Published on July 31st, 2013 |
by Oliver Campbell
Image © East Midlands Ambulance Service NHS Trust. 26 May 2009
The aggressive privatisation of the NHS is alive and kicking
It could be put forward as the two most overused words of the last few years in UK politics: ‘austerity cuts’. Everywhere you turn it’s there looming like Glenn Close in Fatal Attraction, only this time it’s public spending that’s in for it and not a little girl’s bunny rabbit.
This push towards cutting the budget has seen dramatic changes, especially amongst the large public funded workforces such as the National Health Service. The NHS is currently in the process of saving £20 billion by 2015, and these major cuts have consequently intensified the debate over whether the NHS should be privatised.
The NHS is already partly privatised and this is steadily increasing as seen in the government’s recent sale of PRUK to Bain Systems. PRUK is the main supplier of plasma to the NHS, which is used to combat immune deficiencies, neurological diseases and haemophilia. It was formed in the 1970s as part of the government’s reaction to plasma contamination, with the World Health Organization recommending that countries look to creating self-sufficient plasma supplies to combat this threat. In 2002 when plasma was again at risk of being contaminated the government intervened thus avoiding the problems encountered in the 1970s. With PRUK’s take over assured it is not surprising that there is a fear of future plasma contamination due to Bain System’s wish to tap into the global market, therefore outsourcing their plasma from a number of areas that could potentially be high risk. Perhaps more importantly though PRUK’s sale symbolises a move away from what parliament seems to have stood for since the 1970s: Providing a safe public funded plasma supply.
Lord Owen, who was at the heart of the UK’s move toward self-sufficiency, wrote a letter to David Cameron to try and convince a rethink on the sale of PRUK. He cited these exact dangers of contamination, pointing to the past tragedies created by plasma being supplied from private companies.
This is a worrying prospect; however when the Health Department was quizzed regarding PRUK’s sale they pointed to how 70% of the plasma provided to Britain is already sourced from private companies. So does it really matter that PRUK has been sold off if the risk of contamination is seemingly already present in Britain? And with the government maintaining a 20% stake in PRUK, money will be made for Parliament to use in the future, which is surely a good thing? However this issue of risk mixed with profit is exactly the problem. This is because it highlights how it’s not the 40-year stance on plasma that has changed, instead it’s the opinions towards the NHS that seem to have ultimately shifted.
This opinion shift is best represented by the Health and Social care bill that was rolled out by the government last year. In the bill it states how the NHS is now open to ‘any willing provider’ to enter the market to increase competition, effectively leaving the NHS open and vulnerable to private companies. This suggests that the government is not committed to maintaining the NHS as a public institution. The government thinks that competition will improve the NHS but I harbor serious doubts about this insinuation. There is the problem of ‘cherry picking’, with private hospitals potentially acquiring low risk wealthy patients, leaving the NHS to care for the rest. This would consequently reflect badly on the NHS creating an anger towards them that would not be able to be stifled. The result? Goodbye NHS. Look at insurance companies; some won’t insure particular people, as it does not make them money. They pretend to care but at the end of the day they are looking to make money. Is this the right mindset a health care system should be run in?
However this ‘cherry picking’ idea is still merely a guess, the best thing to do is to collect evidence and the ideal place to look for this is in a particular country that lies across the Atlantic. How many times have we seen in American shows the story of ‘Oh no I can’t afford quality healthcare so I’ll either ignore my illness or get a botched job which leads to tragedy’? Whenever I think of this topic I always remember a Simpsons quote from the early 1990s that is still relevant today. In the episode Homer needs serious heart surgery in order to survive and Marge is worried. To make her feel better Homer tells her not to worry and goes onto say how ‘America’s health care system is second only to Japan…Canada…Sweden….Great Britain, well, all of Europe’. It’s a funny yet true observation and it therefore seems bizarre that we would want to move towards such an unfair system.
It is therefore not an exaggeration to say that the Heath and Social care bill of 2012 was the biggest change to the NHS since it’s formation. This is not necessarily due to its immediate implications but the ideology that it shapes into clear outright policy. After the adversity of WW2 Britain was a country carrying a lot of debt with some cities lying in ruin, and yet in 1948 Bevan created the NHS. In 2013 after the double dip recession the country is slowly recovering while the NHS is cut and sold off. It’s almost laughable when thinking about it that a government created the NHS out of such a destructive patch of history in a lot of debt, but when a debt returns 60 years later a government uses it to justify the cuts already taking place. Yes we need to save more but if we could afford it then, why on earth can’t we afford it now?
People may say that this is a naïve suggestion with healthcare becoming more expensive with the advancement of modern times. However what is also naïve is to ignore how the combination of New Labour and the Coalition government have chocked the NHS. New Labour saddling it with debt and almost doubling NHS administration costs, the coalition government then slowly selling off bits while demeaning the NHS service making it ever more vulnerable. As Bevin stated in 1948 the ‘NHS will last for as long as people are willing to fight for it’. It seems to me that politicians don’t want to fight for it anymore and are attempting to get rid of it instead of supporting it.
This does not seem to be the mindset of just politicians though. The Economist recently cited a poll, which showed how the creation of the NHS seems to have gained less significance amongst the younger generations. In the article it put it down to a laissez-faire perspective towards business and culture dominating, letting people get on with it and being free; allowing competition in every sector of business. In other words the young have a more capitalist mindset, which isn’t surprising after the downfall of the unions since Thatcher. But then people want an equal and socially mobile society. You want equality and social mobility? Well then do you want a health system that largely benefits the rich, or one that benefits everyone, that doesn’t tie a poorer person down due to their inability to afford care?
The sale of PRUK is therefore a clear marker of where government policy towards the NHS seems to be heading. In the grand scheme of things it is a minor event, but the principles behind it, the way in which it signals such a dramatic shift from the motives behind the beginning the NHS in the first place, makes the sale of PRUK suddenly become an extremely important event.
When deconstructed this debate can be put down to the clash of altruism with profit and margins. The problem can be said to be capitalism. At this point you’re probably expecting me to get the red flag out and start yelling ‘up the proletariat’, but I’m not. Capitalism is brilliant but the NHS was made to be a service first, and a business second. I would want everyone in this country to know that if they fall ill or get injured then they will get treatment. Isn’t that fair? Is it bizarre to think that everyone deserves to be able to get care no matter what the size of their wallet or where they live in the country? At times I can understand privatisation but when it comes to health care and people try to justify it by quoting profit margins and statistics I feel disgusted. Surely public health is a basic right, if not the basic right for British citizens?
The NHS’s apparent downfall has at times been blamed on a number of different groups from smokers to obese people. I’ve often over heard suggestions to exclude these people from the system but this obviously leads to widespread disapproval due to an inability to draw the line, as this is unfair and undemocratic. However privatisation would do exactly that: draw a line and restrict a widespread group of people from health care. The classic advice of you don’t know how good something is until it’s gone seems to ring true here. The question is will Britain make that mistake? With the sale of PRUK, it’s starting to look a lot more likely.