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How the super-rich cheat up to £85bn on dodged taxes
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PFI is a con. I've got an article a mate wrote about it for a webzine I used to edit. I'll try and dig it out....
The Private Finance Initiative and Corporate Welfare.
by Dave Stamp
As some of you may be aware, Birmingham Health Authority has recently announced the exciting news that, 'at the start of a new century, the people of Birmingham together with the statutory bodies responsible for the NHS in Birmingham, have an opportunity to secure hospital facilities that will...meet the needs of generations to come.' Those of you with a nose for this sort of thing may well have sussed that this translates as an 'opportunity' to close hospitals, and you would be right. In this article, I hope to shed some light on the implications of 'opportunities' of this type, both in Brum and elsewhere in the UK(plc), putting the situation into some sort of wider political context.
In Birmingham, then, the plan is to demolish both the Queen Elizabeth and Selly Oak Hospitals, replacing them with a new, single-site, state of the art hospital complex. The rationale for this, the Health Authority claims, is that the existing buildings are crumbling before one's very eyes and, as a result, severely constrain the quality of the health services provided in the south of the city. Now, at this point I'd just like to step in and say that there is some truth in this claim. I actually work at Selly Oak Hospital, and the environment is pretty much what you'd expect of a converted Victorian workhouse which runs at about two-thirds of its staffing capacity simply because of a political refusal to pay nurses a decent living wage. That, however, is not to say that the 'opportunities' for change offered by the Health Authority are in any way an improvement.
To understand why that is the case, it is essential to consider how the new hospital is to be paid for, and how that fits in with the ideology of the 'New' Labour Government. In line with the thinking of the previous Tory Government - which, in its turn, was shaped by the conditions set out in the Maastricht Treaty - any new developments within the National Health Service have to be opened up to competition, enabling private companies to bid for them. This is the Private Finance Initiative (PFI). The general ethos behind it is a sort of Free-market Fundamentalism, which argues that the market is the most 'efficient' means of allocating resources. Healthcare and other public services, therefore, can only be delivered efficiently within a competitive market environment. According to the government and its partisans, PFI is a way of getting public buildings built without recording capital spending in the national accounts. The public, theoretically, gets a shiny new hospital, but the taxpayer doesn't end up footing the bill. But, as most people realise by the time they're old enough to tie their own shoelaces, you don't get anything for nothing : particularly when you're dealing with bankers and property developers.
Under PFI procurement an NHS Trust enters into contract with a private sector consortium which will design, build, own and manage the hospital, while the Trust itself will provide only the clinical services (i.e., Doctors, Nurses etc.) The Trust's existing assets are made over to the consortium, and the Trust then makes an annual payment to the consortium for the use of the hospital. What this means, with specific regard to Birmingham, is that the Selly Oak and Queen Elizabeth sites are to be bulldozed and the land sold off for property development while a business grouping builds a new hospital, which it will own and rent for an as yet unknown sum to the NHS Trust. A large part - if not most - of the revenue from the sale of the NHS's assets will be handed over to the consortium to finance the development.
In other words, two hospitals owned and controlled by the NHS, founded and operated on the ethos of universal free healthcare, will be replaced by one hospital, owned and run by private financial interests for a profit, but heavily subsidised in the first place by the sale of NHS properties. Now, maybe it's just me but, frankly, that sounds rather more like a stitch-up than an 'opportunity'.
As ever, the official government rationale for the injection of market forces into our health and welfare is 'efficiency'. Consumer demands on the welfare state have grown to such a degree that it is no longer practical or realistic to expect healthcare provision to be funded entirely out of the public purse. Accordingly, we are told, it is necessary to look for new sources of funding, which will take some pressure off the NHS, ensuring that more money is available for clinical services. Theoretically, therefore, all PFI schemes are subject to rigorous examination to ensure that they meet the two criteria of 'affordability' and 'value for money'.
Yet, even on its own terms, this argument falls down. The British Medical Association has noted that, far from saving
the NHS money, PFI developments place far greater demands on public revenue than public sector procurement. For one thing, the average costs of PFI developments to date across the country have been calculated as 72% greater than the various consortia's original estimates. Far from proving 'affordable', in other words, PFI schemes have so far been a licence to print money for private business interests at the NHS's expense, amply demonstrating Noam Chomsky's maxim that the wealthy are wholeheartedly in favour of socialism, provided that they are the beneficiaries. Or, as the British Medical Journal recently put it, PFI is a 'perfidious financial idiocy that could destroy the NHS'.
Underlying this general inefficiency is the very nature of the hospital developments that PFI, as a funding mechanism, favours. Quite simply, there is no financial incentive to refurbish existing hospital buildings, as the scope of a relatively small-scale project of that nature does not allow for a significant return on any investment. While Birmingham Health Authority's executives have kept quiet on this issue, it is probably worth pointing out that this drive for profit may well have a bearing on the sudden 'discovery' that the two existing hospitals are beyond salvage. It's certainly quite strange to note that, as recently as 1994, the Health Authority's Chair announced a capital investment of over 60 million pounds into the two existing sites, 'designed to create modern centres of excellence to rival advanced acute hospitals anywhere in the world'. If the hospitals were potentially 'centres of excellence' five years ago, and consequently worth spending money on, how have they so rapidly become lost causes?
In other words, criteria of 'local affordability', rather than health needs, become the factors that determine the nature of new NHS hospital developments. To get a whiff of interest from the 'business community', obviously, the health trust has to guarantee revenue. This system, as has recently been pointed out in The Guardian, (5/7/99) favours those with land to sell and/or those willing to make cuts and closures. Rather than an exciting new health 'opportunity' for the 21st Century then, PFI is an instrument of health inequality.
Again, the point is proved by the Health Authority's plans for South Birmingham. At present, the Queen Elizabeth and Selly Oak sites combined offer 1070 inpatient beds. Anyone who has either worked or been a patient at either hospital will know that this capacity barely meets the local populationÕs needs, particularly during the busiest winter months. The Trust's plans estimate a 'revised' bed capacity, on the new site, of 950 beds. And, obviously, using the market logic of our times, fewer beds means fewer staff. So the Trust Executives anticipate a reduction of between 450 and 500 workers, while many of the non-clinical staff lucky enough to still have jobs will miraculously find that they are no longer employed by the dull, old NHS, but by private employers, with 'new', Third Way ideas on pay and working conditions .
And if that all sounds like A Bad Thing, bear in mind that thatÕs only based on what the Trust is actually admitting. Estimates from other sources paint an even bleaker picture, so that South Birmingham Community Health Council, the local health 'watchdog' which is vigorously opposed to the PFI scheme, anticipates cuts to in-patient care of around 50%, while other critics have noted that the drive for revenue inherent within such projects necessitates an increase in private beds.
In case I haven't actually made this clear enough, what we're talking about here is: fewer hospital beds for those who need them; an increased likelihood of charges for such beds as there are; fewer jobs, with worse working conditions for those who have them; all housed within a building which the NHS will rent for the duration of a fixed term contract, but will never actually own. The National Health Service, essentially, is being privatised with the minimum of debate or discussion, while those with the most to lose from this process - health service users - have the privilege of paying for it. And, in a beautifully Blairite touch, all of this is being sold to us in the guise of an 'opportunity'.
Clearly, there is a need to organise against this; health service workers, trade unions, user groups and anyone else who cares about the notion of health as a fundamental human right, rather than another commodity to be bought and sold, should be getting together to raise awareness of what's happening within the NHS. But a useful first step would be for readers of this article to make their views known to the Executives of Birmingham Health Authority. The Authority have produced a 'consultation document' on their proposals to 'renew' our health service, and they are inviting members of the public to express their views, no later than August 16, 1999. (In a wonderfully Kafkaesque twist, it should be noted that they specifically do not want comments on the funding and ownership of the new hospital - i.e. The Things That Matter - because 'the source of capital funding for the development will be directed by government policy. {We are} therefore not consulting on the source of capital finance, as that is not within our legal powers.' Isn't it great to know that you live in a democracy?)
Please make the effort to let the Authority know what you think of their plans to privatise our local health resources by writing to:
Mr. Michael Waterland
Birmingham Health Authority
St. Chad's Court
213 Hagley Rd.
Edgbaston
Birmingham
B16 9RG
or by e-mail to:
info@hq.birminghamha.wmids.nhs.uk
Only if you believe the hype.
PFI means the Government can pledge to spend money on new hospitals, without it showing up on the audit accounts. It is, as far as the government see it, money for nothing. It costs lots more, but it doesn't cost lots more in one go.
It's buying a hospital on credit, with an interest rate that twats the living daylights out of you.
In essence, though I think that's a bit simplistic.
I'm not sure, I think privatisation is only one reason why they do it- the fact that it costs nothing to start with is also a good thing for a government worried about a deficit.
One criticism though, the beds argument is flawed. The majority of NHS Trust are inefficient in their use of beds with huge numbers of patients staying longer than necessary. I don't mean the lengthy "delayed discharges" which hit the press and have Social Services jumping for cover - I mean the patient who stay one day longer than necessary.
80% of patients stay less than 7 days. If you can reduce this by one day you will reduce the need for an enormous number of beds.
We also need to consider whether all of the people, currently using beds, actually need to do so. Many patients are admitted for "observation" and don't recieve any treatment - so is the right place for them an acute bed, or would they be better servced by a community beds or better still by being "observed" in primary care.
With 17m people currently suffering from Chronic Diseases, would we do better to invest in treating these people in primary care - preventative medicine too - rather than investing in bed space for these people because we didn't treat them in their own homes when we could.
This also impacts on the staff you mention, those who "may" lose jobs. The reality is that we need trained staff in primary care so that we can offer greater input in the community. Because these staff are then travelling, this role is much more labour intesive - where one nurse could treat 20 people a day in hospital, a community service only offers the opportunity to treat about half of that.
Out of interest, private business has always seen the NHS as a "cash cow". It was interesting to see how prices increased in the weeks following the Govt announcing additional funding... :mad:
A penny saved from a taxman is a penny gained twice.
A penny saved from a taxman by a rich man is a penny gained three times.
hahaha
wheres the proof that the money rich people dodge is being used to help the economy
Why rich men’s money are so important for economy? Sigh… economics is quite an easy science if you don’t mix it with politics.
I don’t want to explain this simple thing, I want you to reach the proper conclusions by yourself… so think about this- for millennia people worked hard, for millennia there were lots of crazy talents inventing this and that, for millennia there weren’t a lack of good intentions but anyway, for millennia absolute majority lived in absolute misery. What does happen in the last 200-250 years? Why do we have cars and computers, planes and fridges, lots of food and clothes, are able to travel, to work 40 hours a week, to choose our careers and occupations, drinks and bands, lifestyles and T-shirt mottoes?
The only answer is Capitalism.
But what is the difference between a capitalist and a rich man of a non-capitalistic society let he be a Roman patrician, a Chinese mandarin, a medieval baron, a Communist party official or a Labour party apparatchik?
Don’t guess?
Not if I can help it.
Tally Ho chaps! Lets crack some commie skulls!
A reign of Edict is socialism or feudalism or communism or despotism or slavery or democracy whatever you like to name it.
A reign of Contract is capitalism.
A world where is no edicts that is no coercion that is no power that is no authorities is anarchy, An-Archy : No-Power. That is a world where only contracts are valid.
Got it?
It seems you my poor commie friend even can’t imagine a world of adult people based on voluntary agreements without this monstrous hermaphroditic nanny-mommy-daddy State with its big spoon and big club
the director of ici is an anachist ...we should all become capitalists
with no controls over how we make our money ...who we exploit to make it ...
capitalism =anarchy ...i like it!
And a poor man mugging that rich fucker is justice.
Do you know anything about political history? Obviously not. You don't even know the definition of the political theory you reckon you ascribe to.
Go back to school.
What's any of that got to do with anarchism?
http://flag.blackened.net/revolt/history.html
http://dwardmac.pitzer.edu/Anarchist_Archives/anarchisthistory.html
http://en.wikipedia.org/wiki/Anarchism#Anarcho-capitalism
etc etc
Its comments like the above that mean that I only ever read the politics forum and dont bother posting.
Welcome to politics and debate. If you're not a plank you're not likly to get it, though Blagsta is probably the bluntest of us. If you don't know what you're talking about, it'll get noticed quickly.
(a) that was your first post, so I don't quite believe you
(b) if you actually read these forums, you would know that labrat has a history of claiming that anarchism and free market libertarian politics are one and the same thing, when the history and actuality of anarchist philosophy proves otherwise
(c) labrat conveniently ignores the history and facts of anarchist philosophy
(d) it's rather irritating
a- Ive been reading the politics and debate forum for over a year now. The reason I have never bothered to post is because I have seen the abuse that some people get when they make "uninformed" comments or in some cases just disagree with other posters.
b-If Labrat doesnt understand certain poltical theories its no reason to be told to "shut the fuck up" IMO.
c- See b
d- If you find someone someone rather irritating in real life I very much doubt you tell them all to "shut the fuck up". Because you feel you are more informed than Labrat or that he doent listen to debate does that give you the right to swear at him? Surely a non response to his comments would mean he would get bored as he cant debate on his own? To behave like that on a message board in the safety of anonymity is weak in my opinion.
The one thing I have noticed is that certain members of this board are very harsh when others disagree with them, or dont seem to understand the points they are making. For example some of the abuse Lukesh has recieved IMO is compeltely unfair.
We all want people to understand different political theories, to be able to debate seriously and to be able to make informed decisions when it comes to voting otherwise democracy beomes a joke (many would argue our democracy is already but thats another point). If you keep knocking people down its not going to encourage their interest in politics.
If you actually paid any attention to this forum, you would know that people only get shit when they deserve it, i.e. they cannot argue logically, refuse to back up their points with any reliable evidence, constantly ignore facts, make racist or otherwise idiotic statements etc.
Again, if you actually paid any attention, you would know that labrat consistently posts ignorant nonsense and refuses to actually acknowledge the history and facts, even when pointed out to him.
See above.
I do actually.
Again, you know nothing of the history here.
Tough. That's life.
Again, you obviously don't really read this forum, 'cos if you did, you would know that I constantly post links informing people, but in labrat's case, he constantly ignores them. There's only so many chances you can give people.