SIMON Stevens the new Chief Executive of NHS England is no stranger to the NHS and the struggle to privatise it. He was chief adviser to two health secretaries under a Labour government, Frank Dobson and Alan Milburn, from 1997 to 2001, pioneering the beginning of the health market and Foundation Trusts, that required huge cuts so that they could balance their books as if they were just another private commercial concern.
He advised Blair for three years on privatising healthcare. It was however a battle. Health Secretary Frank Dobson opposed targets and privatisation measures such as Foundation Trusts in the NHS and went in 1999.
He was replaced by Milburn and, together with Blair and Stevens, they pushed forward plans for waiting targets, foundation trusts, contracts with the private sector, many of which became extremely controversial, alongside the notorious PFI schemes that saw the banks make hundreds of billions of profit out of building and then leasing hospitals to the NHS.
After that initial assault, Stevens took a sabbatical and on the basis of his record in the UK, no doubt, he became President of United Health Europe, and then became vice president of the huge private health group group, the world’s largest private health company, based in the US.
Milburn quit on June 12 2003 when he was not allowed to completely privatise Foundation Trusts.
There was however a price to pay. In the wake of the Mid-Staffs NHS disaster, Frank Dobson returned to the fray and lambasted the Blair gang.
He told the Mail that he had ‘warned Mr Blair that a “mad rush” to bring in more competition and targets in hospitals could harm patients. But Mr Blair ignored him and gave his Cabinet job to a crony who agreed to force through the changes.’
Dobson added: ‘I told Blair that reckless changes could undermine patient care, but he didn’t want to listen.’
Dobson criticised two of his Blairite successors as Health Secretary – Alan Milburn and Patricia Hewitt. He said: ‘They became obsessed with wanting to break up the NHS into individual units. I made my views known to them but was ignored. They preferred to take the advice of management consultants to medical consultants.’
Now Stevens is back to complete the privatisation job that he began with Blair and Milburn. There was some surprise at his return, because of the former battles. He however stated that the challenge of leading the health service at a ‘defining moment’ in its history was too great to refuse.
The big battles lie directly ahead. Stevens intends to shut down the big District General Hospitals.
The crucial point, he says, is that the health service needs to ‘experiment’ with a variety of ways of working, not try to enforce one model on different places. This will mean District General Hospitals being replaced by groups of family doctors and hospital specialists working together in the community; in other areas, small hospitals could take over the running of GP services; or be part of chains of successful private healthcare providers.
He intends to bring in a system of small hospitals linked to networks of GPs and backed by private healthcare companies, that we are told work excellently in the USA, where private medicine reigns supreme and people are afraid of falling ill.
Stevens says that other countries have found it possible ‘to run viable local hospitals serving smaller communities than sometimes we think are sustainable in the NHS.’ He cites the private US health care business as a good example of this.
On Wednesday, Stevens is due to make a major speech to the NHS Confederation’s conference in Liverpool, outlining new models of care to build community services around small hospitals to allegedly meet the needs of ageing populations.
You have been warned. The trade unions must respond to the new wave of attacks that are about to be launched. They must decide not to accept the closure of a single hospital or GP practice, and to prevent closures with a policy of occupations and a refusal to allow these services to be destroyed or halted.
The unions must warn the government that they are prepared to defend the NHS with a general strike to bring it down and bring in a workers government and socialism.