A new wave of privatisation
Health bosses in England are trying to push through a dangerous new form of privatisation.
Several have set up “wholly-owned subsidiaries” to run their estates and facilities departments as a bridgehead to full-blown privatisation. At hospitals in Chesterfield, Leeds and Wigan, bosses are now trying to outsource hundreds of jobs to these subsidiaries.
The privately-registered companies are—for now—owned by NHS trusts. But workers transferred to them would no longer be on the NHS payroll.
This means bosses can, in the future, drive down their pay, terms and conditions. And they can hire new starters on worse contracts—driving down costs further.
The collapse of outsourcing giant Carillion forced bosses to change tack to push through privatisation.
Andrea Proudlock, a real estate lawyer at DAC Beachcroft, described the shift in strategy in a recent article. “The aim is that it starts to attract private sector experience into the company,” she said
“Surveyors with specialist skills, for example, wouldn’t necessarily be attracted to an estates role in the NHS.”
The wholly-owned subsidiaries will “start to attract that expertise, which could help drive up revenue and capital”.
This will make the NHS run even more like a private business. Some health bosses see it as an opportunity to implement the Naylor Review, which called on trusts to let private developers manage their land.
Cutting the wage bill will make estates and facilities departments more attractive for private investors in the future. And down the line hospital bosses are likely to sell some of their shares, making them “partly?owned subsidiaries”.
Labour’s shadow health secretary Jon Ashworth has promised to reverse wholly-owned subsidiaries.
Yet while Labour talks of “renationalisation” of the NHS, its manifesto only promised to make the NHS the “preferred provider” of health services.
The real solution is to abolish the internal market and kick out privatisers who are leeching off the NHS.
Racism damages the NHS
Tory cuts and privatisation have caused the NHS crisis. But the Tories want to shift the blame onto migrants.
They are spearheading their racist assault by talking up “health tourism” to smear migrants as a drain on resources. The government brought in passport checks last October as part of Theresa May’s “hostile environment” policy.
This forces migrants from outside the European Union (EU) to pay for non-emergency care.
The cost of this care adds up to just 0.3 percent of the health budget. The results of a pilot scheme in London hospitals, pushed by health secretary Jeremy Hunt, revealed the real agenda behind passport checks.
Hospitals had asked 8,894 patients for two forms of ID—and refused only 50 people free care.
The idea of health tourism is a racist lie that encourages hospitals to question black and Asian people and people who “look foreign” who are using the NHS. And it’s a step away from having a health service free at the point of need for everybody.
Hunt said the checks would make “chargeable patients make more informed choices about whether they continue to seek care in England”.
Anti-racist campaigning and outrage after the Windrush scandal forced the Tories to make some retreats.
They performed a U-turn last month and suspended an agreement that forced hospitals to share patient data with the Home Office. This data sharing allowed the government to check patients’ immigration statuses.
And Home Secretary Sajid Javid said last week the government would “relax” visa rules for migrant doctors and nurses. “Doctors and nurses play a vital role in society and at this time we need more in the UK,” he said.
Admitting that migrants play a vital role in the NHS is a significant set-back for the Tories’ racist scapegoating.
But the battle over who’s to blame for the crisis isn’t over. A YouGov poll at the beginning of the year showed that people’s top concern is the NHS—but immigration was a close second.
Big pharma pilfers for its profits
The drugs industry exposes the deadly consequences of running health service for profit not people.
Pharmaceutical multinationals Pfizer and Flynn Pharma took the industry watchdog to court earlier this month—and won.
The Competitions and Markets Authority fined them £90 million for hiking the price of the epilepsy drug phenytoin sodium.
They won an appeal against the watchdog and had the fine quashed.
A deal between the two companies in 2012 saw the price of the capsules rise from £2.83 to £67.50—almost 24 times the original price.
Pfizer had sold the British distribution rights for phenytoin sodium to Flynn Pharma. It got rid of the brand name and sold it as a generic product, so avoiding all NHS price controls for drugs.
The firms made big money, and the cost to the struggling NHS jumped from around £2 million to £50 million. Previously the watchdog found that Canadian firm Concordia overcharged the NHS by 6,000 percent for a life-changing thyroid drug between 2007 and 2017.
Big pharma also took the NHS to court last summer over the “rationing” of treatment and drugs. The government introduced a new cap on treatments in March.
The NICE medicines body rejected giving new drug abiraterone to men with prostate cancer last month because it wasn’t deemed cost effective. It is thought to be able to extend life by 15 months.
Rationing is a disaster for patients—and must be opposed. But the solution is not to allow big pharma to overcharge the NHS.
The development and production of drugs should be taken out of the hands of the multinational corporations. Drugs companies should be publicly owned and geared towards meeting people’s needs.
Social care on the brink of collapse
It’s not just the health service that needs huge investment—it’s adult social care too. Thousands of vulnerable and older people face eviction from their care homes because the sector is on the brink of collapse.
A report earlier this month found that evictions from care homes have risen by nearly 40 percent in one year. Some 2,492 people had to be rehoused after their home closed.
There are higher death rates among people forced to undergo unplanned moves than those who aren’t.
There will be a £2.3 billion funding gap in social care by 2020, according to the Local Government Association. And a Tory green paper this summer is unlikely to promise the funding that the sector desperately needs.
The total wealth of the richest 1,000 people in Britain is more than six times the entire NHS budget.
It’s one of the biggest pressures on the NHS.
Local authorities are raising spending on adult social care by 1 percent. But a legacy of cuts mean funding levels are still lower than they were in 2009.
Britain has an ageing population—it’s projected to have an extra half a million people over 85 by 2025. Yet a staggering 83 percent more care home businesses entered insolvency in 2017-18 compared to 2016-17.
Social care shouldn’t be left to the whims of bosses who withdraw care if it’s not turning enough of a profit for their liking.
It should be properly resourced and run alongside health services. Services should be built, funded and provided on the basis they are needed—not because they are lucrative for fat cat bosses.
Tax the rich to save the NHS
Tory chancellor Philip Hammond this month announced £20 billion in extra funding for the NHS in England over five years.
A 3.4 percent average annual increase will see the current £115 billion budget rise to £135 billion by 2023.
It sounds like a lot—but it’s only a fraction of the funding needed. And a source close to the Tories said the cash would only be promised if NHS bosses agreed to publicly welcome the deal.
Chief executive of NHS England Simon Stevens has previously blasted underfunding of the NHS. Earlier this month he insisted that at least 4 percent extra funding was needed to save the service.
Stevens described the Tories’ announcement as “the funding we need to shape a long-term plan”.
But after years of slashing public services, the Tories say some of the money is going to come from higher taxes.
Speaking at the Royal Free Hospital in London last week, Prime Minister Theresa May said tax rises would be done in a “fair and balanced way”.
But nothing the Tories do is fair or balanced. And an increase in national insurance or income tax would hit poorer people much harder than the rich.
The money’s there to properly fund the NHS—and it’s in the pockets of the rich.
The total wealth of the richest 1,000 people in Britain is more than six times the entire NHS budget. They’ve got £724 billion—a new record, according to this year’s Sunday Times Rich List.
Their rise in wealth since 2017, over £72 billion, would pay for nearly two thirds of the NHS budget.