25 November 2021

Oh no! The NHS is being privatised – again


The NHS is being privatised – again. The only people who can save our NHS (peace be upon it) are the heroes of the Left rabble rousing at political rallies, sending out angry tweets that instantly go viral and spreading misinformation in meme form.

We’ve heard this all before pretty much every year of course, with spikes in outrage whenever any healthcare related Bill passes through parliament. Now it’s the new Health and Care Bill.

The Bill has passed the final hurdle in the House of Commons and will now head to the Lords. It will, according to the government, restructure parts of the NHS in England to create a ‘truly integrated’ healthcare system that involves less central bureaucracy. According to the Left, it will lead to the NHS being sold to private profiteers and a US style healthcare system being imposed in its place.

Instead of addressing the reforms, the Left are once again wailing ‘we only have xx days to save the NHS!’.

The Health and Care Bill proposes to establish 42 independently run Integrated Care Systems (ICSs). This is not, as Twitter seems to believe, to break up the healthcare system into easily sellable chunks. There are already 42 ICSs in England, the Health and Care Bill will simply establish them as statutory bodies.

As they are not currently statutory bodies there are no formal requirements on their governance, leading to concerns about a lack of accountability and transparency. The Health and Care Bill seeks to address this.

The Bill will also overhaul the (wasteful and inefficient) procurement rules used by the NHS. Currently the rules require local NHS funders to publicly announce all contracts over £615,000 to allow NHS and private operators to bid and be treated equally. The new Bill drops these requirements.

NHS England claimed that the old rules ‘lead to wasted procurement costs and fragmented provision’. The new rules allow contracts to be rolled over when the existing provider is deemed to be performing well and means local NHS funders can decide when to use transparent competition in the interest of patients.

Objections have been raised to the development of the integrated care provider contract which will allow commissioners to award long-term contracts to single organisations to provide a wide range of health and care services. The numerous anti-privatisation campaign groups (Keep Our NHS Public, The Great NHS Heist, We Own It, Every Doctor UK and many more) claim it will mean more services being controlled by private companies.

However, both judicial reviews brought against NHS England in relation to the integrated care provider contract were dismissed. The NHS Long Term Plan then set an expectation that the integrated care provider contracts would be held by public statutory providers. This rolls back previous market-based reforms and creates stronger public sector partnerships. It’s highly dubious to claim that this will lead to further privatisation.

Despite the hysteria, there is nothing in the Bill that will change the NHS from being a universal healthcare system. After the reforms the NHS will still be a publicly funded service, free at the point of use

Of course, none of this will do for the Corbyns, Burgons and Zarah Sultanas of this world, nor their tedious media cheerleaders. For them, even the NHS paying private companies is a form of privatisation. Even though the NHS has been paying private providers to deliver free healthcare ever since it was founded by Labour’s Saint Clement Attlee.

GPs, dentists, optometrists and pharmacists have always been profit making contractors. NHS money that used to go to NHS trusts is often now spent on other private services, such as hospitals, mental healthcare providers and charities. The sky didn’t fall in and neither did ‘our’ NHS.

When this Bill fails to lead to the sale of the NHS, they will move onto the next scare. Regional health authorities didn’t lead to privatisation. Neither did primary care groups and trusts, nor strategic health authorities. Andrew Lansley didn’t privatise the NHS, neither did Donald Trump.

The most contentious part of the Health and Care Bill should be the increase in power for the Secretary of State for Health. The new powers for the Health Secretary to intervene in local services and direct the NHS risks introducing party politics into decision making processes. There should be far more focus on this instead of privatisation hysteria and anti-Tory memes. The Left is warping the debate again.

The NHS is not being privatised. The Conservative Party adapts to circumstance to win and stay in power. That is the Party’s purpose above and beyond any ideological concern. Privatising the NHS when it is the national religion would lead to electoral oblivion. It makes no sense.

The NHS has all sorts of problems and all reforms should be subject to scrutiny. Sadly, we can never discuss the real issues because of the NHS privatisation fear mongering that dominates the healthcare debate.

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Ben Kelly is a freelance journalist.

Columns are the author's own opinion and do not necessarily reflect the views of CapX.