Morals & Markets:Welcome to Health and Social Care Plc,we are here to care for you, how would you like to pay?…..

Evil drug companies, bailiffs in care homes and profit before people, welcome to the brave new world of Health and Social Care Plc.

As we wonder why compassion in care is so difficult to maintain…..

The Independent reports an influential group of cancer experts warn high prices charged by pharmaceutical companies for cancer drugs are effectively condemning patients to death, claiming drug companies are “profiteering” using unethical methods.

Government reform will mean multi-million pound opportunities for pharmaceutical companies in the provision of goods and services to the NHS in the UK.   Is this advisable when we consider previous reports from The Independent who highlighted the criminal wrong doing of drug companies along with The Guardian  who reported on GlaxoSmithKlines fine of $3 billion dollars, for admitting to bribing doctors to encourage the prescription of unsuitable antidepressants to children, and then reports that GSK  concealed data about the damaging side effects of the drug Avandia.

However, ‘big pharmas’ reach extends well beyond the suppression of drug trial data, drug production and distribution. A central tenet of the health care reforms is the introduction of ‘any qualified providers’, which will now force CCGs to put provision out to tender to private firms to provide NHS services.  This means the Department of Health will take the most potentially lucrative, standardised, high volume and low risk treatments provided by the NHS and offer these up to private companies, the Americans charmingly refer to private providers who deliver such treatment as ‘focused factories’.  These healthcare companies will already have had some influence on deciding which treatment will be handed over to the private sector, for example companies like 2020Health  who have links to the two big pharmaceutical companies Pfizer (fined over 2 billion dollars since 2009 for criminal wrongdoing) and Lilly.   There is evidence to suggest pharmaceutical companies explicitly determine which health care problems are publicised and researched to maximise their profits.

Such unethical practice is linked to profit.  Pharmaceutical companies appear driven by a different set of moral and ethical standards than most professionals working in the health service.  The government is effectively asking advice from a woefully under regulated market on creating a market for its products, which may actually damage patients health.

At a macro level those private institutions who have already taken over some areas of  care provision have been found lacking, which does not bode well for extending this strategy.  Take, for example, HSBC who were fined £10.5 million last year for mis-selling care bonds to older people.  The Financial Services Authority found unsuitable sales had been made to 87% of customers, with the average age of those who purchased bonds being 83 years of age, many of whom having already died before the scandal came to light.  Whilst £10.5 million might sound a lot it’s not for a company who was recently exposed as allowing the laundering of at least 7 billion dollars of drugs money through its bank and has set aside 700 million dollars to cover fines.

The selling of care related products by the private sector can leave individuals vulnerable in a variety of ways, look at the doubling of the number of private care homes going bankrupt leaving older people without secure housing or care provision. Latest reports in The Independent suggests nothing had changed as the bailiffs are set to move in on some care home providers.

Successive governments are keen to point to the failure of ‘state’ provision as an argument for the introduction of more private sector provision. True there are problems, however, rather than addressing these issues government seeks to displace them into the private sector, an under regulated private sector, where problems can conveniently disappear from view and politicians can relieve themselves of any responsibility. When ‘responsibility’ is lost all we are left with is accountability, and as privatisation extends deeper and deeper into the psyche of our health and social care system that too will be lost, leaving individual ‘consumers’ of health and social care at the mercy of the markets, and look where that has led us!

And we wonder why compassion in care seems to have been lost, surely for compassion to be integral to care it needs to be present at every level? The language of the free markets, individuality, austerity, profit and value for money is so ingrained in the fabric of our lives that I wonder if our capacity to care is now so corrupted compassion in care is beyond us? All I want is compassion, honesty and integrity in a free market approach to our care system, but that seems increasingly unlikely to me.

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About digalpin

I gained my social work qualification from the University of Southampton and worked for 14 years in mental health, disability and older people services. I am currently a senior lecturer in post-qualifying social work at Bournemouth University and am conducting research on government and societal attitudes and responses to the mistreatment of older people in health and social care provision for my doctorate. My views are my own.

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