It’s always been a point of pride and principle for me that I’ve never taken a penny for any of my writing or activism. It’s a matter of personal passion and conviction that has led me to devote virtually every spare moment to researching and writing, contacting experts and MPs, travelling to meetings etc.
It’s cost me money, but I have never even taken expenses – I believe we need to put our time and money where our mouth is to defend what’s important. But I believe it’s now necessary to depart from my usual rule in one very specific area, and I’m hoping you’ll help.
If you’ve visited my ‘SKWAWKBOX‘ blog, you’ll know that the NHS is under sustained, concerted attack by the Tory-led government, which is using every means possible to erode, dismantle, wither and sell off the UK’s greatest social achievement. The attack is based on ideology and greed – and a complete lack of concern for the wellbeing of ordinary men, women and children.
In April, one of the most major and far-reaching changes kicks in as the new Clinical Commissioning Groups (CCGs) become responsible for commissioning all health services in their local area. Through its ‘Section 75’ secondary legislation, the government is trying to force CCGs to include private healthcare providers in every bid for services.
But even if this move is defeated, CCGs will be under significant pressure to include private bidders in tenders for health services – and to award contracts to those private, profit-taking companies. Private health providers have already attempted to gain influence over CCGs by creating joint ventures with GPs that will participate in CCGs, and the government has a clear preference for ‘marketising’ the NHS.
Monitor (the regulatory body that oversees NHS services) will impose a ‘lowest-cost’ interpretation of the Health Act’s ‘best value’ provision, even though a true NHS provider – which doesn’t take profit out of the NHS funds and will keep health facilities in public ownership – will inevitably represent true best value. Once gone, true NHS bodies will be lost permanently and replaced by private bodies subject to profit targets and the vagaries of market forces.
The scale of the problem
With over 200 CCGs taking over the commissioning of services from April, it will be incredibly hard for the public and health workers to know what’s happening with regard to their services in time to do anything about it effectively – and extremely difficult for activists to have a clear picture of what’s going on, let alone to co-ordinate action.
But there is still hope. A couple of weeks ago I discussed with Shadow Health Secretary, Andy Burnham:
The NHS Constitution
The NHS Constitution gives statutory rights to patients and public, and places specific, statutory duties on NHS bodies. The rights include:
- to be involved in discussions and decisions about your healthcare, and to be given information to enable you to do this. (NB: not just treatment, but wider healthcare)
- to be involved, directly or through representatives, in the planning of healthcare services, the development and consideration of proposals for changes in the way those services are provided, and in decisions to be made affecting the operation of those services
In addition there are (non-statutory) commitments that form part of the constitution. These include a commitment
to provide you with the information you need to influence and scrutinise the planning and delivery of NHS services (pledge); and to work in partnership with you, your family, carers and representatives
to engage staff in decisions that affect them and the services they provide, individually, through representative organisations and through local partnership working arrangements.
The document also places expectations on anyone working within the NHS:
- to play their part in sustainably improving services by working in partnership with patients, the public and communities
- to view the services they provide from the standpoint of a patient, and involve patients, their families and carers in the services you provide
Based on these rights, duties, commitments and expectations, I believe that it will be possible for the right person or group to:
- engage with local communities and unions to be named as a ‘representative’ to allow a legally-underpinned interaction with CCGs
- require of CCGs to provide timely information on any plans to change how services are provided, especially details of planned tenders or approaches to the Any Qualified Provider (AQP) marketplace
- work with local communities and unions to demand representation on the CCG and involvement in both discussions and decisions about awards of contracts to provide NHS services
- demand that ‘best value‘ is applied in its widest sense of long-term sustainability, public ownership, community impact (through lost wages and restricted services due to private companies taking a profit margin etc) and the retention of public NHS personnel and infrastructure that, if lost to a private provider, will be very hard ever to reacquire or rebuild
- provide a central, easily-accessible source of information for individuals and community action groups to know what their CCGs are doing or planning and a partnership to help co-ordinate the above actions
- challenge awards to non-public entities
If these rights and duties can be effectively harnessed, they will provide the means to prevent, or at least seriously impede, the government’s back-door sell-off of the NHS to private health interests that will seriously harm the interests and wellbeing of ordinary people until we can oust our odious excuse for a government in 2015.
With a view to this, I am launching CCGWatch. If I can get it off the ground, CCGWatch will:
- build contacts with local unions and activists to engage them in the process
- contact every CCG to remind them of their statutory duties and to require them to provide information on their activities and tenders
- publish details of tenders, bidders and decisions
- co-ordinate resistance to the transfer of services to private providers based on the information obtained as a legal right
Can you help?
It will take a lot of time and resource to start and maintain such a service – to do it properly will be a full-time project and might also mean employing others once things are fully up and running. There will also be significant costs involved in travel to meet local community groups, unions and CCGs, in communication and possibly in legal expenses if CCGs or private providers contest the involvement of local people.
To meet this challenge, I’ve decided to try to crowdfund the project, so that I can devote myself to it full-time for the next couple of years leading up to the 2015 general election. If successful, this will provide a powerful statement to politicians and clinical commissioners of the public’s commitment to the NHS – and it will fund what may be the best chance of minimising the impact of the government’s attrition of genuine, public health-service provision between now and the next general election.
To this end, I’ve set up a crowd-funding page. If you’re a believer in a national NHS that is truly publicly-owned and that will continue to deliver health-care ‘free to all at the point of need’ as it was founded to do – and if you think that the idea I’ve outlined is a worthwhile effort to help preserve it – please click the link and donate what you can. Any amount, great or small, will be a massive help.
If I’m unable to gather sufficient funds to make the project work, I will donate every penny collected to health- and disability-related charities, and will give the idea to any non-profit entity that can make it happen.
If I am able to collect enough to run the project, I will take professional advice on how to set up the finances for best efficiency and transparency, and will set up a section of this blog for full reports on funding received and how it is spent. I believe transparency and integrity are essential to combat the deceptions and misleadings this government employs to achieve its ends, and I want supporters (and opponents, for that matter) to be able to see how every single penny is raised and spent.
Thank you for your help if you choose to offer it, and for reading this far even if you don’t.