A hard Brexit is not our National Health Service's biggest threat. The Tories are.
News outlets continue to be awash with coverage over Donald Trump’s – now U-turned – insistence that the NHS and all other sectors of the UK’s economy could be up for negotiation and potential access in a free trade deal with the US.
As a result, there has been an overly simplistic trend in the coverage and assessment – both in the mainstream media and on social media – of to what extent a trade deal with the US would subject the NHS to the risk of being privatised. The Twittersphere is awash with #FBPE accounts claiming that those who voted Leave ought to be the first to have to pay for their healthcare. In the majority of these tweets it is taken for granted that the NHS will inevitably be privatised because of Brexit, no matter how “soft” or “hard” said Brexit is.
At the same time, even those who are slightly less zealous in their ideological purity and attempts to have the UK remain in the EU lock stock and barrel, continue to repeat the mantra that a hard-Brexit inevitably means the privatisation of the NHS. However, both of these positions are flawed, and it is time they are called out as such. Because their continued repetition does damage to an objective account of how the NHS has been privatised and continues to be privatised whilst we have been, and continue to be, a member state of the European Union.
In short, being in the European Union in no way shape or form guarantees that the NHS cannot be and will not be privatised.
For a start, a “hard” Brexit, understood as the UK leaving the Single Market and Customs Union, does not automatically guarantee the privatisation of the NHS. In fact, a series of experts and expert bodies, the majority of whom are against Brexit, at least have the intellectual honest to recognise that Brexit could in fact afford a British government certain tools with which to renationalise parts of the NHS that it currently cannot as a result of EU competition law. These expert bodies include the Kings Fund, and the British Medical Association.
To be clear, I am not arguing – and neither are they – for Brexit. Nor am I trying to minimise the fact that there is a degree of truth to the argument that the UK trading on World Trade Organisation (WTO) rules could incentivise governments to grant greater foreign access to the NHS, in order to entice larger economies such as the US or China, into signing a free trade agreement. The National Health Action Party has pointed this out on a number of occasions in the pages of Left Foot Forward. But what I am arguing, is that there is a real risk that by simply equating Brexit with Trump and therefore the total privatisation of the NHS, that we fail to draw attention to the fact that large parts of the NHS have been privatised, and continue to be privatised, whilst we have been, and currently are, a member state of the EU.
By repeating the simplistic mantra of Brexit = privatisation it is clear that those who are actually responsible for the privatisation of the NHS, both past and present, are benefiting from this simplification. In some cases, it is allowing those who actively privatising the health service to pose as its the saviour. A case in point being Health Secretary, and Tory leadership candidate, Matt Hancock. Only recently the Daily Mail – admittedly hardly a bastion of objective news coverage – wrote a fawning article covering Matt Hancock’s response to the affair. The article being entitled, ‘”The NHS is Not for Sale”: Health Secretary hits back after US Ambassador says healthcare should be on the table in any transatlantic post-Brexit trade talks’.
This gross simplification allows politicians such as Hunt and Hancock, both of whom want to be the next Prime Minister, a free pass to paint the privatisation of the NHS as something which happens, or could happen, purely from the intervention of the external or the foreign. It occludes, or at the very least, it fails to direct attention to where it should be.
For example, our current Health Secretary has appeared in advertorials – paid for by a private company – to promote the rollout and uptake of that company’s app (GP at Hand) across the NHS. An app which is currently undermining the financial foundations of general practice; leads to the cherry picking of patients; and has resulted in already cash strapped Clinical Commissioning Groups (CCG) across London having to bail out Hammersmith and Fulham CCG where the app is registered, to the tunes of millions. In fact, it now looks like local services could close as a result of the app. And still, the Health Secretary refuses to release funding to alleviate the deficit the app is causing.
Where’s the outrage about this? Why aren’t people writing about this on Twitter? If they care so much, then where are the protests against this? It’s hardly news, the National Health Action Party and others have been writing about these issues for months! The same goes for Jeremy Hunt.
During his time as Health Secretary, Jeremy Hunt was aided and abetted by the Chief Executive of NHS England, Simon Stevens, who incidentally before coming into the post worked as a lobbyist for an American healthcare company and actively sought to privatise the NHS through the now defunct EU-US TTIP trade deal, to Americanise the NHS from top to bottom. I am referring of course to the attempts to rollout Accountable Care Organisations (ACOs) across England. These models of delivering healthcare, now rebranded at Integrated Care Systems, represent the total privatisation of the NHS, and guess what? They’re being rolled out as we speak, in plain view, in a process which began in 2016, whilst we were a member of the EU, and currently remain one.
The biggest threat to the NHS is not some ginger haired, foul tempered president, as unsavoury an individual he may be. The biggest threat to our NHS resides on the benches of the House of Commons. They sit under the respective banners of the Conservative Party and the Liberal Democrats.
In sum, none of this is to argue that citizens should not be concerned about the impact a hard Brexit could have on the NHS. However, we do the NHS a disservice when we make out that a hard Brexit is the biggest threat facing the service when it is literally being privatised beyond recognition whilst we are members of the EU.
Ultimately, the responsibility and the power to fight for a fully funded NHS lays in the hands of the people, we can’t delegate our responsibilities to fight for what represents the very best of this country, to a foreign trading bloc – a bloc it is worth noting that hardly has a squeakyclean record of its own when it comes promoting free marketisation within public services.
Kane Shaw is Press Officer to the National Health Action Party.
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