Dismantling the NHS Internal Market by stealth. Ninjas strike again

Croydon Health Services NHS is about to advertise for a new Chief Executive.

This isn’t unusual. It’s been a troubled Trust on and off for a while, formed from the merger of Mayday Healthcare NHS Trust with Croydon Community Health Services. It operates University Hospital Croydon along with lots of Community Services, and a Community Hospital.

The Trust has the second worst accident and emergency performance in London, it sees just 60 per cent of type-one patients within four hours, compared to the 95 per cent target. Both the Trust and the Clinical Commissioning Group have been in special measures over the last few years due to endemic financial problems.

What is unusual is that it is a joint appointment with the Clinical Commissioning Group. Which means that the CEO will have responsibility for the purchaser and provider bit of local health services. The 2 organisations already share a Chief Nurse and a Chief Pharmacist.

This is a quietly radical proposal which undermines the fundamental principles of the NHS internal market – the purchaser/provider split.

It also pretty clearly illustrates one of the attractions of getting rid of the internal market – you need a lot fewer senior managers.

I can’t help but note that if you took University Hospital Croydon out of the equation the rest of the role is:

Commissioner CEO + Community Hospitals + Community Services + Minor Injuries + Intermediate Care = my old job.

How much of this is Matt Hancock (Secretary of State for Health and Parkour Champion), and how much is Simon Stephens (NHS England CEO) is unsure – my guess is it Stephen not Matt.

Next time someone tells you that the NHS is being privatised by stealth, feel free to tell them they are wrong. There is a quiet and stealthy dismantling of the mechanisms of the internal market taking place, unpicking one of the final parts of Thatcher’s legacy. This is a dry run for the full scale repeal of the Health and Social Care Act 2012.

And this is the Secretary of State for Health demonstrating Parkour:

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