Health Secretary Lansley yesterday outlined coalition plans to step up the privatisation of the NHS, announcing the White Paper titled Liberating the NHS.
In his speech to MPs, Lansley said that ‘all NHS trusts will become foundation trusts’ and that ‘our aim is to create the largest social enterprise sector in the word’, and ‘patients will have the choice of any willing provider’.
He reiterated that there will be £20bn ‘efficiency savings’ by 2014.
The White paper adds that the government intends to proceed ‘by increasing the freedoms of foundation trusts and giving NHS staff the opportunity to have a greater say in the future of their organisations, including as employee-led social enterprises.
‘All NHS trusts will become or be part of a foundation trust.’
Current foundation trust watchdog Monitor ‘will become an economic regulator, to promote effective and efficient providers of health and care, to promote competition, regulate prices and safeguard the continuity of services.’
GMB national officer Sharon Holder warned: ‘This is the beginning of the end of the NHS as we know it.
‘This is the wholesale selling off of the NHS to private companies and businesses at the expense of the British taxpayer.
‘We built the NHS in 1948. If we don’t want to see it destroyed in the next few years, the British public will have to stand up and defend the NHS.
‘The unions should lead this defence with whatever action is necessary.
‘All the public sector unions must join together to fight these plans and defend the NHS.’
Labour shadow health secretary Andy Burnham warned: ‘This is taking a huge gamble with the NHS.’
He added: ‘Staff organisations will be alarmed that their system of national bargaining will be torn up.’
Karen Jennings, Unison Head of Health, said: ‘Far from liberating the NHS, these proposals will tie it up in knots for years to come – they are a recipe for more privatisation and less stability.
‘NHS staff will feel badly let down by plans to undermine national pay bargaining.
‘In a race to do this, the government wants employers to lead negotiations on new contracts resulting in a two-tier workforce within Trusts and anomalies across the NHS.
‘If the NHS is to be more efficient it needs to have stability. People in fear of their jobs, or how they are going to be able to deliver services, will not be able to make informed or rational decisions.
‘This is no way to take patients or staff with you.
‘There are just too many contradictions, e.g. cutting back on bureaucracy and doing away with PCTs and SHAs, but allowing the proliferation of GP consortia.
‘Handing over £80bn to untried, untested and probably private sector-led consortia, is reckless.
‘How will they be held accountable for that money?
‘Accelerating the approval of Foundation Trusts means that managers will be concentrating on the business of preparing for that, rather than on patient care.
‘We must learn the lessons from recent disasters such as Mid Staffs.’
Under the government’s plan, GPs will have to bring in ‘external organisations’, i.e private health companies, to manage the purchasing of hospital, mental health and community care services.
The planned GP consortia will be overseen by an NHS Commissioning Board, staffed by government appointees, which will tell GPs what to spend and where to refer patients.
Dr Richard Vautrey, deputy chair of the BMA’s GPs committee, said: ‘We do live in tough economic times, but we must make sure that doctors, working together in groups, are given the necessary resources to implement any reforms properly.
‘It is also vital that spending time with patients remains the top priority for all GPs.’
NHS foundation trusts are to be turned into businesses run by ‘social enterprises’, (government spin for private companies), who will set staff numbers, wages, pensions and conditions.
Under the White Paper, the Department of Health will be slimmed down to one fifth of its size.
Lansley’s plans also include moving NHS foundation trusts from the public sector balance sheet, as initially planned by former Labour health secretary Alan Milburn in 2002.
Community services will either form community foundation trusts, merge with GP consortia, or be taken over by hospital foundation trusts.
