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
35 Responses to “Why it’s dishonest to claim that the NHS isn’t being privatised”
marje arnold
i would also point out that a large proportion of the front bench tories have huge shares in the private companies which are stealing the NHS out from undre our noses
DrPlokta
Have you seen Tesco running short of products or getting shoddy products because it’s squeezing its suppliers? It clearly works for Tesco, despite complaints from their suppliers; why should it be different for the NHS?
Leon Wolfeson
Works? Oh yea, the shoddy crap there which got me to change to another supermarket.
As you ignore the fact it’s not a market where we can chose provider (and healthcare isn’t a market anyway, realistically), plus again there’s single providers for many things.
marje arnold
i agree with the above comment. we all know that the aim is to fully privatise and the NHS will be left with most expensive options because the private companies will cherry pick the services they want. regarding TTIP. people in europe are marching in protest about this thorny issue. why arent we . we are so apathetic that we are sleepwalking into this disgusting issue.
Anthony Kilcoyne
In Dentistry we widely recognise the Government Spin regarding NHS status, when already it’s neither N or H or S free to all regardless of income equally etc.
In short, we call it The Big Lie from HMG and their Civil Servant agents, to the public.
http://www.telegraph.co.uk/comment/letters/11320751/Letter-Rotten-teeth-system-its-time-to-change-NHS-dentistry.html
Many practices (especially small local ones) are being forced to close or go Private to continue to be able to spend the TIME to deliver high quality bespoke dental care AND prevention – indeed Prevention treatments are the most economic and healthy option.
Shame the NHS mandarins don’t recognise that as the No.1 medical reason for any Primary school child to be hospitalised, is rotten teeth !!!
Yes that’s not some poor deprived Country statistic, but England in 2015 🙁
But hey it’s free to the patient so that’s OK, don’t make a fuss, right ???
Err no, clearly not, but it just reflects CONTINUED centralised neglect, waste and flaws IMHO.
I can’t believe the Journalists are giving Politicians a ‘free ride’ on such aweful Dentistry issues – if Politicians and their Civil Servants get away with it there, what awaits the rest of the NHS ???
Yours deeply concerned,
Dr. Tony Kilcoyne
Dentist and Specialist in Prosthodontics.