COVID-19 conceals deepening privatisation of the NHS

by David Wrigley

The Government’s COVID-19 response has accelerated private outsourcing – and the race toward a disastrously fragmented health system

Location: UK
Published: Thursday 23 July 2020
david wrigley bma council deputy chair

Since the passing of the Health and Social Care Act in 2012 the NHS in England has been forced down a route of increased marketisation and privatisation – and the Government has accelerated its aggressive outsourcing to private firms during the COVID-19 pandemic.

That is the clear conclusion of a report released today by the BMA, which shows that in the space of just a few months ministers have given significant contracts to companies to procure and store personal protective equipment, manage national drive-in testing centres and super-labs and build the COVID-19 data store.

In perhaps the most galling deals of all, Capita and Serco were given the tasks of recruiting and overseeing the return of NHS health workers and running the contact tracing programme, respectively.

These firms are no strangers to many of us in the health service, and certainly not for a record of unblemished success. Capita was responsible for wrongly archiving 160,000 GP records in 2018, and Serco admitted in 2012 that it presented false data to the NHS 252 times on the performance of its out-of-hours GP service in Cornwall – just two examples of how these firms have performed when given responsibility for NHS services.

This pandemic has already highlighted the disastrous effect of austerity politics on our patients and the health and care system – with once comprehensive public health services cut to the bone, social care stretched beyond reason and more or less the entire NHS, for so many years run at full capacity with no flex, having to shut down to ensure intensive care services are not overwhelmed.

And rather than finding a moment of clarity in this crisis to reinvest in a publicly provided health service and build for a better future, the Government has doubled down on its failures, choosing to throw huge amounts of money at scores of private firms – money lost to public services and frittered away forever – rather than rebuilding the health and care system and empowering those with the greatest expertise.

These contracts have often been handed over with no oversight or due diligence. This health system continues to be fragmented and hamstrung by this government’s decisions.

The effect of these decisions – and those mistakes made since 2010 – on this country’s ability to respond to the pandemic has been monumental. We are still left with a contact tracing system which is unfit for purpose, testing policy and output has been consistently shambolic and the Government swerves regularly from one direction to the next, leaving the public confused and worried.

The mixed messages we have seen have serious consequences. The worrying truth is we may be feeling the results of these failures for many months and years to come.

The BMA has been lobbying against this dogged policy in England of outsourcing for many years but the level and nature of the contracts being handed to these corporations is increasingly concerning.

We are seeing this outsourcing being carried out with minimal oversight, governance or transparency. There is no ability to scrutinise these deals and taxpayer money is haemorrhaging from the Treasury while a health and care system in desperate need of investment and resource is ignored.

Urgent action is required to protect the NHS and ensure taxpayer money is spent in a responsible manner. In the long term the health service must be protected and returned to being a genuinely publicly funded, publicly provided and publicly accountable system.

That must include a substantial year-on-year real-terms increase in funding for the NHS, local public health departments and a genuinely reformed and properly financially supported social care system.

In the shorter and medium term it is crucial that a more robust governance system – under NHS control – is given oversight of management and coordination of procurement, transparency of private contractual arrangements is provided and commercial confidence no longer used as a constant excuse to avoid accountability.

We should be empowering and expanding our NHS to undertake additional health-related work and not continually running to the private sector which has shown time and time again that it is not able to undertake and fulfil contracts to a satisfactory level.

David Wrigley is deputy chair of BMA council

Read the report