Future of the NHS

Debate between Andy McDonald and Ian Byrne

Monday 31st January 2022 Westminster Hall

[Ian Byrne (Liverpool, West Derby) (Lab)]

It is a pleasure to serve under your chairmanship, Mr Gray. The privatisation of the NHS has been a lengthy and well-documented process that started during Thatcher’s Conservative Government in the 1980s. It has shifted the responsibility for the long-term care of the elderly and the vulnerable from the NHS to local authorities, and allowed hotel-type charges for long-term care. This violated a key NHS principle that patients should not pay health charges. Charges became means tested, and homes had to be sold to pay for the bills. Local authorities were forced to pass on their responsibility for healthcare to outsourced private companies. That created a for-profit industry worth £6 billion a year.

Ninety per cent. of nursing home beds are now operated on a for-profit basis. Almost 400,000 elderly patients are now a source of income in an increasingly privatised sector. The staff in those nursing homes are an increasingly casualised and deskilled workforce. The privatisation of care for the elderly created such a mess that we are still trying to sort it out 40 years later. That is the shameful legacy of privatisation in one sector of healthcare. We can see clearly that the process of privatising the NHS itself will follow the same pattern. It will be run by private contractors who will de-professionalise and casualise a temporary workforce.

There has been a creeping privatisation of the NHS. In 2012, an Act was passed that, among other things, required all NHS contracts to be tendered to any qualified provider. Now we have ambulance services run by taxi firms, private companies that have taken over GP practices covering half a million patients in London, and a private company taking over an NHS hospital and cancelling the contract when there was no more money to be made. I have seen first hand, working for Unite and organising outsourced workers in the health sector, the damage that privatisation does to our essential care services.

If that tale of incompetence was not enough, the Government are now pushing through a new reorganisation, this time to establish what they call “integrated care”. It does the complete opposite, instead butchering our NHS into 42 separate areas. It should not be called integrated care but “disintegrated care”. Each area has a fixed budget that cannot be overspent. This will create a postcode lottery and force each area not to co-operate with each other to save cash. Each area board will allow private healthcare companies—another play on words: they are mostly private health insurance companies—to make decisions about the provision of healthcare.

Here we go again: the Government’s answer to underfunding our NHS is to let private companies run it. History has taught us that this is not the solution. NHS staff employed by 42 different organisations face a most uncertain future of casualisation, deskilling and the introduction of poorer terms and conditions. The people of England face a regional, not a national, health system, which will have different terms and conditions for its workforce and different provision of treatment. It is chaotic and irresponsible.

Every Government of the day have been entrusted to preserve and protect one of the country’s greatest achievements—to cherish, not cherry-pick and hive off to the private sector. I urge the Minister to listen to the calls of my constituents, campaigners and the trade unions and scrap the catastrophic Health and Care Bill, which destabilises, fractures and imperils our NHS.

[Andy McDonald]

rose—