Monday, June 28, 2021


This post is an update on the original page published in June 2021


It is a commonly said that the NHS is being privatised, changed from being a service owned and run by and for the nation. Politicians often try to deny this or muddy the water, so here are the plain facts in a very brief summary.

The accepted definition of privatisation is the transfer of a business, industry, or service from public to private ownership and control. It is undeniably the case that contracts for NHS services are being transferred from public control to private corporations.

1.       In 1987 Margaret Thatcher introduced the “Internal Market” in the NHS, by creating a division between purchasers and providers of care services. This immediately increased complexity into the NHS, with huge amounts of administrative work needed to calculate (or estimate) the costs of everything from brain surgery to a cardboard bedpan. This administrative work has imposed a serious cost burden on the NHS.

2.       The Private Finance Initiative which used private money to build hospitals, ran from 1992 until 2018. It provided £13bn, but will cost £80bn by the time the debt is repaid. This benefits the private sector, but cripples the NHS.

3.       Foundation Trusts were introduced by a Labour Government, which breaks the NHS down into smaller chunks which can be sold off. This was attempted in the case of Hillingdon Hospital, but the experiment failed.

4.       GPs have been re-organised into consortia, which again are capable of being marketed.

5.       Lansley’s Health and Social Care Bill in 2012 removed the responsibility for the Secretary of State for Health to care for the NHS, and obliged NHS Trusts to put contracts out to tender. Since then, contracts worth billions have gone to the private sector. In the five years to 2015 the private sector was awarded the majority of the contracts for: Pharmacy, patient transport, diagnostics, GP out of hours.

6.       In the course of negotiations of a post-Brexit trade deal, US corporations are very keen to reduce the ability of the NHS to control drug prices. Their plans could increase the cost of drugs to the NHS by a massive £27 billion.

7.       Integrated Care Systems were introduced in 2017, and are very similar to US Accountable Care Organisations. Their aim is to reduce spending. If a private partner in the ICS manages to reduce spending, it is allowed to keep the savings. This is an incentive to cut corners.

8.       Sir Simon Stevens, (until recently, CEO or head of NHS England), has introduced Sustainability and Transformation plans. These aim to reduce NHS beds (the UK has among the lowest ratio of beds to population in the developed world), save £5 billion a year in NHS spending, and reduce the number of A&E departments in the UK from 144 to 50. Sir Simon opposed Obamacare when he was CEO of a US healthcare corporation.

9.       Car parks, cleaning, portering and catering have all been privatised.

10.    Hospitals are increasingly renting space and facilities to private health care organisations.

11.    Increasing numbers of private centres are being set up to do things like hip replacement surgery, which are simple and relatively predictable. If anything goes wrong subsequently, the NHS is expected to put things right, not the private corporation who did the operation.


All of this is clear evidence of a gradual process of privatisation of the NHS.

On the next page we discuss the debate about privatisation.



The Debate about NHS Privatisation

Conservative ideology holds that private is good, public is bad. This is based on the philosophy of individualism, which insists that politics must be based on the individual. This philosophy is false, because Homo sapiens is a social animal. Sadly, health corporations can persuade politicians to see things their way by giving donations to the Conservative Party.
This article lists no less than 70 MPs, mainly Conservative, who have received serious money from health corporations, or have had other connections.

Politicians argue
that GPs, pharmacists, dentists and opticians have always been independent sub-contractors. This is true, but this arrangement was stable, whereas since 1987, the changes that Conservatives (and to a lesser extent, Labour and LibDems) are creating is causing the role of private agencies to be steadily expanding. 

Politicians argue that privatised healthcare is more efficient than care provided by the NHS. This is just plain wrong. Private provision is far more expensive because of all the bills and invoices which have to generated. Different sections of the NHS, which just used to cooperate, now have to send each other itemised bills. In the US, administration costs amount to about 40% of total healthcare costs; in the UK before privatisation began, administration costs were 6%. In addition to administrative costs, private corporations will cream off some of the money they get from Government as profits to give dividends to their shareholders.

Politicians argue that it does not matter who owns the bricks and mortar of the place where treatment takes place, so long as the treatment is delivered. PFI (see other side) proves this to be wrong. It is more efficient for the NHS to own its own hospital than to pay rent or interest to a corporation. 

Politicians argue that health care costs are rising unsustainably. Rising costs of health care is a universal problem in the modern world, and the NHS is placed in the middle the range in international comparisons regarding cost. Privatisation will only add to the cost. Health care in the USA is about twice as expensive as the NHS. Social and economic reform will reduce health costs, not privatisation.

If we do not stop the process of privatisation, we will be left with a rump NHS that does emergency care while anything that is remotely profitable will have been sold off. Private care facilities may be able to perform procedures from cataract surgery to hip replacement, but they do not have A&E departments. Any emergencies in these facilities are shunted over to the NHS to be sorted out.

At the end of the privatisation process lies insurance-based health care. Insurance is always based on risk assessment, which means that high-risk patients will be left to fend for themselves.

The NHS is our NHS. We paid for it with our taxes. Now it is being privatised.

Protect Our NHS is conducting an opinion poll in North Somerset. You will have received a polling slip with this page.

Please join in and cast your vote, so that we can tell your MPs exactly how much local opposition there is to the Government’s NHS Privatisation Plans.

Everyone can help to resist the privatisation process by opening a correspondence with your MP>

This vote will be carried out in North Somerset, but if you are interested in running a poll in your area, get in touch via the comments


DocRichard said...

PFI must not be forgotten.

DocRichard said...
Boris Johnson is facing fresh questions over privatisation in the NHS after new research revealed that £15bn of health service contracts have been handed to private companies since 2015.
The analysis found that almost two-thirds of NHS contracts by value have gone to the private sector in the last four years, and that their total yearly value has almost doubled since then. NHS contracts worth £15bn given to private companies since 2015 despite government’s ‘no privatisation’ pledge, analysis reveals | The Independent