by Priscilla Alderson.
Quaker concerns for equality and integrity relate to NHS policy: equal healthcare for everyone according to their need, not their ability to pay, and honesty about the government’s health policies. Can these standards only be achieved through Socialist healthcare policies?
Equality and privatising the NHS
The UK is heading that way with USA companies running some of our services such as GP surgeries, management and IT support (2). For example, USA dialysis companies are paid £100,000,000s to run NHS kidney care, even though these companies have paid out $billions when sued for corruption, fraud and negligence that killed patients in the US (3). The NHS pays almost twice as much for private cataract surgery as it pays for the NHS equivalent.
The Labour Party say the NHS will always be publicly run and publicly funded. But crucially they do not say publicly provided by the state. When there are two or more providers that involve private companies, they compete to cut costs and increase profits for shareholders thereby lowering standards. This is seen in the USA, which spends twice as much on healthcare per person as comparable nations spend (1), $4.8 trillion in 2023. Yet Americans experience worse health, and many millions of them cannot afford to pay for any medical care, or else they are deeply in debt to healthcare companies.
In 2022, 10% of NHS patients, over two million people, were treated by private companies (4). Many patients did not realise this, as private healthcare companies can use the NHS logo. In addition, millions of people are insured to have private healthcare, or they resort to it because of long NHS waiting lists. Costs are higher but standards are lower in private care, which does not cover the most complex conditions and seriously ill patients. The NHS has to repair damage done to many private patients (5).
The Labour Party say little about their decades of stealthy, costly and wasteful privatisation of the NHS (6). This includes measures set up by the Conservatives and expanded by Labour during 1997-2010: PFIs, public-private finance initiatives, when every year the government pays tens of £billions in interest to private companies to build and run hospitals; the very expensive time-wasting NHS-wide ‘internal market’ set up in 1991 ready to support a wholly private system (7); use of private agency staff, and of chemists to replace GP services (8).
Labour is now advised by politicians who led these moves during the Blair-Brown years and since then have made fortunes working in companies such as KPMG (Jacky Smith) and Price Waterhouse Cooper (Alan Milburn). These companies not only drive privatisation, they also specialise in giving advice on tax-dodging, whereas the NHS depends on a fair tax system. NHS management boards now include representatives from private companies who are reshaping the NHS.
Before the election, Health Secretary Wes Streeting received £175,000 from donors involved in UK and US private healthcare companies. He plans to increase NHS privatisation. He has appointed Lord Darzi to chair another ‘independent’ Inquiry to support further NHS plans. Darzi also advocates private healthcare based on the US leading company Kaiser (9). His Reports in 2008 and 2018 led to closures of hospitals, A&E departments and GP surgeries to be replaced by privately run ‘polyclinics’, policies based on profit not on need and equality.
Integrity and health policy
Journalists publish information from convenient but not critical sources, such as three leading ‘independent’ health thinktanks with deep roots in private healthcare. For years one of them, King’s Fund, drove plans to reduce hospital bed numbers by one half (10), though now it complains about shortages. Journalists let politicians spread misinformation through the mainstream media (11).
- They gloss over privatisation.
- They pretend to support the ‘amazing’ NHS, while also criticising its many failings.
- So they encourage the public to be very critical of the ‘broken’ NHS and shortages, paving the way for public acceptance of gradual further privatisations, such as having to pay to see a GP.
- They present the NHS as a cost. Yet it is an asset and wealth creator whenever it helps people to be more fit and active and able to contribute to society. Health is as vital as wealth to social prosperity.
- They pretend that referring NHS patients to private healthcare can ‘cut waiting lists’. Instead, this lengthens NHS waiting lists because even more staff who were trained and employed by the very short-staffed NHS are transferred away into private services.
- They concentrate on needs for ‘new technology’. One in three radiology specialists are missing (12) and patients desperately need doctors as well as machines.
- Instead of admitting that the problems are caused by Government privatising and cost-cutting policies, Conservative politicians blame immigrants and the growing numbers of long-term sick and disabled, old and overweight people who ‘demand’ too many services and too much support from taxpayers. This stirs up conflict and resentment, eroding the NHS’s basis in Socialist solidarity.
- Labour politicians blame Conservative cost-cutting and emphasise how much the NHS depends on migrants, one fifth of its staff. They rightly add that we should not take healthcare staff from other countries but should train our own professionals. Yet between Labour’s plans to reduce net migration, the continued severe underfunding of the NHS, the years needed to train medical staff, and constraints on training capacity, NHS staffing for the next five years at least is very uncertain.
Ministers say they will not ‘renew’ austerity. Yet current plans to keep down state funding will continue and increase austerity. Labour’s proposed 1.1% annual rise in spending will be lower than even the austerity years (13).
The British Medical Association estimates that during 2009-2024, the NHS has been underfunded by £362 billion (14). Funds are urgently needed to reduce long waiting lists, which lead to patients becoming more ill, more expensive to treat, and more likely to die. Over 340,000 people in England died in 2023 while they were on NHS hospital waiting lists (15). More than 250 people each week ‘die unnecessarily’ while waiting for A&E care (16).
Funds are also desperately needed: to restore practitioners’ pay levels and improve their working conditions to stop staff haemorrhaging from the NHS; to train new staff to replace them; to repair and replace broken systems, buildings and equipment that were neglected over the past 15 years; to invest in new healthcare services and technologies when these are constantly innovating and developing.
Large reforms are needed to expand social care to receive the patients ‘blocking’ up to one in three hospital beds, when they need social care not hospital care (17). Another huge challenge is adequate funding and reforms for all areas of state services that help to keep people healthy: housing, a proper minimum wage, child benefit and social security, clean water, public transport, schools, sports centres, environmental protection, and many other nation-wide ‘levelling up’ supports.
The greatest lie is that Britain, the sixth richest economy in the world, cannot afford to fund public services adequately. The NHS was founded during a time of higher national debt than today’s, when Socialist spending policies brought 30 years of prosperity (18). Today, the richest 1% in Britain holds more wealth than 70 per cent of British people, and globally the richest 1% has gained another £21 trillion since 2020 (19). Leading experts agree that Labour’s austerity policies for economic growth will not work (20,21).
It seems that wealth cannot be spread more fairly, debate be more honest, or the NHS be saved, until a Socialist government that really respects equality and integrity is elected.
Priscilla Alderson 17/07/24
1 https://www.bmj.com/content/383/bmj.p2340
2 https://www.england.nhs.uk/hssf/supplier-lists/
4 https://www.left-horizons.com/2024/07/10/the-battle-to-rebuild-the-nhs/
6 Allyson Pollock, NHS.plc. 2004, Verso.
7 Colin Leys, Stewart Player. The Plot against the NHS. 2012, Merlin.
8 https://www.left-horizons.com/2024/07/10/the-battle-to-rebuild-the-nhs/
9 Lord Darzi’s interview for Nuffield Trust. https://www.youtube.com/watch?v=YbIegux_bLk. His place at the centre of privatising the NHS is explained by Nicholas Csergo https://www.youtube.com/watch?v=P1iinbpq5Ds
10 Youssef El-Gingihy. How to Dismantle the NHS in 10 Easy Steps. 2015, Zero.
11 Peter Oborne. The Assault on Truth. 2021, Simon &Schuster.
12 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10441819/
15 https://fullfact.org/health/times-labour-deaths-on-waiting-lists-nhs/
16 https://www.bbc.co.uk/news/health-68707883
18 https://thenextrecession.wordpress.com/2024/07/08/britains-securonomics/
20 https://www.resolutionfoundation.org/publications/growing-for-gold/
21 https://thenextrecession.wordpress.com/2024/07/08/britains-securonomics/
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