Privatisation has long been held up as a panacea to the NHS’s problems. The first ‘PFI’ (Private Finance Initiative) schemes in the 90s were hailed as a possible solution to the NHS’s difficulties in funding large capital projects, like new hospital buildings, under the Major and Blair governments. Since then, it’s been estimated that taxpayers’ money will be used to pay more than five times over what those PFI assets are worth, at £57bn. Private money into the NHS meant public liability, many times over, for no private risk.
But far from taking the lesson that private money to fund the NHS causes it greater problems, the NHS leadership’s most recent move to meet its under-funding is to approach City hedge funds to borrow £10 billion. This marks a great leap forward in privatising our NHS.
Hedge funds are investment companies using private wealth to invest in a wide range of businesses and ventures. Their most striking characteristic is their almost completely unregulated nature. They are set up deliberately to avoid most financial regulation and are by their nature far from transparent. They exist for but one purpose: to make a profit. Many now think the NHS is 'inefficient' and the City will be its salvation.
Benefit for all, it is assumed, will somehow trickle down as capital is invested and profits returned. Yet it will not. It will stay firmly in the deepening pockets of the wealthy fund investors, who are not accountable to the public in any way. The only ultimate benefactors of any deal between City hedge funds and the NHS will be the very few with the privilege and fortune to be a part of the machine. The rest of us will keep paying, through our taxes, for years to come.
Billions of pounds of taxpayers’ money will be siphoned off for years to come into the pockets of the wealthy backers of organisations that could not be more opaque in their dealings. They would then command unparalleled influence on policy making by this country’s greatest service – our NHS. How much easier will it then be for private contracts to be awarded on a widening scale and further cuts to be made, as market ‘norms’ replace those precious to the NHS and on which it was founded? Patients will suffer as profits are upheld.
That the NHS should be forced to consider borrowing like this is the greatest indication that there is something deeply flawed in the way public services are now seen. Public services are paid from our taxes. Some feel politicians should grasp the nettle and advocate an increase in taxation of the better off to properly fund the NHS. We should not delude ourselves into thinking ‘private money’ or ‘private know-how’ is the answer.
Dr David Wrigley is a GP in Carnforth, Lancashire and Deputy Chair of the BMA. Views expressed are his own. @DavidGWrigley
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