• Thirdly, there will be a new insurance market set up for top ups and co-payments; and
• Fourthly, in the next Parliament, it is likely that more direct patient charges will be introduced.
A failure of the NHS to provide a comprehensive service and the move towards opening up a mixed funding system requires the Secretary of State to abdicate his/her duties and powers to provide a comprehensive healthcare service to the nation’s population. This effectively denationalises the NHS and explains why the Government will not back down on Clause 1 and related clauses, which have been hotly debated in the Lords. They need to abolish these clauses to abolish the NHS and create the mixed funding systems. The work of Peter Roderick, Allyson Pollock and others is an essential read to understand this in more detail. I therefore strongly recommend the Duty to Provide website.
English citizens will increasingly have to consider taking out healthcare insurance policies as financial pressures cause the NHS to fail. Healthcare rationing by CCGs, Rising waiting lists, and reduction in NHS core services will fuel the insurance industry’s engine. This clearly has the most adverse effect on the most vulnerable in society because of the Inverse Care Law .
Finally, opening up the NHS to EU competition law will dramatically increase the amount of capital available to bring into our health service, but ultimately this capital will flow back to the investors at a profit, which will be at the expense of the UK citizens as taxpayers and in the form of private healthcare insurance premiums and out of pocket healthcare expenditure.
Conclusion: The politics and false economy of the reforms
The Government’s reasons for radical reform of the NHS are flawed, lacking in evidence, and driven by ideology. Their solutions will actually create more problems by increasing healthcare costs and bankrupting the NHS, leading to a mixed funding system of healthcare, with increasing marketisation and privatisation. Of course, increasing privatisation is a key supply side economic policy of the Government, which they are applying right across the public sector. New Labour were doing similar things, but not in such a drastic manner. I have discussed the politics of this neoliberal approach in another blog. The basic premise is that privatisation of public services will reduce the tax burden on corporations, reduce inflation and stimulate economic growth. However, the drive towards privatisation and a mixed funding system will increase economic and healthcare inequalities, which are both known to damage economic growth, which in turn impacts heavily upon the social determinants of health, causing a viscous circle of greater inequality. This is in direct contradiction to Clause 3 – the new duty of the Secretary of State for Health to reduce health inequalities.
The reforms will be economically damaging for a number of reasons. Citizens will have less money in their pockets as they have to pay for increasing proportions of their healthcare costs. Thus they will have less money to spend in their local economies. In addition, private companies will reduce terms and conditions for health workers who will have less money to spend in their local economies. These companies will also siphon off taxpayers money into their profit margins, the meteoric pay packets of their CEOs, and offshore tax havens. This will all be damaging the UK economy and thus NHS privatisation is a false economy.