This extraordinary post was first published on the False Economy site - which is always worth reading. It's incredibly important at a time when the government claims that NHS reforms are not about privatisation when their actions so very clearly show that they are. As such I reproduce it in full, I hope with their agreement:
Campaigning for the 2010 election, David Cameron said “in place of Labour's self-defeating top-down targets, we will harness the power of information and publish the details of healthcare outcomes.”
He said that he would get rid of the Labour government’s “process drive, top-down targets”.
After not winning the election, but still becoming Prime Minister, Cameron was true to his word and abolished the NHS targets.
However, as Lansley’s ill thought out reorganisation started to divert resources from frontline care, waiting times started to rise.
Worried about the public backlash, Cameron reimposed the waiting time targets. Cameron made dropping targets a big issue of his election campaign and yet within a year he had re-imposed them.
Now we see that he is about to impose another target. Cameron’s new target is how quickly he can privatise NHS care.
The Operating Framework 2012-13 is the rule book for the NHS. The technical guide gives a list of “indicators” that the Department of Health uses to determine if PCTs are implementing the requirements of Operating Framework.
One of these indicators goes by the snappy name of:
PHF09: Trend in Value/Volume of Patients Being Treated at non-NHS Hospitals
This says that PCTs should collate the number of patients the NHS have paid to have treatment in private hospitals.
Since there are private providers who are paid to do NHS work, there is no problem with monitoring how many patients use them. However, the reason for this indicator is not merely to “monitor” this patient choice. The explanation is:
"Patients should have the opportunity to choose a range of providers for their first outpatient appointment, including those in the Independent sector. This indicator shows a percentage of patients who have exercised choice, since it is likely that an alternative NHS provider was also offered to them. An increasing percentage of CAB bookings being made to the IS may be indicative of more choice being offered to patients."
CAB is “choose and book” which is the system where patients choose from a list of providers - NHS and private (IS, or independent sector).
The last sentence is shocking. The government says that patients must have choice and the only way that they can be reassured that patients have had a choice is if the percentage of patients who have chosen a private provider increases.
A PCT has to show that patients were given choice, so a PCT must make sure that more patients choose a private provider. This indicator does not take into account that when a patient is given a choice, they may choose to use an NHS hospital: the government does not treat this as the patient choosing. Their only measure of a patient choosing is if patients choose someone other than the NHS.
All political parties say that NHS patients should have choice, but the current coalition government take a Henry Ford attitude to this choice. Rather than “any colour you like as long as it is black” the government is saying “any choice you like as long as it is not the NHS”, and they have set a target to increase the number of patients choosing a private hospital.
Richard Blogger writes about the NHS and social policy at NHS Vault.