Chief Executive of the NHS, Stevens was a Vice President at the gigantic United Healthcare Corporation of America?

So it is hardly surprising that Tory leader Johnson has indicated he would support Stevens and “they would sort out the NHS”.

But what does ‘sort out the NHS’ really mean? Stevens appears to have convinced himself that his past employer, United Healthcare, and other American healthcare companies could reorganise the NHS so that it could dovetail into a new international market for healthcare provision. This would be good for him, the American healthcare providers and it would make the NHS more efficient. Sounds good on paper!!

The Prime Minister and the Secretary of State for Health and Social Care protest that the NHS will not be part of any trade agreement with the US or that there are “no plans to sell the NHS”. The reality is that the NHS does not have to be sold for it to be privatised and wrecked!!

Stevens plan appears to be that the NHS will pay US healthcare companies to install the infrastructure needed to make Accountable Care work in the NHS. If it can work in the NHS then, in theory, it can work anywhere, especially in the US.

Currently, the private US healthcare market has numerous hospitals, clinics etc run by thousands of companies, foundations, trusts etc. It is insurance based and its administrative costs are much higher than for the NHS. The result is that healthcare takes some 20% of total US expenditure. So, in reality, the NHS is being used as a guinea- pig to see whether Accountable Care can make even more money.

The truth is that a new privately owned healthcare model is being proposed for the international healthcare market and the British taxpayer, will, knowingly or unknowingly, have to fund it.

There can only be two outcomes, both disastrous for the NHS and the British taxpayer. Firstly, this scheme could be declared a resounding success and the model used across the world with the active participation of private UK health compamies  including a decimated NHS.

However, success for the corporations has always been and will always be measured by the amount of profit they make.  And that profit is based on medical insurance principles (membership schemes, risk pools, incentivised contracts to cut costs with providers, exclusions of bad risks and excess charges). The administration will be more expensive and so will the transaction costs and we only have to look at the US to know where this ends:  The rich will have insurance and the poor will rely on charitable hospitals and food banks.

Secondly and more likely, this grandiose scheme will eat more and more money as it goes more and more over budget and ends up as a gigantic failure. By this time the politicians who authorised this scheme will have fled the scene of the crime to the  boardrooms of the US medical compamies and will, no doubt, think they have earned their peerages and seats in the House of Lords. .

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