Labour and the NHS: Why More People are Turning to Private Healthcare

I recently spoke at some length to a very good friend of mine who retired from our employer a little over six years ago. As always, we talked about work-related bits and bobs, caught up on things affecting the railway industry in general (including another lengthy closure on the line between Ryde Esplanade and Ryde Pier Head on the Isle of Wight), but we also spoke about the NHS. 

Both of us, my friend directly and me indirectly, have had first-hand interaction with the NHS over a prolonged period and found our recent experiences to be, to say the least, patchy. At least based on our own personal accounts, the standards of service in the NHS, whether it be at GP, clinic or hospital levels, is wildly inconsistent in terms of standards of quality and availability of provision. It was during this portion of our discussion that I mentioned that I was seriously considering helping my wife in making use of private GP services.

Patient Experience of NHS Care

She is currently undergoing a course of treatment which carries with it a wide and varied range of side-effects. These side effects change constantly and can be very disruptive in terms of maintaining even a modest degree of stability in daily life. The hospital which is administering her treatment has been helpful at times in offering advice and medication for some side effects, but for others has directed her to her GP, despite them being aware that she is taking legal action against her GP surgery for medical negligence. Further to this, transferring from one GP surgery to another is practically impossible because surgeries in the area (like most areas) are at capacity and will not accept new patients. This leaves my wife in the unenviable position of effectively having no GP. 

It was because of this that I suggested that I would pay for a private GP consultation if it meant that she would get the help that she needed. When I mentioned this to my friend, he replied that this was “exactly what the Tories wanted when they were in power”. He was, at least in part, correct – the Tories knew that to undertake a full-scale privatisation of the National Health Service would be deeply unpopular with the general public and would in all likelihood be strenuously resisted. However, governments of both colours have instead chosen a two-pronged approach to the NHS which goes back over thirty years. Their approach is as follows:

• The first was to farm out huge sections of NHS service provision to the private sector, which began under the John Major government from 1992-1997 but was hugely accelerated under the Tony Blair Labour government from 1997-2010, of which more later. 

• The second, which was more subtle but arguably more pernicious, which was to manage a run-down of NHS services at every level sufficient to encourage people with even the most modest incomes at least consider using private healthcare.

One example of someone driven to private healthcare was a former work colleague who had severe cartilage damage in his knee, which gave him great difficulty in walking, climbing stairs and so on. His lack of mobility had made his weight balloon and this in turn had put further stress on his already injured knee and made exercising to shed the weight all but impossible. Prior to his employer deciding to pay for his private healthcare themselves, he was in the late stages of planning a trip to the Ukraine (this was prior to the Special Military Operation) to have the surgery he desperately needed but was told that he would have to wait over a year to get if he was to use the NHS.

For every person who even considers using private healthcare for anything from a GP appointment to a full-blown operation, the British state has, at least in part, met its objective, which is to sow seeds in the minds of people that the NHS will not be able to fulfil their needs and using private provision is an expensive but potentially viable option. When I was growing up, access to private healthcare was reserved for people with only the highest incomes and most working class people didn’t even know how to access such healthcare, let alone pay for it.

Today, access to private healthcare is available for people with far more modest incomes than it was in the 1970s and 80s and, with BUPA charging £150 for a private online GP appointment within 48 hours, even the most ardent advocate for the NHS would be hard pressed to make a case against someone driven to raiding what meagre savings they have in order to find the peace of mind of seeing a GP within a reasonable timeframe. 

Labour: No Friend of the NHS

Whilst my friend and I agreed on the problem, he sadly had made the same mistake that many people have made and will continue to make for as long as they rely solely on the mass media for their information, which is that the Labour Party, a party of imperialism, will ‘save’ the NHS from the rapacious clutches of the Tories. History has shown very clearly that it will not. Labour has managed the decline of the NHS with equal enthusiasm to the Tories, yet they have created and steadfastly maintained the myth that they and they alone are the guardians of the service. 

In fact, I have made the case that Labour have been dining out on the foundation of the NHS for the last seventy six years, despite their self-proclaimed act of benevolence being forced upon them by an highly organised and motivated working class, returning from World War 2, who demanded far better for themselves than their parents were handed by David Lloyd George after their personal sacrifices in The Great War. Those workers also had clear and convincing evidence of how a better world can be with the example of the world’s first workers’ state, the Soviet Union.

A timeline of the history of the NHS, particularly since 1990, shows clearly that Labour, despite being the party of government when the NHS was founded, was every bit as willing to bend the knee to the needs of finance capital as the Tories have been when it comes to the management of the NHS. It was Labour who, in 2000, published The NHS Plan, which headlined promises of more nurses, doctors and hospital beds, but in fact was one of, if not the biggest, handover of NHS service provision from the public to the private sector in its history. Under the so called Private Finance Initiative (also known as Public-Private Partnership), the NHS was compelled to take out private loans at eye-wateringly high interest rates to pay for improvement works on its estate (hospital wards and so on) – this meant that the service has, to this day, been saddled with billions of pounds in debt and interest payments while privateers have mopped up enormous state-underwritten profits. When any government, of any colour, has proclaimed over the last twenty years that they have boosted NHS funding, what they omit is the fact that most, if not all, of that extra money is swallowed up in servicing the colossal PFI debt that the NHS is carrying, debt that has only increased as interest rates have gone up after almost fifteen years of flatlining at little over 0.25%.

In the period from 2000 to 2010, the number of NHS hospital beds went down by almost a quarter and continued to drop until 2020, when the numbers started to rise but are almost a third down on the number of beds in 2000. The publication of the Darzi Review, on 12th September detailed not only the steep decline of the NHS and the mismanagement of the service by the previous Tory government but also the decline in the health of the people that use it through poor housing, insecure employment and low incomes in the last 15 years (arguably since the financial crash of 2008). The NHS cancelled more routine care during the pandemic than any other ‘developed’ country. The number of operations per surgeon has gone down by 12%, despite hospital staffing going up by 17% since 2019 and community and social care has continued to dwindle and wither. Anyone who has received care from an NHS hospital over a prolonged period of time will have noticed how fragmented hospitals are: departments rarely communicate with each other and often assume that other departments have carried out certain tasks (like sending a patient a letter to attend an appointment) when not only have they not, but they haven’t checked to make sure that they did.

It is clear that the Labour government will use the findings contained in the Darzi Review as leverage, partly to gain more money from the Treasury, but also to push through reforms. Prime Minister Sir Keir Starmer said only five days ago that there would be no extra money for the NHS without reforms which, while presented under the guise of cutting gargantuan waiting lists which were bad before Covid but have grown exponentially during and after, will effectively be yet another handover of huge chunks of the NHS to privateers, underwritten again by the state. These reforms will of course be waved through by the trade unions which organise in the NHS, as they did in the early 2000s when they took slightly more generous pay settlements from the Blair government in exchange for turning a blind eye to the part privatisation of the service.

To further complicate matters, General Practitioners, the challenges of whom I wrote about in my inaugural article on this website, are leaving the profession at a faster rate than they are entering it and have already commenced industrial action, which includes limiting the number of patients they see in a day, refusing to use NHS data services if they are deemed to act to the detriment of patients and circumventing existing NHS referral practices to get access for patients to specialist care quicker.

All in all, the utter mess that the NHS has become has been over thirty years in the making and is every bit as much the responsibility of the Labour Party as it is the Conservatives. The message that must be sent loud and clear to working class people everywhere is that, regardless of the colour of the rosettes adorned to the stuffed shirts in government, they will first, last and always act in the interests of the ruling class, a class which sees the NHS as a tiresome burden on the one hand but as a state-backed money-printing machine on the other. Despite the proclaimed aims of The NHS Plan, end users are no closer to having say in how their NHS is run than they were when the plan was published in 2000. Voting Labour, despite their proclamations to the contrary, offers only more of the same run-down services, demoralised staff, falling bed numbers and rising waiting lists.

Only socialism, the ownership and control of the state by and for the working class, can deliver a health service that can truly offer care from the cradle to the grave, a service which not only can deliver comprehensive and high quality care for its people, but offers full democratic accountability and control to the communities it serves.