Health Services Or Public Transport, The Contractual Issues Are The Same.

PFI contracts are again in the news, as the London Underground Northern line grinds to a halt and no-one knows who to hold accountable. But what does this also tell us about private (and social entreprise) service provision which is bought in by NHS and Foundation Health Trusts? Private sector buy-in contracts need careful thought if they are to deliver what is expected, no more, no less. So who is going to provide this legal scrutiny?
”No-one, it seems, is in charge…. London Underground needs a simple line of control and responsibility and does not have it…. In truth the problem is not the involvement of profit-making companies in the underground, but the terms on which they are involved and at present these are failing badly.’ Thus runs the Guardian’s second editorial today.
Just two days ago (this website, NHS Contracts and Foundation Hospitals: Who has the Legal Expertise?) I predicted that issues around PFI would continue to run, and that the problems which have plagued PFI contracts would in all probablity also plague new Health Service arrangements. It didn’t take long to see that unfortunately there is indeed mileage in this prediction.
The NHS is now taking financial management very serously indeed. How long will it be before there is similar attention to matters contractual? Significant external commercial partnerships are a fairly new development in the NHS, which has almost always previously provided its own in-house services.
Much has been made of the political implications of private service providers being involved in the NHS, but I wonder whether the same reservations would be applied to social enterprise involvement? If the answer is No, social entreprise involvement is alright, but private sector provision is not, then perhaps we have our eyes at least partly on the wrong ball if we simply dismiss the idea of buy-in as such?
Given the complexities of modern technolgies and economies, does it matter where the service comes from, as long as it’s good, in budget, well-delivered and properly accountable and managed?
It’s the management and accountability issues which are critical – and it’s here that NHS and Foundation Trusts need to think very carefully. They are accountable, and they need to manage.
There are an awful lot of smart city lawyers out there. We must be sure some of them are on the public service side when it comes to negotiating health provision contractual arrangements.

Posted on October 18, 2005, in Education, Health And Welfare, Knowledge Ecology And Economy, Politics, Policies And Process, Regeneration, Renewal And Resilience. Bookmark the permalink. Leave a comment.

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