Established 2005 Registered Charity No. 1110656

Scottish Charity Register No. SC043760

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Concern over homeless health services

May 21 2009
Open commissions could lead to readers being sidelined and forgotten Healthcare professionals have voiced concerns about the future of financial support for homeless health services, fearing open commissions could lead to those on the street being sidelined and forgotten in a bid to maximise profits. But while changes within NHS will affect everyone in the country using it, it is likely it will hit those living on the streets hardest. Commissioning is the process by which a Primary Care Trust (PCTs) distribute money to health service providers. This in itself is not a new system, but now, with open tendering, the potential for the PCT to ‚Äö?Ñ??sell off' services has been legitimised. Any willing provider ‚Äö?Ñ?¨ from the private, public, and third sector - is welcome to bid for a service. If you have the experience and staff, the only criterion is that you outbid the others. And when it comes to commissioning, it is most likely that a PCT first choose those which it has difficulty funding, particularly those working with people who might not give a good financial return. The concern is that this is a conscious step by the NHS toward privatisation. Dr Ron Singer, president of the Medical Practitioner's Union (MPU), says: "I fear very much for the direction that the NHS is moving in - getting the private sector in to basically offer services to hard to reach groups. The culture of privatising the NHS is awful. It will lead to fragmentation of all public services and profit will be put before care." Open tendering, it is believed, would allow commissioners to gamble with the future of health services that are under financial pressure. Yet, according to The Department of Health, the changes made within the commissioning process encourage PCTs, local housing authorities, directors of public health, and voluntary organisations to come together to improve local health services for the homeless community and promote joint commissioning where necessary. Yet it is thought problems will arise, and that while this restructuring of the commissioning process will unsettle all users of the NHS, our readers will be among those most affected. Indeed, there are bids pending on Primary Care for Homeless People (PCHP) in Camden. PCHP provides homeless healthcare within surgeries and day centres in Camden, notably in King's Cross and Spectrum day centre, but due to funding constraints PCHP was put on the market last year. We are yet to hear who has successfully bid for it, although St Mungo's is known to be interested. Meanwhile we can report that Great Chapel Street Medical Centre, in Soho, is safe from closure thus far. The Great Chapel Street practice, which offers a walk-in medical centre for homeless people who are not registered with a doctor, has come through the commissioning scheme unscathed. A Westminster spokesperson said: "The Great Chapel Street practice provides an essential service to patients in Westminster and there is no intention to change that service. The PCT is committed to improving access to services for homeless people." But do such words ring hollow? Is this simply rhetoric? The MPU has been tracing the whereabouts of the millions of pounds that had been invested in the NHS under Labour. Dr Helen Groom, of the MPU, found that the majority of the money was distributed to a few PCTs who then invested in the private companies that are moving into the health services independent sector. "This is a poor use of money," says Dr Groom. "Now PCTs are looking at where they can cut finances. Most vulnerable groups, in other words refugees and homeless people, go first."