What I wonder is the real attitude of the public to the claims that the NHS is being privatised by stealth? It’s a complex question with no completely perfect answer. I suspect there are those who would say: ‘It is fine to use the private health industry to help reduce waiting times and improve outcomes for patients as long as it is adding to the overall offer rather than replacing an NHS service.’ There will be others who have no real opinion as long as when they need help, they get it. You will also have your political response, much along party lines where Tories will say more private and Labour will say less.
The truth, as ever is more complex and I would argue more shocking. Let me tell you a true story. Over the last couple of years until recently, I was the Chairman of Coventry’s Health and Wellbeing Board. I had steered it from its infancy and unsure beginnings to set a clear and decisive course to really tackle the health inequalities which has bedevilled Coventry for successive generations. The solution to these problems does not lie with one single organisation and most definitely does not lie with the NHS alone.
That’s why, when Labour were last in government, Andy Burnham commissioned the Marmot report which looked at the wider determinants of health and what societies leaders needed to do reduce inequalities. As Chair of the Health and Wellbeing Board, I took on these factors and used them as our route map and challenged partners such as GPs and Public Health to think differently about what they did. I used to say: however you did it before, it didn’t work. You need to think and show how you can do things differently. That was my challenge and still is.
I had, and still have, great problems with what the government are doing to the NHS spending billions reorganising whilst depriving front line professionals the resource required to do their job as well as they would want. I did, and still do though, believe Health and Wellbeing Boards can play a huge part in bringing people together to think outside the box and challenge orthodoxy to improve outcomes. It will require constant oversight and challenge from political leaders who should never be satisfied or complacent. I wanted and expected that challenge to be two way. Only by debating, challenging and questioning can we hope to improve and move forward.
It was with these principles in mind when some eighteen months ago, I was invited to a meeting at a local university in Coventry to hear some ideas from academics and others from a private American company who wanted to invest in the health economy in Coventry. I listened politely to what they and others had to say. I was neither convinced nor reassured by what I heard. What shocked me was the seeming willingness of many from the public sector to champion this company and buy into what they were selling. What was their motivation I wondered? I still do. I was robust and made clear my scepticism in the way that I do! What’s in it for the company I asked? I was assured of their good intentions and their willingness to want to tackle health inequalities in the way I had described. And maybe that is true. This company are not small fry. They were talking millions of pounds and have interests all over the world and do some excellent innovative work in the health sector.
I understand the project has been put on hold or maybe stopped for good. I’ve certainly not heard a thing about this since even though further meetings were promised. I do know the company has had some internal structural changes which mean maybe its focus and priorities have changed.
I also know that this sort of whole scale ‘investment’ or ‘interest’ described to me about this potential project went way beyond anything I understand when it comes to the NHS. It’s also the case quite obviously that this sort of commercial transaction can put the whole viability of the NHS at risk when these projects become so big. Too big to fail perhaps? Where have we heard that before?
This is the direct result of the government opening up all aspects of the NHS to privatisation. This isn’t adding to the overall offer of the NHS but taking over whole parts of its service. Secondly, it demonstrates where politicians need to be robust and stand up to overblown plans and hyperbole and not to get distracted or flattered to overtures by powerful organisations with interests which clearly overpower the interests of the public.
Otherwise, what would the public think then?