Keep our NHS Public: Health Warning – A mutual may be heading our way

Keep our NHS public

Jan Ainsley from Keep our NHS Public writes:

Michael Scott, Chief Executive of Norfolk & Suffolk NHS Foundation Trust (NSFT), was “delighted” to be able to write to staff with good news. NSFT has been successful in its application to investigate becoming a mutual in the government’s “Mutuals in Healthcare Pathfinder” initiative. Sounds cuddly doesn’t it? Who could be against mutuality?

Evidently the initiative is all about changing the ownership of the Trust for the benefit of staff and, in turn, the care of patients. The Trust has been listening and has heard that many staff are disengaged, disempowered and demoralised – and that can’t be good for the quality of care provided can it?

Here are a few starter questions for the Trust, staff, patients, carers and local people to consider:

  1. Have we, the people who already own the NHS, been consulted about a change of ownership?
  2. What is a mutual? The letter refers to the John Lewis model but there is no single definition of a mutual. If the emphasis is on shared ownership, then it is wide open to interpretation. The government include Circle in its list of recognised mutuals. Circle is 50.1% owned by hedge funds (Circle Holdings plc) and 49.9% owned by Circle Partnership (senior executives and consultants). If this was the chosen model, the private sector could be involved right from the beginning as “partners”.  Curiously, Circle do not seem to be a very good example of either high levels of staff satisfaction (falling in the bottom 20% in the latest national survey) or in high standards of patient care (shortly to be confirmed in the latest CQC inspection) at Hinchingbrooke Hospital.
  3. No matter which particular model is selected, NSFT would be severed from the NHS. In the event of a future financial or care crisis, it is likely the mutual would have to be sold or wound down. We all know what happened to the mutuals in the financial sector- they were demutualised. Given the Trust’s current financial and care crisis, is this a good time to explore a major risky change of organisation, when so many urgent issues need to be resolved?
  4. Mutuality is not just about a “business” organisation. It can also refer to workplace democracy and decision making within an organisation. Does NSFT have a workers’ co-operative in mind?
  5. Since 2008, 29 health organisations have been established as mutuals. In addition, since 2010, 91 mutuals have been created in other parts of the public sector. Where is the evaluation of their successes or failures in delivering their goals? No-one would want to see further experimentation based on flimsy or anecdotal evident, would they? Norman Lamb and Francis Maude are touting heavily as evidence an “independent” report by Chris Hams of the King’s Fund, “Review of staff engagement and empowerment in the NHS” (2014). Given the government’s highly selective use of independent reports it is worth looking closely at what this one has to say. Of the three core recommendations, only one actually refers to the mutual option. The other two recommendations, that NHS organisations should redouble their efforts to engage staff and that there should be greater devolution of decision-making within the NHS, do not seem to have attracted much government attention.
  6. As mutualisation is about greater staff involvement, what engagement took place across the trust between July and September to make the decision to apply for membership of the mutual pioneers? Were patients, carers, staff, unions, governors, members of NSFT and the wider public consulted at all?
  7. Could the £100,000 to be spent on management consultants investigating mutualisation have been better spent on providing mental health care to the public?

Since the passing of the Health and Social Act, creeping privatisation has accelerated throughout the NHS. So far it mainly consists of selling off health services to private companies. But the government is only too aware of growing public concerns about profit hungry corporations. Now under the cover of mutualisation, privatisation is taking a new turn. No matter what form mutualisation takes, the Trust would be moving out of the public sector into unexplored new territory. In case there is any doubt about where mutualisation will lead, the government provide the answer:

“public sector mutuals are organisations which have left the public sector”

Watch this space for more about mutualisation!

9 thoughts on “Keep our NHS Public: Health Warning – A mutual may be heading our way”

  1. Healthcare is about ten per cent of GDP in Europe and about 17 per cent in the US. When did the Coalition get permission from the electorate to simply give away about ten per cent of the economy to its mates in the City via phoney mutualisations? At least with privatisation, the businesses were actually sold with proceeds flowing to the Exchequer.

    If health expenditure rises to US levels of GDP as a result of this giveaway, the cost will be enormous for the taxpayer and society but investors will enjoy massive returns. How many Liberal Democrat voters would be happy with duplicitous Norman Lamb championing this policy? Very few. However, Norman Lamb is looking forward to juicy directorships and consultancies in opposition, following in the inglorious footsteps of Patricia Hewitt, Alan Milburn and most recently Stephen Dorrell.

    Is it simply a coincidence that the Chair of NSFT, Gary Page, was formally an investment banker at Royal Bank of Scotland (RBS), where he was global head of financial institutions and portfolio management until he lost his job when RBS went bust at the cost of ten of billions of pounds to the taxpayer? Or that the mutualisation proposal is written by another former investment banker, this time at Cazenove and JP Morgan, and now Chair of the Investment Committee at NSFT, Adrian Stott?

    We are told that bankers with ‘financial acumen’ are needed to run NSFT properly but NSFT has been run into the ground and Monitor is investigating. Perhaps the real reason bankers are needed in healthcare is to smooth the way for the sale of distressed state assets at knockdown prices to the Coalition’s mates in the City?

  2. I think story is entirely speculative and scaremongering. Surely this is a step too far what your suggesting? NSFT is criticised ( rightly or wrongly ) for poor staff morale and staff engagement and they say this is a different approach to do something about that. Well done I say

  3. Very apt choice of name. According to Wikipedia:

    “Like his cousin Goober, Gomer provided comic relief, awestruck by the simplest of things, resulting in the exclamation of his catchphrases, “Shazam!”, “Gawwww-leeeee”, “Sur-prise, sur-prise, sur-prise!”, and “shame, shame, shame!”, as appropriate.”

  4. Surely, with the fiasco at Hinchingbrooke, with the collapse of the Circle attempt to run the hospital, the £100,000 to be spent on this mutualisation proposal with management consultants looks like an astonishing waste of money and management time which should be spent on improving mental health services?

    Governors, staff and the public haven’t been involved or consulted in this whole process. What did Adrian Stott write in the mutualisation application which nobody appears to have seen beyond the Board? On whose behalf? The Board of Governors haven’t seen it, service users haven’t seen it, the public hasn’t seen it – never mind formulated or agreed it.

    How can Stott claim to be a legitimate representative of the prospective ‘owners’ excepting the interests of the Board and the City of London, where he worked for Cazenove and JP Morgan? Why does the Mental Health Foundation have such a man as a Trustee, when he is willing to fail to consult or inform stakeholders, particularly service users, in such a momentous decision as to investigate leaving the public sector and the NHS at the cost of £100,000?

    How is this transparent decision-making with service users at its heart? The application must be released so that we can see what is being proposed on our behalf.

  5. Pingback: EDP: A half-way house to privatisation? « Norfolk & Suffolk Mental Health Crisis

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