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'Don’t duck the issue – tell us why the NHS should be privatised'


New concerns emerged this week about the privatisation of the NHS.

To be fair, the evidence so far is less about the NHS being privatised - that is, turned into share options and sold off cheaply to raise money that may be used to rescue the rail industry, which was the last company that was turned into share options and sold cheaply - and more about it being franchised out to companies overseas. These companies are desperate to preserve the principles of meeting the population’s health needs while making a profit, which is probably a whole different thing right?

Every time we have a Tory government the prospect of privatising the NHS rears its head; up to now the nation has tended to close ranks around one of its most beloved institutions and cry, “Never,” leaving disgruntled public schoolboys across the Cabinet exclaiming through gritted teeth: “Privatise the NHS? Us? Wouldn’t dream of it.”

Maybe this time the nation may consider saying in one, unsarcastic voice: “OK, tell us how privatisation will work. Be honest, don’t try to dress it up, sell it to us”. Surely, the only point in having Nick Clegg tagged on to your government is to make you look less right wing than usual, so tell us how privatising healthcare would make things better. Because if we are going to change the health service so profoundly, wouldn’t it be good to have a clear, honest and transparent discussion about why?

Maybe the NHS has been drifting towards an ideological amalgam of short-term fixes, political faddism and neoliberalism for the last 20 years. A disparate collection of organisations laced with buzz words like “choice” and “fairness” but motored by bust and boom economics. But, despite what sometimes looks like the best efforts of government, it has actually done OK. Our health service costs less than that of France, the US and Germany; the Commonwealth Fund recently rated the UK highly for effectiveness and care; and mortality rates for cancer and heart disease are falling faster than anywhere. We know there are challenges: Mid Staffordshire Foundation Trust highlights the fragility of some practice, and we’ll still be paying for the private finance initiative when the sun goes down but, thanks to the goodwill and single-mindedness of staff, the NHS has survived and some evidence suggests it has even flourished.

So why the change? To save money? Because in these austere times when we are all told we must all make sacrifices, is the estimated £2bn to implement the Health and Social Care Bill not just a little profligate? To improve care? Nobody seems to be explaining how that might come about and no evidence exists to suggest it will. To improve efficiency? By introducing even more organisations and attendant bureaucracy? Hardly. This health bill is not about recession management or service delivery; it is not about the social imperative of caring for the sick or about making the best care available equally to everyone; it is about politics.

Perhaps the real problem is that no matter who is in government, the health service becomes a political football, driven by ideology but sustained by a workforce that tends to absorb the difficulties and keep things working. Perhaps this enormous and hurried health bill will be a step too far even for them. Because as things stand, the NHS is drifting towards a future that will be defined by economic taste rather than social need. Is that really the best we can do?


Readers' comments (6)

  • I agree, Mark; but this open and frank debate will not happen because the government know that their arguments will not stand up. The decisions to privatise the NHS are based more on ideology rather than logic or necessity.

    I agree there is room for satellite services being run as private businesses competing amongst themselves and being contracted BY the NHS or supporting the NHS, but there is certainly no call for private business concerns to RUN the NHS. The two things are wholly different.

    The NHS works, as is. Yes, it has problems. However, many of those problems stem - as you quite rightly say - from the politicisation of it. Idiots playing party politics and tinkering with this and that, changing ideology's, shutting down services and setting up unnecessary expensive white elephant projects.

    What is needed is the complete de politicisation of the NHS, politicians should be told in no uncertain terms they are not needed, wanted or welcome. The NHS runs just fine without them.

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  • Easy - the NHS should be privatised so that when the next government comes to power they can spend lots of time and money de privatising it. Is there anything we like better in the NHS than going around in circles and spending our time and energy on change?

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  • It is the rise of the right using the banking collapse and debt crisis to drive forward their agenda. The NHS was the only successful socialist experiment worlwide, loved by both the Tory and labour voters and envied by the world. The spite and jealousy of the rightists has undermined the NHS and the right wing press have relentlesly attacked public sector workers by creating false envy of their pensions. I say if you want my pension step forward and care for the sick. Marx has been proved correct, reactionaries have always laid hidden in the NHS and now they think their time has come but they have yet to show their true colours being the cowards and traitors referred to in the Red Flag.
    So commrades lets hear it loud and clear 'Keep the Red Flag Flying Here'. The NHS is not just for the left, it is for all, free at the point of entry. Once it is lost it will be confined to the annuls of history never to return.My old man always said that everything we call a right blood was spilled for. The price of the NHS was the blood sacrifice of the world wars and now the rich are snatching it back again.
    So time to fight for what is right.

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  • George Kuchanny

    There is a very strong argument in favour of multiple service providers. Unfortunately the biggest by far is the lack of integrity that has been evident for many years within Trust offices. Unfortunately this is the single (unspoken about) driver that makes an evolution of the NHS an imperative.
    Admittedly this lack of integrity and the damage it has done the NHS may not be entirely apparent to those working on the wards. The damage has been enormous.

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  • I have to say that as a provider of equipment to the NHS and as an educator of NHS staff for many years I do think that reform is vital. the question I am forced to ask is whether the current governments idea of reform is the right one? The answer i'm coming to is no.

    Let's not pretend that the NHS doesn't need a shake up however. Nurses have long been institutionally devalued, there are huge inefficencies in many of the management tiers, the power of doctors outside medical issues is out of control and the ongoing existence of silo'd budgetting prevents any form of joined up thinking with regard to service provision.

    The NHS is not some golden heaven, it is ramshackle, it muddles by and it needs reform. However, what the current government are offering is not reform so much as an ideologically driven decimation.

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  • The thing is, if a private enterprise can run something for profit eg. a hospital, then why is it that the government cannot run it Not for Profit? My local hospital in Australia has just gone from being totally Gov funded to private / gov partnership with services tendered out and what a suprise - the gov is saving money! How does that happen and the private enterprise still make huge profits. It must be down to management, waste and inefficiency. I miss the NHS, lots of my patient get no treatment here because they can't afford it. My private healthcare fund costs $500 per month for my family which is not far off half of my fortnightly take home pay.

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