World Socialist Web Site
10 May 2003
Britain: Parliament backs plans to privatise health care
By Julie Hyland
The Labour government’s proposals to further open up National Health Service (NHS) hospitals to the private sector were passed by parliament on May 7.
Through the establishment of Foundation Hospitals the government aims to end the system of centralised control and accountability, enabling individual hospitals to raise finance from the private sector and determine their own wage rates and clinical priorities.
The proposals, contained in a new Health and Social Bill, are a clear break with the system of universal health provision established by the post-Second World War Labour government and are widely recognised as such.
Government ministers often complain of the affection in which the NHS is held by many in Britain-citing it as an example of the kind of backward-looking nostalgia that must be overcome if the country is to step into the twenty-first century. Their own ire is directed not at the very real failings of the NHS-the long waiting lists, overworked staff and poor facilities that have resulted from decades of underfunding-but the progressive principle on which health care has been organised in Britain since the Second World War.
As the “crown jewels” of the social reforms enacted by the postwar Labour government, the NHS was deemed to be an example of egalitarianism in practice, guaranteeing health care to all regardless of their financial status and free at the point of use.
In capitalist Britain, the ideal could never match the reality. Not even the most egalitarian structure could compensate for, much less overcome, the health problems generated by a system built on social inequality. The private drug companies continued to milk the system and add enormous costs in terms of taxation, while the rich could still utilise private treatment that occupied a parasitic relationship to the NHS-using staff it had trained and usually renting access to facilities bought from the public purse.
But under conditions where prior to 1948 more than 50 percent of Britain’s population had no access to health care, the NHS was correctly regarded as a significant advance and eminently preferable to the system of health care in the US, for example, which was seen as outdated and barbaric.
In line with the right-wing monetarist policies that have come to dominate official politics in Britain over the last 20 years, successive Conservative and Labour governments have carried out a policy of deliberate sabotage against public health care-starving it of the necessary funds and introducing numerous “reforms” aimed at resurrecting the profit principle and forcing people into privately funded insurance-based schemes, creating a financial bonanza for the corporate sector.
Utilising the poor state of public provision that their policies have caused, the official parties have sought to ridicule any notion of equality as simply meaning the right of all to suffer equally.
http://www.wsws.org/articles/2003/may2003/nhs-m10.shtml
Comment: Rather than face the delicate problem of ensuring adequate public funding for health care, British politicians are turning to the private sector to provide innovative methods of limiting public spending. No amount of rhetoric about market forces can ever change the reality that private business models in health care shift funds from patient care to the business entity. This then requires an even greater amount of private funding just to maintain the same deficient level of care as would exist under public funding. And worse, greater private control of funds automatically equates with greater inequities in care.
The British and American issues are different. At 7% of their GDP, the British are not spending enough on health care. At 15.2%, we’re spending enough, but we’ve placed the control of funds in the private sector. As a result, we have the most inequitable system of all industrialized nations.
Wouldn’t it be better for politicians to be honest and face the realities that public administration benefits health care, but that funding needs to be adequate? The British don’t need privatization; they need more public funds. Americans don’t need more funds; we need public administration with equitable public pooling of our existing funds.