As the government plans to outsource unprecedented amounts of the NHS the practice seems to be in crisis, with society's most vulnerable the inevitable victims.
As the government plans to outsource unprecedented amounts of the NHS, the practice seems to be in crisis, with society’s most vulnerable the inevitable victims. The simple truth is that we have still not got outsourcing right, leaving glaring issues over public interest, regulation and accountability.
In each case the problems are different and unique but the overall picture is undeniably worrying and damaging to a government that has set out a stall for transferring public services to “willing providers” in the private sector as almost a panacea to all financial and logistical problems.
Left Foot Forward have reported on the massive problems facing our social care system. Public funding has seen minimal increases while private companies have taken over the sector almost by stealth, with some very mixed results.
Castlebeck, the company that ran the Winterbourne View care home, where Panorama took video footage appearing to show residents being abused by workers, is one of many private care providers that with charities, dominate the learning disability sector.
Those who have a case to answer were not made cruel or sadistic by the fact they worked for a private company. Nor is it fair to say this type of scandal could never, or has never happened in public services.
As David Brindle writes in The Guardian:
“Forty years ago, the standard model of care for learning-disabled people and those with severe mental illness was a long-stay NHS hospital, where patients were locked away and often forgotten and where abuse like that filmed by Panorama was widespread.”
However we can say that the safeguards to protect these people appear to have failed dramatically with a whistleblower previously ignored and inspections failing to spot the problems. To put this bluntly in the private sector you can be abused just as easily, if not more so, but you or your local care commissioner might be forced to pay some £3,500 a week for the privilege.
Yet safeguards in private care cannot just be limited to individual safety. As Brindle writes:
“Another consequence of the quiet revolution in social care is that no provision was made, or much thought apparently given, to market failure. With Southern Cross teetering on the brink, local authorities have been left to work out their own emergency plans for safeguarding the company’s residents – both the majority who are state-funded and others who pay their own fees – in the event of the company’s collapse or any home closures…
“The forthcoming reform of social care funding and law, to which the government is pledged, presents an opportunity to overhaul the sector’s legislative framework and commissioning arrangements to bring them up to speed with a world where the private sector delivers the care. For there can be no going back on that.”
The government have already been taught a lesson on monitoring the private profit of public services in higher education. The Office of Fair Access, the body originally supposed to ensure fair pricing for tuition fees, turned round to the government and quietly informed them they did not have the power to force universities to charge certain fees. Resulting in so many universities charging the full £9000 when it was intended to be the exception.
The out-sourcing of the ownership of the nation’s forests was quickly shown up for the violation of public principles and interests that it truly was.
In health the huge opposition to the “any willing provider” concept does not need to be re-stated. But it is worth repeating the public opposition to further competition within the NHS, and privatisation.
Dr Laurence Buckman, chairman of the BMA’s GPs Committee, called the idea of GP bonuses “wholly unethical”. The Kings Fund have also stated that “the changes proposed in the embattled health and social care bill will not improve local accountability”.
Finally in local government, Barnet held themselves up as a an “easyCouncil”, a flagship borough in the fight for outsourcing.
Barnet blogger Vicki Morris, who writes at vickim57, has uncovered with a team of other bloggers, a scandal behind a lack of due diligence that Barnet council have taken to their outsourcing. She writes:
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“Barnet council’s audit committee meets on 16 June to consider a report into the council’s dealings with MetPro Rapid and MetPro Emergency Response, in the light of exposes by bloggers that showed:
• MetPro Rapid Response was going into liquidation;
• the company had illegally filmed residents at a council meeting;
• the company’s employees did not have all the required authorisation to carry out the tasks they were performing;
• the council has no record of any contract ever being signed with MetPro Rapid Response.
“We are calling for a full inquiry into the council’s relationship with the MetPro companies; we also believe that the failures in this relationship call into question the council’s capacity to deal with mass outsourcing, which is what it currently plans for council services under the One Barnet Programme – an approach now discredited in Suffolk Council which has abandoned its similar New Strategic Direction.”