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Outsourcing 3: Capita’s performance for the NHS and local government


Capita, the FTSE 100 outsourcer, which manages the congestion charge for Transport for London and administers military bases across the UK for the Ministry of Defence, has just been awarded a £1bn NHS contract. Other reported triumphs:

  • A contract helping new doctor-led clinical commissioning groups to buy billions of pounds of services for hospitals and GPs.
  • An £80m, 10-year contract providing IT, finance and estate management services to the Central London Community Healthcare NHS Trust, which employs 3,000 staff providing services in west London.

The NHS seeks to use the private sector in its pursuit of savings – really?

The FT’s Gill Plimmer and Sarah Neville, who report that Capita has largely avoided the scandals that have tarnished rival outsourcing groups G4S and Serco, are directed to the work of Professor David Bailey on the company’s record, ‘assisting’ in the local government of Birmingham. One of many analyses is his Service Birmingham’s £63,000-a-day Dividend Bombshell. For others, search on David Bailey, Capita.

Despite its recent London and Liverpool setbacks . . . another reward for failure?

The seven-to-10 year contract will see Capita provide GPs, opticians, pharmacists and dentists with a range of back office services, including payments administration and the management of clinical records.

Five Liverpool NHS Trusts withdrew from a contract with Capita because of concerns about the quality of the service provided. In September 2014, a few months later, West London Mental Health NHS Trust cancelled their contract after the company proved “unable to meet acceptable ‘time to hire’ targets”, particularly for nurses. At the same time Alder Hey Children’s NHS Foundation Trust and Liverpool Heart and Chest Hospital NHS Foundation Trust terminated their contracts. And in November Mersey Care Trust revealed that “information governance issues” had been uncovered when the services were taken back in house.

A change of tune

After their recent lobbying – see Health corporates rampant – private sector providers are now said to be ‘quietly confident’ that more opportunities will emerge. They believe that many healthcare trusts, faced with a £30bn shortfall in the NHS budget over the next seven years, will have little option than to work with the private sector, which pledges to invest in technology, improve staff productivity and use economies of scale to deliver services at lower costs.

And caring health professionals say?

nhap_candidates 2small-660x330

Dr Clive Peedell, a cancer specialist who is co-leader of the National Health Action Party, established before the general election in May with a full manifesto commitment to improving the nation’s public health care, said:

“This is exactly what we predicted would happen. The ludicrous NHS structure created by this government has meant a whole new layer of administration is needed to support it, increasing costs and diverting money away from patient care. Now a giant outsourcing company is cashing in on providing a service the NHS should not even need, that has been cultivated by this government.”

Applause for the concept of a small parties’ coalition: SNP, Plaid Cymru, and Greens – could NHAP work with this?

Underlining the need for the NHS, Colchester Hospital has declared a “major incident” following an inspection by the Care Quality Commission (CQC) which found staff struggling to cope with “unprecedented demand” and raised “safeguarding concerns” 

On BBC1’s Question Time this week, Plaid Cymru leader, Leanne Wood, put forward this scenario; looking at the latest National Health Action campaigns, the NHAP seems to be a worthy candidate to work with the other parties.

nhap header (2)

Co-leader Dr Clive Peedell has contacted the newly appointed NHS advisor, Sir Stuart Rose, and the current and future NHS Chief Executives, Sir David Nicholson and Simon Stevens. His open letter, published in the Health Service Journal, ends:

  • “There will never be effective NHS clinical leadership and followership, and successful NHS reform until the failed market based policies of the last 25 years are abandoned and the medical and nursing professions are brought back into the policy making process”.

He finished with a quote from Arnold Relman, Emeritus Professor of Medicine at Harvard University and former editor of the New England Journal Medicine, which sums up the situation: “Medical professionalism cannot survive in the current commercialised healthcare market. The continued privatisation of healthcare and the continued prevalence and intrusion of market forces in the practice of medicine will not only bankrupt the healthcare system, but also will inevitably undermine the ethical foundations of medical practice and dissolve the moral precepts that have historically defined the medical profession.”

  • Leading members of NHAP are calling for the ATOS assessments to be scrapped – and a new system be introduced that ensures doctors are properly consulted.

Cambridgeshire representative, John Hully condemns the possible merger of world-famous Papworth Hospital with a failing hospital 30 miles away.

  • He says it’s disgraceful that the distinguished & profitable Papworth heart and lung transplant hospital may be forced by the Treasury into a partnership with Peterborough City Hospital, 30 miles away, in order to balance the books of failing Peterborough City Hospital which is saddled with PFI debts, adding:

“Such a move defies all advice and the needs of patients, and is based purely on short-term financial considerations. This situation underlines the need for decisive government action to lift the burden of the unaffordable PFI scheme from Peterborough and Stamford NHS Trust to allow it to concentrate on delivering care to local patients . . .“

  • London GP and Euro-candidate Dr Louise Irvine has launched a strong attack on the planned closures of A&E departments in North West London.

The soundness of the estimates in plans to close four A&Es in north west London, outlined in “Shaping a Healthier Future” are inconsistent with research figures from the Department of Health. They underestimate how many people will have to go to A&Es in other hospitals by tens of thousands a year and Dr Irvine fears that this can only lead to chaos in other hospitals in the capital. She also examines the DoH claim that they are not closing the A&E at Charing Cross Hospital but making it into a “local A&E”:

“That “local A&E” will be run by GPs and not by Emergency Department doctors, it will not accept patients who are arriving by ​blue-light ​ambulance and it will not be able to admit ​seriously ill patients”.

Would the SNP, Plaid Cymru, and Greens agree?

The ‘ancien regime’ besieged by ‘populist insurgents’: FT & Spectator

“The pillar of past stability – predictable government built on turn and turnabout between the Tories and Labour – is crumbling”, according to the FT’s Philip Stephens:

“The two parties used to command more than 90% of the national vote – in the early 1950s it was 98%. The duopoly was underwritten by the winner-takes-all electoral system. But the Tory and Labour tribes have shrunk. In 2010 their share fell to 65%. It could be less in 2015. The Tory-Liberal Democrat coalition turned two-party into three-party politics. Four or five parties could be in the game after 2015”.

Labour and Conservative in combat mode: “the threat insurgent parties pose to mainstream politics” . . .

Isabel Hardman in the Spectator says, “the Greens are creeping up on the left-ish parties, just as UKIP crept up on the Tories. Everyone is more aware of the threat insurgent parties pose to mainstream politics”.

isabel hardman brighton

The membership of smaller political parties is rising. Though most concern is expressed about UKIP there has been a less well-publicised focus on the Green Party. Ms Hardman reports that, in September, the Labour Party set up a Green attack unit in its headquarters, led by Sadiq Khan, including party staffers and Khan’s advisers. It intends to create a toolkit of local campaign materials for constituencies to use and advise on a national media strategy to combat the Greens.

brighton public buildings solarA few days later the Spectator mounted an emotive attack on the record of the Green Council in Brighton. 

Specific charges related to its recycling regime, (described below) and its support for wind turbines, omitting reference to its solar achievements.

chris williams latestGreen Cllr Chris Williams of Solihull Council’s main opposition party, responds to the recycling disatisfaction charge:

The last Council put in an order to use Italian-made communal street bins which don’t work and no other council in the country uses, and the Greens have been stuck with the contract”.

He sends a link which records some achievements of Brighton’s Green Council, saving energy and money. They include:

  • bringing down the number of buildings used by the council, cutting council running costs and reducing the council’s carbon footprint;
  • installing solar panels on council buildings to cut energy bills (planning to do this in other public buildings and sheltered housing);
  • installing automatic meters to monitor and reduce water waste;
  • launching a seafront anti-litter campaign to encourage tourists and visitors to the city to dispose of their rubbish responsibly or take it home;
  • introducing a requirement that dogs living in council-owned homes be micro-chipped, encouraging more tenants to behave responsibly as their pets are easier to trace;
  • introducing an ethical procurement strategy to improve minimum standards for the products the council buys, being awarded WWF Gold standard for timber purchasing;
  • introducing refuse collections on bank holidays outside the Christmas period;
  • expanding community composting sites across the city; in ten of the city’s 26 schemes, residents can turn their food waste into free compost. More than 500 people are now using the community compost service;
  • increasing recycling options for small electrical items and unused paint and exploring the possibility of a commercial waste and recycling collection service;
  • supporting community food growing in public parks such as Dyke Road Park and Wish Park & working with the local allotment federation on a new allotment strategy to publicise their role in promoting health, well-being, social contact, wildlife, biodiversity, as well as growing fresh nutritious, affordable local food;
  • successfully securing outside funding to transform the central Level Park – a large, decaying urban green space – with new gardens – with more diverse and sustainable planting – a new playground, new public toilets, a cycle café, better lighting and furniture, a new skate park, and more green space.

In yesterday’s FT article, Philip Stephens noted: “The stable political order of Thatcher’s boast has lost a vital centripetal force just as the populists harness the anger of those left behind by globalisation”.

He is missing the point. Those angered by the injustice and environmental damage caused by globalisation are rejecting those mainstream politicians who not only permitted but aided and abetted it, furthering the interests of large corporations over those of the people who had elected them to serve – not exploit.


The writer is not a member of the Green Party, but welcomes the rise of smaller ethically based parties, including the National Health Action Party and – in Cornwall – regionalist Mebyon Kernow.

Will free healthcare be a thing of the past within a matter of years?

Clive Savage sent an article which expresses this belief.The account in the Chichester Observer reports that Dr Lucy Reynolds (London School of Hygiene and Tropical Medicine) spoke to an audience at St Paul’s Church recently, warning them that only the very poor or sick will be immune from paying for doctor appointments and surgery, with the ‘whole system about to fall apart’.

dr lucy reynolds

She said that some Clinical Commissioning Groups were going ‘hell for leather’ handing out NHS contracts to private companies and ‘totally encouraged by the government: “In the future, the NHS will still be tax-funded, partially, but we will also be expected to pay, either by insurance premiums or paying doctor’s bills directly. If we allow private companies to come in and take that money away then there will be less and less available to treat sick people. The system is about to fall apart and the government want someone to take the blame for it so GPs are taking the brunt of it.”

The meeting also heard from Margaret Guest, chairman of Don’t Cut Us Out, who said the same level of privatisation had been occurring in adult social care to the detriment of the disabled and elderly.

A month ago, following the award of a £235m Musculoskeletal (MSK) contract to BUPA, the Observer launched a major campaign called A&E SOS to protect vital hospital services in Chichester. It has the backing of Chichester MP Andrew Tyrie and a number of campaign groups, NHS staff and patients.

hmg epetition logoIts epetition calls for a written guarantee that Accident & Emergency and orthopaedic services services at St Richard’s Hospital will not be adversely affected by a controversial NHS contract being awarded to BUPA CSH Ltd. 

The new National Health Action Party shares Dr Reynolds’ fears.


Plutocratic Britain: health service ‘floor staff’ are denied a 1% rise but well-paid MPs are offered 9%

Reward for costly failure

A senior Cabinet minister is reported to have told The Times: “We’ve made three mistakes that I regret, the first being restructuring the NHS. The rest are minor.”

pirate fm logoRehana Azam, GMB National Officer, adds – in an interesting account on Cornwall’s Pirate FM – that this was a very expensive mistake, estimating that £3 billion was wasted on NHS reorganisation while £13.5 billion of NHS services have been offered to the private sector and over £1 billion returned from the NHS to the Treasury.

1% rise: alleged to cost only £500m

broken britain 3 mps bankersGovernment has accepted the IPSA recommendation of a 9% pay rise next year for MPs (an extra £7000 p/a) but decided to ignore the independent Pay Review Body recommendation of a 1% pay rise for 2014/15 for 60% of NHS staff and 70% of nurses. The Guardian reports that increasing salaries by this amount would add only £500m to the pay bill.

Stuart Roden from Unison told Pirate FM: “Morale was pretty low anyway. People are under a lot of pressure. The hospital has been virtually full for weeks on end . . .Our action is aimed at the government to try to persuade them. They honoured their own pay review body for MPs’ salaries yet they’re stopping it for low paid NHS workers.”

These events reinforce the foreboding expressed by Oliver Huitson in 2011, as political decisions continue to hit the lower income groups who cannot afford private healthcare:

“The political class have busied themselves selling off the national inheritance, leaving nothing to future generations but debt. The NHS is now being privatised without a public mandate, in the face of warnings from across the medical profession and independent bodies and in clear breach of an electoral pledge. Both the Tory party and Lansley himself have received substantial payments from the firms who will profit from the break-up of our health service. “We may not quite be an “elective dictatorship”, but this does have the feel of a nation sinking into an elective plutocracy”

Will even more people now take up membership of the ‘patients not profits’ National Health Action Party?


Government’s ‘clear agenda to increasingly privatise and commercialise the NHS’ condemned

A new party, co-founded by two doctors – former MP Richard Taylor and oncologist Dr Clive Peedell – with virtually no public awareness, no media coverage, and no money, resources or local party infrastructure, gained quite a good result in the recent elections.

Dr Clive Peedell (left) and Dr Richard Taylor

Dr Clive Peedell (left) and Dr Richard Taylor

The National Health Action Party (NHAP) – set up to defend the NHS and its values – polled 23,253 votes, coming 9th out of 17 parties in a very crowded field in London’s Euro election. Local election candidates around the country on average polled 20% more than the Lib Dems, 50% more than the Greens and took almost 20% of the Labour vote, gaining an average of 6% of the total vote.


NHAP condemns this government’sclear agenda to increasingly privatise and commercialise the NHS’.

Promoting this agenda, they write, the BBC and the Daily Telegraph revealed their allegiance today with ‘sickening’ headlines about the sad death of a baby from a contaminated drip.

telegraph headlines baby drips

Though the food was manufactured and supplied by ITH Pharma Limited, a private pharmaceutical company, the Telegraph used this distressing story as an excuse to attack the NHS, with its headline: “15 babies poisoned by NHS drips”. This afternoon the BBC website declared: “Three new baby NHS poisoning cases”.

After a storm of protest on twitter, both organisations changed their headlines. NHAP co-leader, Dr Clive Peedell, is making formal complaints to both the Press Complaints Commission and the BBC.

Two months ago, it was also revealed that the private healthcare firm Bupa was bribing their patients to use NHS services in order to maximise the company’s profit. Yet this scandal received only limited attention in our partisan media.

NHAP is thinking seriously about the most effective way to make more people aware they exist and to build on this positive start in the recent elections. They hope to ensure that the tens of thousands of Londoners who have publicly declared they are seriously concerned about running down and selling off the NHS grows to hundreds of thousands and then millions around the country.

Defang insidious and undemocratic paid persuaders

Once again our attention is directed towards the lobbying industry – this time by the National Health Action Party.

cameron lobbying

The recent intervention from the Reform “think tank” was a useful reminder of the tactics used by corporate lobbyists to manipulate the public, media and politicians.

Reform is described as one of the new breed of parliamentary/corporate hybrid lobbygroups, backed by the chief executives of major corporations, with ready access to the corridors of power.

Until all these insidious and undemocratic ‘paid persuaders’ are defanged, they will continue to skew the decisions of government in favour of their corporate paymasters.

spinwatch logoNHAP summarises an excellent article by Tamasin Cave and Andy Rowell of Spinwatch – well worth reading in full – who open: “Typically, they operate behind closed doors, through quiet negotiation with politicians. And the influence they enjoy is constructed very consciously, using a whole array of tactics”.

NHAP lists the key steps (in brief) required to control the agenda taken from the Guardian article by Tamasin Cave and Andy Rowell

Control the ground – Lobbyists succeed by owning the terms of debate, steering conversations away from those they can’t win and on to those they can.

Spin the media – Even if the corporate goal is pure, self-interested profit-making, it will be dressed up to appear synonymous with the wider, national interest.

Engineer a following – Some lobbying firms specialise in mobilising voices from business and academia to give the impression that there is broad support for their message.

Buy in credibility – Corporations are one of the least credible sources of information for the public so they fund seemingly independent people to carry their message for them.

Sponsor a thinktank – Worried that your message will be seen as special pleading? Get a thinktank to say it but make sure they don’t mention their sources of funding.

Consult your critics – Businesses have to be able to predict risk and gain intelligence on potential problems. The army call it reconnaissance; lobbyists call it consultation.

Neutralise the opposition – Find the influential opponents and neutralise their impact by whatever means it takes.

Control the web Flood the web with positive information by creating phoney blogs and press releases and push dissenting content down the search engine rankings.

Get access – Lobbyists need access to politicians. One easy technique is to hire politicians’ friends, in the form of ex-employees or colleagues.

The revolving door The number of people moving through the revolving door between the public and private sector is off the scale and with it comes influence.


Learn more in their latest book: A Quiet Word: Lobbying, Crony Capitalism and Broken Politics in Britain, published by The Bodley Head.

Political alternatives 1: NHA Euro-election candidate, chair of the successful ‘Save Lewisham A&E’ campaign

News from GP Online, a website dedicated to supporting doctors in general practice in all aspects of their working lives, providing daily news, clinical and management resources, focused CPD and educational materials. Summary: 

dr louise irvineLewisham GP Dr Louise Irvine – a leading campaigner for a group that defied health secretary Jeremy Hunt over plans to downgrade Lewisham hospital – will be running in the European elections, as a candidate for the National Health Action (NHA) Party, ‘formed by a group of like-minded healthcare professionals’ to challenge the government over NHS reforms.

Dr Irvine, chair of the successful ‘Save Lewisham A&E’ campaign, said that the NHS was under threat from a forthcoming US-EU trade deal. She hopes Londoners will vote for her to send a ‘powerful message’ to politicians in Westminster and Brussels to stop the demolition of the NHS.

Dr Irvine said: ‘I am standing because I care passionately about defending the NHS. I’ve been a London GP for 20 years and I have seen the damage done by this government’s policies of top-down reorganisation.

‘I want to alert the public to the gravity of the threat to the NHS from this government with its programme of cuts, hospital closures and privatisation and to send a powerful message to politicians in Westminster and Brussels that people will not stand by and let their NHS be destroyed.’


Time to out the open lie, that the NHS is not being privatised. We as GPs know it, the media know it, but like the emperor’s new clothes the true facts are still unclear to the general public . . . and personally I hope she wins and brings the truth out.

Time to stop the forced tendering of NHS services so the private sector can cherry pick contracts – cutting services in the name of finding efficiency, while just increasing profits for their companies.