Britain’s NHS is a hugely impressive achievement. Some of the founding assumptions may have been naive, but the principles have stood up well. Unfortunately, the NHS is now under threat, its key principles in danger of being abandoned.
The NHS does far more than its founders could have contemplated, and its cost has risen substantially. But, despite the talk of it being unaffordable, it is actually very economical. Health spending in the UK is low in relation to comparable countries. Outcomes are, if not always the best, at least good, and in some areas exceptional.
The USA spends twice as much for rather poorer outcomes. Yet we are being pushed into turning the NHS into something that resembles the American system. American health companies are pressing for a slice of the NHS pie. Yet many Americans are denied proper health care and many others are bankrupted by the costs. Patients are commonly over-treated, leading to worse outcomes.
The people who want to change the system want to cling to only one principle, and even that is in danger. They say that the NHS will continue to be free to use. They claim that how the service is provided doesn’t matter.
But it matters a great deal. The fundamental and most precious feature of the NHS is not that it is free, it is that it is a public service. A public service is quite different from a business. The primary purpose of a business is to make money, the provision of goods and services are only a means to that end. We know too well how businesses such as banking have been only too willing to sell inferior or even useless products to their customers in the pursuit of profit. Why, when we are sick, would we want to be treated by someone whose main aim is to make money? By contrast, the primary aim of the public service NHS is to look after sick people, and that is the wish of many of the people working in the NHS.
The idea that businesses have some magical ability to run things better than public services is a pure fiction. Sometimes businesses run better, sometimes public services run better. On the whole, the NHS runs rather well. That doesn’t mean there can’t be improvement. Some areas could undoubtedly be improved, and it is Green Party policy that the NHS must be a “learning organisation”, one that is capable of self criticism and constant improvement. There are many in the NHS who want it to be that, and they are the ones to lead the service.
Why should we want to see money diverted to encourage “Getting rich on the NHS”? On Teesside, Virgin Care is running clinics for sexual diseases. Sadly, as in other areas, private health operations have been found to cut the quality of the service in order to make profits, and to disguise this with questionable figures.
GazzetteLive has reported on members of the new Clinical Commissioning Groups having financial links with Virgin Health, Serco and the drug companies. There are numerous connections between politicians and companies seeking contracts to take over parts of the NHS. Is this really the way forward?
And even the supposedly sacrosanct principle of “free at the point of delivery” is under threat. Personal health budgets could be a positive step that gives patients control over their own treatment and care; it could also be a way to limit the cost of patients with expensive conditions, much as would happen in an American style insurance based system. Moving control of the NHS to local authorities could be a step towards localism, a principle favoured by the Green Party; it could, however, be a prelude to further squeezes that leave local authorities unable to provide services and getting the blame for measures forced on them by central government.
What are the practical steps that can be taken? Green MP Caroline Lucas has presented the cross-party NHS Reinstatement Bill to Parliament, and it has my full support. The bill will end the privatisation of the NHS and restore the founding principles of the NHS: providing care that is truly public, free at the point of delivery, and fully protected. The NHS should not be subject to market forces, whether internal or external.
The proposed NHS Reinstatement Bill would restore the obligation on Government to provide a comprehensive health service, abolish competition and market-based commissioning, and re-establish public accountability of our NHS. Caroline’s presentation of this bill is emblematic of the Green Party’s commitment to taking back our health service for the public good. We have championed the fight for a publicly funded, publicly provided NHS, and will continue to do so until a complete restoration is achieved.