“The NHS is being privatised. We need to bring it back”.
What does this mean?
Having a National Health Service means that we can use the state’s power to give us all the healthcare we need, whenever we need it.
Unlike the state and NHS staff however, private healthcare companies are there to sell healthcare if, and only if, it makes them money.
It often happens that private companies can keep more money by not giving care (as an ex-company executive explains).
To them, you and I suffering and dying as a result is not their greatest concern. They’d rather keep the money as profit than spend it on care. This is the very reason they’re involved in the first place.
Indeed, there are circumstances in which they can make money from you dying.
They know that people will always need healthcare. They see that as something to take advantage of, rather than a reason for making sure people are looked after.
If you find it hard to imagine how someone can think like that, then this cynical fictional character explains the same thing as the exec, very well.
Let’s be clear, we are talking about the people who run these corporations, rather than doctors, nurses and other medical staff who want to look after people as best they can, even in a private system that doesn’t look after everyone properly.
The state has no need for profit, so if the people in government behave responsibly towards the population’s needs, it can simply focus on meeting our health needs. For most of its life, that is precisely what the NHS has been about.
That is, until Margaret Thatcher decided she wanted to secretly turn our NHS into a profit-making system, (one that leaves people out of the equation). Since then, we’ve only ever had governments that would rather work for the private health companies than work for us.
Like Thatcher, all politicians in the UK know that most people are opposed to this (as demonstrated in this poll).
So governments have been slowly and quietly transforming the NHS from a public service for everybody into a system where private companies can sell healthcare when they want to and deny it when they want. This stealth is required to avoid too many people noticing, reacting angrily and getting in the way. If that happened, we’d stop them.
Let me explain what some of this privatisation looks like
If it’s hard to imagine politicians being so disdainful of our health, part of the explanation lies in the many ex-health ministers since Thatcher who have benefitted private health companies and then gone on to work for such companies upon leaving office. They are like the exec and the fictional character I mentioned above.
The exception has been MPs on the left, particularly the left of the Labour Party and the Green Party. They are politically committed to a public healthcare system and genuinely believe it’s a human right that should not be run for profit.
The left of the Labour Party is now in charge of Labour, which has, for the first time, committed to renationalising our NHS – reversing the process that began under Thatcher.
The real aim, for those of us who believe people have a right to be cared for, is to focus on saving lives, rather than money.
However, because our mainstream media is owned by large companies that also believe in profit over people, we hear a lot about “cost” and “saving money” whenever healthcare is discussed.
This insistence is designed to encourage us to accept that profit-making is right, and that denying care is acceptable. Of course, for them “saving money” (making profit) is the priority.
They want to make us think like businesses, rather than like a society that takes care of everyone.
How has the NHS been privatised?
This is a commonly asked question (even if some of the people who know the answer pretend they don’t, and ask it sarcastically).
To make the NHS function like a private business, where it puts money before patients, the NHS was broken into “NHS trusts” in the 1990s. Each of these trusts was told it had to be “responsible for its own finances”, just like a business.
So, in order to provide care, as staff wanted, like a public service, they had to learn to think like a business — in terms of “saving money”. If the money they received from the state wasn’t enough to meet patients’ needs, it was the trusts (who have the budget the state gives them) who were blamed, and not the state (which can pay for whatever it decides to).
Trusts had to produce a surplus, i.e. have some money left over. Just like profit-making businesses.
They were also set up so that they could go “bankrupt”, like a business, and placed in plenty of debt by another form of privatisation: The Private Finance Initiative (PFI).
PFI came about because some bankers and financial firms thought it would be a good way of making more money from our public services and they lobbied governments to do it.
Some of these financial firms, such as PwC and KPMG, are linked to politicians mentioned above and later went into other forms of NHS privatisation.
Yet again, the state didn’t simply have the hospitals built. Instead, it made sure that huge additional sums were paid for these private companies to keep.
They forced NHS trusts to use the limited money government gave them for healthcare to do this, forcing them into “debt”. Buildings costing about £11bn to build are paid off at about £80bn.
Many other things have happened in the course of privatising the NHS, filling several books. These include the NHS’ rules being rewritten in the year 2000, so that private companies could run medical services in the NHS.
As a rule, a private company running a service in the NHS makes profit by cutting spending on the services and staff wages. This shows just how detrimental profit is to healthcare.
In the mid 2000s, American companies like HCA (its UK branch is now based in the Shard in London) and United Health (whose boss is now in charge of the NHS in England) were allowed to run a floor of the University College Hospital or various GP clinics.
More than once, such a company has found that a GP service wasn’t sufficiently profitable for its liking. In these instances a clinic would be closed down and lost to the community that needed it.
Conversely, NHS GPs tend to work for the benefit of patients, building strong relationships with the local community. They don’t just up sticks and abandon patients when they fail to generate millions.
At the same time as being forced to think like a business, forced to make a surplus and placed in a position where they could be claimed to be “in debt”, and then loaded with PFI debt, trusts were told they could “make” 2% of their own income, by their own means.
In 2012, this figure was hiked up to half: 49.9%. Now, hospitals like the Royal Marsden do think like businesses. In fact, they are businesses. They make almost half of their income from additional activities, mostly charging patients. Wards that used to be available for everyone have become wards for people who can pay at point of need.
As well as receiving money from the government, private companies inside “NHS” hospitals that don’t belong to the NHS, can now directly charge customers – I mean, patients! – under the NHS banner.
Is the logo what makes the NHS popular? Or the fact it was made to attend to all our medical needs?
The Theresa May government is now installing a system from the Californian private healthcare company, Kaiser Permanente, to replace the NHS across England. It has long been secretly favoured by politicians from all UK parties, (except for those on the left).
“Accountable Care Organizations” involve private companies even more than before; they will make very sure that healthcare is not available to everyone and that people access services as little as possible.
Again, they say this is intended to “save money”, not lives. Many more people will feel they need to pay for private insurance, so as not to be left untreated.
This is only good news for the companies involved, and the MPs and Lords who make the laws that enable this to happen.
It is not fair and it is not necessary.
These are just some of the reasons for wanting to see our health service renationalised. We need it to be brought back as a full service that the state gives everyone, whenever we all need it.
In this election, we are presented with a choice we’ve never had before – profit for a few, or healthcare for everyone. The same choice applies across other areas of government.
Make sure you and everyone you know registers to vote and vote for people before profit.