The NHS Is Slowly Dying of Privatization

Britain’s NHS is on its knees after decades of austerity. The British government is deliberately underfunding the system, raising the real question of whether or not the public health system can survive much longer.

A nurse arrives to join a picket line during strike action by the Royal College of Nursing outside the Northern General Hospital in Sheffield, UK, on Wednesday, January 18, 2023. (Dominic Lipinski / Bloomberg via Getty Images)

We are living under a deeply cruel, ideologically driven government. Since coming to power in 2010, the Conservative’s austerity program has caused over 330,000 deaths, and the mishandling of the pandemic saw a further two hundred thousand deaths, many of them avoidable. Currently, an estimated five hundred people are dying each week because of delays in emergency care, while countless more pass away on National Health Service (NHS) waiting lists.

The human cost of the government’s mismanagement of the NHS is difficult to overstate, but it results from an intentional policy to underfund health care and allow private interests to extract money from the system.

The UK now spends about a fifth less on health care than our European neighbors — a gap of over £40 billion each year. In fact, one of the first acts of the Cameron government was to cut costs by halting the expansion of medical school training for doctors and cutting four thousand nurses’ training places. The wages of NHS workers were the next target, resulting in more than a decade of below-inflation pay rises, causing the real-terms pay of staff to plummet — nurses are paid over £5,000 a year less than they were in 2010.

We are paying for these decisions today. There are 133,000 vacancies in the NHS, including fifty thousand nurses and seventeen thousand doctors, including GPs. Years of underfunding have resulted in a deadly shortage of hospital beds, GP surgeries and health centers in a state of decay, hospital buildings that are literally crumbling, and a burnt-out and frustrated workforce. In my years of practice, I have never seen staff morale so low.

All the while, money that should be spent improving services is being syphoned off by private companies. The government is pouring money into private contractors to cherry-pick NHS patients from waiting lists. As a result, private companies are now performing more hip replacements for the NHS than the NHS. The funding for these operations comes from the NHS, but privateers take a slice.

Year on year, more and more services are handed over to the private companies to deliver, including imaging, pharmacy, data collection, and IT services. Some of these contracts are for eye-watering amounts, such as the £2.25 billion contract to provide pathology services in South East London, awarded with no public consultation. The “public” element of our public services is being eroded.

It is bad enough that an increasing number of NHS services are farmed out to the private sector, but just as concerning is the impact of substandard public health care in driving patients toward privatized healthcare. With 7.3 million people on waiting lists, wealthier people are paying for private operations, normalizing a two-tier health service and devaluing the NHS.

Britain’s adult social care system is a cautionary tale of how a fully privatized system might look. Often owned by hedge funds based in tax havens, private providers take between 20 and 40 percent of their budget as profit, neglecting those in their care and underpaying staff. The poverty wages paid to carers are evidence of the type of exploitation that happens in a system where private companies are free to maximize profits.

Beyond the money that is wasted and taken out of the system as profit, privately provided health care is less effective, with research from Oxford revealing a link between outsourcing services and increased death rates.

The state our NHS is in and the trajectory it is on is concerning, but there is room for optimism. Most Britons want a properly funded, publicly-owned NHS, with just one in ten supporting a wholly or substantially private service. And the large majority of voters, including 73 percent of Tory voters, rightly blame the government for the current crisis.

The NHS is in serious danger, but we know how to save it. That’s why this Saturday, March 11, we at SOS NHS will be demonstrating in London along with fifty-five supporting unions and campaigns. We will be demanding that all NHS workers get the pay rise they deserve, a commitment to end privatization in the NHS (including from Labour), and that our NHS receives the funding it needs. And we’ll be opposing the new laws attacking the right of health care workers to go on strike too.

If you share our aims and think a public NHS is worth fighting for, join us.