Deborah Harrington draws parallels between the Greek economy and England’s health service.
Three things stand out in the documents Wikileaks published showing the detailed bailout terms for Greece: the removal of political power, giving them no other option but to the privatise their services; the sequestration of their public assets into a private holding company; and the removal of choice over their economic policy. Together these form the effective removal of their democracy.
It is not only the immediate decision that has that effect, but in the long term, what is left for a Greek government to legislate on, other than the deployment of their armed forces and police to quell the riots?
Has democracy in the UK already gone the same way, but with the cooperation of the government in our case? Our public assets are being sold off at extraordinary speed, and have been transferred into private company portfolios pending sale. The NHS is being privatised in profound ways. The Health Secretary is no longer legally responsible for the NHS. We no longer have a right to healthcare. Austerity and privatisation were forced on Greece; here our government accepted them voluntarily.
Selling England By The Pound
Hospitals we used to own are being demolished whilst the new PFI ones are not in our ownership, but in private consortia. We have to lease them back and are tied into maintenance contracts whose combined cost can be more than 20% of the annual budget, financially destabilising the hospital and damaging patient care.
All this and more – contracting out, complex relations between different fund holders – has enormous cost attached. This is not about ‘NHS management’ but about the proliferation of private healthcare management companies involved at every stage – negotiating contracts for PFI, drawing up tender documents for every kind of service from cleaning to cancer care and advising on the financial ‘viability’ of hospitals, which can now be bankrupted as they are businesses, not public assets. When the Trusts are put into liquidation the administration process is also run by these companies.
We are so deeply enmeshed in this ‘depoliticising’ of our administration that we can’t even see it. Where was the outcry when the ownership of some of our schools and hospitals was found in the offshore tax avoiding accounts of HSBC who had been advised by PwC? Why is PwC still involved in advising at government level and running our public sector at operational level when the Public Accounts Committee said they were responsible for ‘industrial scale tax avoidance schemes’?
Like Pasok in Greece, the Labour Party agrees with the political Right that management of the economy under austerity rules is the only acceptable proposition. They may (possibly) deviate on the means to achieve it, but not the principle. We have a dominant political voice agreeing that There Is No Alternative. Labour and Tories alike have called for the state to be reduced and ‘resilient’ communities built. (A resilient community is one that can survive on an individual and collective level without state support mechanisms.)
NHS Healthcare on a par with NHS Dentistry?
The list goes on… but the NHS won’t. The devolution project will split the national NHS budget into a hundred pieces to be privatised by local councils and city mayors. As with social care the NHS will become a last resort for the poor, whilst the rest will end up as means tested and chargeable, either through co payments or insurance. Imagine the health service being operated on the same lines as dentistry and you’ll get the picture. Local authorities will provide a minimal service for the poor, in health, social care and social security combined. At the dentist the free or low cost treatment is called ‘NHS’ treatment, but it’s as far a cry from the principles of universal, comprehensive and equitable treatment that have characterised the NHS as it can possibly be.
Those people who keep saying ‘it doesn’t matter who provides the service’ had better buck up their ideas and start fighting against this. Otherwise we may well find, as in Greece, that when the NHS is gone, democracy has gone with it.