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At the heart of general practice since 1960

The conspiracy to destroy the NHS is no 'fake news'

There is clear evidence of a conspiracy to destroy general practice and the wider NHS, argues Dr Youssef El-Gingihy 

In her blog ‘The real conspiracy of NHS England’, Dr Nishma Manek dismisses the notion of a conspiracy to destroy general practice as fake news. She proceeds to embark on what purports to be a courageous myth-busting exercise.

As I’ve outlined in my book How to Dismantle the NHS in 10 Easy Steps, there is overwhelming evidence of a conspiracy to privatise the NHS stretching back three decades. Dismantling the current model of GP services is central to this.

The internal market was introduced in the 1990s and expanded into an extensive market through Private Finance Initiatives (PFI) and outsourcing. Post 2010, the flagship Health and Social Care Act 2012 accelerated the process by abolishing the NHS in legal terms, opening up contracts to competitive tendering and enabling foundation trusts to make up to half their income from private patients.

The blueprints can be found in two key 1980s documents – Britain’s Biggest Enterprise by Conservative MPs Oliver Letwin and John Redwood for the Centre for Policy Studies and The Health of Nations for the neoliberal Adam Smith Institute.

NHS England’s Five Year Forward View explicitly states that the NHS should emulate US style accountable or integrated healthcare, which cuts costs by restricting access to hospital care and specialists. Simon Stevens has confirmed that STPs – which entail £22 bn of efficiency savings taking the total for this decade to some £40 bn - will usher in accountable care organisations.

Dr Manek says there is no hidden agenda to destroy the partnership model or to ‘sell us off as salaried slaves to super-partnerships’. But the GP Forward View names ‘federations and super-partnerships’ as central pillars, announcing further public-private partnerships despite the disastrous £300 bn PFI debt.

More than 650 surgeries have been closed, merged or taken over since 2010; the RCGP warns that up to 600 more surgeries could close. Current plans envision 7,500 GP surgeries being reduced to 1,500 super-hubs. The STPs spell out a series of hospital closures, downgrades and mergers. NHS England earlier outlined plans to cut the number of major A&Es in England down to between 40 and 70.

At the same time, we are seeing the deprofessionalisation and deskilling of the workforce, for example through the introduction of physician associates, while pharmacy, self-care and digital technology will supposedly act as a substitute for medical and nursing care.

Corporates have not found NHS contracts as lucrative as hoped; networks of GP surgeries and chains of super hospitals are really about creating economies of scale for future corporate takeover and private equity buy-outs.

Dr Youssef El-Gingihy is a GP in Tower Hamlets, East London. You can follow him on Twitter @ElGingihy. His book How to Dismantle the NHS in 10 Easy Steps is published by Zero books

 

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Readers' comments (10)

  • Dr Manek reported there was no conspiracy within NHSE but people doing their best in a hard place.

    As to a conspiracy, that would presume that there was no open evidence of the direction of travel. In her analysis she elected to miss the evidence of what is actually happening or was unable to to interpret it.

    This is no longer a conspiracy but the final chapters of an outcome.

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  • "future corporate takeover and private equity by-outs"

    So why don't we hear anything about this from our GP leaders?

    GP Federation Leeds, CCG, BMA, RCGP,.. are just waiting for the private equity buyouts. Then they will sell to the corporates making them millions. Meanwhile for the rest of us..

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  • Brilliant article.

    The one place where NHSE is likely to fail is that any wholescale contract within an MCP setup has no profit to be made.

    Although MCPs will form the sort of unit size that would interest corporates, the saving grace for the NHS will be the extreme efficiency with which most GP's run.

    Only GP's can make any little 'profit' within the system - there will not be enough for corporates.

    virgin keeps trying but gets its fingers burnt very regularly even with cherry picked contracts on favourable terms.

    No Pharma company wants to touch the NHS contracts with a bargepole.

    Its not much of a saving grace but any vultures flying over are likely to find themselves in big trouble!

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  • 🤔🤔🤔 sounds like left wing Bernie foo fighting to me. All is well, calm down and get that home visit done...😀

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  • Dr Gund

    Well said Dr Trump! Spot on .

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  • Of course. Thousand times so. In dear ole NI, funding to primary care cut by 50% from 11 to 5.5% in 12 years. The DOH is laughing at GPs and wondering when we fools will realise they are wanting us to work for nothing. [ Profit per consult is less than £3.]
    Meanwhile, there is 1500 million pounds for pellets to be burned heating empty chicken houses.

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  • The country can't afford the pensions of the public sector particularly the NHS workers. The drive is to get people employed by private firms who will have sweetened deals to lure the workforce away from the public sector. The NHS will exist in name only as it will still be free to the end user but via tax breaks or insurance provided by the state as outlined in Direct Democracy. The profession will be salaried and the family doctor concept will disappear. Only continuity will be if people are willing to pay privately. Can't run a socialist ideology of the NHS with capitalist business models and not have casualties.

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  • Just Your Average Joe

    The NHS is being hollowed out slowly, so eventually just the shell will be standing.

    20 odd years ago, all chronic disease pretty much was done in hospitals and everyone was seen and got their ops done, though long waiting lists. There was no back door rationing being done. And the funding was far less than now.

    The money has been increased by huge amounts, the chronic disease has been farmed out to primary care in much cheaper costs. There is rationing and overspends and though wait lists are much better, why can the NHS not cope?

    Partly PFI black holes that NHS trusts are throwing money into to cover costs that are long paid, but PFI profits must continue for years to come. Locust like layers of exc3essive management brought in to the NHS to monitor targets and each other - who could all be lost to the NHS tomorrow and the world would still function and patient care may even improve!

    Many private companies are coming into the NHS and being offer sweet heart deals which pay them huge premiums over and above the funding on offer to routine NHS services to do the same work - so they can make a profit large enough to make coming into the NHS worthwhile. In almost all cases the services on offer are worse.

    The cherry picking of easy surgical cases means the NHS is left with all the difficult and costly cases with reduced funding as the easy patients are seen elsewhere, unbalancing the books.

    The NHS should return to being a closed system, where private profit making companies which have no interest in the patients or quality of care, and whose only loyalty is to the shareholders or the bottom line. They have no qualms dropping contracts leaving patients in the lurch with practically no notice when profits fall.

    The private companies should only be allowed to stay if they swallow the deficits and continue to provide a high quality service even if they run a loss - until the end of the contract - so they are forced to actually maintain minimum standards of care - ie doctors not any person who can pass themselves off as a health professional because it's cheaper and we can get away with it.

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  • Just Your Average Joe

    The NHS should return to being a closed system, WITHOUT private profit making companies which have no interest in the patients or quality of care, and whose only loyalty is to the shareholders or the bottom line.

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  • Just Your Average Joe

    THEY SHOULD BE forced to actually maintain minimum standards of care - ie doctors not any person who can pass themselves off as a health professional because it's cheaper and THEY can get away with it.

    Sorry!

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