Expand the ‘domestic market’
The use of the ‘NHS brand’ to sell healthcare abroad has greatly benefited commercial organisations, with over 80% of contracts landing in private hands. This disproportion towards private healthcare contracts is also taking place on a much larger scale in the NHS. Since the Health and Social Care Act officially began in April 2012, research carried out by the NHS Support Foundation revealed 70% of NHS contracts have ended up with private firms amounting to billions of pounds worth of income.
What this amounts to is an aggressive expansion of the UK healthcare market, which although not mentioned in government propaganda, is their intent. Healthcare UK was also meant to benefit the NHS, but contained in the memorandum signed between Healthcare UK and the Chinese Ministry of Health, it is clear that the main areas of cooperation are designed towards channeling contract opportunities towards private companies. See Appendix 1
The financial awards from China are potentially immense with David Cameron claiming the Chinese healthcare market will grow by $400 billion by 2017. China is seeking to develop a “safe, effective, convenient and affordable” healthcare system to both urban and rural areas by 2020; furthermore, Premier Li Keqiang recently stated he wants to “open the door for private capital”. It is no wonder Cameron wants the UK private sector to be a part of that process.
The use of the ‘NHS brand’ to sell healthcare abroad has greatly benefited commercial organisations, with over 80% of contracts landing in private hands. This disproportion towards private healthcare contracts is also taking place on a much larger scale in the NHS. Since the Health and Social Care Act officially began in April 2012, research carried out by the NHS Support Foundation revealed 70% of NHS contracts have ended up with private firms amounting to billions of pounds worth of income.
What this amounts to is an aggressive expansion of the UK healthcare market, which although not mentioned in government propaganda, is their intent. Healthcare UK was also meant to benefit the NHS, but contained in the memorandum signed between Healthcare UK and the Chinese Ministry of Health, it is clear that the main areas of cooperation are designed towards channeling contract opportunities towards private companies. See Appendix 1
The financial awards from China are potentially immense with David Cameron claiming the Chinese healthcare market will grow by $400 billion by 2017. China is seeking to develop a “safe, effective, convenient and affordable” healthcare system to both urban and rural areas by 2020; furthermore, Premier Li Keqiang recently stated he wants to “open the door for private capital”. It is no wonder Cameron wants the UK private sector to be a part of that process.
Access to Policy
When
asked about the nature of the ‘confidential’ and policy information provided to
CITIC, Ian Cranshaw the Chinese lead for Healthcare UK said, “The confidential information referred to would likely be commercial
in confidence type information”. However, he failed to address the policy information
that would be imparted. Will
CITIC be in advance notice of policy so that it can better select its
investments? Will CITIC receive policy before parliament or the people?
The
secretive nature of Healthcare UK beyond the marketing publications that adorn
its website, means such questions remain unanswered.
Selling debt
The
opportunities for private companies don’t end there. A further MOU made between
Healthcare UK and the health Bureau of the Eastern coastal province of Zhejiang
contains a much wider level of agreement.
These
include the design of ‘Health policy and regulation’, ‘Training Medical Staff’,
establishing primary care provision, and ‘Systems for national and private
insurance’. In addition Healthcare UK will find UK companies to aid China in ‘public
and private hospital finance, construction, operation and regulation (PFI)’.
The
policy of PFI in the UK has been catastrophic for the NHS with the treasury
predicting a total financial burden of £242 billion. PFI continues to plague
NHS Hospital Trusts to the point of near bankruptcy, which led to the first
takeover of the running of an NHS hospital in Cambridgeshire by Healthcare UK
beneficiaries Circle.
Elite
private companies largely run PFI, and it is the cruelest of irony that more
PFI opportunities should be made by using the ‘NHS brand’. Companies like
construction firm Interserve, who have Conservative Peer Lord Blackwell as a
director, have raked in millions of pounds through selling
some of their PFI interests. Serco and Carillion, who both have representatives
on the board of Healthcare UK, have also gained major revenue through PFI schemes,
and this particular avenue in China, will do nothing for the NHS.
In
order to gain “business wins” in the Zhejiang province, Healthcare UK provides
pilot programmes from which they aim to gain contracts for those involved. Yet
here again, Mr Cranshaw explained “the pilots involve private UK companies rather than NHS
institutions”, and as the pilot schemes are ongoing, what these pilot schemes
are and who is involved face commercial restrictions.
The government
has claimed the three agreements with China will provide £120 million to the UK
economy, though how they have reached that sum is currently unclear and a
request for a breakdown of these figures has been made. Of course any deals
that are confirmed will not necessarily have the names of the companies
attached and so we will be unclear whether those gaining contracts are based in
low tax jurisdictions; have donated to any political party or indeed held
meetings with government officials.
The
push to be involved in the global healthcare market is well under way. Private
companies dominate the list of firms put forward by Healthcare UK to
operate in China and the contracts won.
The NHS is staring into the barrel of the Health and Social Care Act legislative gun, weighed down by debt and deliberate underfunding. The idea that an overstretched NHS can compete financially or even manage to operate an international trade arm is highly questionable. Healthcare UK appears as yet another government vehicle designed for the market over that of the NHS that has very little intention to benefit patients.
When the government announced the Chinese deal, the NHS was not mentioned in their press release and based on the contracts won and the money gained so far, the NHS will be but a minor beneficiary of the global expansion that markets in their name.
The NHS is staring into the barrel of the Health and Social Care Act legislative gun, weighed down by debt and deliberate underfunding. The idea that an overstretched NHS can compete financially or even manage to operate an international trade arm is highly questionable. Healthcare UK appears as yet another government vehicle designed for the market over that of the NHS that has very little intention to benefit patients.
When the government announced the Chinese deal, the NHS was not mentioned in their press release and based on the contracts won and the money gained so far, the NHS will be but a minor beneficiary of the global expansion that markets in their name.
Appendix 1
The
five areas of cooperation listed in the agreement with Zhejiang MOU are:
Digital healthcare – Multiple commercial companies
providing telehealth, telecare technology
Healthcare training and education – this could be NHS but
majority of organisations mentioned in the Healthcare UK publication ‘China and the UK: partners
in healthcare' are private
Hospitals: Planning, design, built management
equipment – KPMG (business consultants), Arup (design, contractors)
Care for the elderly - Circle
Primary healthcare including implementing
a GP system -
Circle