This week the British Coalition government’s plans to reshape the country’s National Health Services (NHS) came one step closer to becoming law. Despite professional outcry and a controversial passage through government, the 2011 Health and Social Care Bill threatens the very fabric of our health service. A year of outrage following the Conservative’s 2010 election is the best indication of fundamental public support for the NHS.
The House of Lords, one house in Britain’s legislature, rejected attempts to delay the bill by 330-262 votes.
But the proposed policy changes are just another step backward in a 20-year history of ideological policy tussles. Many see it as another stage in the Tories’ rampage of privatization, Friedmanite economics and cuts to the public sector. American readers might not share the widespread British fear of privatization in health care.
The NHS has long been a contentious institution. Its core principles were that care would meet the needs of everyone, be “free at the point of need” and delivery, and that it be based on need and not the ability to pay. Since its founding in 1948 the NHS has been an object of great pride, as well as derision.
Public dissatisfaction with the service is at its highest ever. In a recent YouGov poll 46% of people thought the NHS needs reform but proposed policies are “not going in the right direction,” while 21% said the NHS “generally works well.” This isn’t a justification for privatization, only for better and more focused reform.
American think-tank Commonwealth Fund found that the UK had the only health service in the industrialized world where wealth did not determine care. The U.S. fared much worse. Some 46% of insured working-age adults in the U.S. with below-average incomes went without needed care. Around 33% of U.S. adults went without care when sick because of costs, compared to 5% in the UK.
But the NHS has changed so much since its foundation that when British people complain about “the NHS,” they’re often actually complaining about more recent structural adjustments – bad organization, too much emphasis management and not enough on primary care.
Between 1988 and 1989 former Prime Minister Margaret Thatcher reorganized the NHS in the language of neo-liberalism. From 1997, Tony Blair’s New Labour continued the initiative and, now, Tory Health Secretary Andrew Lansley is following Thatcherism’s controversial lead too.
According to Lansley’s Department of Health, the new Bill “proposes to create an independent NHS board, promote patient choice, and to reduce NHS administration costs.”
The fact is, “competition” from independent groups equates to damaging privatization. There is no proof that competitive policies will help, just as there was no proof for Thatcher’s reforms. Profits will go back to private companies and corporations before they do the NHS. High costs in the U.S. show the potential damage of privatized health care. I believe private sector involvement in public service by nature dilutes quality. Amid “austerity Britain” and a global financial crisis, is more of the same the best way forward?
The bill is undeniably drafted along the lines of free-market capitalism. The government believes that submitting the NHS to “the markets”, it will naturally improve. Doctors and experts, on the other hand, disagree. The stakes are high when this is used with peoples’ money, but what about when it’s peoples’ lives?
All this has not exactly passed by without mention. UKUncut recently started a campaign against the proposed reforms. Banks and companies guilty of tax evasion were converted into “emergency operation” clinics. Last weekend they organized “Block the Bridge,” a sit-in demonstration on Westminster Bridge, right outside Parliament.
But, as with the Iraq War protests in 2003, it remains to be seen how effective demonstrations are in the face of a government bent on bypassing its public. We hope that this public pressure will influence coming legislative stages before privatization of the NHS is legalized.
Photo Credit: 38 Degrees