Funded publicly, ran socially, there once was a time when the NHS was a global case study for success in the universal provision of quality care. Economics, sociologists and think tanks all saw Britain’s National Health Service as this marvellous new creation that was able deliver healthcare on unprecedented scales, at unprecedented costs. Not only had our NHS been able to provide outstanding healthcare to every single British citizen, but it had to be able to achieve this at costs well-below the expenses of the private sector. Today, the story is much bleaker. Debts and budget deficits are the weapons of privatization being used by our Conservative friends to reinforce the very component that is causing these spiralling costs – the internal market.
Introduced by the Thatcher government, our NHS underwent its biggest reform yet in 1988 with the introduction of the notorious internal market. Healthcare itself became a commodity which hospitals were to buy and sell from each other, and of course private contractors. This was a fundamental change in the duty of our hospitals; for no longer were they bound to the duty of universal care – instead, finances and surpluses became the motivation. Our doctors, nurses and medical professionals were quite literally pushed out of senior positions, to be replaced by a host of bureaucratic financiers, bankers and ex-business leaders. What happened to care? What happened to compassion?
Today in 2013, our hospitals are businesses in all but name. The internal market is to be strengthened even further by the Health and Social Care Act passed last year in parliament; giving greater freedoms for our hospitals to buy and sell from private providers. However, the reforms to be made a result of this bill will be much harder to reverse as our hospitals will be completely handed over to local boards of stakeholders. Our NHS will finally be out of the hands of democracy and the British people will have to put up quite the fight to get it back.
Don’t misunderstand me though. With the growing opposition to Tory-led privatizations, as seen in the Manchester rally on Saturday, I think we should all be optimistic for the struggle ahead. However, optimism shouldn’t be confused with foolishness. The lords of privatization, Richard Branson, BMI Healthcare and Circle Group are very much lobbying the Conservatives for more hospital sell-offs, more privatization. Unfortunately for Britain, the Conservatives are already succumbing the pressures of corporate power.
Unlike the Tories, British people value compassionate care, universal access, and do not want a US-style private healthcare system. We want an NHS, not one big market that sits backs as the poor are denied vital life-saving treatment. On the streets, I can tell you right now that nobody wants hospitals to allocate 90% of their budget for the wealthiest 10% of patients. This isn’t what people want, but these extremes are becoming increasingly real as our politicians steer us in the direction of even more rapid and severe privatizations, sell-offs and internal market reforms.
I for one think it’s the time to say no to privatization and to the internal market.
James O. Gibson is a Young Fabian member.