Visiting the United States a little while back I was stopped by a local who'd heard my accent. After a few pleasantries he asked a very specific question, “Is it really true that in your country any of you can just walk into a hospital or visit a doctor and get treatment free of charge?" When I said it was he simply shook his head in amazement, telling me how lucky we were and that there was nothing like it in the US.
Hearing that question and seeing his reaction brought home to me just how precious the NHS is. So often we take it for granted, believing it will always be there. But since the coalition passed the 2012 Health & Social Care Act, I like many others believe that is no longer the case. Like a car on a steep hill whose handbrake hasn't been applied, we're hurtling ever faster towards the inevitability of a US style healthcare system. One where illness is simply another way for big business to make money from us.
Obviously some reading this will scoff at such a notion. On the surface, for many people, the NHS looks and feels relatively normal. Access to GP appointments, prescription medicine and access to A&E services are all still free at the point of entry are they not? But take a closer look and it becomes apparent just how misleading that assessment is.
According to the Nuffield Trust 2012 saw seven per cent of NHS expenditure in the East of England go to the private sector. Since then the proportion has risen three times as fast as spending on NHS provided services. According to the NHS Support Federation, since the government changed the rules in April 2014 almost 70 per cent of NHS contracts have been won by private firms. At a regional level the figure is the same. If that trend is replicated here in Norwich, and there's no reason to believe otherwise, private health will end up being paid around ￡45m to run NHS services in and around our city.
But here's the bind. Typically a private health firm will look to make anywhere between 8-15 per cent profit on each contract. That means here in Norwich around ￡5 million (our taxes) is in the process of being siphoned off as profit to shareholders and individuals. And that's just the start. The Coalition wants to see the entire NHS budget opened up to private companies. In Cambridge the biggest ever contract - worth ￡1billion of services currently provided by the NHS - is now being offered to private health and others. That's the entire NHS provision of various services for an entire county, lock, stock and barrel. Before our very eyes the NHS is changing from a provider of healthcare into a purchaser of services from private companies. And unlike the NHS these companies inevitably have shareholder profit, not patients, as their main priority
Now I understand it was under New Labour that the door to private companies - all be it a minuscule proportion of the overall NHS budget (two per cent), was opened up. Politically that was a mistake. For under the Coalition that small chink has been levered open, the floodgates released and the regulatory die stacked against the NHS in favour of private providers.
So where in the Liberal Democrat or Conservative manifestos was there a pledge to sell off the NHS? Clearly there wasn't, but that hasn't stopped them from doing so. For the Tories this is ideological. Break the back of the NHS and nothing will stand in the way of finally dismantling what remains of public services. For the Lib Dems, complicit in this act of public sector vandalism, selling off the NHS is proving profitable. We know Liberal Democrat peers such as Lord Renard and many others have financial links to private healthcare companies. Companies profiting generously from the demise of the NHS. The Lib Dems, who came in 'to clean politics up' have wasted no time in getting their snouts into the trough.
And to date, private health care firms with Tory links have been awarded NHS contracts worth nearly ￡1.5billion. Nobody gave David Cameron permission to sell the NHS to his friends.
Its clear the Coalition is hell-bent on breaking-up our NHS into little bits that they can parcel out to their backers in the private healthcare and hedge fund industries. But Labour will always put patients before profit. Labour’s NHS plans could hardly be more different to current Lib-Dem/Tory health policy. We will refocus the system to make sure your GPs best option is to get the services they need to keep you well from public rather than private health sources.
I will also push to get rid of all the business and market elements of the NHS in the longer term. But I also know that one thing our battered and bruised Health Service doesn’t need now is another multi-billion pound, top-down re-organisation. So the next Labour government will work with the institutions which we inherit but will make sure they play their part in reclaiming our public NHS.
Under Labour, the future NHS will be fairer - but it also needs to be better. We have an ageing population and many desperately want co-ordination of care – a single point of contact for all of mum or dad’s needs. The solution? Our plans to integrate physical, mental and social care services - cutting admin costs and benefiting patients and their carers at the same time. But perhaps the most exciting change is our commitment to spending on ‘Early Intervention’. A future Labour government will take a fresh look at every pound of public expenditure and prioritise spending that prevents problems for people and the economy further ‘down the line’. Early intervention is Labour’s common sense way of improving public services like the NHS and, at the same time, getting more (and better) healthcare for our money.
Clearly value for money and cost are important factors when considering the NHS. It's part of the economic reality we currently inhabit. But I believe the NHS to be more than the mere sum of its financial parts. Whilst the Coalition knows all about the price of the NHS they fail entirely to understand it's value.
Sat in Westminster watching celebrations for the NHS's 60th birthday, Nick Clegg was heard to say, "I don't see what all this fuss is about, it's just another health care provision system." And that ultimately is the difference between us. Because those of us who have a vision for a better, fairer, kinder, caring society and world know the NHS is the embodiment of those ideals. And that's ultimately why we love it so.