Recent government announcements suggest the Tories have finally clocked that the public are sick to death of privatisation. But that hasn’t translated into policy that would put the forty-year experiment to bed. Rather, the Tories have plumped for a cynical rebranding, hoping to pull the wool over the public’s eyes while clinging doggedly to their ideological obsession.
That’s the case with ‘Great British Railways’ seeking to hide a continuation of the status quo under a cloak of ‘patriotic’ rhetoric. It’s also true of the government’s new Health and Social Care Bill, pitched as a reigning in of privatisation and a reversal of the 2012 Lansley Act which accelerated private sector involvement in the NHS and forced services to be put out for competitive tender, transforming our health service into a full blown ‘market’.
With media reports regurgitating the government’s narrative, many people have been asking whether the bill was perhaps good news.
The answer, of course, is no – and this Thursday, the NHS campaigners who believe that this bill will lead to an even bigger corporate power grab over our NHS were proved correct.
Central to the government’s forthcoming legislation is Integrated Care Systems. The opaquely-titled ICS is a new regional structure for our NHS that will make decisions about our health services locally. At its core, the idea is that all health service providers are brought together to make joint decisions about health care for a particular locality.
The problem? When so much of our health service is riddled with private companies, those same companies also get brought to the table. You supposedly need ‘everyone’ in the room to make ‘joined-up decisions’, and as long as private companies operate within the health service, they get an invite, too.
Thanks to local campaigners drawing it to the public’s attention, it has now emerged that Virgin has been given a spot on the Bath and North East Somerset, Swindon and Wiltshire ICS Partnership board.
Virgin Care’s Managing Director will now be part of discussions about what health care is provided locally, who provides it, and to what standard – directly impacting the care of patients. They will no doubt think that private companies can provide care just as well as the public sector. They will no doubt think it makes no difference that our health service is sliced into disconnected, fragmented chunks, parcelled out to companies that prioritise private profit rather than public health.
In reality, Virgin’s ‘care’ has already put local patients at risk. Hundreds of people had to quit the GP services the company ran in Essex due to inadequate care, and in another area, Virgin ‘asked staff not to report safety concerns’ to a health watchdog.
All the while, Virgin has shown time and again it will do whatever it can to maximise profits. When Virgin didn’t get a contract in Surrey, the company successfully sued the NHS for £2 million. In 2018 Virgin paid no corporation tax on the £200 million turnover it had from NHS contracts.
The insidious effects of Virgin’s influence will be catastrophic for people locally. It will also be deeply damaging for all patients across the country, as this model isn’t a one-off. It’s being replicated throughout the UK, central to the formation of ICSs and enshrined in the forthcoming legislation.
Virgin being the big player in your local care could become the norm.
And the hellscape this promises isn’t in the future. We’re already seeing the effect of the company being at the decision-making table. In the minutes for the Bath and North East Somerset, Swindon and Wiltshire ICS board meeting, discussion was had regarding the ‘extent of their [the private providers] financial transparency toward system partners’. It’s no surprise that Virgin Care ‘had reservations about sharing information in public’.
The ‘action’ that was taken away? To ‘further discuss how the ‘open book’ approach could be applied to private/independent providers while protecting those providers’ corporate and commercial interests’. There will now be a balance in the region between sharing information with the public about what money there is available, and what the company wants to share to safeguard their competitive advantage. A public body would never get away with this – but unsurprisingly it’s one rule for the public sector, another for the private sector.
Integrated Care Systems have been introduced across the country with little guidance as to the legal power they hold, and these vague structures are already risking patients’ safety. The legislation being introduced by this government is supposed to flesh out all of these details. So far, we’ve had little detail.
This legislation won’t just allow private companies onto boards. It will also incentivise cuts and closures by allowing organisations—public or private—involved in the ICS to hold on to financial ‘savings’ made on a set budget for health services. The potential for providing less care as a means of protecting the bottom line is clear.
After profiting from a lack of care, who will fill these gaps? Some people will be forced to pay through the nose for private healthcare, while others will be priced into ill health, and in the worst cases, shorter lives.
It’s for all these reasons and more that we have to campaign to stop this legislation going through.
The NHS does need root and branch reform. Our health service—built on the principles of Nye Bevan, with the aim of providing comprehensive care to all who need it, regardless of whether or not you can afford it—has been eroded well before this bill.
But the reform it needs is to be reinstated as a fully public service providing proper care to all. Campaigners have already put together the blueprints in the form of the Reinstatement Bill and the NHS New Deal. There are exciting, necessary plans about how to provide a caring service that actively keeps us all healthy, and offers workers a rewarding, well-paid job. There is a clear alternative.
Unless we move towards that alternative—of an NHS built and maintained in the interests of patients, rather than private profit—the health service cherished by all will pass into memory. We’ll see more and more Virgin-type companies sitting on decision-making boards. We’ll see the core values of the NHS eroded bit by bit. And we’ll see our healthcare swallowed up and taken over by private companies looking to make a quick buck.
There’s a quote often attributed to Nye Bevan, ‘the NHS will last as long as there’s folk with faith left to fight for it.’ It may be apocryphal but it is no doubt true. Now is the time to fight and fight and fight again.