SOME NHS PRIVATIZATION

A giant American firm is poised to take over the responsibility for spending more than 4 billion pounds a year of NHS money in the biggest privatisation yet seen in the health service, The Times has learnt. Novation, the Texas-based group, is in the final stages of negotiating a far-reaching contract that will make it and its German partner, DHL, responsible for buying everything from bandages to hip implants for the health service. The move will mark a massive step towards opening up the NHS to outside companies and is certain to inflame simmering tensions within the Labour Party over what is perceived as creeping privatisation.

Unison, the largest public sector union, announced plans yesterday to ballot members on strike action over the move, and accused Tony Blair of accelerating his market-driven NHS reforms. Such action could coincide with the party conferences and put the battle for the soul of the Labour Party centre stage as Mr Blair comes under pressure to set a timetable for his departure. Many in the party want to draw a line on private sector involvement in the NHS but Mr Blair says that the test of keeping the health service public is whether services are free to the user.

Karen Jennings, head of health at Unison, said: "The Government's decision to privatise is driven by pure dogma and an obsession with market-testing."

The Times has learnt that DHL/Novation is expected to take over from the NHS Logistics Authority and much of the NHS Purchasing and Supply Agency, which are responsible for 4.2 billion pounds a year of purchasing and distribution, or about 5p out of every NHS pound. The disclosure comes less than a month after The Times revealed that the world's largest private health companies were being asked to submit tenders for control of primary care trusts, which spend 80 per cent of the NHS's budget. The advertisement was withdrawn soon afterwards for "redrafting".

Novation has promised big savings by making tougher, more efficient buying arrangements, alarming unions and the medical devices industry. John Wilkinson, director-general of the Association of British Healthcare Industries, has written to Andy Burnham, the Health Minister, to raise a concerns including fears over "the concentration of such buying power in a single entity". DHL/Novation would make savings by concentrating on a few large suppliers, squeezing out smaller ones that could not compete on price, he said. That, he added, would have a profound impact on whether patients received new and innovative treatments - which often come from smaller companies - and would undermine the strategy of the Treasury and the Department for Trade and Industry to encourage such companies. "We support the need for better procurement in the NHS, but nobody in their right mind would hand over this much power to one organisation when savings, not quality, is the target.

"These small, innovative companies are forging the latest medical breakthroughs for patients, yet the Government's NHS policy is going to send many of them into bankruptcy. Thousands of jobs are at stake and patients will miss out on the latest care. "We would welcome a system of several purchasing organisations to provide contestability, not this proposed monopoly."

DHL/Novation will be paid on the basis of the money it saves the NHS, with no similar incentive for quality. The contract is expected to cover a huge range of equipment, from bandages and syringes to pacemakers and hip prostheses. The Department of Health has refused requests to disclose the full list, on the ground that it is a confidential part of the negotiations. It was no secret that NHS Logistics, responsible for distributing products to hospitals, was due to be privatised, and that DHL/Novation was the preferred bidder. But it appears that the privatisation will go much wider than thought, to include much of the NHS Purchasing and Supply Agency as well. NHS Logistics employs 1,400 staff in five distribution centres, making an average of 1,200 deliveries a day to 10,000 destinations. Unison represents about 1,000 of its staff.

Source







Californian health care "Summit"

Schwarzenegger listens to proposals

Gov. Arnold Schwarzenegger hasn't come up with a concrete plan to help Californians contend with spiraling health care costs. He says he'll unveil one next year if he's re-elected. To date, his position on health care largely has been defined by his opposition to ideas that impose new costs on businesses and government. But to demonstrate that the issue is important to him, Schwarzenegger on Monday sat for four hours in a room with about 200 experts on health care and health costs, including union heads, CEOs of big businesses, directors of health-insurance companies and consumer advocates.

The event -- pointedly called a summit on health care affordability, rather than coverage -- underscored the largest division between two sides in the debate: those who believe the solution is to expand the number of people, especially the working poor, who have health insurance and those who believe the answer is to cut costs by making health care more efficient and requiring consumers to pay more up front to discourage them from using health services if they don't really need them.

Though he hasn't explicitly outlined his position, the Republican governor suggested Monday that he falls more into the second category. At the end of the four-hour session, he said he was particularly struck by the market-based solutions, such as technological innovation and "patient responsibility" that some of the speakers advocated. "We all have the same goal, which is to make health care affordable, accessible and make it more efficient," he said.

Schwarzenegger has also made it clear that he opposes a Democratic measure in the Legislature, Senate Bill 840, that would insure all Californians through a "single-payer" system operated by the state, calling it a "tax increase."

The governor said he called Monday's meeting as a first step toward formulating a plan for solving the health care crisis in a state where insurance premiums are up 55 percent in the past five years and 20 percent of residents -- nearly 7 million people -- are uninsured.

His political opponents called it an election-year ploy. Schwarzenegger's Democratic challenger in the general election, state Treasurer Phil Angelides, followed the governor to UCLA to hold a health care summit of his own. And about two dozen members of the California Nurses Association picketed Schwarzenegger's event, saying his policies were unfriendly to consumers. "What he's talking about when he talks about universal health care is all the health care an individual can afford," said CNA President Rose Ann DeMoro, whose organization has not yet endorsed a candidate in the gubernatorial race. "There's no drug company or insurer that this governor doesn't love."

To date, the governor has blocked health care solutions that would require both private industry and government to pick up the costs. He vetoed a Democratic bill that would have expanded public health insurance programs so all children in the state would be insured. He supported the repeal of Senate Bill 2, a state law requiring all large businesses to provide coverage to their workers.

Until last week, when he changed his stance, he opposed using the state's purchasing power to financially punish drug companies that did not discount their products for the uninsured. Acting on a request from hospitals concerned about the financial impact, the governor tried to overturn a requirement that hospitals have one nurse on duty for every five patients. The nurses stymied that effort in court.

Schwarzenegger's event included participants from all ends of the political spectrum, including Safeway CEO Steve Burd and Andy Stern, national president of the Service Employees International Union. But Democratic Mayors Gavin Newsom of San Francisco and Antonio Villaraigosa of Los Angeles, who were invited, did not attend. Nonetheless, the governor said the solution must be bipartisan.

One of the featured speakers was Timothy Murphy, the head of the Office of Health and Human Services in Massachusetts, where Democrats and Republicans just enacted a universal health insurance program for all residents that expands government coverage for the poor, requires citizens to pay for coverage if they can afford it and works to bring down the price of health insurance for individual buyers who can't get it through their jobs. The key to getting it done was blending many approaches, Murphy said. "You need to be able to compromise and trade," he said.

Source

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For greatest efficiency, lowest cost and maximum choice, ALL hospitals and health insurance schemes should be privately owned and run -- with government-paid vouchers for the very poor and minimal regulation. Both Australia and Sweden have large private sector health systems with government reimbursement for privately-provided services so can a purely private system with some level of government reimbursement or insurance for the poor be so hard to do?

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