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The NHS gets into a Branson pickle

Coalface tales

James Booth

Tuesday, 05 December 2017

stethoscope_AdobeStock_78075013.jpgI have a small puzzle at work. A few months ago, a couple of Virgin Care mugs appeared in the coffee room. No-one seemed to know where they had come from, but they seemed sturdy enough and went into the general circulation (although some of us refused to use them on principle). Then one of them broke in the dishwasher, and the other looks pretty faded already.

I’m probably labouring the metaphor too much, but there can be few of us in the NHS who aren’t aware that since 2010, the Virgin empire has been pushing into health care services. There’s a typically glossy puff piece on their website about how proud their founder is to be moving in this direction. In fact, over the last seven years, they have successfully tendered for over 400 contracts worth around £2 billion. Just a short drive from where I type this, a large GP surgery is run by Virgin Care. Our local Child and Family Wellbeing Service is also now a Virgin service. Amidst the many companies now looking for a piece of the NHS pie, they are a big concern, and one with clout. It’s reported that our Health Secretary is willing to work behind the scenes to facilitate them.

If you click back to that Virgin Care website, this stands out:

We only provide NHS and social care services where we believe we can make a difference. We make services better than they were before for the staff and the people using our services. In turn we provide better value to the NHS and the public.

Can’t argue with that, surely? There’s some steel under the warm fluffiness, though. It’s emerged in the last week that Virgin have taken legal action over their failure to secure an £82 million contract for children’s services in Surrey. According to the HSJ, one CCG has paid £328,000 as their part of the settlement, although it should be noted that this detail has since been removed from their public papers and everyone concerned maintains that the settlement is confidential. Virgin maintain that there were serious flaws in a procurement process that led to a partnership between the local hospital, NHS Surrey and Borders Partnership Foundation Trust, and two local social enterprises, taking the contract on. It’s going to be difficult for the public to judge that use of public funds, though, given that the processes will now remain between the agencies involved. It’s certainly clear, though, that Virgin will have received a significant sum from the NHS as a result of baring their legal teeth. That’s the same Virgin Care that turns over no profit in the UK, so pays no UK tax, and is registered in the British Virgin Islands. I’m wondering what other services may have missed out on that money which NHS Surrey Downs CCG have instead had to pay to settle. Perhaps more alarming is the precedent that this might set; there are plenty of other big businesses looking to get an ever bigger slice of the £8.7 billion outsourcing pie, and they may well have been taking notes over this.

A short blog like this can’t go over all of the arguments for and against privatisation in the NHS. I instinctively recoil from it, but I freely admit that I’m a bit of a lefty. I do wonder whether the endgame is simply a large conglomeration of different private concerns all using the NHS logo as branding, though. That may be a bit extreme, but it’s pretty clear that the NHS is going to be dealing with big business more and more over the coming years. In doing so, we need to become equipped to handle the challenges that will bring. A world in which unsuccessful tenders get followed by lawyers locking and loading, and which sees our member-organisations working with ruthless multinationals is going to need people with the skill set – and the salaries – that will command respect from them. I’m not sure the NHS does that well enough, yet, I’m not sure if it can or should. What is for certain, is that much like my getting on my hands and knees to pick broken china out of the dishwasher, the consequences can cut you.

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James Booth

James qualified from UCL in 2002 and has been a GP partner in Chelmsford since 2006. He is also the named GP for Safeguarding Children locally. All views expressed are his own.
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