Not just bricks & mortar?
'The NHS is not its bricks and mortar,' said health secretary Alan
Milburn when he announced plans to let the most successful NHS
hospitals break free of government control in January (January 15
2002). I'm sure there a quite a few facilities managers working for
NHS Estates who would beg to differ. Buildings and facilities do make
a difference.
In the light of recent events - the outbreak of a winter vomiting
virus which saw a Scottish hospital close it's doors to patients, and
the alleged neglect of 94-year-old Rose Addis for 72 hours at the
Whittington hospital - it would seem that the bricks and mortar are
the only parts of the NHS that haven't come in for criticism. NHS
Estates must be doing something right.
In proposing to let successful hospitals break free from government
control and form foundation hospitals Mr Milburn has been accused of
wanting to create, 'Railtrack on a hospital trolley.' The words of
John Edmonds, general secretary of the GMB union as reported in the
Guardian, who also called the plan, 'a recipe for anarchy.'
If the NHS does eventually go the way of Railtrack it could be good
news for the big guns in facilities management. Robin Southwell the
new chief executive of support services company WS Atkins recently
admitted it had made £40 million in six months from Railtrack deals.
Mr Milburn has always said one way to turn around failing hospitals
would be to hand over management to another public sector health
organisation. Now he is saying hospitals could be franchised out and
managed on a not for profit basis by an external management team.
Surely this is one step closer to privatisation? He says not. The
assets would remain with the public sector and the franchisee would
work for a fee and not for a profit.
According to the Guardian, health service managers at the New Health
Network speech said there were two possible outcomes. Either the
government would call on the services of the few health facilities
management companies that do exist (working on contracts in the Middle
and Far East) or that UK management consultancies would poach the
services of successful NHS managers and then sell their service back
to the NHS.
Officials say foundation hospitals will not be based on the Spanish 'Fundacion'
hospital in Madrid, which Milburn visited in November. It was built
and is owned by the state and run by the private sector for a fee. It
seems ironic that in the UK we do it the other way around. We let the
private sector build the hospitals under the Private Finance
Initiative (PFI) and then the public sector runs them.
Spanish unions have criticised the 'Fundacion' hospital, which has cut
waiting lists and is out performing state run hospitals. They say it
has achieved this by increasing working hours and by turning its back
on difficult cases. It is also reported that staff are unhappy with
the management system.
So, how long before we see the first PFI contract for not only the
provision of facilities management and construction but also the
management of the entire hospital? How long before WS Atkins is taking
£40 million in six months from the NHS as well as from Railtrack?
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