The privatisation of the NHS has already happened – more or less since the introduction of market forces 2001-07. But it is a process, not an event. So it’s taking time for the public to realise, and meanwhile, they may be missing an opportunity to take it back.
But the renationalisation of the NHS will be a long, arduous process, even with an immense budget, as it will be fought through the courts as each private health provider bellyflops on the beach to the bitter end. And it’s a long way from happening. Mrs May is determined to take the ‘public’ out of public health care, and Labour isn’t paying attention.
So step by step, the privatisation strategy continues, bringing the NHS to its knees reducing budgets as if the world is running out of money, and replacing it with ‘fair’ tender contracts.
The Success Regime
One of the new arms of the strategy is the overarching governance, The Success Regime. The very use of the word ‘regime’, beautifully teamed with ‘success’ makes the phrase a perfect metaphor for ‘corporate fascism’. It has a cheerfully threatening tone. The language around all the documentation is scary, and it appears to be some kind of government takeover since each organisation that administrates it is a public body that reports to the Department of Health.
One of the first three ‘challenged local health economies selected to enter the Success Regime’ (see how creepy it is?! Sounds like the Hunger Games!) is North Cumbria. Now, Cumbria has its problems. But this new governance gives them ever more KPIs with patient targets of better-funded institutions, coupled with the stranglehold of endlessly rearranged budgets and the constant threat of collapse (to be replaced with private health care, of course). Not to mention restructures, where fewer staff work larger loads for the same money as before. Frozen wages in some cases. (Article is from 2013).
The Chair for the Success Regime, Sir Neil McKay, seems a very charming chap. He spoke to a small demonstration outside one of the consultation meetings, and reassured them their voices would be listened to. I heard somewhere he is being paid what I’d call an exorbitant amount of money to do the job, so I daresay he can afford to be nice to the people who are losing the beds at Alston Moor Cottage Hospital.
(At least Cumbria isn’t in the same situation as Devon, where it happens the ‘healthcare consultation company’, Carnall Farrar, ‘selected to provide consultancy support following a competitive tender’ is the baby of Dame Ruth Carnall, the appointed chair of the Success Regime (that followed as a result of Carnall Farrar’s consultancy, presumably). Nice).
So public healthcare as we think of it is on its way out in Cumbria, a long, painful, drawn-out death, not a quick one.
What will happen to our health care system?
The effect of a fully privatised American-style health care system on the British public most likely can’t be quantified or measured ahead of time. Americans say they still have to pay hundreds of dollars even when they are insured, so if you’re too poor to pay, you’re in trouble. Imagine not going to the hospital with a broken bone because you know you won’t be able to afford the hundreds of pounds it will cost to set it. That limp and the aching bone will last you forever. It’s why Dickensian characters are deformed (some of ’em, anyway).
What will happen to us?
Capitalism is destined to destroy itself by destroying its workers unless it is mitigated with a strong welfare state and health service. By turning public services into businesses, the NHS privatisation removes the need to deal with everyone. They only deal with those who can afford to visit. Bed numbers reduce, money is made, and everyone calms down and falls into place. To give it context, that was more or less Enoch Powell’s suggestion in 1961, and even he knew that couldn’t be called a health service.
The result is that even though ‘the weakling, the old and the subnormal would be left to die’, the workers also become less healthy, more sick, less likely to live as long …
But there is, if you can imagine it, a potentially deeper cost.
A cost that is, in a sense, greater than the lives of the people living today.
It started out as an unforeseen beneficial effect of the National Health Service, and now the entity is being slowly turned over to full-on market forces, this benefit has been forgotten again.
One of the things William Beveridge explained in his nation-changing report on the Welfare State (1942) was that the introduction of a National Health Service would make the workforce more well and fit. It would make the nation healthier.
He was wrong. Instead of being more well, the people seemed to become more ill.
What’s more, the whole thing got really expensive.
In 1946 when the NHS Bill went
to Parliament the estimate of the total net cost annually was £110 million. At the end of 1947 it was £179 million. At the beginning of 1949 a supplementary estimate of £79 million was added and the figures turned out to be £248 million. The actual cost in 1949/50 was £305 million. The following year it was £384 million. The government became alarmed.
There was one major cost they hadn’t accounted for, and they’re forgetting it again.
First of all, they underestimated the need. They’d based their figures on the people already using health care. Hadn’t accounted for those who were too poor to even contemplate it until it became free.
However, the most unforeseen result of the NHS creation was an explosion of medical research. With all the people coming to the doctor for the first time ever, doctors did more research and shared new information. University hospitals were renowned. Common diseases were eradicated within ten years of the inception of the NHS and new ones discovered, all because of research. Research cost money and it was worth it, because it was cheaper in the long run to cure and mitigate diseases.
So the people weren’t more ill in 1952; they didn’t go to the doctor before the NHS was formed, and the doctor was likely not to know what they had anyway.
Medicine and public health care is doomed without renationalisation
The medical profession is the epitome of respectability, but it’s only made a difference since free universal healthcare was made available. The research, the breadth of patients, the new information and wider experiences benefited staff and in turn made things better for patients. The NHS was a glory across the whole world for a long time. But all that new knowledge only occurred because the organisation came about.
Scientific research sponsored by drugs companies are not a replacement for truly unbiased research. It’s impossible to truly trust the research. Even charities who produce good and useful work may have their biases due to the way they’re funded.
We’ve only had this opportunity provided by the existence of the NHS to improve medicine for 70 years, and now we’re losing it to privatisation.
In some ways, this is worse than people suffering now as a direct result of these austerity-based plans.
This is all future British research and breakthroughs relying on large charities, contaminated by private interests, or lost altogether. Patients are just pawns in the money flow.
That’s why I would like proper, fully-funded renationalisation of the NHS. Research matters. Medicine needs to improve.