The pandemic has shown how interconnected and interdependent public health and economic health are. With our society facing further seismic public health issues, namely an ageing population and the health impacts of a heating climate, the case for prioritising well-being – including through the provision of universal healthcare – has never been stronger.
This is why I voted against the Tory’s health and care bill – which would be more accurately named the corporate takeover bill. These reforms will usher in a huge transfer of decision-making power to private companies and democratically unaccountable third parties through innocuous sounding “Integrated Care Systems”, which will not guarantee my constituent’s right to access the healthcare they need, when they need it.
Some readers may be thinking, what’s the problem with private companies providing healthcare? For starters, this model has already been used in the US for years as a way to reduce Medicaid spending by rationing access to expensive forms of care. It will likely lead to more and more services – community care, mental health, physiotherapy – being pushed out of the NHS, where they are currently free to everyone who needs them.
Behind the rhetoric of improved services and joined-up management lie two decades of lobbying by US health corporations to bring this system to the UK – and to be handsomely paid for designing and running it. Already we see healthcare corporates such as Virgin Care invited onto the Integrated Care Boards that will run the new local systems, deciding where contracts go and – more importantly – what care will be funded.
Many essential healthcare services in the UK have already begun the process of privatisation by stealth, including social care, dentistry, and mental health care. The results speak for themselves, and I see the effects in my constituency.
Systematic underfunding of the NHS to create a “market” for private companies has played no small part in creating a backlog of 60,000 people awaiting treatment at my local hospital. Meanwhile, a report into three deaths at a specialist private hospital in my region questioned whether NHS patients can be safe in hospitals driven by “business opportunism and profit-driven priorities”.
Thanks to swingeing cuts to local authority budgets, the social care sector is now dominated by private equity companies. They place more importance on building a property portfolio and extracting as much profit as possible to siphon off to tax havens, than they do on looking after patients.
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This has all played a role in diminishing public health outcomes. Since 2010, life expectancy in England has stalled for the first time since at least 1900 and there has been a resurgence in cases of scurvy and rickets. All this has happened while £15bn in NHS contracts were handed to private companies – even before the pandemic.
When the pandemic struck, under the cover of a crisis the government siphoned off public funds through corrupt contract giveaways to breathe life into the private healthcare industry. Money has been poured into private testing labs, data systems, recruitment agencies, and Serco’s disastrous Test and Trace system. All of this is new infrastructure that could have stayed in public hands, but was instead designed for profit, not for need.
Public funding remains the most efficient and fairest way to finance public health and seven in 10 of us believe healthcare funding should stay the way it is. Public ownership and provision leaves little room for profit. This is why health corporates and their Tory investors have spent 30 years lobbying to take advantage of the money to be made from breaking Bevan’s model.
Although the UK famously does not have a written constitution, NHS England does. Spelled out in that constitution is a commitment to the existence of a “comprehensive service, available to all” which “belongs to the people”, where service provision is based on need, “not an individual’s ability to pay”.
Just imagine the kind of society we would have if such principles were extended to all public services and areas of public life. Unfortunately, these principles are not shared by Tory MPs, who are tearing up the NHS’s constitution with their corporate takeover bill.
Clive Lewis is MP for Norwich South
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