“The NHS will last as long as there are folk left with the faith to fight for it”
– Aneurin Bevan, founder of the NHS, 1948
The British print media are doing their very best to persuade us that the ‘fighting folk’ Nye Bevan placed the future of the NHS in no longer exist and that it is being dismantled brick by brick; fortunately for Britain, this is not the case.
The term that continues to appear in the discussion about changes to the NHS in England and Wales is ‘privatisation’ and it is here that the first issue lies. Privatisation is a rather straightforward concept; it is the sale of an industry from the public sector to the private sector. To use the term ‘privatisation’ to describe the changes to the NHS is like referring to nuclear launch sequences as ‘the red button’; an oversimplified misconception of the truth. Privatisation in the true meaning of the word has occurred in the past to British state-run industries including coal, gas, rail and air travel, and others, but the process of outsourcing very specific contracts in areas of health care where the NHS simply cannot provide sufficient services is not a privatisation.
The NHS has had links with the private sector ever since its creation in 1948, GPs, for example, have always been independent contractors of the NHS rather than official public employees and dentistry is largely similar. We must establish a crucial distinction between the current British health system and other sectors of industry in which private firms have become involved. The private firms responsible for providing additional health care are not competing with the NHS, they are working with it. It may seem an odd concept because this collaboration between the private and public sectors occurs so rarely but in health care, this is what is happening. The NHS is financially incapable of providing all the services which people require and as such private firms are needed to close the provision deficit. In addition to GPs and dentistry, the private sector has access to minor injury units, maternity care, ambulance services, and mental health care. First of all, there’s a heck of a lot of services not on that list which perhaps demonstrates how overblown the ‘privatisation’ claims are, and secondly these are all areas of health care which the NHS is currently underprovided and yet are all vital services. It makes me question whether those who are so vehemently against the inclusion of the private sector would prefer for these vital services not to be sufficiently provided, as would be the case if private firms took no part in health care. What’s more, these services are all still provided on a ‘free-at-the-point-of-use’ basis and the idea that this is a movement towards being charged for health care is a complete myth.
I return to my initial statement about the role of the media in misrepresenting this process as a ‘privatisation’ when this is so far from the truth, similarly, the private firms involved in health care have also been grossly misrepresented. A quick glance at a handful of newspaper headlines would lead you to believe that the NHS was being sold off to multinational corporations hell-bent on profit maximisation and slave labour. Yes, I’ll admit that’s a slight exaggeration but my point holds, the firms providing health care alongside the NHS are, in the main, charitable organisations and hospice trusts. The issue for many opponents of private provision of health care seems to be with the principle of making a profit from actions where making profit seems immoral, but may I remind those critics that most major charities rake in significant profits year-in-year-out and not a single eyebrow is raised. In 2010 for example, Cancer Research recorded a profit of £48million, Save The Children £25million, Oxfam £23million and so on. Yet because of the admirable work these organisations carry out their profit making is not frowned upon and so I ask, how is it any different for organisations who provide vital health care services and make a profit? Yes, these firms do make a profit but they do so on the back of essential care which the NHS would otherwise be incapable of providing.
The counter argument may have a valid point that profit-making is in some way against the ethics of free-at-the-point-of-use healthcare but the reality is that profit is in no way important in the discussion about the NHS. Firstly, as I addressed earlier, the free health care we receive is in no way at threat from this so-called ‘privatisation’, mainly because there is no such privatisation occurring. Our focus should be on whether the system provides enough of the care we need, and that this care is provided at a high enough quality, not whether profit is made. The outsourcing of care to non-state organisations does not threaten either provision or quality of care, in fact, I would argue it enhances both. We now have more health care available than if the NHS acted alone, and as of the improvement in the quality of service well that’s a simple lesson in economics; the more providers of a service there are the higher quality that service will be. Despite the stories of a Conservative plot to sell-off the NHS, the private sector is maintaining and improving the British health care system and whilst doing so poses no threat to the free-at-the-point-use care we hold so dear.