The Big Privatisation Debate


This afternoon in parliament in Westminster Hall there will be a debate on privatisation in the NHS. This debate has been granted in response to a petition to government. It is a shame that the debate will be held in a committee room rather than in the House of Commons, but what will be most interesting to see is whether the debate moves away from its current framing by the government.

Privatisation – the transfer of responsibility or ownership from the public to the private sector – is a long established economic policy of UK government since the late 1970s. Its intention is not always financial benefit to the public purse. In 1981, the then Secretary of State for Energy, Nigel Lawson, stated that, “no industry should remain under state ownership unless there is a positive and overwhelming case for it doing so.” 

But there is a distinct downplaying of debate about privatisation in the NHS.  It is suggested that it doesn’t matter who provides the service, the public or private sector, as long as quality is maintained. In the recent Health Select Committee oral evidence sessions privatisation of clinical services was described as ‘only 7.9%’, which Johnny Mercer MP thought was too small an amount to bother the public. This is in marked contrast to the high levels of positive publicity around early sales of public sector utilities such as British Gas.

This downplaying can be seen in the response from the Department of Health and Social Care to the petition on privatisation, which suggests that nothing of significance has changed in the NHS, “the private sector has always played a vital supporting role in the NHS, for example in building hospitals, in providing facilities management services, in supplying medicines and equipment. Primary care contractors – GPs, dentists, pharmacists – have always been independent contractors and are not NHS employees.” 

Are the parties capable of discussing this subject openly and honestly? The Conservatives have a fear of being seen as the party who privatised the NHS, so describe what they are doing in any terms but that. The Labour Party has the millstone (or perhaps that should be the Milburn) of New Labour dragging at its heels like the chains of Marley’s ghost. Raising any serious questions about privatisation carries with it the fear that the accusation will come back ‘you did that first’. and, of course, in many cases they did.

There are serious concerns about what is happening with clinical services. There have been previous incidents where patients have suffered serious harm receiving NHS treatment in private hospitals as well as the NHS having to repair the damage when private patients have suffered in private hospitals. Today a coroner has taken the extraordinary step of writing directly to Jeremy Hunt with concerns over NHS patients’ treatment in private hospitals following the death of an NHS patient at a BMI Healthcare hospital in January this year. This was reported today in the HSJ (behind paywall). But the privatisation agenda goes far beyond clinical services.

It is possible that this debate would be better framed in terms of the role of the NHS within the wider healthcare setting.  We will be publishing a series of blogs over the coming weeks to help broaden the debate beyond the ‘7.9%’.


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