THE courageous campaigners of Cambridgeshire should take a bow, having halted the biggest potential privatisation so far since the Health & Social Care Act.

Undeterred by the apparent odds against them, the Cambridgeshire campaigners got stuck in, challenging the secretive process put in place by Cambridgeshire and Peterborough clinical commissioning group (CCG), its refusal to divulge any details to the public and its attempt to force through the tendering of a complex £800 million five-year contract for a care pathway for older people’s services with no consultation.

The plan dreamt up by the shadowy Commissioning Support Unit, which stands behind the CCG, involved a complex contract linking not only services in the community and outpatient care, but also hospital care, including accident and emergency.

The CCG had made no attempt to negotiate these changes with local NHS providers, despite the fact that the local trust delivering community health services, Cambridgeshire Community Services, was already delivering high-quality care. 

To raise suspicions further, the initial shortlist of bids — and every succeeding list — included a majority of private-sector providers. 

Cambridgeshire Community Services was soon eliminated in its own right, and its ill-advised link-up in a consortium with Optum — aka UnitedHealth, the US-based multinational — was also swiftly eliminated.

The campaigners kept up the pressure, demanding the publication of basic information on the contract itself and what was being asked of the bidders. 

The threat of a legal challenge to the CCG for its failure to engage with the local public eventually forced a grudging, last-minute publication of a heavily redacted and out-of-date document.

But the continued pressure also succeeded in delaying the process and the the CCG eventually agreed, unwillingly, to go through the motions of a “consultation” — although its intentions remained quite obvious.

Campaigners, banging home their point with leafleting, meetings, town centre stalls and lobbies of the CCG, focused on exposing the failures and shortcomings of the private-sector companies involved in tendering.

One other factor which helped the campaign was that the contract itself offered little in the way of sure-fire profits, and some companies began dropping out and withdrawing bids even before the CCG could decide. 

Serco, up to then a market leader in tendering, was one of the first to drop out — a prelude to its later decision to pull out of all tendering for clinical services, revealing losses on many of its contracts.

Revelations by the GMB that the lead clinician driving the CCG’s tendering process, Dr Arnold Fertig, had only recently been a director of a subsidiary of Virgin, one of the bidders in the final shortlist, piled on the embarrassment — but many still feared the CCG would tough it out and privatise.

Soon after the shortlist was reduced to just four — an NHS bid led by Cambridge University Hospitals and three private bids — another private consortium, this time led by Interserve, pulled out, leaving the NHS bid up against Virgin and Care UK.

Cambridgeshire Community Services, having been excluded from the process, intervened to warn that the CCG was attempting to impose an unrealistic timetable for the handover to whoever won the contract — and the CCG reluctantly postponed implementation of the new contract to within weeks of the 2015 election.

Campaign pressure was maintained. We may never know what tipped the balance, but on October 1 came the welcome announcement that after the entire rigmarole of the tendering process, costing well in excess of £1.1 million before NHS management time is taken into account, the Cambridgeshire contract had been won by the NHS bid.

The CCG has shown that tendering need not always result in privatisation. 

However better and cheaper results that would improve and integrate services for older people could have been achieved more quickly and simply — by talking to the local trusts. 

The one big loss for local people is that Cambridgeshire Community Services has now been excluded from the contract — and a hugely complex and legalistic contract has now been put into place which may well cause financial headaches for the new NHS providers.

However one plus is that NHS bids do not have to deliver shareholder dividends, so resources can be focused on patient care. 

Local providers already have experience, organisation, committed NHS staff with proper training and recognition deals with the unions.

So the campaigners who made life so difficult for the privatisers have helped the fight everywhere. 

As CCGs up and down the country line up their various irresponsible plans to carve up and hive off services regardless of the threat to destabilise vital local NHS trusts, every challenge is important.

In Staffordshire, Cancer Not for Profit, the mass campaign that has already amassed thousands of signatures against plans by local CCGs — shamefully egged on by cancer charity Macmillan — to contract out control of £1.2 billion worth of cancer and end-of-life services, also shows the way to fight back. 

Everywhere we have to challenge the tiny handfuls of arrogant GPs on CCG boards who are driving through plans for privatisation or reconfiguration without any reference to their GP colleagues and even less concern for the views and needs of local communities.

The floodgates of competitive tendering, fragmentation and privatisation were of course deliberately opened up by the Tory Health and Social Care Act — while campaigners are fighting rearguard actions now to contain the damage, it’s clear that if the Tories get back in next May, an even weightier privatisation juggernaut will slice out all of the profitable parts of the NHS, leaving the spending freeze and cuts to whittle down what’s left.

Labour started the rot with its determination to find a growing role for the private sector from 2000 — but it has more recently been talking up its commitment to repeal parts of the Tory Act and is backing a private member’s Bill along these lines in the name of Clive Efford MP. 

Ed Miliband has even proposed to inject more cash into the flagging NHS finances, although nowhere near enough to repair the damage done since 2010. 

Campaigners, still bitterly aware of Labour’s record under Tony Blair and Gordon Brown, will be demanding more than talk from Miliband and Ed Balls. 

To reinstate the NHS and repel the privateers we will need more than the limited, if welcome, measures of the Efford Bill. 

We need a commitment to legislate to sweep away the competitive market in healthcare, along the lines of the draft NHS Reinstatement Bill drawn up by Professor Allyson Pollock and lawyer Peter Roderick. 

The NHS budget also needs a sustained commitment to increase spending above inflation each year to catch up lost ground and meet growing needs and cost pressures.

All this means that whoever wins in May, the fight will have to go on.

Nottinghamshire’s Sherwood Forest Hospitals Foundation Trust is the latest to reveal the scale of its rip-off payments under the private finance initiative.

The trust is forking out a massive £3.56m each month — almost £1 in every £6 it receives — to service the £320m PFI on the new King’s Mill Hospital. 

The total repayments, including some support services, will come to a staggering £2.5bn — eight times the initial cost. 

Sherwood Forest has a projected deficit this year of £26.37m — 10 per cent of its total operating expenditure.  

Two-thirds of the trust’s underlying deficit is seen as the result of the extra “cost burden” of the PFI contract — for which the trust is seeking central support, so far without success.

This is just one example of the nightmare created by NHS PFI schemes, which are now set to cost almost £80bn to repay £11bn of investment. 

Labour remains silent on this grim legacy of the Blair/Brown years, but if Miliband wins next May, with this and many other PFI-lumbered trusts fighting for survival, the questions will come back to haunt him and ministers like Balls who still argue that PFI is a good thing. 

It’s high time Labour faced the facts and committed itself to reject any further PFIs and force renegotiation of the contracts of all of those like Sherwood Forest that are milking fat profits from struggling trusts to line the pockets of shareholders — many of them in tax havens.

John Lister is director of Health Emergency.