I wanted to add a link to the video below, which shows Lucy Reynolds discussing changes to the NHS that suggest that we are heading towards the privatisation of healthcare in England and how this could be disastrous. What’s interesting about this is that Lucy Reynolds is an academic who studies “medical and healthcare programmes”. It’s clear that she’s very critical of what is happening to healthcare in England and a lot of what she says certainly makes sense to me. One issue I had was that, as an academic, maybe one should aim to be objective and unbiased when discussing one’s research, and so I wasn’t quite sure what to make of an academic who studies healthcare provision having such strong personal views about healthcare in England. On the other hand, I sometimes feel that academics in the UK aren’t sufficiently political. Aren’t we meant to be intellectual and think about society and the implications of decisions made by politicians on our society. If not, then who else? So, fundamentall, I was very pleased to see someone, who is clearly an expert in this area, discussing – very clearly – why the proposed changes to the NHS in England could have a very damaging impact on our ability to provide decent healthcare for the population.
I don’t want to say too much, but one of the basic messages was that in a publicly funded healthcare system you can prioritise the needs of the patient. It still costs money and so there isn’t complete freedom, but if one assumes that most doctors and nurses went into healthcare in order to help people, it makes sense that the optimal system is one that allows them to put the patients first. In a private healthcare system this is no longer necessarily the case. Legally, private companies are obliged to do what’s best for their investors. They therefore need to optimise their profits. They can’t simply put the patient first. They’re not obliged to treat those who haven’t taken out suitable healthcare. They can refuse treatment if someone hasn’t told them their complete healthcare history when taking out insurance. They can prescribe treatments or tests that may not be strictly necessary. Profit has to come first, ahead of patient care.
Something that has confused me about this supposed desire for privatisation of the NHS in England is that the private sector is already very heavily involved. The NHS doesn’t make anything. They buy all of their equipment, vehicles, pharmaceuticals, etc. from private companies. Also, once the staff have paid their taxes they spend most (if not all) of their money in the private sector. They buy food, electrical goods, pay for holidays, etc. Most of the money that goes into the NHS ends up passing the private sector anyway. If we continue privatising the NHS all that this will mean, apart from the damage it is likely to do to healthcare provision, is that a new set of investors will be making a profit from the NHS. I would have thought that companies like Sainsburys, Tescos, Currys, Thomsons travels, …. would all be slightly worried about this. Surely there’s no great benefit to them to see the NHS privatised. Of course, if their investors are the same as those who will be investing in healthcare companies, maybe they’ll still see the dividends. On the other hand, if the investors are American pension funds, they will effectively be losing money.
I appreciate that you can’t have a successful economy if it is fully public. Similarly, however, I would argue that it’s hard to see how you can have a successful economy that is fully private. You need some kind of balance. Certain things fit well within a market. I can have a choice of foods, types of transport, holidays, entertainment, etc. It is, however, harder to see how you can apply a market philosophy to healthcare, education, policing, the military, the justice system. If you apply a market to these it implies a variety of different provisions and hence some receiving a better level of healthcare (for example) than others. I don’t really care that my car is clearly not as fancy as someone else’s. Similarly, I don’t really care if some people have to catch a bus rather than driving. It’s a perfectly fine way to get around. I do, however, care about my children’s education or about the healthcare that I may receive in the future. I don’t think these type of things should depend on your income/wealth. It should, ideally, be provided at an equal level to all. Getting educated or receiving healthcare isn’t really something you want to have to choose. You would like the best you can get. A private healthcare system may well benefit some but at the expense of others who will be locked out because of the costs, and I think that would be very unfortunate.
Anyway, I recommend watching the video below. It is a little long but she does make a very strong case for why we should resist what is essentially the privatisation of the NHS in England.