Why it’s dishonest to claim that the NHS isn’t being privatised

To hold ideological support for the privatisation is one thing, but to pretend it isn't happening is a far more insidious lie.

To hold ideological support for the privatisation is one thing, but to pretend it isn’t happening is a far more insidious lie

Last week on BBC Question Time, the panellists were met with yet another question about NHS privatisation.

The Times columnist Camilla Cavendish attacked the ‘misleading’ use of the word ‘privatisation’ and immediately asserted that such a trend simply ‘isn’t happening’.

Nigel Farage similarly condemned the ‘entirely false debate’ on the issue, concluding that ‘the word privatisation is bandied about without really meaning anything’.

And, to an extent, Farage is right. A fundamental lack of understanding and transparency has surrounded the government’s changes to the NHS.

The incomprehensible and jargon-filled Health and Social Care Act was presented in a way that few people could engage with.

And when concerns were raised – as they were by the overwhelming majority of doctors,nurses and patients’ groups – they were ignored.

Even the timing of the announcements (who is really following political affairs just two days after Christmas?) seemed to suggest that the government was determined for their ‘reforms’ not to be scrutinised by the public.

Yet, almost three years since the legislation was passed, discussion about the NHS is still dominated by the same ungrounded mudslinging. On one side are fears about ‘creeping privatisation’, which are crudely dismissed as nonsense by the government.

Meanwhile, the prime minister has resorted to defending his actions using emotive anecdotes about family illness.

What these debates are desperately lacking are details of the reforms themselves, the effect they are having and the views of those best placed to debate them: patients and medical professionals.

So, how did the Health and Social Care Act change the NHS? Perhaps the most contentious issue was the decision to encourage competitive tendering and introduce the concept of ‘Any Qualified Provider’.

This allows NHS services to be replaced by healthcare provision from private companies and charities, based on open competition. Furthermore, the Act stated that clinical commissioning groups had an explicit duty to ‘not engage in anti-competitive behaviour’, highlighting the pressure for local commissioning groups to outsource health services.

Only this week, figures showed that since the reforms, a third of NHS contracts have been awarded to private sector providers. These contracts attracted interest from companies such as Serco and Virgin, with some worth over a billion pounds.

In fact, the government’s reforms so clearly represent a form of privatisation that an attempt to reinstate public sector healthcare provision by reversing the Act would likely result in a legal battle with competition lawyers.

And it’s not just NHS contracts where privatisation has taken place – the government’s changes encouraged NHS hospitals to open their doors to patients who have paid to receive healthcare privately.

Before the reforms, up to two per cent of a hospital’s income could be generated in this way. The coalition government raised this cap to 49 per cent. As predicted by campaigners, hospitals are exploiting the change to generate extra income in the face of a funding crisis.

Earlier this year it was revealed that some hospitals had seen up to 40 per cent increases in income from private patients.

When NHS hospitals are encouraged by government policy to offer almost half of their services to private patients, I think it’s fair to use the word ‘privatisation’.

If this is contentious, then what proportion of hospital beds must be filled with private patients before journalists such as Camilla Cavendish concede that the NHS is indeed being gradually privatised?

The irony in the current government’s attitude towards the NHS is striking. Consider the pre-election promise that guaranteed ‘no top-down reorganisation’, followed a year later with the largest piece of health legislation since the NHS was founded.

Or the irony of introducing reform supposedly designed to empower doctors in decision-making, while ignoring the medical profession’s almost unanimous opposition to the changes.

But the most insidious lie is the idea that privatisation isn’t taking place, at a time when NHS contracts are being offered to private companies and hospitals encouraged to welcome fee-paying patients to a greater extent than ever before.

Whether the involvement of the private sector in healthcare should be resisted or welcomed is a different question. But it’s clear that the government’s changes to the NHS cannot be re-branded as anything other than privatisation.

Only when both sides drop their emotive rhetoric, and instead start scrutinising legislation, will this be realised.

George Gillet is a medical student and blogger. Read his blog here, and follow him on Twitter

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35 Responses to “Why it’s dishonest to claim that the NHS isn’t being privatised”

  1. treborc1

    God this site has been taken over by Tories and New labour .

    Sadly the NHS which New labour tried to take down the privatisation route has changed people views I cannot for the life of me get an NHS dentist for example and now get use to not going, if I get toothache pay the emergency dentist who takes it out even if it can be saved.

    People in the main who are middle class who earn above the £38,000 would be willing to pay insurance UNUM Provident I’m sure will be happy.

    My hospital was up for closure in 2007 we marched through town with about 1000 people with Unions banners flying, last year we marched to say it and 80 people marched .

    Pe4ople are now getting sick of the use of the NHS by all parties we all know Blair and Brown were willing to allow the yanks to take a shares so are the EU so for me the fight is over what happen happens I’m sure that MP’s and Minister will have BUPA paid for them.

  2. Robbie

    Come on, you can’t sincerely think that paying employees wages is the same as peoples I’ll health generating company profits? Yes optical care, dental care and prescriptions have been partially private (meaning the NHS is no longer free at the point of care) but the costs for these have been steadily rising and qualifying to get them free has been increasingly difficult. Braces are a new thing that you now pay for, they were free when I got them but my sisters braces were £1500!

  3. Robbie

    These are not the only options. We learnt about the NHS in my course (Podiatry) and whole sections are dedicated to overseeing private contracts and making them fairer. Getting rid of these parts would save money! Not to mention that healthier happier societies generally require less health care. The year of the financial crisis (2008) so an increase in spending as people lost money and therefore become unhappy, stressed, and more likely to drink, smoke, eat badly etc…

  4. John Devine

    The extra money going into the NHS every year is what is needed to pay for the PFI hospitals. It does not reach the ‘frontline’ of healthcare. Somewhere in the region of 118 PFIs at some £5 to 6 M per month each adds up to a lot of front line staff having to be cut from the budget !

  5. Paul Lawrence Hayes

    It’s not just NHS privatisation. [At least] the appalling austerity and ‘welfare reform’ policies have been facilitated largely by deceit too. The UK is in a very dark place now. It’s a democracy, Jim, but not as we knew it.

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