Privatisation is at the centre of the "ongoing fiasco" of PPE shortages, according to a new report co-authored by a University of Greenwich business expert.
Detailed in the report, released today, is the privatisation of the NHS Supply Chain, and its break-up into 11 outsourced contracts. The authors say this has contributed to the failure of the NHS to acquire and distribute sufficient PPE (personal protective equipment) to medical staff.
The report shows how the procurement process itself has been entirely outsourced. Instead of being handled by civil servants directly employed by the NHS, companies such as DHL are in charge of selecting suppliers for the NHS.
These suppliers in turn select other private companies to make specific items, such as PPE gowns, and then hand them to another private logistics company to deliver them to the NHS trusts.
The authors detail how trusts have been told not to source PPE from local suppliers, but to use this centralised system. In doing so, every piece of equipment goes through four more layers.
The report authors, including campaign group We Own It and Professor David Hall of the university's Public Services International Research Unit, show that the privatisation of sourcing NHS supplies has created a "fundamentally dysfunctional system". The report adds that this has "severely undermined the national effort to protect NHS and care staff", which has "helped turn the pandemic into an utter disaster".
Professor Hall said: "Privatisation of the NHS supply chain has created a complex, fragmented, unresponsive and bureaucratic mess which has left us unprepared and ill equipped to tackle the current crisis.
"So much responsibility has been outsourced to so many contractors that the secretary of state cannot know what he is doing. It is shocking that DHL, the parcel delivery subsidiary of Deutsche Post, has been deciding how to spend over £4billion of the NHS budget.
"The entire system must be simplified and brought under direct NHS control, with clear lines of accountability. This is work which should be done by civil servants employed by the NHS, responsive to the needs of their fellow workers. It needs a public service culture of prioritising safety, long-term planning and smart use of skills and resources within the NHS, local communities and the local manufacturing sector."
A central problem the report identifies is the "just in time" business model used by logistics contractors such as Unipart in the stocking and distribution of PPE.
The "just in time" model is common in industries, such as car or electronics manufacturing, and is designed to reduce stock levels. However, the report argues that this creates risk for the NHS that sufficient supplies are not available to manage unforeseen events, such as the current pandemic.
Stocks of key PPE items were not maintained by the contractor responsible for the pandemic stockpile. NHS trusts were warned that their orders for PPE might be treated as "excessive" and "may be subject to automatic system reduction or cancelled".
A number of private companies also face specific criticism in the report, including those involved in the procurement process such as DHL and Foodbuy; logistics companies including Unipart, Clipper Logistics and Movianto.
We Own It Director, Cat Hobbs, added: "It is beyond scandalous that so much of the coronavirus response has been handed over to private companies - companies that have failed time and time again to deliver. Whether it is Unipart or Deloitte, Movianto or Clipper Logistics, these companies should be kept well away from our NHS.
"This crisis has shown us that the NHS is made far more vulnerable by privatisation, and so many failings - from the failure to distribute sufficient PPE to the ineffective approach to testing - lie at the door of private companies.
"From now on, we need to ensure that our NHS is run in the interest of public health, not private profit. In doing so, the government needs to reinstate it as a fully publicly owned and run health service."
