Health NHS exposed

Solomon Hughes

1st April, 2004

In 1993 Tory MP David Willetts wrote a pamphlet called The Opportunities for Private Funding in the NHS, which proposed using Private Finance Initiatives (PFIs) and other commercial mechanisms to provide health services in the UK. Conservative ministers thought Willetts’s proposals too radical. They were consigned to the shelf until 1997, when the New Labour Government put them into action.

In Tony Blair’s first term the government gave British corporations like Balfour Beatty, Amec and ISS Mediclean control of hospital buildings, but kept medical staff like nurses and doctors on the public payroll. Now the government is paying private companies from Canada, South Africa, the US and the UK to run fast-track surgery facilities called ‘Diagnostic and Treatment Centres’. The government is also hiring US firms like Kaiser Permanente (KP) and UnitedHealthcare for management advice. United, which is advising nine primary care trusts, has been fined over $7m by US regulators since 2000. Most of these fines were incurred for overcharging the US authorities for hospital charges. The ‘not-for-profit’ KP has a turnover of $13 billion.

Another organisation with experience of working with KP is the California Nurses Association (CNA), whose members have had several bruising industrial disputes with the firm. The CNA says: ‘Meaningful distinctions between private non-profits like KP and for-profit healthcare corporations have all but disappeared.’ But KP’s not-for-profit status means the firm pays less tax than conventionally defined corporations. KP chief executive...

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