She Must Be Mad(3) - Letter on GP Commissioning

Got this letter printed today in the Herald (one of Scotland's broadsheets)on GP commissioning. It is done from the Scottish perspective and the attempt here to try and introduce private companies into GP practices. For those of you who don't mind signing in to read the letter (it's free for the Herald) the link is here. Otherwise, here is the text of the letter below.


In March 2007, just a couple of months before the May elections, a small but significant fight over the future of the NHS took place in Scotland. SERCO, a utilities company, attempted to take over Harthill GP practice. It was unsuccessful, partly because it was publicised and partly because an election was looming. This was the first attempt by a private company to take over a GP practice in Scotland. Since then, legislation has been passed by the current Scottish government to prevent future occurrences of this nature.

England has not been so lucky. For some time now, companies like United HealthUK (a subsidiary of United Health in America), Atos and others have been taking over the running of GP practices in England. When this happens, the next move is generally to ‘hollow out’ the practice by replacing partners with salaried doctors and doctors with nurse practitioners. Drugs companies often link up with these practices, paying large sums of money in return for use of the practice as a shop window for their brand of drugs. Astra Zeneca was partnered with SERCO for example. The old, the chronically ill and the disabled are not welcome at these practices, because they drag the profits down.

Now the final nail in the coffin has come in the shape of the NHS White Paper and GP commissioning. Handing over control of the NHS’s budget to GP practices might seem a great idea, until you realise that you are not handing it to GPs, but to anyone who happens to be running a GP practice. In England this can be a GP, or United Health or Richard Branson under the guise of Assura UK. This means that these companies, not GPs, are going to decide how hospitals, mental health and elderly care are funded and who is going to provide services such as pharmaceuticals to them. To this already toxic situation is added the possibility that the purchaser and the provider can belong to the same company. Serco run facilities management in Leicester Royal Infirmary and Norwich and Norfolk University hospitals; if they move into GP practices in the area they could be both commissioning care and providing it. As ordinary GPs cannot possibly run their practices and the whole of healthcare commissioning for their area at the same time, these companies will be brought in to do it for them and this conflict of interest will arise.

This bill, if passed, will mean the end of the NHS. It will be a franchise owned by myriad private companies, funded by public money. Strategic health planning and regulation will be a thing of the past as services get splintered between competing health care organisations. The recent divesting of NICE’s powers to regulate prescription drugs and the proposed lifting of the cap on private patients being treated at NHS hospitals will mean a market free for all. Although this bill is currently for England and Wales, nobody in Scotland should delude themselves that it would not cross the border if it was enacted there. Harthill is the proof of that. For anyone who cares about the NHS, now is the time to lobby MPs and take a stand.