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GPs given licence to make a fast buck out of taxpayers. This isn't reform, it's corruption

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As everyone knows, the NHS is Britain’s sacred cow because it stands for certain values that the public believe form the essence of a decent and civilised society.

You really do have to wonder, therefore, if somewhere deep in the bowels of the Department of Health lurks someone with a secret agenda to destroy the NHS by stealth through one cynical, self-serving and destructive ‘reform’ after another.

At the weekend, it was reported that certain members of the new NHS commissioning groups, which will design and commission health services in England and come into operation this week, have a financial stake in private companies or organisations which can then bid for lucrative contracts with the NHS.

At the weekend, it was reported that certain members of the new NHS commissioning groups have a financial stake in private companies or organisations which can then bid for lucrative contracts with the NHS

More than one-third of the GPs who sit on these bodies, along with many practice managers, have a stake in such firms. In one case, a clinical commissioning group awarded a deal worth £150,000 to a company created by the group’s chairman.

It beggars belief that the Government has introduced this travesty into the NHS in the guise of a reform. For in any other walk of life, such an institutionalised conflict of interest would be called by its proper name — corruption. 

You just cannot have a situation where people running an organisation stand to rake in personal profit from contracts awarded by that organisation.

And what a honey-pot this is. For these commissioning groups will control an annual budget of no less than £65 billion.

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The groups claim there are no conflicts of interest because board members will not take part in any decisions related to their companies. This is, to put it mildly, disingenuous. The fact such a board member may notionally leave the room when a contract award is decided does not alter the fact that he will still make a personal profit from a decision taken by his own board.

The very idea of health service staff financially profiting from commercial NHS decisions is not just a cause for concern because it is potentially corrupt. It is in itself deeply repugnant. 

For it strikes at the very heart of what the NHS is supposed to be all about. 

Paid for out of general taxation to deliver health care equally to all, the NHS is emphatically not about making a profit. It is a public service, and its staff — from the highest administrator to doctors and nurses and the lowliest porter — are all public servants.

As a result, they are not supposed to profit financially from the service other than to draw a salary.

According to one of the Care Quality Commission's non-executive directors, Kay Sheldon, it has been declaring hospitals with high mortality rates to be safe for fear of rocking the boat

Making any kind of profit on the side is in effect to siphon off public money into their own pockets. 

Whatever happened to altruism? For disinterested public service, in which private self-interest is nowhere and the public interest is all, is the fundamental principle upon which the NHS is founded.

But in truth this principle has been foundering now for many years. 

The root cause is the never-ending attempt to remedy the massive problems of the NHS without honestly acknowledging that these are fundamental — and fatal.

Instead of admitting that the NHS could no longer bear the burdens being placed upon it, previous governments introduced an ‘internal market’ to open it up to a measure of competition and thus make it run more efficiently. 

Accordingly, this new round of reforms is intended to allow companies, charities and other health providers to bid for contracts.

But this attempt to graft the market onto public service was always doomed to fall heavily between two stools by not delivering the one while undermining the other.

Indeed, the market has already destroyed another basic NHS principle: that politicians are accountable for its performance.

It introduced arm’s-length administration — of which commissioning boards are but the latest example — on the specious grounds of loosening top-down controls and making the service more responsive to patients.

In fact, this was a wonderful way for politicians to wash their hands of responsibility for the NHS as it staggered from disaster to disaster — calamities created in large measure precisely because the buck seemed to stop nowhere.

For example, the NHS watchdog, the Care Quality Commission, has been worse than useless; according to one of its non-executive directors Kay Sheldon, it has been declaring hospitals with high mortality rates to be safe for fear of rocking the boat.

Craziness: In the scandal of widespread abuses at the Mid Staffordshire Trust, almost no one was fired as everyone passed the parcel of responsibility around in ever-widening circles

When the balloon eventually did go up in the scandal of widespread abuses at the Mid Staffordshire Trust, almost no one was fired as everyone passed the parcel of responsibility around in ever-widening circles. 

And the man at whom the buck should have stopped, the shameless NHS chief executive Sir David Nicholson, is even now still in his post — ready to preside over the next catastrophe.

And so on and on goes the craziness. Today, the new NHS 111 urgent care service is being introduced — despite urgent warnings it still does not have adequate equipment and risks being a shambles which will cost lives.  

The result of this systematic shunting of responsibility has been that incompetence or abuses of one kind or another in the NHS are ignored and connived at across the board.

The shameless NHS chief executive Sir David Nicholson is even now still in his post following the Mid Staffordshire scandal

There is systematic neglect of and cruelty towards elderly or otherwise particularly vulnerable patients. Horrified staff who tried to blow the whistle on what was going on were gagged. And now NHS staff are using taxpayers’ money to feather their own nests.

If altruism and accountability have disappeared from the NHS, what then is the point of it? 

What, indeed, can possibly justify the holier-than-thou opposition to private health care, on the basis that this introduces antisocial profiteering into a system which embodies the disinterested ideal of public service, when the Government is now enabling NHS staff themselves to make a fast buck from the taxpayer? 

The brutal fact which successive governments have refused to acknowledge is that far from serving as the sole possible guardian of altruism in health care, the NHS has for years been destroying it. 

For at the very core of the NHS sits not altruism but self-interest, since the service is controlled by politicians whose ultimate aim is not to preserve people’s health but to get re-elected.

Today, the new NHS 111 urgent care service is being introduced - despite urgent warnings it still does not have adequate equipment and risks being a shambles which will cost lives. Image taken from NHS direct website

While private health care and social insurance systems — to which the NHS is supposedly morally superior — are directly accountable to the patients who pay for them or select insurance plans to suit them, in the NHS staff instead look upwards to their political paymasters. 

As a result, NHS patients have next to zero leverage over the care they receive — which is why so many staff have got away with acts of unspeakable callousness and worse towards those patients who are particularly helpless.

For sure, there have always been and still remain many NHS staff who are motivated by the highest ethical principles, believing as they do in the ideal of health care available to all free at the point of use.

But that ideal is amply fulfilled by social insurance systems, where everyone pays towards a health service provider — the system used in many European countries, where the standard of basic care is vastly superior to the NHS.

In the NHS itself, altruism is being steadily beaten out of its staff by the toxic cocktail of inappropriate managerial remedies for insatiable public demand, the erosion of the ethic of disinterested care within both nursing and medicine, and top-down power without responsibility, of which the latest egregious example is the commissioning groups’ distasteful money-making cottage industry.

Time, surely, to put this sacred cow out of its misery at last.

m.phillips@dailymail.co.uk





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