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Trojan horse or millstone?

26 June, 2012

Author: Warren Town

Trojan Horse

And so we pave the way to further fragment and privatise the healthcare system. The announcement that the South London Healthcare Trust (SLHT) could be dissolved is, to many, not unexpected. The idea that hospitals could run out of money has always been known and the question was never ‘if ‘ but ‘when’.

Trusts that accumulate debts that are not reduced have always been threatened with closure or reorganisation. But whereas this has been a running theme for all political parties, the latest announcement has to be considered in the wider context of the coalition policy for health care and in particular the health and social care bill that is currently being implemented across England.

In truth the situation for SLHT is manna from heaven for the coalition, especially the Conservatives.

In one stroke they can realise their dream to privatise health care and thank Labour for their assistance in doing so.

The Private Finance Initiative (PFI) was heralded by Blair as the way forward. Private money would be used to fund the capital cost of building hospitals and clinics, leaving the public purse free to concentrate on service delivery.

The NHS would benefit from new and state-of-the-art building and companies would maintain and develop the site under a contract that would provide a steady stream on income for the builder.

From the outset there were stories of hospitals paying extortionate amounts for changing light bulbs and notice boards. Despite the clear signs that PFI was not the panacea that was claimed by Labour, the concept continued to flourish. PFI for prisons based on the healthcare model was positively encouraged in the face of opposition from public sector unions and economists.

There is cold comfort in say ‘we told you so’ when the cost of this failed policy may well be jobs and services.

But there is a wider agenda here and to discuss the problems for SLHT in isolation of a wider coalition agenda, is to miss the implications that could resonate across the NHS in England and potentially the UK.

The Health and Social Care Bill was always a roadmap for privatisation of health. The problem for the conservatives was that the Bill did not go far enough because of the opposition from unions and the Lib Dems in the coalition.

But at least one partner in the coalition has now found a way to achieve their objective to design an NHS that is fragmented and open to market forces and competition.

They can make health care ‘affordable’ by using the debts incurred by PFI as the reason to fragment and hive of health care to the private sector.

The beauty of this is that they can do so by legitimately claiming that they have to do so because of Labour’s failed policy to use PFI to underpin capital cost. They are now no longer the demons but the saviour of the NHS.

Of course, the Government could simply reassign the debts from PFI into the public purse but why should they if they have been gifted with the means to privatise health?

Just as Thatcher will be remembered for destroying manufacturing and driving industry off shore, so too will Blair be remembered as the architect of the destruction of the public sector.

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