The NHS White Paper produced by Health Minister Andrew Lansley should surprise no-one and is a direct result of Labour’s timidity in standing up to the flawed philosophy of markets in the public sector.
The White Paper proposes to give commissioning (aka purchasing powers) to GPs and abolishing PCTs. Whilst many would argue that PCTs have been ineffective, the idea that GPs will have the time, expertise or inclination to run budgets and contracts to this extent will simply pave the way for external providers to act as the commissioners of local services for GPs. It paves the way for greater market involvement in primary care delivery.
The Tories have the audacity to suggest that this is the ‘third way’ in a big society but even their own MP’s admit that the capacity for the third sector to step in and bridge the gap is not there yet. They have publically acknowledged that this will mean that there will need to be an increased role in private providers (laughingly suggesting that this will only be until the third sector can develop capacity). They’re already suggesting social enterprise companies as the way forward.
Whilst there is no in principle objection to social enterprise companies, if it is about running a small community project weaving baskets, they are not a public ownership model and UNISON should have no time for pandering to Tory-lite philosophy on the third sector. Like the private sector opening up markets to the third sector fragments public provision and is an unaccountable and undemocratic way to run services. It is not and never can be a model for public service delivery.
This White Paper is fundamentally about privatisation and greater marketisation of NHS services. It is not about staff training or capacity building – lets not get drawn into these softly softly arguments. Do we as a public service union believe in a publicly owned and accountable NHS? I think our conference agreed that we did. Every negotiator, organiser, every branch, every steward needs to get the message out there that this is NOT about tinkering with structures and how efficient or inefficient they are.
This is the reinvention of the Tory right-wing ideology of purchaser – provider splits in public services. Put it to the market and the market will deliver efficiencies. We know that this was tested in the days of CCT in local government and in health. We know it is flawed. Labour lets us down by their own timidity in arguing against flawed marketisation ideologies. They paid the ultimate price in losing the election.
UNISON is better placed than any political party or any other union to argue against this Trojan horse privatisation of the NHS. The battle needs to begin now. The public will be on our side.
