A few days before the general election I found myself increasingly frustrated as I tried (and ultimately failed) to get a family member to understand the threat to the NHS from privatisation. He had 2 lines of argument that I just couldn’t break through.
1. Boris has said that the NHS won’t be privatised
2. Even if it is privatised that’ll just make it more efficient.
Trying to get him to understand the contradiction between his two points was as useless as attempting to make chicken soup from a brick. He just wasn’t prepared to listen, preferring instead to flood my Twitter feed with American alt-right memes equating socialism with totalitarian communism and countering any attempt to provide reasonable balance with accusations of Marxism or just plain accusations that I was lying to him.
Well, it’s now a little under 3 weeks since the election that gave Boris Johnson an overall majority and carte blanche to do as he pleases with Britain’s economy, with the country’s approach to rights and of course with our precious public services like the NHS. So let’s review the situation, shall we?
First some history. It’s not true to say that the NHS won’t be privatised when large parts of it already have been. Private providers are rife, especially in the South of the country where Richard Branson’s ‘Virgin’ owns huge tracts of the service which are run for profit. This is the company that managed not to pay a single penny in corporation tax in 2017! The service may continue to operate under the NHS umbrella but it’s modus operandi is very far from that of the rest of the service.
NHS contracts go to private hospitals, private outpatient departments, private GP surgeries and even private ambulances. Many of these firms are indeed American, by the way so it’s very definitely not true to suggest that US healthcare firms aren’t interested in the NHS. They are and they have been for quite some time.
Almost a quarter of NHS mental health beds are now in the hands of private firms and they are paid handsomely out of the public purse for their efforts. This includes approaching half of the child and adolescent mental health services (whether in the community or hospital). And we all know how hard it is for adolescent mental health services to cope with demand – perhaps we can also see why.
Three private firms, Elysium (Luxembourg), Cygnet (US) and Acadia (US) own and make huge profits from British mental health services and yet they are responsible for fully thirteen of the sixteen mental health units judged “inadequate” by the Care Quality Commission in 2019.
All of these services continue to provide care that is free at the point of delivery but there’s a catch. Well, actually there are several catches…
1. Private companies tend not to provide the less profitable services – they cherry pick the ones they can make most money from, leaving the NHS to carry the cost of the really expensive treatments and procedures. In the past the NHS used money from one pot to subsidise others but that’s no longer possible. The delicate balance of public health care budgeting is being destroyed by private profiteers.
2. Private companies don’t train staff – they let the NHS do that and then they poach them. This may make them look more efficient but that’s only because they’re relying on the public purse to train their staff – staff the private firm then uses to make money for its shareholders. And make no mistake – it is all about profit. The money the NHS ploughs back into research and development is the same money that private firms plough into shareholder dividends. That means for every procedure done privately there will be less money available for treatments next year. It’s an endless spiral, a race to the bottom as we can see…
3. Private companies starve the NHS of funding and resources as outlined above. They leave the NHS impoverished as it struggles to provide the most expensive services with less and less funding. This inevitable results in reduced conditions for staff, run down buildings and equipment, overworked staff and even closures of hospitals and departments. We have seen al this in spades over the last few years, beginning with new Labour but dramatically increased in pace since the ConDem government changed the rules in 2012 to make it easier for private companies to cherry pick work from the NHS. It’s interesting to learn that many of the ConDem ministers involved also hold shares or even sit on the boards of private healthcare companies.
4. It’s not uncommon for private surgeries to go wrong and need to be fixed by the NHS. Private firms still get their money but don’t compensate the NHS for sixing up their mistakes. This cost the NHS £250 million in 2016.
5. The NHS is publically owned. That means it’s an ‘arm of the state’ and as such is bound by human rights legislation, freedom of information and data protection legislation to a much higher degree than private organisations are. If you want to know what’s happened in the NHS you fill in a Freedom of information request and the information is provided in keeping with the Data Protection Act. If you want to know what happened inside a private organisation… well… erm… not so much.
6. Healthcare data is worth a fortune to private companies who sell it to insurance companies, marketers and even political organisations (via third parties, of course). Why wouldn’t they? It’s all about profit in the private healthcare market.
This isn’t the complete list of reasons why private healthcare is strangling our NHS but it may include the most significant. At least the most significant to date.
On December 28th 2019, 15 days after we learned of Boris’ electoral victory the news broke that the government is inviting still more private firms to tender for the right to deliver NHS cardiology, paediatrics, oncology and gynaecology services. Officially this is a way to cot waiting lists but hang on a minute. Given the 6 points listed above is private healthcare really the solution to waiting lists or is it actually the cause?
This government, like the tory and ConDem governments that preceded it is using our health as a political cash cow. We’re the victims, sacrificed to ever increasing lengths of stay on hospital trolleys in A&E, all in the name of profit. Our NHS diminishes in size, in scope and in quality whilst private entrepreneurs profit from providing sub-standard care in its place. And you tell me that the NHS hasn’t been privatised.
I think you’d better go and give your head a wobble.