Our GP surgeries are where our care starts and where most of it is provided. Good primary care reduces the need for other interventions, but quickly identifies where fast hospital intervention is needed. Good care through pregnancy, childhood and adult life makes us, both as individuals and as society, healthier, wealthier and with more time to enjoy life in good health.
In Liverpool we have already seen major problems from commercial take overs of GP practices, as with the situation in 2015 at Princes Park Health Centre (Now taken over by a different provider, who, we are told, do a good job. Tell us more if you know more)
Princes Park was once a historic innovating, socially conscious practice. We are awaiting the publication of a full history of the practice being written by Dr Katy Gardner
However in 2015 it was taken over by a private company and in February 2015 Keep our NHS Public local campaigners wrote,
As soon as Princes Park Health Centre was handed to a private company – SSP Health Ltd (on April Fools Day 2013), patients, staff and campaigners started screaming about it, but no-one in power was listening. One of the SSP directors had already written to the Telegraph backing Lansley’s monster Health and Social Care Bill: the other runs over twenty companies including property and private medical care. Healthcare services at Princes Park Health Centre started to deteriorate from day one and it is clear that the priority for those running the practice has shifted from patients to profit. The authorities responsible for providing primary care services did nothing, so Keep Our NHS Public Merseyside took the trouble to organise a meeting in Arabic, English and Somali, giving voice to the community whose views had been ignored at every step.
The campaigners won. The CQC report on to the service was critical and eventually the service was taken over by a new provider
Around 90% of NHS transactions take place in primary care. If we are serious about saving our NHS, we cannot stand by while private companies, including US health corps, take over local GP surgeries and other primary care services.
Save Liverpool Women’s Hospital Campaign are supporting a joint campaigning group on this and we are grateful to them for some of the material we use in this posting.
Our objectives are:
1. To reverse the Centene deal (Operose Health is its UK subsidiary).
2. To alert the country to the risks of Alternative Provider contracts.
3. To help inform opposition to the White Paper.
4. To show a link between Centene and other privatisation.
We need to
- expose the scale of the problem at local level
- challenge the award of contracts, and
- campaign against the Alternative Provider contracts that make takeovers possible.
What has changed in general practice?
Even NHS campaigners rarely understand how general practice works We think this urgently needs to change as it is too easily raided by big business
The key points are as follows.
- On a traditional family doctor contract (a GMS or PMS contract*), GPs are sub-contracted to run primary care services, indefinitely, on behalf of the NHS. They are not true businesses, because there are strict controls on the services they provide, the ways they can spend their money and how they treat their staff.
- When new Alternative Provider (APMS*) contracts were introduced in 2004, all that changed. GPs and private companies were offered the chance to run some surgeries differently on five-year rolling contracts. They were offered extra funding, encouraged to form chains and allowed to make profits for shareholders.
- In practice, the first of these Alternative Provider contracts were mainly taken on by GP partners who swapped contracts to try out the new model. But now we are seeing the practices and chains they built being hoovered up by the insurance giants.
- There is much more detail on how GP services work here
Why this matters
The key difference between the contracts is that GP partners running a surgery for decades have a commitment to their patients, families and local areas. A US health corporation, with a time-limited contract, has a commitment to profits.
- US and other private companies have a poor record at running UK practices (for example: www.theguardian.com/society/2012/dec/19/when-privitisation-gp-practices-wrong). They often have a dire reputation back home too.
Let us look more closely at Operose and Centene.
Keep our NHS Public writes.
Operose already have contracts for twenty-one GP practices and several health services across England. Operose is a heavily loss-making subsidiary of the US-based health insurer, Centene Corporation which is registered in Delaware. Operose has paid no UK tax. Centene could pull the plug on Operose at any time forcing the shut-down of a large number of GP practices. In the USA Centene has been found guilty of fraud many times and is currently being sued by Ohio for fraudulent overcharging. Operose Health’s publicity states openly that its market strategy is to exit NHS contracts that do not make a profit. In one instance an Operose associate company pulled out of running Camden Road Surgery giving patients only 4 weeks to register elsewhere.
- Since they cannot up their prices, these companies can only increase their profits by cutting back on staff costs and services.
- When a private company like Operose Health becomes big in primary care, it will inevitably demand seats on the new NHS bodies that decide which services to commission and who to give contracts to.
- There is serious potential for conflict of interest. Centene, for example, owns 40% of Circle Health, which in turn owns the huge chain of private BMI hospitals – which all make a significant amount of their income from treating NHS patients.
The following are all important elements of the ‘transformation’ of the NHS promised in the Health White Paper
The takeover of GP surgeries by US health corps,
the cuts to beds and A&E services in hospitals,
the restructuring of the NHS in England into 42 Integrated Care Systems,
the privatisation of areas such as pathology
the debacle of test & trace,
the takeover of back-office functions
Please get involved in our campaigns and those of other NHS groups
This campaign has been launched by a concerned group of NHS campaigners and academics from around the country. It is backed by Keep Our NHS Public, 999 Call for the NHS, We Own IT, Doctors in Unite and EveryDoctor.
We thank our partners in this campaign for much of the material in this bulletin. Together we are stronger and we can make a difference
We Own it are also campaigning on this and have produced good videos.
We need you to help defend the NHS free at the point of need, fully funded not for profit, publicly provided and available to all.