'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?