The poorest, sickest areas still have the lousiest health care. What's John Lister, London FOURTEEN massive multi-national corporations have been given the goahead to bid for contracts "advising" Primary Care Trusts on how to spend £75 billion a year of NHS "commissioning" budgets, in a dramatic new lurch towards privatisation.
Four of the approved companies are giant US-based health care firms - Aetna, Humana, UnitedHealth and Health Dialog Services and two of these are currently embroiled in a fresh scandal and facing investigation over their role in the US Medicare system (health care for older people).
The US corporations are part of a ruinously expensive, inefficient and fraudridden that costs over $2 trillion a year but leaves one in six of the population without insurance.
Indeed, Michael Moore's film Sicko reveals (see page 26), many of those who do have insurance still find themselves denied treatment at the most crucial times as companies resort to the most crude devices to avoid paying out: Aetna, Humana and cally named in the film as among the worst offenders.
But the British companies are no better: they include private insurers BUPA and Axa PPP, and private providers Tribal and consulting firm KPMG, as well as US management consultants McKinsey's, whose overpaid consultants, charging £1,200 per day plus expenses, are already all over the NHS like a cheap suit.
One thing all 14 companies have in common is that not one of them has any KEEP THE PUBLIC experience of commissioning or providing a comprehensive and universal health care system like the
Exactly what relevant skills they might be expected to bring to PCTs, which hold local commissioning budgets to buy hospital, community and primary care services for their local populations, is not explained. GPs who prefer to practise in leafy and prosperous areas!
Health Secretary Alan Johnson - who should be forced to sit down and watch Sicko from start to finish -has insisted that they are "trusted" organisations, and claims that they will not be able to award themselves contracts as a result of their work with the PCTs. be able to steer policy and resources towards greater it have to say? private provision, allocating CENTRAL BRISTOL HEALTH BRAN lucrative contracts to their private sector friends, and to press PCTs to run down NHS provision make more space for the so-called "independent" sector.
As far as New Labour are concerned, the corporations are clearly pushing at an open door: ministers are already instinctively looking to private sector 'soluence.
Take the interim report of to the need for it. Lord Darzi's much-herservices in England for Darzi revealed the far from
earth-shattering fact that after ten years of New Labour, health inequalities continue CLO widen in Brown's Britain - the poorest, sickest areas still have the lousiest health care. Darzi's findings confirm that patterns of provision of GP services continue to fit the "inverse care law" first identified in the early 1970s Lions for read and ere guy a billy of d evidence and past experi- primary care services tends
- are not discussed.
from start to
finish
Darzi also ducks the hard questions hospital hygiene.
He calls for tougher regulation, for nurses to have
powels to impose standards and for a "deep clean" of filthy wards - but he shirks the vital call to clear out the cowboy private firms whose cheapskate methods, backed up by the imposition of "competitive tendering" have brought a slump in standards since they were introduced in the mid 1980s.
Here is another example of competition serving to undermine standards rather than improve them.
Despite his insistence on page one of his report that "I am not a politician", Darzi is now a member of Gordon Brown's government.
This becomes clear when, unlike his London report, which praises NHS services and offers few encouragements to the private sector, his report on the rest of England's NHS includes a number of stomach-turning New Labour-style hackisł plugs for the (unproven merits of "independen sector treatment centres". These are the same treatment centres which the Health Service Fournal recently reported have now to be invertely proportional poor by ings for the NHS - and lease
page 7 of the scan
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