ourNHS

What are charities for?

Charities and voluntary sector organisations should protect the poor, sick and dispossessed by building alliances with those highlighting the damage caused by cuts and privatisation - not by queuing up for the spoils of these coalition policies.

Andy Benson
20 December 2013
for the poor.jpg

Image: Steven Depolo / Flickr

Charities and voluntary agencies exist to support and defend the interests of their beneficiaries – poor, ill, disabled, excluded and dispossessed people and communities. Surely voluntary agencies are at the forefront of resistance to coalition policies responsible for increasing poverty and inequality and deteriorating public services? Policies that cut rights and entitlements, and dismantle or privatise public services? 

Nothing could be further from the truth. Many Voluntary Services Groups, the groups that employ staff and deliver services, see the changes as opportunities for them, rather than threats to the very people they work with and care about. These groups have been trying to place themselves at the front of the queue as contracts are tendered, producing all kinds of arguments as to why they will be better than public servants at providing these services. The winners here have been the large national charities like Barnardo’s, the Shaw Trust and Turning Point; the losers locally-rooted charities that have been working with users for many years, in partnership with NHS agencies and local authorities. 

The pressure is on to outsource as much and as quickly as possible. 200 NHS contract opportunities were offered between April and July this year, worth an estimated £2.5 billion. 

As the true scale of the privatisation programme has emerged it has become clear to the voluntary sector that privatisation does mean ‘private’. Despite weasel words from government ministers about valuing the unique virtues of the voluntary sector, the point of open markets is to open up markets and the only built-in protections will the labelling of  Serco, Capita, ATOS or G4S as ‘too big to fail’. Appeals for a ‘level playing field’ are met with polite nods and vague assurances. 

Faced with this real threat to their viability, many voluntary sector groups are now scrambling to be included as sub-contractors in private sector supply chains. Charitable activities become designed to maximise private company profits. Lost in the rush is the evidence from schemes such as the Work Programme that these supply chain arrangements actually end in aggravation for and exploitation of the voluntary sector groups silly enough to sign on the dotted line. 

‘Clinks’, for example, a body which supports VSGs involved in the criminal justice system has set up a... “new supply chain and consortia directory, which helps Voluntary, Community and Social Enterprise (VCSE) organisations working in criminal justice to promote your services to commissioners and prime providers”..... Serco sees Clinks’ Partnership Finder as a useful tool to aid us in identifying VCS organisations for our bids and delivery work," says Stephen Hornby, Rehabilitation Lead, Serco UK & Europe. 

The so-called ‘leadership’ bodies within the sector have been muted, compliant, or positively enthusiastic about the cuts and privatisation programme. Principal amongst these have been the National Council for Voluntary Sector Organisations, the Association of Chief Executives in Voluntary Organisations, the National Association for Voluntary and Commuity Action, and Locality. The misery and disempowerment brought by the cuts is seen as regrettable or misguided but too often it is the voluntary sector’s organisational interests, rather than that of their clients, whose needs are forefronted. 

Why so few alliances between the voluntary sector and groups like False Economy or the People’s Assembly? Even when dragged into campaigning - currently around the Gagging Bill – the spade work on actually protesting has been done by the outsider groups like Friends of the Earth and Action Aid.   

Florid support for privatisation of the NHS has come in the form of Sir Stephen Bubb, Chief Executive of ACEVO. In 2011 investigative research exposed Bubb’s secret connections with the ‘NHS Partners Network’, a private healthcare trade and lobby group. He pressed their interests in his role as Chair of the Government’s ‘Choice and Competition’ sub group. And he was at it again this year, with his Partner’s Network urging Jeremy Hunt not to “water down” the Section 75 NHS contracting out regulations. 

The nadir came in December 2012, when NCVO, ACEVO, NAVCA, Locality and ten other national voluntary organisations wrote to the government to tell them that:

“....our sector stands ready to make a greater contribution to the Government’s Open Public Services agenda. Crucially, we need the opportunities to do this. National and local commissioners need more encouragement and support to engage with the sector.”

Now that NHS outsourcing is virtually compulsory, talk turns to outsourcing the outsourcing itself. Alongside the private equity firms, voluntary sector leaders are queuing up to push for greater involvement in the commissioning and procurement processes - rather than questionning the whole model.

Last month Nuffield published ‘The Role of the Voluntary Sector in providing Commissioning Support’ with ACEVO, Macmillan Cancer Support, Neurological Commissioning Support and NHS England. This coalition argues that Clinical Commissioning Groups and Commissioning Support Units should use the voluntary sector’s special expertise including “....needs-assessments, business intelligence, service re-design, and public and patient engagement.” They assert that: “Commissioners, commissioning support units (CSUs) and the voluntary sector itself are enthusiastic about expanding its role in the provision of commissioning support.”

In other words, we all want to play an active part in the privatisation of the NHS.

The choices for voluntary sector groups are not straightforward. But around the country, small acts of resistance continue and are beginning to multiply. A local Council for Voluntary Services formally aligns itself with the local anti-cuts group, two charities in Liverpool decide to withdraw from contracts, and Lewisham Hospital campaigners expose Jeremy Hunt’s unlawful manoeuvring.

But what is needed is principled action on a widespread scale. Voluntary sector groups need to oppose public service privatisation and resist the use of voluntary sector groups for mainstream public service delivery, including through sub-contracting of VSGs to private companies. And they need to forge working links with campaigners, trades unions and others involved in the wider fight to stop cuts in entitlements, rights and access to vital services.

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