Blood, a race to the bottom and unhappy Lib Dems

By Lisa Nandy MP / @lisanandy

PMQs was dominated by the disquiet among Liberal Democrats, largely as a result of what the BMA has termed ‘the creeping privatisation of the NHS’. A key concern which is causing considerable political strife is the ability of private companies to ‘cherry-pick’ profitable services and leave the more difficult, research intensive and complex cases to the NHS. Already, private companies are demanding the right to compete for very specific and easy to deliver services from the PCT.

We have already seen this in legal aid reforms under the last Labour government, and it should serve as a lesson. One size fits all ‘Tesco-style’ contracts do not work for the most complex cases. I saw this at The Children’s Society with legal aid for asylum cases, particularly for children who need time to tell their story and may not even know or comprehend what has happened to them. It means scrupulous lawyers spend considerable time researching the case and interviewing the client at considerable financial loss, allowing unscrupulous lawyers to flourish, and ultimately makes it virtually impossible for a child with a complex case to get access to justice.

Lives can be ruined by the inability to get decent legal representation but they can be lost without a well functioning health service. The difference is that while those who cannot get legal representation can be left on the scrapheap, those who need particular medical treatments will become the responsibility of the state, and the costs could be astronomical.

Just as in legal aid, putting services out to tender with a view to minimising cost provokes a race to the bottom. We have seen this with hospital cleaning contracts put out to tender in the 1980s where contracts were cheap, but hospitals were dirty. It is no exaggeration to say that people died as a result.

On Wednesday Jim Dobbin MP called a debate on the future of the national blood service which the government is currently reviewing, and is in talks with private providers about. It was well attended, good tempered and a number of my colleagues raised similar concerns specifically in relation to the NBS which saves countless lives every year. A particular problem in the national blood service is that it relies on 1.4 million people voluntarily donating blood each year, and there is real concern about whether this would continue if donors knew private companies were profiting as a result. Unfortunately the minister spent a great deal of time accusing MPs of scaremongering but didn’t have answers to key questions about safeguards, like Grahame Morris MP’s question of whether Monitor’s remit would extend to the blood service, or whether, as Tom Blenkinsop MP asked, the review will be subject to EU competition law.

It is reminiscent of Cameron’s floundering over the opening up of the NHS to EU competition law at PMQs this week – a confusion repeated by his ministers over the question in response. It is yet another sign of a government in such a rush to introduce ideologically driven reforms they have not taken the time to think through the implications of their actions or the necessary safeguards that must be in place if they are not, as many of their own coalition believe, going to wreck the NHS.