By Andy Ford, NHS Unite rep
The collapse of the private midwifery provider One-to-One Midwives shows the limitations of the ‘Any Qualified Provider’ regime in the NHS.
Any Qualified Provider was introduced by the New Labour government on 2011. Initially, under the ultra-Blairite and pro-market Health Ministers Patricia Hewitt and Alan Johnson, it was ‘Any Willing Provider’ and opened NHS services to bids from any commercial outfit. Milburn and Hewitt went on to lucrative employment in private health companies.
In what was regarded as a major shift at the time, Andy Burnham converted it to ‘Any Qualified Provider’, which meant that bidders had to pass a qualification process controlled by the NHS regulator, Monitor. However, as noted by Health Service Journal, the change was largely cosmetic. The whole scheme is pure New Labour ‘social market ideology’. The theory is that use of the market will drive diversity, innovation and customer focused care, which the (well funded) ideologues and think-tanks counter-pose to the supposed ‘monolithic, hide-bound and paternalistic’ NHS.
One to One Midwives was one of the smaller entrants to this newly created ‘market’ in healthcare. In fact relatively few corporate giants have got involved, with Virgin Health being a notable exception. The small companies are often either tiny one-mam (or woman) and a dog outfits or ‘Social Enterprises’. Of course the directors and founders of these companies pay themselves generous salaries and expenses out of the guaranteed income stream from the NHS.
The state has to stand as guarantees for dubious market model
One to One Midwives was started by an ex-NHS midwife from the Wirral. It aimed to return to the old model of midwifery where the midwives each had an individual case load as depicted nostalgically in ‘Call the Midwife’. Their model proved popular with women and midwives but of course was expensive. The company expanded its operations from Wirral to Cheshire and Merseyside and more recently to Essex. The owners of the firm must have thought they were on the way to being millionaires.
But of course their service model was expensive and the NHS was unwilling ultimately to fund it. So the company has gone into administration, withdrawing services on one or two days notice.
This shows the limitations of the market in the NHS. If these providers go bankrupt it is not like your local newsagent closing down. So behind this toy-town market the state has to stand guarantee.
The other lesson is that all this was a creation of New Labour, a fact that will be conveniently glossed over by the Labour right-wing when they hypocritically decry another “Tory failure”.
Under Corbyn, Labour now stands for ridding the NHS of this fake market – no wonder the Blairites hate him for it.
August 5, 2019
