Panorama, Undercover: Britain’s Biggest GP chains, BBC 1, BBC iPlayer, undercover reporter Jacqui Wakefield

https://www.bbc.co.uk/iplayer/episode/m0017x2b/panorama-undercover-britains-biggest-gp-chain

https://www.theguardian.com/society/2022/jun/13/britains-biggest-chain-of-gp-surgeries-accused-of-profiteering

My partner recently had to go into hospital. The Queen Elizabeth Hospital in Glasgow, Accident and Emergency. It was recently slated for having up to a thirteen-hour waiting time. We know there is little point phoning for a GP appointment on the Tuesday, after a Bank Holiday. The phone will ring off the hook. My tactic to avoid this is go to the surgery window and wait to catch the receptionist’s gaze. We’re an ageing population with more money needed to be channelled into health care.

What we get instead is Thatcherite ideology of the market knows best. The market does know best. It knows best how to take money from poor people and give it to the rich. In this case Operose Health, which is a subsidiary of private healthcare firm Centene. In the United States their looting of welfare funds led to them being sued by a number of State bodies for fraud. They paid the fine, but, of course, didn’t admit guilt.

What we have here is a different kind of fraud. A rentier class, who are paid a fixed amount for providing a service where there is no risk to the rich. We also did it with trains. Subsidised other nation’s rain networks and it gave them a guaranteed income.  

70 GP surgeries and 600 000 patients. Jacqui Wakefield logged 300 patients waiting to get through to her. And she couldn’t offer any GP appointments for any of them. One ruse was to offer appointments with a cheaper option. Put them in a white coat. Give them a fancy title. Work them with appointment after appointment so they do the equivalent work of two GPs. That’s called efficiency savings. In other words, profit for destroying the worker’s health and the health of the people he or she is trying, but failing to help.

  A study of the equivalent of Norwegian GP’s, for example, found that the more highly qualified those practicing medicine the better outcome for the patient. Not only were they able to pick up early signs of disease and treat it earlier saving more costly treatments with knock-on effects at later stages. A virtuous circle.   

A vicious circle looks something like this model. Underqualified staff.  Clinical correspondence – medical reports, test results and hospital letters – that had not been read for up to six months.

In the Thatcherite model of health care, patients would be able to shop around for better treatment, where they weren’t treated to the indignity of having to spend days on the phone. Similarly, GP practices would compete against each other to bring in the brightest and best and innovate, while making a profit. In the same way we did with our prisons, or the probation service, before that was scrapped as being unworkable.

Scotland has largely rejected this carpetbagger model of modern finance. But the Queen Elizabeth Hospital was extended with many of the same principles. Give money to rich people for building something you could do cheaper and better with forward planning. We can clap NHS workers, while not giving them a pay rise and look for savings elsewhere.  We know how this looks. It looks very much like the one rule for the rich and one rule for the poor of Centene and their ilk. Efficiency savings are only efficient if they end up in a tax haven. We all know how that feels. Because we’re all in it together. In George Orwell’s Animal Farm, ‘some animals are more equal than others’.  Some patients are more valued than others.

gazingstock

I shared a post on Facebook (Fakebook) from Harriet Goodale which just about sums up how I feel.

I can’t wait to shut up about what an absolute fucking abomination the Tory party is. If you’re still voting conservative, now fully aware of the consequences, I concede defeat. Congratulations, you’re a prize cunt. Four million destitute children with empty bellies salute you. Have fun remortgaging your house when your appendix bursts. I hope they put us all in labour camps so I can find you in the gruel queue and stamp on your foot.

Reading about Boris Johnson’s victory is depressing, the fake humility and the promises, like any new football manager to turn things around. He’s a winner and we’ll be winners too. Trust him.

Johnson has got that bit of leeway now, results might not go his way initially, but it’s a new project. New Conservatism with big spending plans. When Brexit is dealt with he’ll get back to those other things he plans to fix. It’s a matter of faith.

Perhaps the most depressing thing I read was an interview with a homeless man living on the steets. He said he wasn’t registered to vote, but if he did, he’d have voted Tory. If I’d have put a £1 in his cap I’d have taken it back and taken another fiver or whatever he’d collected. I’ve faith in that’s what the Tories do. Take from the poor to give to the rich.

When things start going wrong, as they will very quickly, are indeed happening at this very moment, when the grace period of Johnson’s government is over and they revert to type, then we know what type they are.

Johnson is wooden and hollow, and his lies are Pinocchio in disguise. Does anybody really believe, for example,  that when Britain are locked out of the block of the richest trading nations, the monopoly on healthcare we call the National Health Service won’t be on the table quicker than you can say wooden nose?

Noam Chomsky tells us the standard technique of privatisation, defund, make sure things don’t work, people get angry. You hand our NHS over to private capital. You hand the United Kingdom over to Boris Johnson and his ilk. He talks about Brexit. How he’ll pull it out of the bag, ready cooked. Results might go against him, but he’s one of us. He’s doing it for us.

The underfunded NHS is low hanging fruit. Perfect for rich fund managers to pick up as a bargain. The infrastructure is already in place. Borrow money cheap and buy. Economic rent can be paid as dividends to the already rich and increased every year.  Look for example at the £400 million profit to Richard Branson for not running Virgin trains very well. Or any of the privatised water companies, not investing in infrastructure but paying huge dividends to their already wealthy shareholders. Not only is privatisation costly it doesn’t work any more effectively than publicly funded corporations.

Deregulation, of course, means no regulation. If we look for example at Ted Genoways The Chain: Farm, Factory and the Fate of Our Food we see what it means is animals, including the human animal, are ever moveable replacement parts where profit is the only thing that counts. Land is degraded and runoff shit poisons rivers and streams. There’s a metaphor for the relationship between capital and labour.

External costs, land deregulation, water and air pollution are prices paid by the majority. Our problem isn’t just chlorinated chicken and degraded beef that will inevitably follow cheaper food, but fishing and farming in Britain being unable to compete and also locked out of EEC food markets. Our ongoing trading deficit with other nations becomes even wider.  The biggest external cost of all is global warming. The Third World War against climate change has begun and we are feeding that fire.   

Deregulation, of course, also gave us the 2008 banking crisis. The weapons of mass destruction were bonds, ostensibly backed by governments. Government money bailed out bankers, taxpayers money made the rich richer. But it also, ironically, provided an alibi for the Laurel and Hardy of British politics, Cameron and Osborne to cut back on public spending. The same promise of public spending that Johnson promises to put on hold and spend big.     

We live in an apartheid state, but it’s not the colour of our skin that matters (although if you’re classified as non-white it might not feel that way) it’s class. If you’re working class you know what to expect. If you’re comfortable, you can look away and smirk at Boris’s foibles. We lost the election, but more importantly we’ve lost the propaganda war.   Harriet Goodale gets it pretty much right. That’s what I call righteous anger.