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
