The NHS is effectively being privatised

Aug 3 2004

The NHS is effectively being privatised – broken up into hundreds of competing companies with an independent regulator overseeing the system according to Professor Allyson Pollock of UCL's School of Public Policy.

In her new book, NHS plc, published by Verso on 9th August, Pollock argues that this is a disaster that looms larger than rail privatisation.

“The disaster that is unfolding is overwhelming in its complexity and its magnitude. Even rail privatisation looks modest alongside it.” says Allyson Pollock in her book.

Recent statements from both Tony Blair and Michael Howard have made it clear that the future of the NHS will be the single most important issue in the run-up to the next general election. However, according to Pollock, the NHS is heading for similar failures as other privatised services such as the railways.

NHS plc warns that the links that are being fostered between business and the NHS are not in fact saving the government money nor ensuring a better healthcare system, but instead costing the taxpayer money while creating a less efficient system, where care is becoming more fragmented and ownership lies in the hands of private business.

A vast number of private companies are contracted to provide the NHS with finance, buildings, maintenance and repairs, cleaning, catering, laundry and portering – a £1 billion market for private agencies in the UK which looks likely to expand into new areas.

Key quotes from NHS plc :

“All this [market regulation of the health service] is defended in the name of giving people ‘choice', when the opposite is really occurring. When people are really sick they are seldom in a position to exercise rational choice, as Tony Blair found when he had a heart problem – doctors alone were in a position to decide where the best care was to be had, and he got it. Most people don't know what health care they need, or, if they have to pay for it, whether they can afford it; nor can they pick and mix according to what happens to be on offer that week. The supermarket model of health care implied in politicians' rhetoric is a sham. Before long people will get a kind of choice that they can make: to take out insurance – and be prepared to find the ‘co-payments' (i.e. fees) and the ‘deductible' (excess) – or go without.” (p224)

“The high-profile private sector failures of the railways, government information technology systems, the Benefits Office, the Passport Office, the Channel Tunnel and long-term care all illustrate the difficulties governments will face when confronted by the monopoly power of private suppliers of health services.” (p215)

“The NHS, with its enormous range of activities and £74 billion annual turnover, offers marvellous opportunities for companies seeking security of income and healthy profits. Health care corporations, pharmaceutical companies and the construction industry are finding lucrative new openings in the NHS, thanks to Labour's strategy of privatisation and public–private partnerships.” (p1)

"Performance targets will increasingly focus on the bottom line. Under the new GP contract, for example, payments are linked to performance measures such as the percentage of patients whose blood pressure is maintained within strictly defined limits. GPs are already concerned that there will be a temptation to manipulate the readings in borderline cases, and to treat even mild blood pressure problems with drugs for quick results, rather than treating the disease in a holistic way, i.e. focusing on diet, exercise, stress and lifestyle.” (p219)