Dec 5 2008
The government needs to rethink its approach to NHS reforms, says UNISON, in the wake of a new damning report on the cost of commissioning and outsourcing.
It should concentrate on giving NHS patients the care they need - and value for money - rather than using reforms to outsource services and 'throw precious money away to the private sector' says the union, following publication of the report, Driven by Dogma, by the Office for Public Management.
The report says outsourcing in the NHS has failed to deliver value for money, patient involvement or improved working conditions.
The government's pre-budget report in November made much of the potential efficiency savings to be made by the NHS from shared services operations with the private sector.
But first hand evidence in the new report, looking at the experience of those commissioning and delivering services, reveals that in fact promised cost benefits have simply failed to materialise, and quality has suffered.
"At a time when finances are increasingly tight, the NHS cannot afford to be throwing precious money away to the private sector and wasting time and resources on the complexity of the commissioning process," commented UNISON general secretary Dave Prentis.
"Patients want more involvement in decision-making and staff want to spend more time on providing excellent patient care than tendering for contracts.
"Unfortunately this report shows that the various reforms to outsource or privatise parts of the NHS are working against these goals."
The report draws on the experiences of NHS senior managers and commissioners to highlight the sheer complexity of the commissioning process, and the mountains of bureaucracy and paperwork attached to it.
"My experience has been that the problems associated with monitoring contracts far outweigh the benefits of the outsourcing," said one of those intereviewed: "We will go on spending more and more money on this - contract negotiation skills, transaction costs, etc.".
UNISON points out that there are alternatives - Scotland has recently announced that it will no longer permit any contract cleaning and Wales has done away with the purchaser-provider split in favour of a more integrated system.
The report makes clear that markets should not be the only option and that those working in the devolved administrations did not feel they were disadvantaged by the minimal use of outsourcing in their systems.