Major Privatisation Drive In North Of Ireland


UNISON has called on the Public Accounts Committee and the Assembly Health Committee to investigate the startling growth of private medicine funded out of the health service budget in the north of Ireland.

This disturbing trend can be directly traced to the appointment of Edwin Poots as Health Minister.

Last week’s announcement of two privately funded ‘health centres’ in Newry and Lisburn is the latest development in a strategy to create a two-tier health service in Northern Ireland.

It also raises big questions on probity, transparency and the relationship between private companies and politicians. It poses real threats to the future of Lagan Valley and Daisy Hill Hospitals.

Last month the trade union movement presented preliminary evidence of the growth of private medicine to the First and Deputy First Minister. But the announcement by Edwin Poots is further privatisation.

Unison says ‘the current evidence shows a disturbing trend:

• The treatment of private patients in the NI Health Service has jumped by 10% while the health services in Scotland and Wales have dramatically reduced private treatment. (By 18% and 8% respectively)

• At the same time, thousands of NHS patients in Northern Ireland are being displaced out of the health service and into private treatment in the new private health companies, which are mushrooming in Northern Ireland, or into private hospitals in the Republic of Ireland.

• Where are the private patients coming from? Unison is receiving continuous reports that NHS patients are now routinely being asked by hospital consultants if they have private medical insurance or funds to pay for treatment. If they have not, then they are being told that they will have a long wait in the NHS.

• Government states that there are not enough doctors and that this is the reason for the queues. However, the largest private medical company 3Fivetwo has two NHS consultants as nominal shareholders and over 100 consultants and senior doctors on its books. In its latest financial statement it identifies ‘a change in Government policy on waiting lists’ as the only risk to its business. The current government policy is to push NHS patients into private treatment.

• Many of the senior doctors on this company’s books have control over the waiting lists in the NI Health Service. The company’s core business is the transfer of NHS patients. The doctors are paid by the NHS to treat them in the NHS. But as the waiting lists grow many of the same doctors receive further payment from the health service budget to treat NHS patients in the private sector. This has all the appearance of an income generation scheme using public money and supported by the Minister for Health and the Health and Social Care Board.

• NHS patients referred to private companies are now receiving adverts through the post encouraging the use of more of their private facilities including A&E. One company shares its Titanic Quarter offices with a private health insurance company.

• Now Edwin Poots has announced two health centres using the discredited Private Finance Initiative under another name.

This is the slippery slope. The public are continually told that services or hospitals must close or be centralised for medical safety or because we do not have enough doctors. But the same doctors are receiving second payments to treat our patients privately.

Our NHS facilities are being opened up to private companies. NHS patients are being displaced in favour of those who can pay and the nature of the contracts with the private sector is not open to public scrutiny.

It is now time for the Public Accounts Committee and the Assembly Health Committee to move to investigate before irreparable damage is done to our health and social care system.

It is now time for people of conscience with responsibility for running our health system to speak out publicly to defend the NHS’ says the union.

Unison has been consistently warning of the dangers of this growing privatisation and the threat it poses to our health care system and says: ‘It is now time for the government watchdogs to act’.

Meanwhile, the BMA is preparing a public information campaign to help GPs inform patients about the dangers of the government’s NHS reforms, the Pulse magazine has revealed.

The move comes after legal concerns meant the BMA had to abandon the idea of asking GPs to offer patients a pledge card to ensure they would always be referred to public NHS providers where possible.

The cards were branded ‘divisive’ by private health providers, and plans were put on the back burner in November because BMA lawyers warned that GPs or the BMA could be sued by private healthcare providers as a result.

The BMA said it was still planning to help doctors communicate the impact of the government’s changes to the NHS to the public, and that it is currently developing resources to do this.

A spokesperson said: ‘We still believe that doctors and the BMA have a role to play in communicating the impacts of the changes to the NHS to the public.

‘Although the principles and motivations behind the pledge card idea were supported at BMA Council, there were concerns about some elements of the practicalities.

‘We are developing resources for the public designed to inform them about the changes currently taking place in the NHS.’

BMA Council member and hospital consultant Dr Clive Peedell, who lobbied for the BMA to back the pledge card, said that they were trying to ‘resuscitate’ the plans in a different form.

He told Pulse: ‘It is not completely quashed and it is being looked at by our political and economic research units and legal team.

‘I thought the risk was low but they thought there was a risk and therefore they couldn’t put that onto GPs so they are looking at other ways of doing it.

‘That is still in the pipeline at the moment, in terms of not necessarily a pledge card but some way of doing it whereby GPs wouldn’t be under any legal threats or getting the BMA into hot water.’

It comes after Dr Peedell and another doctor ran 35 miles dressed as Prime Minister David Cameron and deputy prime minister Nick Clegg to raise awareness of their objections to the government’s NHS reforms.

There will be a crucial vote in the House of Lords on the 24 April attempting to block the government’s controversial rules on competition for CCGs. The rules were redrafted in March due to opposition from commissioning leaders and the RCGP, but commissioning leaders still warn they will place unnecessary obligations on CCGs that will hinder their ability to put patients’ needs first.

l The Royal College of Physicians (RCP) has come under fire for its relationship with health minister Earl Howe because of his role in driving the Health and Social Care Act through Parliament and opposing tobacco display legislation.

Six senior members of the college who are opposed to the NHS reforms are calling for Earl Howe to be removed from his role as chairman of an advisory group known as The Friends of the RCP.

The group – which includes Nicholas Hopkinson, a clinical senior lecturer at Imperial College London and consultant chest physician at The Royal Brompton Hospital; Trisha Greenhalgh, GP and academic; and Gabriel Scally, who last year resigned his post as regional director of public health for the south-west of England to voice his concerns about the NHS – has written to RCP president Sir Richard Thompson pointing out that only 6% of respondents to an RCP poll supported the Health and Social Care Bill.

They complain that Earl Howe played a key role in reassuring opponents of the Health and Social Care Bill that their fears were unfounded. They say he told the House of Lords that clinicians would be free to commission services in the way they considered best and would be under no legal obligation to create new markets.

But his reassurances about the controversial s75 regulations, which outline when and whether NHS commissioners will be able to decide when to put a contract to compulsory competitive tendering or just place the contract with their local NHS provider, are false, says the group.

A motion has been laid in the House of Lords to oppose the regulations later in April and the letter says: ‘We wait patiently for a clear statement from the College calling for their withdrawal, so that members of both Houses of Parliament know that there is no ambiguity in the profession’s position.’

The protestors also complain about Earl Howe’s actions in 2009 in leading the House of Lords in a vote which threw out the then Labour Government’s proposals to ban displays of tobacco products in shops, arguing that it would hit small businesses hard and do little to improve public health.

‘Given both his role in the introduction of this legislation, almost universally opposed by members of our College, and his opposition to public health legislation that it is central to the College’s goals, we are astonished to discover that Earl Howe is chairman of the Friends of The Royal College. His actions, in relation to both the NHS and the tobacco industry, clearly suggest that he is not a fit person to fulfil this important role and we respectfully request that he should be asked by the College to relinquish the position,’ says the letter.

The group’s actions follow an unprecedented attempt by Dr Richard Taylor, the former MP and chair of the new political party National Health Action, to challenge Sir Richard’s presidency of the RCP. He lost by 406 votes. Dr Jacky Davis, BMA council member and regular Hospital Dr blogger, said the ‘mid-term’ challenge was due to the ‘abysmal’ performance of the RCP during the passage of the Health and Social Care Bill.

The RCP confirmed it had received the letter and said it would be responding to it fully this week.