Comment & Opinion
by Cornwall Green Party
Transformation or creeping NHS privatisation?
Just how accountable are Cornwall Council’s ‘Accountable Care Partnerships’?
As part of its Sustainability and Transformation Plan, the so-called Transformation Board, chaired by Cornwall Council’s Chief Executive Kate Kennally, is developing so-called ‘Accountable Care Partnerships’. These are a variation on what are more often known as Accountable Care Systems (ACS) or Accountable Care Organisations (ACOs).
Cornwall’s proposed ‘Partnership’ has the stated ambition of becoming a fully fledged ‘Organisation’ whilst operating the ‘system’. A ‘shadow ACP’ will be in place by spring 2018.
An idea imported from the United States, these organisations are supposed to run health and social care services in particular areas, but do this outside the aegis of the NHS. This makes them very different from the current Clinical Commissioning Groups (CCGs), which are clinically-led, statutory NHS bodies.
In contrast with CCGs, Accountable Care Organisations are set up on a commercial basis and their partners may include private companies such as Virgin and Circle.
Despite their name, these organisations’ accountability for spending NHS and taxpayers’ money would be under commercial contracts, not government statutes. And this could amount to very large sums indeed, either for whole packages of care provided by the organisations themselves or for care subcontracted by them to other – possibly private – providers
Cornwall has been earmarked as one of several areas in which these organisations are being trialed, but Cornwall Greens say there has been scant public consultation and that the public has not been made aware of the possible role of private companies in such partnerships.
Claire Hewlett, Green Party Spokesperson for North Cornwall, said:
“’Accountable’, ‘Care’ and ‘Partnership’ are all words with warm, positive associations. But they cloak what appears to be a major change to health provision, and one that would put important decisions affecting our wellbeing into the hands of private companies motivated by profit rather than the public good. We believe that this has not been made clear, and that Cornish people have not been properly consulted.
“As Greens, we believe strongly in devolution of decision-making to local level. But that shouldn’t be used as a way of smuggling in privatisation by the back door – and that’s what we think is happening here. At the very least, the Council needs to explain itself to the people of Cornwall.”
Concerns over this development in Cornwall and elsewhere have prompted a group of medical professionals and senior NHS staff to take legal action against Health Secretary Jeremy Hunt and the Department of Health. Some Cornish health campaign groups are considering joining the legal action.
Green Party MP Caroline Lucas tried last year to introduce an NHS Reinstatement Bill that would guard against such backdoor privatisation. The bill was co-authored by Professor Allyson Pollock, a member of the British Medical Association Council. Professor Pollock said recently:
“Our NHS has been an international model for countries around the world for a health system that represents fairness, efficiency and freedom from the fear of illness. It has provided health care for all free at the point of delivery through public funding, public ownership and public accountability. Its popularity has endured since 1948 and is a symbol of all that is decent about Britain. However, it is being starved of funds and progressively dismantled and replaced with corporate structures which will facilitate the introduction of American-style healthcare systems. These latest proposals are the tipping point in steps towards the Americanisation of England’s health care.”
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