Privatisation of the NHS is gathering pace, but the public currently has little right to know how our money is spent.
In the last three years I have spent most of my time in parliament fighting against the Coalition Government’s damaging marketisation of our NHS.
The arguments about the fragmentation and privatisation of NHS services are well rehearsed. The public know the reorganisation wasted £3 billion, vital resources which should have been spent on frontline services. Patients and service users have experienced the consequences of the Coalition Government’s management of the NHS. Rationing of treatments. Escalating waiting times. An unprecedented A&E crisis during the summer.
What has often gone unnoticed is the democratic deficit. The erosion of our rights to question those who run public services and spend our money. This is what prompted me to introduce a Ten Minute Rule Bill calling for Freedom of Information (FOI) legislation to be extended to private providers of NHS services.
The Health and Social Care Act never had a democratic mandate. Andrew Lansley, the Health Secretary who forced through these "reforms" through in the face of overwhelming public opposition, had specifically promised no more top down reorganisation. David Cameron told us you can trust the Tories with the NHS. But had he made his intentions clear at the election there would have been a resounding no.
The unrelenting pace of privatisation and outsourcing of our public services is set to continue under a Tory led Government, as they seek to open up all public services to the private sector. Today, £1 in every £3 that Government spends goes to the independent and private sector. Since January 2012, nearly £8 billion of NHS services have been or are in the process of being privatised, with companies seeking to make profits of 8% or more from each contract.
While public services are being outsourced to the private sector, especially in the NHS, Freedom of Information responsibilities are not following the public pound. Private health care companies can hide behind a cloak of commercial confidentiality when barely transparent contracts are awarded.
At the start of the bidding process private providers already receive a competitive advantage due to unequal disclosure requirements.
Private companies are free to use the Freedom of Information Act to gain detailed knowledge of a public sector provider, which can then be used to undercut or outbid the same public body when the contract is put out for tender.
NHS bodies must answer Freedom of Information requests relating to costs, performance and staffing. Yet a private provider has no similar duty of disclosure despite the fact they could have treated private patients for many years.
Once a contract is awarded, there is little that can be done if a private provider refuses to supply details to allow commissioning bodies to answer Freedom of Information requests. As they are not subject to Freedom of Information laws, the Information Commissioner has no power to investigate private contractors. They cannot serve notices for an investigation, and neither can they take enforcement action if a contractor destroys information or fails to comply with a request.
The Information Commissioner expressed concern to the Justice Select Committee that accountability would be undermined if Freedom of Information did not apply to private providers of public services. It is a concern I share and at one time or another, so have each of the main political parties who have all promised to extend FOI legislation.
It is time for political leaders to deliver on their promises. If we are to safeguard the public’s right to know who and how their money is being spent, we must extend Freedom of Information legislation to all providers of public services no matter if they are in the voluntary, public or private sector.