Our NHS – Great Britain’s finest institution

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How our NHS has been subjected to incremental privatisation

NHS is a key election battle ground with justified fears that a further Tory government would spell the death knell of our NHS. Below is an outline of how we got to this point.

1. Outsourcing – Starting with the Thatcher government, many services, such as cleaning, catering and security, were outsourced to private companies.

2. Private Finance Initiative – Next, private companies were brought in to build and maintain NHS property in return for exorbitant charges.

3. Budgets – After this, Health Authorities were given budgets to purchase health services. Budgets have thereafter been eroded leading to further outsourcing, staff cuts and a lack of investment only for the hospitals and workers to then be faced with outrageous complaints about being in deficit or failing to meet targets.

4. Personal Patient Budgets – Many patients, especially those receiving care in the community or in care homes, are also given a personal budget - another step towards transferring the responsibility of providing care from the NHS to the individual.

5. Employment in private sector – GPs, dentists and so on moved into private partnerships and were encouraged to undertake a mixture of public and private work.

6. Independent Sector Treatment Centres / Qualified Providers / Alternative Provider Medical Services – Under various labels, private bodies were introduced and paid by the government to deliver certain treatments.

7. NHS Foundation Trusts – Next to be introduced were NHS Foundation Trusts that no longer reported to the Secretary of State for Health but to profit driven governing bodies.

8. Health and Social Care Act 2012 – The Coalition Government introduced Clinical Commissioning Groups to control spending. Under this, competitive tendering was required for NHS services that could potentially be provided by outside organisations. This had the effect of doubling private sector outsourcing. Mental health services are, in particular, being increasingly provided by the private sector, even for e.g. vulnerable children.

9. Sustainability and Transformation Plan / Partnerships / ‘Footprints’ - re-named Integrated Care Providers – Here, NHS England was divided into 44 areas, with hospitals, GP’s surgeries, local authorities etc. brought together under an Integrated Care Provider (following a tendering process that is open to private companies) to deliver care within a given budget. Included here is the requirement to cut costs i.e. close GP surgeries and hospitals and increase care in the community provided by profit driven companies.

10. Sale of NHS land – NHS land is being systematically sold off. For example, up to 20-25% of land and buildings at Epsom General Hospital in Surrey has been sold to private developers.

11. Hospital Closures - The South West London Sustainability and Transformation Plan called for the reduction in the number of acute hospitals in South West London from 5 (St George’s, Kingston, Croydon, Epsom & St Helier), to 3 or 4 hospitals, with Epsom & St Helier most at risk. The services at risk include A&E, maternity, intensive care, cancer, coronary and emergency medicine units. Current acute services will be removed and replaced with one acute ‘facility’ (not a hospital). The facility would be smaller, have fewer beds, fewer consultants and only be accessible via ambulance or GP referral. This could happen as soon as 2020.

12. Wholly Owned Subsidiaries – Here, NHS services, staff, facilities etc are transferred into a subsidiary company, initially owned by the NHS. However, ‘companies’ are, legally, separate entities to the NHS and, as highlighted in GMB’s on-going dispute with Frimley Health Foundation Trust, this is another stepping stone to privatisation. See further:

13. Gagging - The incremental privatisation of our NHS has, as no doubt intended, resulted in much of the public being unaware as to what exactly is going on. To make matters worse, NHS bosses are actively seeking to hide the scandal by saying that workers must not take part in debates, activities or events that may be politically controversial during the general election.

14. Insurance based health system / Detrimental trade deals - NHS workers are day in day out experiencing the detrimental effects of underfunding on the road to privatisation and the writing is on the wall as to where this will all end up e.g. an insurance based healthcare system such as exists in the United States. Talks of post Brexit trade deals are also alarming as such trade deals often come with clauses whereby companies can sue governments if profits are undermined.

It is not difficult to be incensed when you know the reasons for privatisation of the NHS are access to wealth, access to patient data and population reduction. It is not difficult to be alarmed at the lack of independent scrutiny, accountability and transparency in the private sector where the business model is based on profit, not care. And it is not difficult to conclude that, ultimately, less care will mean more profit for the private companies and those who depend on work (as opposed to wealth) to live, will be the ones who suffer.

Paul Maloney, GMB Regional Secretary, said,

“It is the ordinary working people who will most suffer from the privatisation of our NHS. Things were desperate before the NHS was created in 1948 but, after this, there was a period of stability with good education, good health and good employment prospects. However, living standards of normal working people have declined since the Thatcher era. There have been ruthless cuts to all sectors of the economy and, in the NHS, this has meant cuts to staffing and endless restructures and re-organisations. As a result, many healthcare workers are bearing the brunt of the cuts and working 20 hour days to ensure patients receive the care they need. I call on the next government to properly fund our NHS, cease and reverse all privatisation and once again fully bring under public ownership Our NHS: Great Britain’s finest institution.”


Please contact your local GMB representative should you require any assistance.