“Under David Cameron we’re seeing a rampant commercialisation of the NHS”
Jamie Reed MP, Labour’s Shadow Health Minister, 21 August 2012
The background
The all-singing, all-dancing NHS tribute at the Olympics opening ceremony baffled some of us. But could it have been one big advert signalling the “rampant commercialisation” of our healthcare services across the globe? Perhaps, given the news today that the government is inviting NHS hospitals to set up profit-making branches abroad.
But FactCheck isn’t convinced Danny Boyle would stake his reputation on that of the NHS – and more importantly we are plagued by a sense of déjà-vu. Labour unveiled a similar idea in March 2010, with then-Health Secretary Andy Burnham trumpeting “NHS Global”.
So what’s the difference between today’s “Healthcare UK” plan and yesteryear’s NHS Global? FactCheck dons its white coat.
The analysis
Just before the 2010 election, then-Health Secretary Andy Burnham said: “The NHS could generate additional funding from other countries and organisations using its knowledge and products”. Outlining NHS Global, Burnham said the health service was “now looking to explore new international opportunities to export its knowledge, skills and services”.
The move was in part prompted by the success of organisations such as BBC Worldwide, he said, which markets programmes abroad and invests money back into the BBC. Under Labour some NHS organisations were already sharing their expertise, Burnham pointed out, such as the NHS Institute and Moorfields Eye Hospital.
Today, Burnham’s camp told us that the consultation on NHS Global ended in the summer of 2010 – by which time the new government was in place and George Osborne was warming up to announce his raft of spending cuts. So what happened to the idea that was expected to earn £50bn for the NHS? It’s rather hazy, but Pulse magazine claimed last December that it had “failed to secure a single contract”.
Both sides of the fence confirmed this to FactCheck, explaining that due to the change of government it never really got off the ground.
However, UK Trade and Industry (UKTI) – the government body in charge of promoting UK exports – confirmed to us it did help set up NHS Global and promote it overseas. So “Brand NHS” was already being sold abroad.
A source close to Andrew Lansley told FactCheck: “Labour had a good idea…We just took it forward”. He told us that during the Olympics, Health Minister Andrew Lansley was busy giving visiting foreign health ministers tours of our health services, in Cambridge for example. And on August 2, Lansley announced the autumn launch of Healthcare UK – which will help British health services expand overseas under a new stand alone scheme manned by former Department of Health and UKTI workers.
Labour maintains that the key difference resides in the fact that Burnham only planned to farm out NHS expertise and services – such as NICE (National Institute for Health and Clinical Excellence) – not create foreign arms of UK hospitals. However, Burnham did say back in 2010 that such things already existed.
Our government source pointed out that they are also focusing on services such as those offered by NICE – and it’s only leading clinics such as Great Ormond Street that are likely to consider setting up arms abroad. The idea that the average NHS Trust would pursue an overseas expansion was, he said, “laughable”.
This angle is one that has been bouncing around today – that expanding abroad could harm local services. Especially in the current climate, said Labour, pointing to the government’s move to raise the private patient cap to allow foundation hospitals to raise 49 per cent of funds. The implication being, that if Brand NHS gains popularity abroad, and the cap is raised on the number of private patients allowed, then more foreigners will arrive to snatch our hospital beds.
“There’s a real danger of hospitals taking their eye off the ball, as they are forced to take these contracts in the face of budget cuts”, a Labour adviser told us.
Though it’s worth pointing out that the NHS still has a duty to treat UK patients within 18 weeks of being referred. Plus, Labour’s manifesto also signalled the removal of the cap. It said: “Foundation Trusts will be given the freedom to expand their provision into primary and community care, and to increase their private services – where these are consistent with NHS values, and provided they generate surpluses that are invested directly into the NHS.”
The verdict
Lansley’s plan to farm out Brand NHS under a new body called Healthcare UK is largely a reheated version of Burnham’s NHS Global.
Under the latter, NHS expertise was already being sold overseas by the UK Trade and Industry. The only problem is it didn’t manage to make any money – a failure that was largely down to the change in government, as well as the confusion of being run by both the Department of Health and the UKTI.
Labour admitted to us today that it was “not opposed to the idea in principle”. However it said Burnham’s ideas were limited to exporting the skills and expertise of the NHS, rather than physically building hospitals abroad – which coupled with the hike in the private patient cap it said could endanger the number of beds available for home patients.
Yet there have been no instances of bog standard NHS hospitals coming forward to announce plans to open up abroad. It’s only specialist clinics – such as the much-mentioned Moorfields in Dubai – which really stand to gain from their good reputation abroad. And Moorfields’ Dubai arm was already up and running under Labour.
Lansley is pushing for greater global exposure. But as for “rampant commercialisation”, how much it will impact the waiting times at your local hospital remains to be seen.
By Emma Thelwell