A new campaign to save the NHS from privatisation-from-within (#yourNHSneedsYou) is going from strength to strength in the UK. In this New Statesman article, Yanis Varoufakis, Nathalie Bennett and John McDonnell explain why and how the NHS is being eaten up from within by Big Tech, Big Pharma and Big Business more generally. What makes this DiEM25-inspired campaign more pertinent in this historic moment is that it is a template for a new way of doing progressive politics: one that involves people from different progressive organisations, parties, trades unions – leaders and rank-and-file activists who have hitherto failed to work together. DiEM25 will work hard to ensure that #yourNHSneedsYou campaign is only the beginning!
Ever since Margaret Thatcher began to vandalise Britain’s pubic goods, her heirs and successors have loathed the NHS for three reasons. First, because it demonstrably gives the lie to their creed that markets always know best. Secondly, because the British public love the freedom-from-the-market that the NHS affords them when it comes to their health. And, thirdly, because their ‘associates’ lose mountains of cash due to the remaining barriers to the commodification of health services and data.
That these barriers to commodification are still standing is a feat largely attributable to the brave staff working in the NHS and the public’s passion for it.
But, decades of concerted assaults by privateers, under the political cover provided by the Major, Blair, Cameron and May governments, have left these defences rickety and full of holes through which the rats of privatisation manage to smuggle out increasing amounts of value extracted at the expense of public health.
For decades now, its sworn enemies have been proclaiming that “the NHS is safe with us” while portraying it as a black hole that no amount of public money can plug and which only privateers can streamline. This is, of course, a lie whose real purpose was always to pave the ground for privatisation-from-within. Their prize? Billions of pounds siphoned off from care and into the coffers of privateers, mostly US corporations who are now deeply embedded in what once was an integrated, publicly run service. And when the ill effects of their lucrative mismanagement affect the public, e.g., waiting lists, they divert blame to the same doctors and nurses whom their shenanigans starve of resources.
So far, privatisation was justified as the prescribed medicine for the chronic underfunding. But underfunding was never only the problem although we do spend less than other comparable nations.. Waste of resources due to privatisation was. Put differently, privatisation within the NHS created the disease of underfunding it was meant to cure. The numbers don’t lie. In the 1980s, NHS administration costs accounted for just 4% of the budget. By the mid-2000s, they ate up 14% of a much larger budget.
It makes sense: The greater the penetration of privateers in any health system the greater its inefficiency, as highly paid managers bring in more underlings from the private sector, pay themselves more, and facilitate the outsourcing to their private sector buddies of things the NHS could provide internally more cheaply and collegially. In the limit, when care is fully privatised, inefficiency and ill health reach their zenith. The United States, were private health reigns supreme, is the case in point: Administration accounts for 36% of the health budget and life expectancy lingers at levels lower than in several Indian prefectures or African states.
Today, the new excuse for wrecking what is left of the NHS is digitisation, artificial intelligence and robotics. Privateers linked to Big Tech await outside the NHS gates while their political mouthpieces in Parliament and the media are waxing lyrical about a brave new NHS that the public sector cannot deliver. They envisage an NHS acting as a market where privateers provide ‘clients’ genomic sequencers to check their food, wearable technology to detect their cancer – and in which medical engineers are replacing doctors while robots are taking over nursing. “When that almighty crunch point comes”, wrote recently Sherelle Jacobs in The Telegraph, “the creaky, tax-sucking public sector leviathan will be shown for what it is: a system that trapped the country in an insane hell of cyclical problems.”
Their dystopic manifesto is being implemented now. The government’s Health and Care Bill is its foundation. By breaking up the English NHS into 42 Integrated Care Systems, the Bill is demolishing the barriers preventing, first, the complete monopolisation of NHS budgets by US insurance conglomerates and, second, the expropriation of the most valuable NHS asset: its data. Health corporations and Big Pharma will have free rein over the NHS budget while Big Tech (with Google and Amazon leading the pack) will realise its dream of adding incredible value to their Apps by immersing them in the rims of health data the NHS has amassed since the 1940s.
The time to stop them is now. While Boris Johnson continues to lull the public into complacency, and Keir Starmer continues to speak of the NHS “partnering with the private sector”, it falls to the British public to resist. This is why we have launched, along with doctors, academics, artists, journalists, unions, and a range of dedicated civil society organisations, the national #yourNHSneedsYou! Campaign.[1]
Our aim is to stop the Bill and start the renationalisation of the NHS: the restoration of a market-free system delivering care as a right, not as a commodity, within a community of providers who extend public provision to social, dental and optician care, and do so by using the latest in modern technology and also focusing on public health measures to reduce the need for treatment without falling prey to Big Tech’s hunger for data extracted from patients in order to turn them into commodities.
There is another aspect of our #yourNHSneedsYou! campaign that progressives can draw comfort from. It emerged after progressives were gathered by DiEM25 to iron out differences in the context of a series of discussions that we labelled the ‘New Putney Debates’. Together, we recognised that, post-Brexit, and in the face of further intensifying attacks on our public services and liberties, it is time to move beyond past differences and electoral considerations. Instead, as the #yourNHSneedsYou! Campaign demonstrates, we decided to encourage our friends, members and supporters to work together toward common goals. Starting with the preservation of the NHS as a magnificent commons, we hope to show the way for a new form of progressive, collaborative politics in the UK and beyond – something we’re already seeing in some local authority ‘rainbow coalitions’.
[1] So far #yourNHSneedsYou! has been endorsed by: Brian Eno, Stephen Fry, George Monbiot, Frankie Boyle, Jonathan Ross, David Tennant, Russell Brand, Jo Brand, Steve Coogan, Joe Lycett, Johnny Vegas, Vicky McClure, Romesh Ranganathan, Ed Byrne, Dane Baptiste, Shappi Khorsandi, Rachel Parris, Charlotte Church, Caroline Lucas, Jeremy Corbyn, John McDonnell, Lemn Sissay and Michael Rosen.
