NHS: beginning of the end?
With the new Health and Care Bill, and funding cuts pushing the NHS to breaking point, Curtis Daly explains exactly how the Tories are setting the scene to privatise the NHS.
“Now, the National Health Service had two main principles underlying it. One, that the medical arts of science and healing should be made available to people when they needed them, irrespective of whether they could afford to pay for them or not. The second, was that this should be done not at the expense of the poorer members of the community, but of the well to do. In short, I refuse to accept the insurance principle.”
The government’s Health and Care Bill aims to remodel NHS England, and not in a good way. Currently, the NHS does have private provision, despite any form of privatisation being massively unpopular. This particular bill goes much further by expanding private companies to have a say on how it is run.
Clinical Commissioning Groups, made up of GPs, are in charge of local services and how they operate. The Health and Care Bill will scrap over 100 of them, and replace them with ‘Integrated Care Systems’ which will span over 42 regions.
The ICSs are made up of Integrated Care Partnerships, that consist of Integrated Care Boards…. Confused yet?
The important part to look for is who’s represented on these Care Boards. It will range from charities, councils… and private health firms.
What insight do private health providers bring to the table? Nothing except profitability over the quality of care. The aim is not to provide patients with the best services but to serve shareholders.
That is the whole point of these structural changes – to move public wealth into private hands.
HISTORY OF NHS PRIVATISATION: PFI
There have been attempts to privatise the NHS for decades. In 1992, Private Finance Initiative or PFI’s were brought in. This was a significant leap toward privatisation.
PFI gave private companies huge contracts to build public infrastructure such as hospitals.
What was great for companies was the terms of the contracts. Instead of the government simply using traditional spending methods for investment, PFI meant that we borrowed from the private sector. The repayments involved very favourable terms for those companies, costing us more.
According to the IPPR think tank, NHS England owed debts of £55bn to private companies in 2019. £13bn worth of borrowing will end up costing NHS England £80bn when contracts come to an end in 2050.
On the face of it, it’s clearly a scam. Why would we choose to pay more for investment when we could just make it ourselves? When successive governments are in bed with business, it all makes sense.
PFI has been used by both Conservative and Labour governments.
Health and Social Care Act
The Health and Social Care Act was a significant move to privatisation. Before the legislation was brought in, hospitals were restricted to only making 2% of their income from the private sector. This dramatically increased to 49%.
The increase of privatisation on this scale pushed competitive tendering, and according to Keep Our NHS Public resulted in “endless rounds of hugely expensive competitive tenders, leading to disastrous fragmentation”.
Between 2010 and 2015, the private sector was awarded 86% of pharmacy contracts, 83% of patient transport contracts, 76% of diagnostics, 69% of GP out of hours, 45% of community health contracts including children and adults with learning disabilities, and 25% of mental health contracts.
The National Audit Office has investigated the government on Covid contracts producing two reports:an investigation into the supply of personal protective equipment and another into government procurement during the Covid-19 pandemic.
The reports expose that £17.3bn Covid related contracts were awarded, £10.5bn of it was given to companies with no competitive tendering.
This can then lead to scenarios such as Matt Hancock’s ex neighbour bagging a £30m contract to produce plastic vials for testing kits… through a WhatsApp message.
That is exactly what these reports concluded when it was found that companies with political connections were ten times more likely to be given a contract.
This doesn’t indicate that decisions were based on quality of outcome but for business interests.
Labour and especially Tory governments have usually denied privatisation, but nobody is falling for it. In 2005, a book was published named Direct Democracy: A New Agenda For a New Model Party.
This book, calls for the NHS to be ‘denationalised’. One of the co-authors of the book was former health secretary Jeremy Hunt.
The Conservatives record on the NHS has been appalling. The NHS is on the edge of what could be its worst winter crisis ever. The waiting times in A&E are at its worst since records began. Response times are three times longer than the target of 18 minutes, and 30% of admitted A&E patients are waiting more than four hours to get a bed.
It’s easy to see why when the levels of spending were well below the average for a decade. The annual increase of spending has been just under 4% since its creation, with record spending of 6% between 1997 and 2010. The coalition government dramatically cut its funding to around 1% with a marginal increase just before 2019.
This is the Tories oldest trick in the book. Systematically underfunding a service and bringing it to breaking point – paving the way for private contracts and ultimately full privatisation. They can then make the case for a US style health care system where care isn’t rationed on need but on the size of one’s wallet.
Examples of a US style system include a woman named Anne Soloviev who had to pay $1,500 a month for toenail cream that… didn’t work. Janet Winston was charged $48,000 for skin testing and a BuzzFeed user claimed they were charged 2.2 million dollars for their NICU baby who was born at 28 weeks.
The National Health Service is Britain’s finest creation. After the bloody second world war, a new consensus was forged, that of community and collective effort. The health service showed the best of this nation, taking care of everybody regardless of financial worth.
For decades that has been slowly dismantled, and this Health and Care Bill is the biggest risk to the principle of health care free at the point of use in history.
The NHS will only survive if there are those who are willing to fight for it; we must protect it at all costs.
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