On the 11th of November Virgin Care was finally confirmed as the successful bidder to run over 200 community healthcare services in Bath and NE Somerset. This was decided by unanimous vote by the local Clinical Commissioning Group and a majority vote (35 to 22) by the Conservative-led local authority.
As a Green Party member I am opposed to privatisation of our NHS and running NHS or other publicly-funded health services for profit. Indeed, this is very much the view of the population of Bath, which is why I was elected as a local hospital governor in 2012 on a platform of opposing such changes. However, regardless of whether one agrees with the private sector running our health services or not, this whole deal has been a farce.
There has been an apparent neutering of democracy in several stages of the bidding process. One of our Green Party councillors in Bath, Lin Patterson, sits on the council’s Health and Wellbeing Select Committee. She was asked to remove herself from discussions about the Virgin Care bid as a result of signing a petition against the services going to a private provider, and the council being concerned that this might be a basis for Virgin to sue.
Of course, there is no legal basis at all for Virgin to do so, so either the Conservatives running the council considered it as a convenient way to remove a dissenting voice, or they genuinely do fear Virgin Care, in which case they should possibly not be handing them vital healthcare services. In either case, constituents who voted for our councillor at least partly on the basis of her views on private health providers had their voices ignored.
Democracy was also badly served in the closing stages of the bidding process. Members of the public were not allowed to ask questions at the meeting of the CCG where it was decided to give Virgin the contract. Later at the council meeting, two motions requesting for the decision to be delayed until details of the bid could be scrutinised by the council’s Select Committee were rejected with no decent explanation.
While Virgin Care have won many services around the country, the deal in Bath would be the first time any adult social care services have been run for profit. Not to allow the Select Committee to examine the detail of the proposed deal seems foolhardy, at best. The 76 page business case recommending Virgin Care to the public was published less than a week before the decision was made - hardly a lot of time for careful examination.
The council and CCG put much weight on the fact that Virgin Care promised to ‘reinvest any profit’ back into local services. One must question how anyone who believes that this promise means anything is in a position to decide how to spend £700m of our money. Virgin Care, like many if not all companies that win NHS work, doesn’t make profits.
In 2015 Virgin Care made a loss of £9.1m, much as it has for each of the last five years. There are many instances of multinational companies using elaborate structures of holding companies and loans to ensure that no taxes are paid on profits. Indeed, the ultimate owner of Virgin Care is based in a tax haven.
Profits are being made, and to assume that they aren’t and that Virgin Care wish to lose money for seven years as some sort of public service shows those awarding this work to them are either dangerously naive or manifestly underestimating the intelligence of the public. Or, more likely, they simply don’t care that the promises are worthless.
The largest opposition group on BaNES council is the Liberal Democrats. Recently they have been vocal in opposing the Virgin Care bid, but this position must presumably be on a technicality in the bidding process rather than an objection in principle. After all, the Liberal Democrats voted for the Health and Social Care Act while part of the coalition government, despite it being in no manifesto and against the wishes of both the public and the medical profession. Many of us warned at the time that it would lead to the fragmentation and forced privatisation of the NHS, and for them to object to this now doesn’t seem very convincing.
One must take both a long term forward view and a consideration of the past to separate convenient political opposition from genuine concern over the future of our NHS. When I ran for Parliament in Bath last year I was the only candidate warning of the dangers of allowing profit-making companies access to vital services. The profit motive leads to procurement processes like this where those assessing bids seem blinded by slick marketing and meaningless promises. Once these services are in the hands of people who profit from them it will be very difficult to get them back. It is immensely frustrating when the very events some of us predicted back in 2010, when we were dismissed as alarmist, are now coming to pass.