From Keep Hackney NHS Public

With no time for union reps to organise attendance after Christmas the PCT Trust Board agreed a move to an Autonomous Provider Organisation on 9th January.

A union rep reports: "This will be a move towards a complete and rigid separation of commissioner and provider services. APOs are seen as a transitional arrangement while 'scanning the horizon' for alternative organisational forms – which could be social enterprise companies, out and out privatisation, community foundation trusts ... The paperwork tries to fudge this a bit, but this is the way it works everywhere else. This is not a static arrangement – it's destabilising, fragments the NHS, and is very likely the first step towards stripping some or all primary care services out of NHS provision altogether. There is also lots of talk of which services can be 'market tested'. I don’t know how much accountability or public control there is over an APO, or to what extent they're obliged to adhere to NHS policies – I’m still pretty ignorant about them.

"All this is being done under the auspices of PUK – Partnerships UK – a public-private partnership set up by the Treasury, but with a majority private sector ownership – Barclays Bank, Global Solutions Limited (the people who run private prisons and detention centres for refugees – very nasty people, SERCO, Prudential, Abbey National, ... PUK's mission statement is all about 'the efficient use of public assets through better and stronger partnerships between the public and private sectors'. PUK 'Module 2' is explicitly about setting up an APO as a temporary arrangement while investigating new organisational forms. This is apparently happening across much of West London, but C&H can’t bear to see a nasty govt initiative that they’re not part of.

"The new arrangements are intended to be put in place by April 2008 ie. immediately in practice. It remains very unclear what will happen to support staff. We’ve only just completed the last restructuring and they’re now planning to do it all over again – the impact on staff morale will be massive."