A Virgin’s Health

I recently attended one of Virgin’s regional road-shows organised for GPs who Virgin thinks might consider joining up with Virgin Healthcare for any number of reasons. Virgin set out its terms for doctors to join and spoke about its agenda.

The audience was not allowed to audio or video record the presentation, so you would understand my suspicions about minimalism of truth. You might say that you already know that Virgin is no epitome of altruism, and that Virgin is charging in to save the NHS more for itself than for the country. You might even add that despite similarities in running a railway business and the business of healthcare, we should not trust Virgin to run health as it is actually struggling to run its railways.

Both railways and health are rich with vast amounts of tax-payers money. That is why Virgin is interested in health, which is much bigger than railways. Public sector health spend is £100 billion in 2007 or 6% of GDP, but this is expected to rise to 37% in 2050 (Virgin slide based on Investec Investment Banking Healthcare Review, January 2008). Some cake indeed!

Yes, Virgin is willing to take over some elements of financial risks away from GPs, such as cost of premises. But it wants all non-clinical staff to be TUPE-ed over to Virgin, and staff must then be coached on Virgin’s corporate approach. Even doctors will have to portray the Virgin ethos in dealing with their patients. So what, you might ask?

In joining Virgin, doctors are told that they can keep their GMS incomes, but must agree to achieve a minimum QOF target score. In effect, doctors end up with two masters – the PCT with whom GPs must comply with the ever changing and inappropriate regulations, and Virgin who requires a minimum QOF score and compliance with the Virgin brand customer (patient-doctor) relationship as stipulated in their service level agreement. GPs joining Virgin for all intents and purposes will have become employees in all but name. Inland Revenue will be watching this closely.

Therefore, once a GP signs up to Virgin, he or she has no employment security any more. Virgin is ready to take over when the GP falters, as will surely happen before long. Clever ploy indeed!

Virgin is unabashed about building its profile and brand name in the world of healthcare. But it has not been transparent about the fate of doctors or the NHS. No mention is made of care of long-term dread conditions such as respiratory failure, end-stage kidney disease, strokes, multiple sclerosis, psychosis, dementias, cancers and terminal care.

Mixing commercialism with healthcare is good for businesses but bad for citizens in a way that is directly proportional to their real needs.

Finally, to demonstrate quality assurance, Virgin says it will set its own standards of accreditation in collaboration with the Royal Colleges that are applicable to the profession. That may or may not have been designed for an ulterior motive, but it could be speculated not unreasonably that the end game is some sort of a private learning centre that leads to awards of parallel medical degrees! After all, the various Royal Colleges are craft institutions, so an ambitious Virgin could overarch all of them. It has already established Heads for the Virgin Department of Dentistry and the Virgin Department of Therapy. Virgin is actively recruiting in all styles - soft sell and hardball.

Labour thinks that dismembering the NHS and hiving off various parts to the private sector leads to better healthcare. Unfortunately, the evidence so far is an irretrievable slide into a poorer and fragmented health service that is going to cost even more!

Will anyone join me in saving the best of British medicine for posterity?