Health

Labour can protect the NHS from privatisation if they choose to – here's how

Labour recently unveiled plans to take private railway contracts back into public ownership as they run out. Campaigners are calling on them to do the same with the NHS

NHS rainbow chalk

Image: Nicholas J Leclercq/Unsplash

Labour has the “historic opportunity” to “reverse” NHS privatisation in its first term in government.

Some 94% of NHS outsourcing contracts are set to expire during the next parliament, according to analysis by public ownership campaign group We Own It. The next government will inherit 7,452 outsourcing agreements – of which 6,983 will expire before 5 July 2029. 

Actor and comedian Stephen Fry has described it as a “historic opportunity” to take these contracts back into public hands.

“As We Own It’s analysis shows, they can make a serious difference in reinstating the NHS as the fully public service their party founded it to be, if they choose to,” he said.

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“Politicians have historically presented outsourcing as a neutral choice, but it clearly isn’t. It’s resulting in billions leaving public services in the form of profits, which could instead be used to provide a better service to everyone. And as we see with water, the railway and the NHS, it has not worked.”

Labour recently unveiled plans to take almost all private railway contracts back into public ownership as they run out. Campaigners are calling on the party to do the same with the NHS.

“Only the NHS has A&Es, trains doctors and treats everyone however complex their case may be. Building up the NHS to treat everyone who needs care is the most efficient and effective reform a Labour government could introduce,” said Johnbosco Nwogbo, lead campaigner at We Own It.

“The first step is to take back NHS outsourcing contracts when they expire. Labour will get a chance to do right by the NHS, and the public is looking to them to protect the NHS.”

How much of the NHS is privatised?

In 2014, a Commonwealth Fund study ranked the NHS as the best healthcare system in the world and the second-cheapest of those analysed. But years of underfunding have wrecked its track record.

Around 7.61 million people are on elective waiting lists in England alone, while a staggering 1.5 million patients in England waited 12 hours or more after arriving at A&E over the past year.

Privatisation, Nwogbo says, is largely responsible for this decline.

The NHS was launched in 1948, with the aim of providing medical care for everyone, “rich or poor.” For decades, this principle was politically unassailable; in 1982, Margaret Thatcher’s suggestion of compulsory private insurance prompted a revolt.

Nonetheless, the 1980s saw non-clinical services – like cleaning, catering and laundry – put out to competitive tender. In the 1990s, Tony Blair’s new Labour further sped up privatisation, allowing private companies to borrow money to build hospitals, charging the NHS trusts ‘rent’ for them.

Nonetheless, health care remained the responsibility of the publicly owned NHS – until everything changed in 2012.  

The 2012 Health and Social Care Act required that all NHS contracts be put on the ‘open market’ for private sector bidding.

It’s worsened healthcare, research shows. A recent University of Oxford study published in Lancet Public Health has linked NHS privatisation to the preventable deaths of 557 people.

Dr Ben Goodair, a University of Oxford public policy researcher, said that the new government should reconsider the “ongoing privatisation” if it wishes to “prioritise the best quality healthcare“.

“This newly presented analysis by We Own It highlights the huge scale of NHS outsourcing, which has been rising consistently over the last two decades,” he added.

“The latest academic evidence, in part produced by me and my colleagues at the University of Oxford, suggests this is a concerning trend for quality of care – as for-profit provision of NHS services is linked with worse patient outcomes, including higher mortality rates.”

For-profit private companies stand to make more than £1bn in profits from the 7,452 contracts the next government is set to inherit. We Own It claims this money could help the NHS hire more than 27,000 NHS nurses at £37,000 each per annum, or cover the cost of knee replacement surgeries for at least 71,000 NHS patients on waiting lists.

Christine Cooper, professor of accounting at the University of Edinburgh, said that the plan for the government to take back control of private contracts was “sensible and workable”.

“The rationale presented in support of privatisation was that the provision of public services by the private sector would mean better, more efficient services at lower cost and investment to modernise old-fashioned systems.

“The evidence suggests that measures to bring back outsourced contracts would enable better public services at lower cost. Whether to outsource to the private sector is no longer a question of ideology, it is a question of economic interest and empirical evidence.”

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