NHS for sale? Too late for many mental health services

Published by The i paper (2nd December, 2019)

For much of the time it has seemed only two issues are at stake in this depressing election campaign. The Tories relentlessly push the phoney idea that they will ‘get Brexit done,’ dropping their duplicitous slogan into every interview and speech. Meanwhile Labour focus with similar determination on the claim that only they can save the National Health Service from being flogged off to slavering private firms. 

Both lines are lies. The dispiriting Brexit saga will drag on for many more years if the Tories win, while no party – even one led by Boris Johnson – is going to sell off the NHS when it is seen as sacred by most voters. Yet these two false claims came together last week when Jeremy Corbyn, desperate to regain momentum after his mauling by the BBC’s Andrew Neil, brandished 451 pages of documents from trade talks with the United States. He claimed the papers prove the Tories are planning ‘runaway privatisation’ of the NHS after Brexit since ‘mega-corporations’ view it as ‘a chance to make billions from the illness and sickness of people in this country’.

Stirring stuff. Shame that Corbyn’s documents showed nothing had been agreed, although clearly longer drug patents are among Washington’s objectives. The Tories hit back hard. ‘We are absolutely resolved that there will be no sale of the NHS, no privatisation; the NHS is not on the table in any way,’ declared Johnson. Ministers and loyal MPs chimed in to chorus that ‘the NHS is not for sale’.

Yet hang on a second. One key slice of the NHS is already lying in a distressed state on the operating table, where it has been chopped up for profit-hungry private firms. And giant US health corporations, along with hedge funds and private equity firms, are already here and bleeding dry this profitable corner of the NHS – with often disastrous consequences for some of our most desperate patients. Sadly, no one seems to care much since it is ‘only’ the mental health sector – for so long the neglected Cinderella service.

Yet in recent years a small cluster of fatcats have got their claws into Britain’s psychiatric services, exploiting the struggles of the health service to cope with surging demand. These operators have grabbed nearly £2bn of business, providing almost one quarter of NHS mental health beds and soaking up close to half the total spend on child and adolescent mental health services.

This means they own many NHS-funded units holding people such as teenage girls who self-harm and adults with suicidal thoughts, along with hundreds of people with autism and learning disabilities scandalously locked up due to lack of support in their local communities. These firms benefit as overloaded mental health services and risk-averse officials send more and more troubled citizens into secure units.

It is a lucrative business when it costs up to £730,000 per patient a year. Bosses can pocket millions – but many frontline workers earn little more than minimum wage and the use of agency staff is routine, despite the need to develop patient relationships.

Acadia, a Tennessee-based health giant, spent £1.3bn buying the Priory Group and now boasts of earning than £188m in just three months from British public services. ‘Demand for independent sector beds has grown significantly as a result of the NHS reducing its bed capacity and increasing hospitalisation rates,’ said its last annual report.

Operating profits at Cygnet, owned by another huge US firm, have surged to £45.2m due to deals with 228 NHS purchasing bodies after it bought a rival group last year. Another outfit called Elysium, backed by private equity through a Luxembourg firm, only launched three years ago, but is already earning revenues of £61.2m from at least 55 units.

But a study by the Rightful Lives campaign group has found these three firms alone own 13 of the 16 mental health settings judged ‘inadequate’ by the Care Quality Commission watchdog, since it found some teeth after the furore over abusive detention of people with autism and learning disabilities exploded a year ago. Cygnet runs eight of these ‘inadequate’ units, although its US boss is reportedly the richest chief executive in the hospital industry, who collected more than £39m in one year from pay, bonuses and stock. Priory and Cygnet also owned hospitals exposed by disturbing undercover television documentaries over the past year.

I have heard a stream of horror stories from despairing families and former patients involving solitary confinement, forcible injections, abuse and overuse of restraint, during investigations into this area. Some were detained in NHS psychiatric units. But most involve privately-run units.

People such as Megan, who was sectioned for self-harm, suicidal thoughts and later found to be suffering post-traumatic stress from childhood traumas. She was in four clinics – but in one run by the Priory, aged just 16, she was even held stark naked for one month to prevent self-harm until her parents delivered a safe suit. ‘It was the most degrading time of my life,’ she told me. The firm was fined £300,000 earlier this year for failings after the suicide of a 14-year-old girl at the same unit.

Unlike many voters, I have no problems with private providers in healthcare if the service remains free at point of use, especially after seeing their role in European systems with superior patient outcomes to our own health service. But seeing these mental health firms has shaken my faith.

Clearly all private operators need to be effectively regulated, especially when providing sensitive frontline services. Sadly, it seems our politicians on all sides prefer to posture over whether the NHS is really for sale to ‘mega-corporations’ while ignoring those that have already arrived and are pocketing vast sums while offering inadequate services to so many despairing citizens. Once again, we see how little Westminster really cares.

Categorised in: Health, home page, Public policy