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What price consultation?
• I WAS part of a deputation attending the emergency meeting of the Camden health scrutiny committee.
We were allowed 10 minutes to put the case against the privatisation of GP surgeries in Camden, and then we listened for two hours to the case put by the PCT. It was an educational experience.
The PCT claimed that they had consulted the public sufficiently about the possibility of a private, for-profit, company running the service because the consultation paper mentioned “APMS services”.
Jeers from the public gallery suggested that members of the public (and indeed no one else apart from the PCT) had understood the significance of these initials. They claimed that they didn’t really have to consult anyway, as the changes do not represent a “significant change” in the way services are run.
They went on to claim that UnitedHealth had a good track record of delivering services in this country – without mentioning that UH only runs one GP practice in England.
They did not have to answer searching questions about the tendering process, because of “commercial confidentiality”, the screen behind which so many crimes against the NHS are committed and concealed. However Pulse magazine has pointed out that the local GPs scored better than UH in clinical areas, and that UH won only when a value-for-money measure was introduced late in the day.
Camden PCT are now putting out-of-hours services out to tender, and UnitedHealth is reported to be interested. The PCT website has been out of commission for weeks, making it impossible to access the consultation on line.
The PCT said that no public meeting was planned, despite the anger and concern arising from the take-over of the GP practices.
It is a great shame that the PCT is not an elected body, which would make them genuinely accountable to local people.
It is difficult to believe that they would behave in this way if they were. Until that changes, our only recourse is to organise locally, and I urge anyone who is concerned about the sorry saga of the privatisation of primary care in Camden to join the Camden branch of Keep Our NHS Public and to keep up the pressure for genuine consultation rather than the fig leaf which has been offered to date.
Dr Jacky Davis
Co-chair NHS Consultants Association
Patshull Road, NW5
Paying for treatment
• THE problem with GP practices is that they have a monopoly and they have
us over a barrel.
The only recourse we have is to change our GP and I imagine this is more difficult than it sounds.
I think it would be better if the whole service was deregulated and we could then find a GP practice conducive to our needs. I also think it a good idea if people were to pay, so that only the needy would go to a GP.
DC Steele
England’s Lane, NW3
Build protest
• THE primary care trust seems to be enthusiastic about the transfer of three of Camden’s health centres to a large American private company.
It repeatedly denies that this is privatisation, but it has obviously not considered seriously the long-term effects of such a fundamental change of management.
Global companies are rich enough to plough money into “flagship” enterprises when they first take over, but gradually the costs and prices increase and there is no effective controlling organisation or democratic accountability to limit this process.
Given that the UK NHS is paid for out of our and our children’s taxes, I fear for the younger generation’s tax bills .
Not only will they be struggling to pay back huge loans to cover their higher education and have no chance of getting on the housing ladder but health taxes and national insurance contributions will increasingly be driven by the private sector’s shareholders’ demands for profit.
Why else does anyone invest in shares but to make money?
Mention has been made of UnitedHealth profiting by £1 million from these three health centres. If they remained under the management of our local trusted and, in many cases, proven GPs, that “profit” would return to help patients for whom the NHS was designed, not distant businessmen with no knowledge or interest in local health services.
I worked in the NHS for more than 30 years and found it to be one of the most generous and unifying components of our society, even when we were criticising it.
A significant proportion of the staff in all specialisms worked extra, unpaid, hours and the sense of public service was strong, despite all the problems over the years.
This will not continue if the NHS is fragmented into many competing public and private sectors.
I simply cannot understand why the PCT has such faith in private business solving the problems of our public services.
I wonder why we cannot redesign and improve our services without importing private businesses. Surely there is enough talent in this country?
The PCT quango claims that it will oversee the management of these health centres with the utmost care, but it seems to have changed the tendering rules to favour private contractors.
It cannot be trusted to expand this process to the out-of-hours service, which we depend on in the middle of the night and early morning when we cannot face a painful wait for ordinary surgery hours.
Camidoc has been providing a dependable service for 10 years.
Why is the PCT planning to change this?
I hope more and more people will join the mounting protest against these changes. They do not have to happen.
Sheila Patton
Spencer Rise, NW5
One day left
• READERS have until tomorrow (Friday) to reply to Camden Primary Care Trust’s consultation about the out-of-hours service.
This follows on from the recent very unpopular decision to award the contract for three GP surgeries to UnitedHealth.
The words in the PCT’s covering letter for the consultation on GPs services from March 2007 are not very clear. This is a quote from that letter: “We expect substantial interest, not only from GPs within existing practices… but also from other health organisations.
These might include alternative providers of medical services (APMS) from the independent sector, voluntary sector, not for profit organisations or other NHS organisations.”
This doesn’t shout out to me that the PCT are planning on allowing a huge private company to provide GP services!
Those of us who went along to the health scrutiny committee meeting last week were shocked by the PCT’s attitude – they seemed to view anyone who disagreed with them as an irritation, and not to be taken seriously.
They don’t want a public debate – about whether health contracts should be put out to tender, about what lies in store for our health service, about how health services can best be delivered.
This is to their discredit.
For many, the PCT’s attitude shows why it is so wrong to have an unelected quango running our health system.
The decisions taken by the PCT, especially about the out of hours service, affect over 200,000 people in Camden.
I am an optimist, but the last few weeks have made me wonder sometimes whether shareholders in large companies may have more of a chance to be heard than the individual men and women who pay for health services through their taxes, and who use, work in and rely on the health service every day.
We will carry on the campaign for an accountable local health board, delivering the services local people want, by the providers they want.
Respond to the consultation at: www.camdenpct.nhs.uk
Jo Shaw
Liberal Democrat Parliamentary Spokesperson
Holborn and St Pancras
Lessons to be learned
• READERS may be interested to know exactly why the health scrutiny committee concluded that consultation about the provision of GP services was inadequate:
a) nowhere in Camden PCT’s consultation document of March 2007 was there any mention of the alternative providers of medical services (APMS), or explanation of how they would differ from traditional GP practices; b) nowhere in the consultation document were Camden residents or patients asked for their views about APMS; c) nowhere were they asked whether they would prefer their primary care services to be provided by the private sector, voluntary sector, or an NHS body; d) the only reference to “alternative providers” was in one sentence towards the end of the covering letter that accompanied the consultation document; again there was no explanation of how these “alternative providers” would differ from traditional GP practices.
The committee believes that what has happened in Camden raises serious questions not only for Camden PCT, but also for PCTs across the country, about the way PCTs consult on potentially significant changes in the provision of NHS services. That is why we have decided to refer the issue to the health secretary. We hope that the secretary of state and PCT are ready and willing to learn the lessons from the public outcry that has accompanied the introduction of the new GP surgery contracts.
CLLR David Abrahams
Chair, Camden Health Scrutiny Committee
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