I posted about the ten year deal transferring management of Hinchingbrooke hospital in Huntingdon to a private, offshore controlled, company this morning.
Now a commentator on this blog has asked the questions which seem to need answers so I thought I would give them broader publicity.
There are a lot of questions that arise from this deal.
1) Hinchingbrooke has a PFI scheme, who is liable for that?
2) Hinchingbrooke has a private patient unit, will its profits go into the trust, or into Circle?
3) The trust is not a Foundation Trust, but it will have to be because the Health and Social Care Bill abolishes the status of NHS Trust, so Hinchingbrooke will have to become an FT or become a private hospital. FT's have a membership (anyone over 16 in the area can be a member) who elect governors and the governors appoint the non-executive directors and the chair of the trust. Governors hire and fire NEDs and they can force the chief executive to resign. If Circle is taking over the management, and given a 10 year deal, does this mean that future FT governors will not be able to fire Circle? If not, then what is the point of them?
Anyone know?
Another comment made an equally pertinent point, which is that a ten year deal manes that the next government can do nothing at all about this. I predicted such a stitch up by the Tories some time ago and it's no surprise that this is exactly what they're doing.
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I don’t know the answers, Richard, but we can bet that they’ve been discussed and agreed. Based on past practice I’d suggest as follows.
1. The government will take on (and obviously has already agreed this) the PFI liability (as it will for all further deals of this kind). Why? a. because if they don’t very few commercial companies – if any – will be interested in entering into such contracts; b. because the Tories will not allow their NHS privatisation agenda to be slowed because they need to get as many deals as this done as quickly as possible.
2. There will be a lengthy and confused statement that profits will be ‘shared’ but in practice I doubt that will happen, despite the fact that I note the hospital remains publicly owned (hence it has not been privatised if you believe the spin) and therefore could use any profit to maintain/enhance facilities.
3. Clearly the contract will not have ben drafted to allow Circle to be fired. If it had been then there would be a way to break the ten year deal and thus un-privatise the hospital. Consequently, Foundation Trust operation/rules will either have to be amended, waived, or ignored until such time as Hinchinbrooke becomes a fully private hospital.
On the last point, one thing Labour could do now is clearly state that as and when there’s a change of government they will investigate all avenues to overturn this contract and any like it. This should destablise the ‘market’ and slow any further developments of this kind. I live in hope, but not that much hope, unfortunately
Whatever the pros or cons of this particular deal you can’t honestly expect governments to only sign contracts that expire during the life of their own tenure.
Nothing would ever get built otherwise. No airports, no M25, no mainline railways, no Olympics, no large hospitals, no Severn bridges etc etc.
This is a pilot
What’s wrong with 5 years?
Unfortunately I dont have an answer, but only more questions. PFI, in effect, is a mortgage or a loan from a loan shark, paying back an extraordinary amount over a period time, on average 30 years. Will Circle be liable for the repayments or will that be excluded? Also, when any private sector involvement is in place, there has nearly always been a pursuit of low cost, high turnover services and an agreement that expensive services are left to the NHS to cover. Circle, like any business, is geared to make a profit amd therefore an expectation should be in place that certain treatments will be deferred or not carried out. Staff will have Ts & Cs attacked in particular their pension, especially on completion of FT status.Another opportunity for profit by lowering the wage bill.
Ten to one none of the questions posed above have been given any consideration. We’ve seen with the NHS bill as we’ve seen with the welfare reform bill the Condems/Tories have only a vague idea of the ideal world they’d like to create and worse are completely at a loss to know how such a place might function in practice. Witness Lord Freud (inevitably nicknamed Lord Fraud by the unimpressed) in the House of Lords repeatedly admitting, again and again he has no figures to support the bills and can’t give details of how the legislation hinted at, not defined, might be implemented in practice. Nonetheless these woolly concepts are being passed into law regardless thanks largely to the supine aquiescence of the Libdems. Chaos looms.
BB
Bill, if you haven’t already you should read The Plot Against the NHS. Leys’ and Player’s research demonstrates that the Department for Health was taken over by marketisers/privatisers many years ago and that since that time very little of what’s happened to the NHS is either accidental or unplanned. Indeed, NHS policy – what politicians talks about – is almost a side show, and deliberately so to enable real change to take place under the radar.
When the Tories came into power Lansley et al were clearly unaware of how the marketisers/privatisers at the DfH had been operating, hence the mess with the NHS reform bill. But it’s now clear that he’s been well briefed and knows the best way forward is to carry on the way the DfH did under Labour. The primary difference now is that whereas Labour ministers occasionally got cold feet about the direction of travel for the NHS the party now in power (singular – as the LibDems continue to be a side show) have no such qualms.
1) PFI – Financed by Royal Bank of Canada, Built and Facilities management by Keir….. Staff on Retention Of Employment model ….so NHS staff seconded to Keir…on NHS T&C
2) Mulberry Suite….the Private unit…the Circle agreement says any surplus is shared with Trust/Local Health Authority/Circle…..
3) Foundation Trust….this has been banded about as the Hospital under Circle Management is exempt…however….I am trying to confirm or deny this….Lansley who was on the panel who selected Circle wont answer me…..so I am awaiting another panel member to get back….one thing to remember….no panel members represented the Public and the Public were not properly consulted….all meetings were held at times when most folks were at work so not biased in favour of the SHA……also unlike the previous consultation the public were kept at arms length as they knew the result if they properly engaged ….
Does the government have the power to do this, even though the legislation hasn’t been passed by Parliament? Is it possible to question the legality of deals being done before the relevant law is in place? More to the point, is it financially feasible?
When commenting on the Fox affair in the Guardian, Martin Kettle recalled something that the chief of the general staff said to Duncan Sandys, the minister of defence many years ago: “Duncan, you’re so bloody crooked that if you swallowed a nail, you’d shit a corkscrew.”
Just substitute David, or Andrew, or Mark (Simmonds – who’s paid £50K a year by Circle Health, apparently for 10 hours a month) for Duncan. These buggers should be prosecuted for fraud, bribery and gross misrepresentation.
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