For years, many have thought that many of the upper echelons of the NHS are morally bankrupt. It now seems that the NHS’s policies are now making it financially bankrupt! Circle Health have thrown in the towel on its, and the NHS’s, flagship privatisation project – the running of Hinchingbrooke Hospital. A hospital not that far from our county’s southern border. Circle make it clear that its contract is not financially viable……They cannot provide the quality of care demanded for the price paid.
It has been argued that many of the NHS hierarchy could not manage a ‘p**s up in a brewery’ with a list of failures a mile long from a culture of cover up of patient harm through to simply being unable, for decades, to manage the training of doctors and nurses to deliver the right level of staffing at the right time.
The latest in a long list of failures for the NHS is its policy of treating the NHS as a ‘market’ and ‘competition’. We all know don’t we that the private sector are just marvellous exemplars. Just look how well they have done with our banks, energy companies, railways etc. If only we could get that sort of quality of management into the NHS then everything would be hunky-dory. Well that has been the view of both the last Labour and this Conservative led government, advised no doubt by the upper echelons of the NHS.
What normally happens in the NHS? Can’t run a hospital at a profit – sack the CEx and Board and get another one. That will fix it. When that fails (repeatedly) continue the mantra that it is all to do with the local management (those at the top have to take that stance to protect themselves and the deeply flawed systems they oversee) and lets privatise it. So that brings us to Circle. If you have the mindset of many of those running the NHS and never analyse the problem properly you come up with the wrong answer. The Circle deal was a classic wrong answer. The problems at Hinchingbrooke are deep rooted – they are much broader whole systems issues which Hinchingbrooke cannot solve on their own. On top of that and of equal if not more significance they work in a deeply flawed and ‘rigged’ market where they get paid for each operation according to a formula worked out by statisticians and approved in London; a formula which bears little relationship to a ‘proper market’.
In this ‘market’ where hospitals get paid per operation etc, some hospitals can get almost as much as 30% more than other hospitals for exactly the same procedure. Hinchingbrooke could not make a profit even thought it fared quite well in this rigged market. Worryingly almost two thirds of our hospitals in England get paid less per procedure than they did….
The one advantage of this privatisation is that the NHS could not revert to some of its other tricks – a bit of creative accounting here, the odd loan there to dress up the balance sheet at Hinchingbrooke and make things look better than they really are. This is a private sector company with its own balance sheet and its own P&L.
Its to be hoped that this failure will shine the spotlight on a deeply deeply flawed market and system of funding and change will follow. Sanity could prevail and emphasis given to co-operation and collaboration rather than competition.
But don’t hold you breath – this is the NHS.