The NHS Reforms and Privatisation in a Nutshell

What has happened to the NHS in England is so shocking that it is impossible to believe it is true.

The Tory / Lib Dem coalition have brought in legislation which requires NHS services in England to be “outsourced” to private companies; this isn’t just ancillary services like the ambulance services, the 111 help-line (which used to be NHS Direct), and diagnostic and testing labs, it’s also clinical services like clinics, surgeries and hospitals. A single hospital will become a mish-mash of several different companies, all with different owners, all with different ways of making profits out of each other.

This is insane? Who benefits from this idea?

Good question.  Putting it bluntly, the 64 MPs and 142 members of the House of Lords who have financial links to “healthcare” companies and who were able to vote on the Health and Social Care Bill into law.

Patients will not benefit because the companies running healthcare services are more interested in profit than safety.  There is a myth that Private Medicine is “better” than the NHS. However, we already know that private hospitals cut corners wherever they can; for example they do not have Intensive Therapy Units so if an operation goes wrong they have to transfer their emergency cases to the local NHS provider.   Private is not safer, though it may be “nicer”.  Here is a story about “chaotic and dangerous care at hospital run by BMI Healthcare“.

In fairness, I should say that privatised NHS hospitals should still have the ancillary services like path labs, ITU, and so on, but they may be run by different companies with different and conflicting service targets.

Why haven’t I heard about this?

The government knew that this would be unpopular so this was not in their manifesto. It has been under-reported in the news because the story was too complicated to understand. It has also been under-reported by the state-owned BBC.

The government brought in the necessary legislation piece-meal over several years and avoided debating the key pieces in Parliament. This started with structures put in place by the Labour governments of Tony Blair and Gordon Brown and the final piece, called Section 75, was hammered into place early in 2013 by the Coalition.

So how did this happen?

This flowchart from the National Health Action party shows how:

NHS Flowchart

What is actually happening?

They key bit is called Section 75 which requires a commercial tendering process; this means the decision will based on money, not expertise or quality of service.  The wording was changed following (some) protest, but it’s been made so complicated that the Clinical Commissioning Groups (ie the local GPs) can be sued if they decide not to put something out to tender, so of course they will take the safe option and put things out to commercial tender.

It’s hard to believe that it might affect clinics,  hospitals and even GP practices, though it’s easy enough to see how G4S might provide an “ambulance” service. But if we compare this with “outsourcing” in other workplaces, it’s clear enough how it could work. If you work in an office you may be aware that your cleaners don’t work for the same company you do but are “outsourced” to a “facilities management company”.  The same may be true for your IT department.  This approach is being applied to all parts of the NHS where the existing job contracts are being sold lock, stock and barrel over the heads of the employees to “service providers”.

But the NHS will still be free to patients, right?

I don’t know. This worries me:

David Cameron’s … new health adviser … advocated … charges to see a family doctor.

And the NHS will always be there, won’t it?

The short asnwer is that it has already gone in England; it is not National and it’s not a Service. The NHS brand will be around for a while but it will just be a brand covering many different companies.   And think about NHS dentistrry: NHS dental services are “there”, but not everywhere. The same could happen to NHS medical services.  Hospitals are being closed all over the place, in particular expensive services like A & E.

The insurance companies are already scaremongering, to profit from the easy work.


You should not need a health insurer to pay your surgeon’s fees.  That is what National Insurance and other contributory taxes are for.

Who is fighting this?

Lots of different groups are fighting this.  The National Health Action Party hope to have parliamentary candidates in key marginal seats in the next general election in 2015. The healthcare unions are fighting it. So are senior doctors and scientists.  So are various petition groups such as 38 Degrees. But the Labour party aren’t.

Unfortunately,  it may already be too late.

But can’t this be undone?

No. Or not easily.  This is being done to “harmonise trade” between the EU and the US,  in other words to enable American healthcare companies to run the NHS. The MPs and others who benefit from this do not want it to be possible to roll the clock back after the next election.  This means  long-term contracts will include such large penalty clauses it will be impossible to buy the service back in.

Surely there MUST be something I can do?

  1. Sign this petition  if you have not signed it already.  It is to require the government to ensure the NHS is exempted from the US/EU Free Trade Agreement as a condition of the UK’s agreeing to participate.
  2. Join the National Health Action Party so they have the funds to do more.
  3. Like the National Health Action Party on Facebook and check their page regularly so you keep up to date and fully informed.
  4. Follow the advice on how to make a difference locally in this post in the False Economy blog.
  5. Join the marches and other events planned for this summer.
  6. Sign any other relevant petitions you see.
  7. Follow CCG Watch who provide information and action on the Clinical Commissioning Groups and anything threatening a truly public NHS.
  8. Write to your MP or visit their surgery.
  9. Keep informed by setting up a Google News search for NHS Reforms
  11. Vote in the next election – abstianing is not seen as a protest, it is seen as consent.
  12. Stay well.

Other links

White writing this, I found other links you might like to follow.  (I have not read these in detail, and I cannot vouch for their politics or their accuracy).

Videos with Lucy Reynolds who is well informed and scarily accurate where she explains the Section 75 regulations clearly and in detail

See my other posts on the NHS Privatisation.

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