One of the reasons the government have had an easy ride over its plans for the systematic looting of the NHS by Tory-friendly private health companies is the sheer complexity of their restructuring. Unlike, say, the Department for Work and Pensions, where there is a single bureaucracy responsible for administering a particular public service and a clear line of accountability stretching from the job centre complaint form to the Secretary of State.

It’s not a perfect set up by any means, far from it. But to use a well-trodden phrase, you know where you stand. The NHS on the other hand was transformed into a patchwork of semi-autonomous, competitive trusts and hospitals under the Blair/Brown governments. As of the beginning of the month, matters have taken an even more retrograde step. The trusts have gone and in their stead are hundreds of GP-led Clinical Commissioning Groups.

It is the role of these organisations to buy in (commission) NHS services from any number of public and private providers. So, while treatment is free at the point of need in the vast majority of cases – for the moment – a new health market underpinned by the taxpayer is the mechanism for its delivery. Continue reading →