This week Iâm taking a deeper look at the growing scale of profit-making companies taking on NHS contracts, and explain why the cherry-picking of low risk, high profit services by private providers represents a risk to the long-term safety of the NHS. Luckily, the scale of the problem and the impact it has on patients is being pushed against by a new wave of leaders from the medical establishment.
There is a small group of people in the UK who have been campaigning against NHS privatisation for a very long time, decades in fact. Paying attention to the various changes in legislation since the 1980s, theyâve predicted a lot of the things that have now come to pass. Itâs been very difficult for them at times; theyâve been dismissed by the various groups of politicians who initiated the very NHS reforms that have allowed layers of privatisation to be steadily introduced into our public healthcare system. However, in the last couple of years the group of people who have become aware about whatâs going on has grown quickly as this long-established process finally comes to a head.
As the major waves of the COVID-19 pandemic subsided, it was clear to a lot of people that the health service had huge problems. The NHS waiting lists began to grow rapidly, people struggled to access the services they needed, and the winter of 2022/2023 was probably the worst NHS winter crisis we have ever endured. People started asking questions.
When the government chose to focus on pushing the Health and Care Act 2022 legislation through Parliament in order to build 42 Integrated Care Systems (ICBs) in England, creating bureaucracy and further fragmentation of the NHS, thousands of people wanted to know why politicians werenât focusing on supporting staff and investing in NHS services instead. When the same government failed to invest in urgent repairs in many NHS hospitals, people had questions about that too. After all, theyâd attend their local hospital and see closed wards, or buckets on the floor to catch the drips, and they wanted to know why all of this wasnât being fixed. Finally, when politicians failed to listen to experts and healthcare leaders in autumn 2022 as they started to raise the alarm about the impending winter crisis, people were angry, and they wanted answers, and this became even more heightened as the crisis developed.
Sometimes, a situation seems abstract until it is affecting people personally, especially if they are struggling in other ways. The problems in the NHS were no longer abstract. People who called for an ambulance in the winter of 2022/23 faced long delays, and some of those ambulances didnât turn up at all. A&E departments were overrun, GPs were struggling to cope with demand. The problems in the NHS suddenly felt very real to a lot of people, and they started asking questions.
Campaigners and journalists were asking questions too; trying to work out if the government was going to take the necessary action to invest in the NHS to get it back to a functional state. The government announced in December 2022 that they were setting up an âElective Recovery Taskforceâ to help bring down the NHS waiting lists, and this was initially met with cautious relief by many, but it didnât take long for scepticism to set in. There were questions about who would staff any additional resources, or whether private companies would be involved.
OpenDemocracy carried out important work looking into who had been present at the launch of the taskforce, and reported in January 2023 that:
âAt the time, the Department of Health and Social Care (DHSC) refused to give OpenDemocracy details of the groupâs members, or say who had attended its launch at Number 10 led by the PM and health secretary Steve Barclay in December...
..A guestlist for the event, obtained by OpenDemocracy through a Freedom of Information request, reveals that half a dozen CEOs from private health firms were in attendance...
...Guests included the chief execs of the UKâs two largest private hospital operators: Paolo Pieri, the chief exec of Circle Health Group, and Justin Ash, who heads up Spire Healthcare. Also present was Jim Easton, the chief executive of Practice Plus Group, the NHSâs top private healthcare provider.â
Despite growing evidence, itâs still difficult to ascertain the scale of the private company involvement in the NHS; just the sense that things in the public service were deteriorating, while private companies reported success after success, and business publications were awash with the âopportunitiesâ available in the UK private healthcare market. Finally weâre starting to gain some extremely valuable (and horrifying) insights into what is going on.