Is the NHS closed to private sector? Up to a point…

Interesting story from the excellent Sam Coates in today’s Times about Health Secretary Andy Burnham falling out with Blairites like John Hutton over apparently planning to freeze the private and voluntary sector out of providing NHS services. Opponents of the move say the Government has “bowed to pressure from the unions”. I suspect the unions would have a good laugh at the suggestion, but that is neither here nor there.

I’m not sure how much of Burnham’s plan is new. He already said in a speech to the King’s Fund in September that the NHS was the “preferred provider” of health services and that outside providers should only take over where an NHS trust was failing badly. He then confirmed this in a letter to Brendan Barber and with NHS chief exec David Nicholson.

Moreover, there’s one big caveat to this policy – and one which is exercising the big unions at the moment.  As David Nicholson said in a subsequent letter, Burnham’s policy doesn’t change the ability of NHS trusts to exercise their “right to request” powers to become a social enterprise, run at arms’ length from NHS management.

Social enterprises as the Department of Health understands them can be for profit. And when the contract to run them runs out, after three years, they can be bought by a private company. I did a story about one such trust last month.

Unions like Unite complain that this move to a social enterprise contradicts government policy that the NHS should be the preferred provider. They seem to be overlooking, or ignoring, Nicholson’s letter. There is a government-approved way of privatising NHS trusts – and it’s not going anywhere.


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