Original article by Peoples Health Dispatch republished from peoples dispatch under a Creative Commons Attribution-ShareAlike 4.0 (CC BY-SA) license.
The UK Labour government is considering increasing the role of private healthcare providers, weakening NHS capacities
The Labour Party is considering a major expansion of the private sector’s involvement in the National Health Service (NHS) as it attempts to reduce waiting lists in the United Kingdom. Recently, the Independent Healthcare Providers Network (IHPN) wrote to Keir Starmer’s government, stating that private providers are ready to spend £1 billion to accommodate more NHS patients—if the government guarantees them long-term work.
While the offer has been welcomed by officials from the Department of Health, health activists have raised alarms over the plan. The We Own It campaign warned that a resurgence of the Private Finance Initiative (PFI) policy, as essentially proposed by the private sector, would lead to higher debt, staffing shortages, and diminished NHS training capacities.
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This wouldn’t be the first time private capital has been welcomed by a Labour administration. When Tony Blair was Prime Minister, PFI entrusted the private sector with financing the construction of hospitals to fill gaps in the NHS network. The NHS would then pay back the costs of building such infrastructure—with interest—over the course of 25 years or more, eventually becoming the owner.
However, earlier reports indicated that while the NHS gained £13 billion in assets through PFI, it also ended up with £80 billion in debt. This meant that until at least 2022, some NHS trusts spent more on servicing debt to the private sector than on medical supplies.
There is no indication that the current government would introduce stronger safeguards when implementing a new phase of the initiative, dubbed PFI 2.0. If anything, the situation might worsen. While the previous round of PFI left some infrastructure for the public sector, PFI 2.0 foresees nothing of the sort. The additional capacities would be entirely private, with the only public involvement being the money paid to them.
“PFI 2.0 would not only drastically expand private provision in the health service, it will also dramatically increase how much is sucked out of the NHS in profits,” We Own It suggested in its analysis. Currently, private companies siphon £10 million weekly from the NHS. Guaranteeing even more private contracts would add to that burden, leaving fewer funds to invest in the NHS’s own capacities.
Labour fails to grasp importance of publicly-owned NHS
According to a recent inquiry, these capacities are in dire need of strengthening, as health activists have claimed for decades. The inquiry indicated that years of austerity have left a deep mark on the NHS, and it was this—not staff inefficiency—that led to the crisis. Unfortunately, the inquiry failed to underline the importance of breaking ties with the private sector and keeping the NHS publicly-owned, according to the group Keep Our NHS Public.
Even if it did, it is highly likely that Health Secretary Wes Streeting would not understand the importance of such a strategy. Speaking at a party conference in September, Streeting expressed enthusiasm about “reform,” a code word used by governments for “anything but public investment in public capacities.”
“Reform or die. We choose reform,” the Health Secretary said. His approach has left activists understandably worried that the government is sticking to a vague health reform agenda instead of making material commitments to protect the NHS.
Rather than pursuing a shift from “analog to digital,” Keep Our NHS Public argued, the government should pledge to move away from underfunding, fragmentation, and outsourcing. As health workers and their trade unions have raised multiple times, a true strategy to protect the NHS must also include a commitment to improving working conditions and ensuring fair salaries.
If the private sector’s role is expanded, this would not be a realistic option. “The private sector does not have its own staff,” We Own It warned. “They steal staff, trained at huge public expense, from the NHS.”
Further involvement of the private sector would also reduce the NHS’s capacity to train new staff, the group stated. The procedures usually handled by the private sector are often critical for the hands-on experience needed by medical trainees. With fewer procedures of this kind being performed in NHS hospitals, these learning opportunities would disappear, condemning new generations of health workers to lower-quality education and undermine patient care.
“If PFI 1.0 was one of the nails in the coffin of the NHS as we know it, PFI 2.0 is the true end of our NHS as a public service that works for patients, not profit,” We Own It warned.
People’s Health Dispatch is a fortnightly bulletin published by the People’s Health Movement and Peoples Dispatch. For more articles and to subscribe to People’s Health Dispatch, click here.
Original article by Peoples Health Dispatch republished from peoples dispatch under a Creative Commons Attribution-ShareAlike 4.0 (CC BY-SA) license.
