Since the 1970s, successive governments have privatized major infrastructure, utilities, manufacturing industries and public services. These include local authorities becoming commissioning hubs and education transferring its assets to the private sector.
Privatisation of the NHS began in 1983 with the cleaning services being put out to tender. The cleaning services were cheaper but of lower standard, and the spread of ‘superbugs’ was attributable to the cleaners no longer forming part of integrated core teams on wards.
The House of Commons Library briefing on privatisation defines a competition regulator as essential to the move from public to private provision.
The NHS Act removes the NHS from government control and places the responsibility for provision outside the government department. The government now only provides funding and authorises the NHS ‘kite-mark’.
The Health and Social Care Act created the Clinical Commissioning Groups (CCGs), which are the engine that powers the privatisation of clinical services. The CCGs are not bound to supply the same range of services nationally.
The NHS Act allows trusts and foundation trusts to earn up to 49% of their income from private patients.
Simon Stevens, CEO of NHS England, produced a Five Year Forward View (5YFV) in October 2014 which aims to integrate services and end the fragmentation caused by the 2012 Act. It follows The Better Care Fund which aims to shift the focus from acute hospital settings to local authority based social and community care.
The 5YFV is a re-shaping of the NHS to fit with a predicted permanent reduction in funding levels. It will result in the closure of 40-70 fully functioning blue-light A&Es and the transfer of services to large major trauma centres.
The 5YFV and Naylor Review envisage using the sale of properties to pump-prime changes in the health service. The 2012 Act created NHS Property Services Ltd., which charges commercial rents.
The 5YFV encourages midwives to form their own companies and the widespread use of vouchers for maternity and personal health budgets.
The overall effect of privatisation in the NHS will take time to be analysed. More people are turning to self-pay options to avoid waiting times.
The privatisation of the NHS is creating unmet need, and the principles of universal and comprehensive care are being lost. The Health and Social Care Select Committee recommends new legislation to stop this.
Below is John Pilger of the Guardian’s recent documentary “The Dirty War on the NHS”