Our team member Aldo Mussi argues that “Perhaps the most inconsistent thing about privatised healthcare is that it’s, well… not very British!”
I held the shiny new 50p in my hand. It was 1998, and this was a special commemorative coin minted for the 50th anniversary of the founding of the NHS – and given one each to (I’m not sure how many) staff for free! I was a team leader in the NHS, and proud to be part of the best healthcare system in the world.
Some might take that 50p to be symbolic of the waste that pervaded the NHS in the past – but the danger would be to overlook the bigger threats that have plagued it throughout its existence. In the early days it was noticeably the medical profession that resisted Aneurin Bevan’s setting up of a nationalised healthcare service – so much so that he complained of having to bribe them by ‘filling their mouths with gold’. Today it is the filling of the pockets of businesspeople and lawyers that we must be wary of.
These days I teach Health Promotion/Public Health, and my students get to see how most of the health of a population is actually determined by factors outside of healthcare (ie our environments and behaviours). That said, while healthcare’s contribution to health is limited, it is nonetheless an essential one, and especially with basic community & family care (Midwifery, immunisations, screening etc). Big, expensive hospitals are great for individuals who are acutely ill, but overall don’t make such a big impact on our average life expectancy, or happiness.
The NHS continues to be treasured by Britons – so, for a country where ‘socialism’ has been treated as a rude word by the establishment, my students are often surprised to consider how socialist an idea the NHS is (we pay via taxation according to our ability, receiving care according to our need). It seems that Britons are more socialist than they realise.
Of course, even at the outset there were capitalist strands to the new system (charges remained for dentists, opticians and prescriptions), but it took the Thatcherite introduction of a contract culture to really start undermining things: It could be claimed that a genuinely national health service ceased to exist when local ‘NHS Trusts’ were set up in 1992, with a ‘purchaser-provider split’.
My students can be puzzled by how many of their healthcare colleagues adhere to the idea that privatised healthcare is the best, for those who can afford it. But even setting aside the now-clear realisation that unequal societies make health worse for everyone at a population level, privatisation doesn’t deliver for us: the same staff could provide care for us in a better-supported NHS (which already has better facilities)… and of course when things go wrong in a private clinic, it is NHS emergency care which rescues people, at the public expense. Another example of ‘socialism for the rich, capitalism for the poor’?
Privateers in the USA point to the few areas where expensive insurance can open doors to fast & high-tech treatments for the few. People paying $100 to get a splinter removed, or selling their house to pay for cancer care, are less impressed. In fact the USA has the most expensive healthcare in the world, but with downright unimpressive outcomes (other than big profits for insurance companies and lawyers).
“We are renowned for waiting our turn in orderly queues, in the interests of fair play and order. Yet privatised healthcare is queue-jumping at best, and damaging to the public’s overall health. So it’s odd that people who wouldn’t dream of pushing in to a queue at something more trivial like the cinema, will in some cases be persuaded that it’s ok to pay for getting treated ahead of someone else.”
That might seem ok if healthcare was supposed to be in a ‘marketplace’, as a commodity to be bought and sold. But that would be forgetting that access to essential healthcare is a human right, and that (as with schooling) attempts to privatise it are a breach of that right.
But perhaps the most inconsistent thing about privatised healthcare is that it’s, well… not very British. We are renowned for waiting our turn in orderly queues, in the interests of fair play and order. Yet privatised healthcare is queue-jumping at best, and damaging to the public’s overall health. So it’s odd that people who wouldn’t dream of pushing in to a queue at something more trivial like the cinema, will in some cases be persuaded that it’s ok to pay for getting treated ahead of someone else. So far, paying for organs is illegal in Britain – but for how long will this be the case, in the event that we have another 40 years of uninterrupted Thatcherite healthcare policy?
Safeguarding the NHS, a collectivist system, will require us to maintain our collective commitment as a nation. As individual citizens, we could also take actions such as
– Decreasing our reliance on privatised healthcare. With the constraints currently being imposed on the NHS, an individual can’t necessarily be blamed for trying to get the quickest care for their loved ones… but we could opt out of, eg workplace healthcare schemes.
– Joining the political effort, such as the upcoming ‘Save Our NHS’ demonstrations led by organisations such as https://keepournhspublic.com/
– And of course, we must also look beyond treating illnesses when they arise, and get more serious about preventing those illnesses, and promoting wellness, in society as a whole.
A happy, healthy 70th anniversary!
Tutor in Health Promotion / Public Health.