Are we witnessing the unfolding of the last chapter of the Tories’ plan to privatise the NHS? The first step was taken by the Tory government under Margaret Thatcher in its National Health Services and Community act in 1990. This act introduced the internal market and competition, instead of cooperation, within the NHS. The Health and Social Care Act of 2012 pushed the marketisation and outsourcing of health and social care to private health providers to new levels. Allyson Pollock, professor of public health research and policy at Queen Mary College, University of London, in an article in the Guardian, characterised the Health and Social Care Act thus:
In March 2012 the coalition passed the Health and Social Care Act, which dismantles the NHS in England, paving the way for private funding (user charges and insurance) and the marketisation of healthcare. This new model of care is based on the American healthcare system, where risks and costs are passed to patients. The first things the act did were to remove the 64-year-old duty on the health secretary to provide services throughout England and to make commercial contracting virtually compulsory. Today, clinicians, nurses, managers and armies of consultants and lawyers spend their days preparing multiple bids, tenders and awarding contracts, instead of providing patient care. Every year thousands of contracts are put out to tender, many of them going to the private sector.
This brings us to the present crisis in our most cherished of institutions, the NHS. This government is demanding more and more from our trusted doctors and nurses, and at the same time shrinking the resources. NHS spending is falling as a proportion of GDP and is projected to fall further by 2020, well below the European average. It is illuminating to look at healthcare spending per capita per year across the world. The World Bank gives these figures for the year 2014 for every country on earth. I have chosen four countries in addition to the UK for comparison. All figures are in US dollars: US 9403, Germany 5411, France 4959, Denmark 6463, United Kingdom 3935.
So the UK spends substantially less than its neighbours and less than half the spending of the US, the country on which healthcare system the Tories are trying to base the NHS. In fact, the US is by far the largest spender on healthcare than any other country on the planet, yet US life expectancy is 50th in the world, and it has a higher infant mortality rate than most industrialized nations.
Jeremy Hunt’s imposition of new contracts on junior doctors and his plans for seven day working for our GPs (and no extra resources) is demoralising our health professionals. It is the well-known technique of divide and rule, junior doctors versus consultants, and shifting the blame onto GPs for the crisis in A&E hospital departments. It is a transparent attempt to show that the government is on the side of the people, and the crisis in the NHS is all the fault of our health professionals. “That’s the standard technique of privatization: defund, make sure things don’t work, people get angry, you hand it over to private capital.” So said Noam Chomsky.
The trouble with free-market ideologues (our present Tory government) is their blind belief in the transformative power of markets. They want to apply the ideology in everything we do. They will ignore evidence in their decision making and elevate dogma above reason. Private enterprise, competition and markets are the right mechanisms in the manufacture of consumer goods to drive up efficiency and quality, however when it comes to healthcare they have the opposite effect as the evidence clearly shows.
Healthcare should be a human right; the quality of which should not be a function of one’s ability to pay. Save our NHS.