According to the information rolled out at Ward Co-ordination Meetings (the invitation only local “consultation” meetings held by Council Officers and local “stakeholders”), the new “GP-led Health Centre” being talked about by Manchester Primary Care Trust (PCT) as “an extra practice” that will “not affect any of the 3 existing practices in historic Levenshulme”. However, it’s not quite as simple as that. In fact, these three new clinics will not only affect local services, but they could end up affecting the NHS as a whole if we don’t oppose them.








The document above (click on it to link to the full online document) shows that the new practice will be set up as an Alternative Provider Medical Services (APMS) contract. What this means is that the PCT are seeking to tender the contract for running the centre outside of the NHS. See the Department of Health’s own explanation of what an APMS is (again, click on it to see the page in context):









As made clear above, these contracts can go to anyone (click here to see the list of those excluded from bidding under the Directions above), including companies not known for their Healthcare credentials. In fact, sensing untapped profit, companies from every part of the private sector are circling our NHS. Back in February, the Virgin Group laid out their plans to bid for GP Surgeries, sparking protests by NHS workers and Trade Unionists outside the Virgin Healthcare conference in Salford.





After what Virgin have done to our rail network, does anyone really want them let loose on the NHS?

Elsewhere in the North West, contracts have gone to CARE UK, (reference here) a “leading independent provider of person-centred care”.

As with most of these “Solutions” companies, none of CARE UK’s board of directors (meet the guys here) has any direct experience in Healthcare, although they do have considerable experience in hovering up our tax money through local and national government contracts.

For example, one of CARE UK's directors is a former main board director of Compass Group PLC, who already have their fingers in the NHS till, providing “innovative patient feeding programmes” in NHS hospitals. (have a look) He remains a consultant to Compass.

Another, Miles Roberts, is a former group director of the Costain Group, a massive building company who, according to their own website have “been involved in PFI since its' inception and completed one of the very first PFI projects - the 800 place category B prison in Bridgend, Wales”. They were also part of the consortium which built the PFI Kingston Hospital, (reported here) and profited from our tax money by doing so. Costain Group also manages the construction projects for the Greater Manchester Waste PFI contract (report here).

And speaking of Waste Solutions, another CARE UK director, Michael Averill, is currently Group Chief Executive of Shanks Group plc. Shanks is the waste management group that bid for a 4 billion PFI contract to deliver Manchester’s Waste Disposal Solutions back in late 2005 (report here).

When these companies look at our NHS, or our transport network or our Post Offices, they don't see vital services that people need. They see only wasted opportunities to make profit for themselves.




We approached local GPs for their opinion on the plans, and they agreed to write a short letter stating their concerns. Here’s what doctors at Levenshulme Health Centre had to say:




Similar concerns are replicated across the two other GP practices in Levenshulme, West Point Medical Centre and Ashcroft Surgery. From Longsight and Burnage too, doctors have contacted us and confirmed their complete opposition to these plans. In fact, it’s not even just local GPs who oppose these plans. Nationally, the British Medical Association have launched a campaign against these clinics, and recently delivered a petition to Gordon Brown signed by 1.2 million doctors and patients calling for these reforms to be scrapped. In Herefordshire and Buckinghamshire, PCTs have withdrawn their plans for polyclinics, since patients appeared not to want them, and due to doubts over "cost-effectiveness" (click here). Most recently (November 2008, see here), in a spectacular climb-down, Camden PCT have pulled out of their plans for a privately-run polyclinic under massive pressure from doctors and campaigners. This Camden Polyclinic was to be the first fully-functional polyclinic in the country, this was the flagship, whistles and bells government photo op. Now it's scrapped. This proves that whilst everyone knows PCTs are acting under instruction from central government, they CAN resist these plans if we force them to. After all, there's only one department of heath, but millions of patients!

Dr Chand, a GP from Ashton under Lyne, and the regional spokesperson for the BMA, has been a vocal critic. He points out that these large clinics, which could hold upto 25 GPs, could end up closing down our existing health centres, so that far from “improving choice”, they actually mean that local people could end up with only one choice: a private clinic. He Chand writes that these new clinics are in fact




But the problems associated with privatisation are only half the story. Even without the private element, problems are anticipated:




So we are potentially looking at a situation similar to the railways. Where rival practices cannot efficiently share information, where the idea of “choice” is constantly undermined by virtual monopolies. (Ever tried getting some "consumer choice" on the Manchester to London line?) The concept of the “family doctor” is replaced by a “call-centre” approach, where you speak to whoever is available when you turn up, where we are treated as customers rather than patients. This is the primary vision of Lord Darzi’s reforms (of which the “GP-Led Health Centre” is one of the key proposals). As the Guardian puts it:


Likewise, further problems have been anticipated in Private Eye (issue 1213, 27th June-10th July 2008):






Local people haven’t been properly consulted about this. The first thing we heard was rumours of the closure of Ashcroft Surgery and talk of a petition. The rumours of closure turned out to be wrong.

Then we began to get the local newspaper calling up for our opinion on the new GP surgery. Which was the first we heard of it. There was no mention of how the new surgery would be funded, of what building it would be in or any details that may concern patients at all.

Finally, after hours of digging around in online minutes (and actually having to go through the Freedom of Information Act at one stage!), we managed to find some details.

It’s not just patients that have been left out of the loop on this one. GPs have been no better informed than us. They and their representatives are still going through the process of trying to convert the rumours into facts and then asking for confirmation from the PCT.

We contacted the PCT to ask some questions:

In terms of the consultation, we were told:


We didn’t see the survey which was designed to be “forwarded on to key community contacts”, until we contacted the PCT and asked for it. Was a single stall at Cringle Fields Park designed to consult with over 12000 people that live just in Levy ward, let alone across Chapel Street in the Gorton South half?

The PCT, based on our intervention, agreed to extend the first stage consultation date from the 26th June to the 11th July.

Here are the surveys they asked us to publicise:

http://tinyurl.com/56bdr6

and

http://www.surveymonkey.com/s.aspx?sm=FrXCIFRvEcfPSCli_2fa0ASA_3d_3d


However, those who are opposed to or concerned about these plans would be better off writing or emailling directly to the PCT:

Nick Gomm, Manchester PCT,
6th Floor,
Mauldeth House,
Mauldeth Rd West,
Manchester,
M21 7RL

email: nick.gomm@manchester.nhs.uk



On the other questions, the PCT said:


So, we don’t know who’ll be running it (although given the sums of money needed, it’s likely to be a private business) and we don’t know where it’ll be. At the moment, the PCT have told us over the phone that they can’t find a building to use, and that in a situation where no building is available the government have told them to use temporary accommodation on a bit of suitable land!

So there’s a possibility that instead of giving additional funding to our local health centres, they’ll instead be spending twice as much per patient trying to undercut NHS services by running private clinics out of Portacabins! Maybe Portacabin should bid for the contract!




No-one is saying that Levenshulme residents wouldn't welcome more health services. Round here, we need all the services we can get. But we shouldn't have to put up with the privatisation of our facilities in order to get the services we deserve.

Levenshulme’s existing Health Centres could provide any number of different health services for local people, including extra GPs. Indeed, we had Family Planning services at Levenshulme Health Centre and a Mental Health Nurse at West Point Health Centre. Both of these additonal services were cut by the PCT, with family planning being moved to MRI, away from the people who need the service most. The same PCT now sends us a "wish-list" of services to be delivered at the new clinic which includes those very things! These absurdities are all part of the supposed "market efficiencies" that the government, using the PCTs as their tool, are forcing on GPs and patients.

The answer is extremely simple: The PCT should provide our existing GP surgeries with the funding through the normal NHS channels. That is something we could all welcome without reservation. Invest in our existing facilities and they can provide extra services. But instead of providing NHS funding for our existing facilities, the PCT are set to pay twice as much per head per patient for this private clinic. Much of this investment will go straight into the pockets of private companies as profit. It's a waste of our money and an attack on the NHS.


If you've not managed to sign the paper petition, then sign our online petition calling for the PCT to provide the doctors we need through the NHS, and calling for the PCT to stop private companies cashing in on our NHS General Practice:

http://www.ipetitions.com/petition/PolyclinicLevenshulme/



click HERE to read a report of what happened at our debate over these plans to privatise GP services.
& click HERE to read the press coverage of our public debate.