I am assuming I have documented everything correctly, but if I have missed something then by all means comment.
There are some worrying events happening out there at present. Mutuals are being made out to be the same as Co-Ops. And, quite frankly, they're not. This is a business thing.
A Co-Op is firm owned by all of it's workers ( minimum 75% of the firm is owned by the workers ). Profits are shared, the workers decide their fate, it's all very ground up & democratic. The Workers & managers between them own a majority of the vote, and everyone has an equal say. It's all very fair. There are usually more workers than managers, so Co-Ops are very much worker led.
Mutuals are not done this way. Mutuals are part owned by workers, managers, and sometimes shareholders as well. The problem with mutuals is usually that the workers, although more in number, only own a small share of the firm. Say 20% of it. This means they only have 20% of the vote. So if management and/or shareholders stand united ( they own 80% of the firm using the above example ) those workers can be ignored. Which means, in plain English, workers in a mutual have next to no say in how the firm is run. It's all rigged so that management retain control at all times. It is not a worker led environment like a Co-Op.
Co-Ops are sold to people on the idea that workers have a stake, so will work harder to help you. Mutuals are now being sold on the same argument, even though in reality those workers are pretty much powerless to effect change. It's rather deceptive. If the managers in a Mutual are only interested in profits & shareholders then they won't be very interested in the service. And the workers won't be able to stop them as they ( the managers ) pay themselves huge bonuses whilst running down the service. You have to be very careful with mutuals.
One of these mutuals is Circle Health. Part owned by workers, so working for you apparently. Apart from the bit where they aren't controlled by the workers at all ( the workers only own 49% of it ), and have Shareholders to pay off ( the 51% that controls the firm ). This one is all about the bankers.
Remember, a Shareholder is a loan you can never pay off. It's one of the most expensive forms of Investment you can get. Bank Loans are faaaar cheaper. And if a Bank has refused to lend you the money for your new investment/ project, thus forcing you to float on the Stock Exchange & get some Shareholders in, well, are you sure your new project was a good idea?
Our Care Homes were Privatised a good few years ago. And in came the Shareholders. Our Care Homes are now buried in debt, having to pay off Shareholders as well, and also pay shockingly low wages. Those low wages now mean that what was once a profession like Nursing ( caring for OAP's in a skilled & professional way, which involves dedicating your life to skill & study ) is now a profession like cleaning ( go in, do the job, go home, leave when better wages are offered elsewhere ). In Croydon they are run by Care UK now, and wages for Caring staff dropped by 40% pretty much overnight due to this. Erm… It should be pretty obvious how bad this is for the end user, when they have a glorified cleaner looking after them instead of a proper qualified experienced Nursing type. And that's our Care Homes. This is what they are now due to this Privatisation. Run down & ramshackle. Given to the Private Sector, stripped of most things of value, and what is left now is a burned out shell.
This is the future our NHS now faces due to the decisions made by The Torys & Lib-Dems. They claim Labour started the process, but we did not. We certainly experimented with out-sourcing when in power ( Croydon IAPT for example ), and learned a lot from what did & didn't work ( Croydon IAPT going to The Priory was a failure after all ). But we oppose what the Torys & Lib-Dems have done with this new NHS act, as we know what does and doesn't work ( due to our experiments when in govt ). And mass-out-sourcing just doesn't work. It never has done. There hasn't been a successful Privatisation yet. Selling off a whole dept to a Private provider is not a very good idea.
BT was sold off. You now have an ancient phone line that can't run proper Broadband services like ADSL 2+ unless you are lucky enough to be next door to the exchange. The copper network is underinvested in to pay for Shareholders, whilst prices are kept low.
Universities are now being sold off. Tuition Fees have trebled due to this. Can you afford University now?
Gas & Electricity were sold off as well. Shareholders make a fortune, bumper profits are declared, and we pay more and more for the same old gas & electricity to fund this Banker bonanza. It's the same for the Trains you'll find.
British Aerospace used to make a profit for the Taxpayer that paid for, amongst other things, our NHS. It was sold, still makes a profit, but those profits now pay for holidays for Shareholders instead.
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The Torys & Lib-Dems ignored our experiment results and are pushing onwards with even more of this failed out-sourcing/ Privatisation ideology.
The new NHS system the Torys & Lib-Dems have brought in is designed around 2 things. 'Choose& Book', where you choose who does your medical treatment from a list of providers in your area, and Any Qualified Provider ( AQP ). Any Qualified Provider is the clincher, as this is the list of providers deemed good enough to do the work in your area you then choose from. Some of them are Private Firms, and some are the old Public Sector you know and use.
As I explained in my previous article if too many opt to use Private firms under AQP then the old Public Sector places ( like Mayday ) will start to go out of business. They won't get enough patients coming in, will still have bills to pay, and will start to spiral downwards financially towards bankruptcy if they can't attract enough Private work. And, most likely, they will then be taken over by Private Providers.
There are 3-4 Private Hospitals in Croydon, and only one Public one ( Mayday ). If those 3-4 Private ones pick up a few punters each from Mayday the hit Mayday takes is 3-4 times as big as the hit people leaving Shirley Oaks ( for example ) would take. Mayday is at a significant disadvantage in this new market the Torys & Lib-Dems have created,
So, in the end, if too many people use the Private firms listed under AQP there will be no Public firms left. And you'll end up with a Care Home situation where wages start to drop ( along with staffing levels in some cases ) and debts pile up to feed the Shareholders. And ultimately quality of care will go out the window as the firms will be able to declare that 'the market has changed', and that they can't provide a good level of care on the old NHS rates.
Recently Care Homes have started demanding more money from The Council to do the same work they have always done. Arguments about how the market has changed and they have to charge more now, as I said above. In plain English this money paid at present was good enough when the Homes were in Public 'not for profit' hands, so what has changed? Well, the Care Homes now have massive debts and Shareholders to support, where as Public Sector & 'not-for-profit' firms don't ( and never have done ). And that is all very expensive to carry. It's an extra bill you take on when you employ these firms. They are financially now in a bad way due to this extra bill. Due to what the market did to them. Exposing a vital service to the market has never worked, and always damages the end-user ( our ) experience. It only helps Bankers& Shareholders. The same ones that fund The Tory party.
It was the decisions of these Private managers that left us in this state with our Care Homes. They chose to get the Shareholders in, and chose to borrow excessively as well. They also chose to pay bumper bonuses to themselves, whist paying the staff seriously low wages and wrecking what was a profession akin to nursing ( low wages mean the quality staff leave ).
Do you honestly want this kind of manager getting hold of your hip replacement or bunion removal as well? Do you want a low paid person ( most likely a trainee if wages are low ) removing your cataracts? Are you happy with all the skilled nurses leaving due to rock-bottom wages or low staffing levels ( working them so hard they burn out ) ultimately creeping in? This is something you need to decide on. There are various ways to make a profit in healthcare, and usually it's by using either cheaper ( less skilled ) staff, or not enough staff. Both of which will harm the end user ( us ).
If you want your NHS Privatised use 'choose & book' to choose Private providers. If you want your NHS to stay Public and/or 'not for profit' then choose your old providers like Mayday and the like. If you're not sure on what is Public Sector& what is Private simply ask your GP.
This is genuinely your choice. And in a free market some people will try to bamboozle you to get your money ( like how dodgy builders can cause a lot of trouble ). If you choose a bad firm then you may not get a great experience in the long-term. Seek advice on this one. It really is this important.
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This is my fear. I expect a large chunk of people to say 'Wooo! Choice!' and wander off into Private clinics under AQP not realising or caring that they are undermining the old Public Providers. They may have read about Mid Staffs & decided that all NHS Hospitals are dangerous for example, as the Govt hasn't been very truthful on this one really.
Those old Public Providers are what force the
market to pay decent wages as well. So
when those Public Providers are gone there will be no proper competition on wages
anymore. The market will simply
stagnate, like what happened with the utility bills. You'll then have to pay more or lose quality,
as there will be no Public Sector left to use to remove the Private Providers
that are now demanding more cash. Once
the Public Sector is gone that's it, it's gone for good. You'll have to rebuild it from scratch. Which is seriously expensive.
Or stay with the naff Private providers that are now demanding more cash to feed the Shareholders.
So, much as Mayday is far from perfect, it's vital that it survive. Or our long-term healthcare will actually get worse if Mayday goes the way of the Dodo. The 'profit motive' ( making a profit to feed the Shareholders & Bankers ) is what wrecked our Care Homes after all. A failed Tory policy they are now trying to repeat with your NHS.
Be careful what you choose. Your vote really does count now.
Christian Wilcox is the Chair of the Croydon Mental Health Forum ( politically neutral ), an NHS Executive ( Advisory ) for the South London & Maudsley ( politically neutral ), and works for the Labour Party privately.
