Service. In essence, the issues are simple:
1. The longstanding obligation of the UK government to provide universal health care has now been ditched.
2. The NHS is being carved open for exploitation by private interests.
The media, notably the BBC – often ranked alongside the NHS as one of the country’s greatest institutions – have failed to report this corporate assault on the country’s health service.
What is deeply disturbing is how little the British public has been told about what has happened, and about the likely consequences for an institution we all hold dear.
Much Profit To Be Made!
On March 20, 2012, MPs passed the Health and Social Care Bill (commonly called ‘the NHS bill’) more than 14 months after it was first put before Parliament. Virtually every major professional medical body had fought against it, and there were numerous public protests. But the opposition was given scant media coverage and the government was able to force the bill through.
Recall that the Conservatives, led by David Cameron, won just 36% of the vote in the 2010 general election. Outrageously, the Conservative manifesto said nothing about the NHS bill. The former Conservative minister and leading political pundit Michael Portillo explained the reasoning:
‘They did not believe they could win an election if they told you what they were going to do because people are so wedded to the NHS.’
Cameron had pledged that there would be: ‘No more pointless and disruptive reorganisations’. Instead, he said change would be: ‘Driven by the wishes and needs of NHS professionals and patients.’ The coalition agreement between the Tories and the Lib Dems of May 2010 had promised: ‘We will stop the top-down reorganisation of the NHS.’ That promise has been well and truly smashed.
The government tried to justify the bill by arguing that the NHS is not working and that it must be ‘reformed’. In fact, the NHS is one of the fairest, most cost-effective and efficient healthcare systems in the world. Its per capita costs are half that of the US healthcare system, a country which has lower life expectancy and higher infant mortality (OECD figures). One can only look on in horror across the Atlantic to see the way our health service is headed.
Michael Moore, writer and director of Sicko, a film about the US health system, tweeted of Cameron’s recent visit to the United States:
‘Is British PM Cameron here in USA this week to study our health care system & bring it back to the UK? There’s much profit to be made!’
‘Last nite, Brit PM watched 1st ever basketball game. Today he goes to hospital 2 watch sick ppl turned away & denied care. It’s a fun trip!’
The NHS bill was hideously complicated and virtually unreadable. Critics claimed this was intentional, serving to hide the bill’s true purpose – selling off more and more of the NHS to private companies. The British Medical Association denounced the bill as ‘complex, incoherent and not fit for purpose, and almost impossible to implement successfully, given widespread opposition across the NHS workforce’.
In a rare instance of BBC Question Time actually putting a senior politician on the spot about something that matters, Dr Phil Hammond challenged Andrew Lansley, Secretary of State for Health, on the disaster the bill would create for genuine health care, for cooperation between medical professionals and for basic human compassion. Imagine if news editors and journalists had been consistently making this kind of challenge in the 14 months before the bill became law.
The Coming Disaster
Most fundamentally, the new Act removes the formal commitment of the Secretary of State for Health to provide healthcare for every man, woman and child in England (it does not apply elsewhere in the UK – yet). In effect, this removes the founding principle of the NHS which was set up in 1948. It means that one of the finest health services anywhere, created by the British people in the wake of the Second World War, has just been primed for demolition.
Private companies will be able to move in and take over NHS infrastructure such as hospitals. The new law also allows hospitals to earn up to 49% of their revenue from private patients; previously the limit was 2%. Doctors and nurses say this will create a two-tier system, with one queue for the rich and one for the poor, with the rich having priority regardless of the seriousness of their condition. So that’s goodbye to one of the founding principles of the NHS: to supply care based on need, not the ability to pay.
Richard Horton, editor of The Lancet, the prestigious medical journal, warns that instigating a new era of private sector colonisation of health services is ‘simply reckless. Not one expert inside or outside government believes this is a sensible strategy.’ As a result, he says, there will be ‘unprecedented chaos’ in the NHS. He continues:
‘People will die, thanks to the Government’s decision to focus on competition rather than quality in healthcare. The coming disaster puts even greater responsibility on us to overturn this destructive legislation.’
No wonder that the NHS bill was opposed by 27 professional medical bodies, including the Royal College of GPs, the BMA and the Royal College of Nurses: that’s all but one of the relevant medical bodies. (Only the Royal College of Surgeons did not actually call for the bill’s withdrawal, but they did warn that it ‘will damage the NHS’.)
The BMA warned before the bill became law:
‘… if passed the Bill will be irreversibly damaging to the NHS as a public service, converting it into a competitive marketplace that will widen health inequalities and be detrimental to patient care.’
The Royal College of General Practioners said they were:
‘concerned that the Bill will cause irreparable damage to patient care and jeopardise the NHS. Three quarters of respondents to a poll carried out by the RCGP said they thought it appropriate to seek the withdrawal of the Health and Social Care Bill.’
The Royal College of Midwives also called for the bill to be scrapped:
‘This bill is a massively expensive distraction from the challenges that the NHS faces in trying to improve healthcare at a time of severe spending restraint… We join the growing chorus of voices calling for the bill to be withdrawn, and the proposed reforms stopped in their entirety.’
It was all to no avail. The government bulldozed the bill through Parliament into law.
Researcher Éoin Clarke has produced a map of England showing the areas affected so far by the NHS carve-up. SERCO, once described as ‘probably the biggest company you’ve never heard of’, and Virgin are two of the corporate giants who have been quick to move in. Virgin Care won a £500 million contract to provide community services across Surrey and began running these services, as well as the county’s prison healthcare, on April 1. Max Pemberton, a junior doctor ‘writing about life on the NHS frontline’, notes that Virgin Care’s takeover in Surrey exposes two fundamental lies propagated by the government (with media collusion):
‘The first is the flat denial that the Bill represented any sort of privatisation of the NHS, despite it being obvious to anyone who read it that this is precisely what it was.’
The NHS will become ‘a nominal logo’, warns Pemberton, and ‘a bureaucratic governing body dishing out public money to private companies.’
The second lie now exposed is the lunatic government claim that the reforms were underpinned by ‘the concept of choice within a nationalised healthcare system’. Pemberton asks pointedly:
‘What real choice did the people of Surrey have in who provided their community health services?’
‘None. The choice was made by unelected, unaccountable bureaucrats who use “public consultation” as a fig leaf for fundamentally changing the nature of how healthcare is delivered. Increasingly, the details of these decisions and the contracts that are drawn up are deemed commercially sensitive, so we are not privy to what is happening to our NHS and our money.’
What about choice of health care providers? There’s none – it’s Virgin Care or nothing. So much for the much-touted ‘market’. The outcome is ‘perverse, warped and corrupt’.
Dr John Lister, of the campaign group London Health Emergency, says:
‘Now we can see Lansley’s nightmare vision of the NHS taking shape, as the full chaos of cuts coupled with privatisation hits services around the country.’ (Dr John Lister, ‘It didn’t have to be this way’, Labour Briefing, April 2012, p. 5)
‘Report after report highlights the chronic, systemic failure of home care services and nursing homes for frail older people – services entirely dominated by for-profit private providers, offering clients the spurious “choice” of uniformly awful services at extortionate rates while paying most of their exploited staff just the minimum wage. The chaos in this sector gives a real flavour of what many other sectors of health care will look like once they have been carved up between “any qualified provider”. ’
Lister cites just one disturbing example from Camden in London following a long-running fiasco in which the local GP surgery was handed over to US multinational United Health on a cut-price contract. They then pulled out and the practice was taken over by the blandly-titled The Practice plc. But now this company has failed to secure premises or invest in services. As a result, 3000 or more patients will be without a GP from next month.
Vested Interests of MPs And Lords
Many of the MPs and Lords who voted the bill through stand to gain financially from the Health and Social Care Act. In a responsible democracy, this would be deemed a serious conflict of interest, and yet it would presumably not come as a shock to a British electorate used to unpleasant surprises – if they ever get to hear of it.
Research by Éoin Clarke has revealed that 333 donations from private healthcare sources totalling £8.3 million have been gifted to the Tories. (Click here for the database of those donations and ‘gifts’.) Moreover, the website Social Investigations has compiled an extensive list of the financial and vested interests of MPs and Lords in private healthcare. This list, says the site, ‘represents the dire state of our democracy’.
Here is a sample from the list:
Lord Bell: Conservative – Chairman of Chime Communications group whose companies include Bell Pottinger, and whose lobbying clients include Southern Cross, BT Health and AstraZeneca.
Lord Blyth of Rowington: Conservative – Senior adviser to investment bankers Greenhill. Former Boots Chemists deputy chairman. Tory Donor. Stands to gain from the break up and privatisation of the NHS, and would surely like to buy NHS Walk-in Centres at an agreed cut-price with Cameron.
Nick de Bois, Conservative MP for Enfield North: De Bois is the majority shareholder in Rapier Design Group, an events management company heavily involved with the private medical and pharmaceutical industries, and whose clients include leading names such as AstraZeneca. The company, which had a turnover last year of £13 million, was established by the Tory MP in 1998. A number of the company’s clients are ‘partners’ of the National Association of Primary Care (NAPC), a lobby group that supported the NHS bill. Rapier Design Group’s biggest clients stand to profit now that the NHS has been opened up to wider private-sector involvement. The GP commissioning consortium for south-west Kent, covering 49 GP practices and known as Salveo, has already signed a contract with the pharmaceuticals giant AstraZeneca.
And then there is Andrew Lansley himself, the Tory Secretary of State for Health. John Nash, the chairman of Care UK, gave £21,000 to fund Lansley’s personal office in November 2009. According to a senior director of the firm, 96 per cent of Care UK’s business, which amounted to more than £400 million last year, comes from the NHS. Hedge fund boss Nash is one of the major Conservative donors with close ties to the healthcare industry. He and his wife gave £203,500 to the party over the past five years.
Nash is also a founder of City firm Sovereign Capital, which runs a string of private healthcare firms. Fellow founder Ryan Robson is another major Tory donor who has given the party £252,429.45. His donations included £50,000 to be a member of the party’s ‘Leader’s Group’, a secretive cash-for-access club. The would-be MP, who tried but failed to get selected as the election candidate in Bracknell, is managing partner at Sovereign Capital.
And so on.
As Social Investigations asks:
‘Why are these people allowed to be in charge of our NHS, to vote on a bill that they clearly have something to gain from? Who cares that they have put it in the register of interests? This doesn’t excuse their interests, it merely highlights clearly why they should have no part in voting for the privatisation of the NHS. It is privatisation, despite the media’s continued use of the word “reforms”. The question must be asked. Are they public servants or corporate servants?’
An insidious network, then, links healthcare companies, politicians, ‘think tanks’, lobbyists and big money. This is yet another example of how public interests and accountability are seemingly forever bypassed by powerful forces.
If this had been happening in an officially-declared enemy state, the British news media would have been shouting themselves hoarse about corruption, greed and the pathetic state of ‘democracy’ over ‘there’. If this had been happening in Libya (under Gaddafi) or Syria or Iran, the airwaves and newspapers in this country would have been filled with condemnations and scorn about the oppression of the people by an unaccountable, tyrannical government.
That is it happening under their noses here at home, largely with the corporate media’s connivance, says it all.
Part 2 focuses on the BBC and will follow shortly. In the meantime, here are additional useful resources:
‘NHS Reforms – what they mean for you’
The Powerbase Health Portal: a guide to some of the companies, lobbyists and think tanks involved in healthcare in the UK.
Save our NHS