Robert Stevens
The Labour government announced a major privatisation offensive in the National Health Service (NHS) on Monday, centering on a new “partnership” with the private sector, aimed at handing over tens of billions of pounds to the corporations.
Downing Street presented its “Elective Reform Plan” as one to “end waiting list backlogs through millions more appointments” and allow better access to health care. There are now a record 6.4 million people on a waiting list to receive 7.5 million treatments
Prime Minister Sir Keir Starmer repeated Labour’s insistence that any funding received by the NHS under his government be linked to “top to bottom” reform, i.e. productivity increases, and allowing further large-scale involvement of the private sector in the NHS.
It is a stark indication of Labour’s transformation into a Thatcherite party that Labour ministers now openly deride the NHS and its workforce in terms only previously used by the most venal elements of the Tory Party.
Health Secretary Wes Streeting has said—via the pages of a cheering right-wing media—“We are not going to have a something-for-nothing culture in the NHS with Labour,” and threatened, “I’m not prepared to pour money into a black hole”. The NHS is “a service, not a shrine,” which is “going to have to get used to the fact that money is tight”.
This agenda is now being enforced, with Starmer bemoaning in his speech that the cash-starved “NHS can’t become the national money pit” and that “Productivity can’t bump along 11 percent lower than it was before the pandemic.”
Outlining his answer, Starmer told reporters: “I welcome a new agreement that will expand the relationship between the NHS and the private healthcare sector.” This would “Make the spaces, facilities and resources of private hospitals more readily available to the NHS.”
He added, in reference to mass popular opposition, “I know some people won’t like this, but I make no apologies,” claiming, “I’m not interested in putting ideology before patients and I’m not interested in moving at the pace of excuses.”
Under the deal struck between NHS England and the private sector, the government is pledged to reach by the next election a target of 92 percent of patients being seen within 18 weeks. The private sector will be given responsibility to treat up to an additional 2.5 million extra NHS patients a year in pursuit of this target.
The privatisation of the NHS accelerated off under the Blair government, with successive Tory government’s legislating to widen access to the profiteers. Starmer acknowledged this on Monday stating, “An element of private sector support in the NHS has been there for a very, very long time,” Starmer commented, pointing to the record of Tony Blair’s Labour and subsequent Tory governments, “and clearly we need to make best use of it.”
Under the plans, private health companies will be handed £2.5 billion to carry out an extra million treatments of NHS patients a year. The private sector already receives anything from £12.3 to £29 billion (around 20 percent of the NHS budget) annually from the Department of Health, depending on how the figures are calculated.
According to analysis of NHS contracts data supplied to the We Own It public ownership campaign by public sector contracts specialists Tussell: “£6.7 billion, or £10 million each week, has left the NHS’s budget in the form of profits on all private contracts given by the NHS from January 2012 to May 2024.”
The one million more treatments would expand private provision within the NHS by a massive 20 percent at a stroke. This would mark a further, huge acceleration of privatisation. Already in 2021, private facilities carried out 13 percent of elective treatments, up from 3 percent in 2011.
Far from Starmer’s claims of providing an “NHS that is faster, easier and more convenient with waiting times cut”, Labour’s plan is premised on kicking as many people off the waiting list as possible, and largely moving care out of hospital settings and into community “hubs” and getting patients to “monitor” themselves at home.
Ahead of Starmer’s speech, the Thatcherite Telegraph—in which Health Secretary Wes Streeting was lauded in opposition, such was his commitments to privatisation—enthused in an article that he planned to “scrap over a million ‘pointless’ hospital appointments”.
Instead, said Streeting, “Our elective reform plan will change the way the NHS runs, to put patients in control, drive up productivity, and cut waiting times. We will cut out appointments that are frankly a waste of everyone’s time…”
The Telegraph added, “Health Department officials believe that ‘remote monitoring’ alone could free up half a million appointments next year, with another half a million freed up by patients being given the choice of whether they actually want the follow-up appointment rather than being offered one as a default.”
Labour’s plan includes the creation of “virtual wards” that will “monitor patients with respiratory problems, heart disease and frailty.” It will be down to patients, often seriously ill, to “record their own vital signs in apps that share the data with teams of NHS medics who check on patients if readings raise the alarm.”
In an op-ed piece in the Times accompanying his Monday speech, Starmer also announced plans to “drag care out of the hospital and into the community”. Diagnostic centres would be set up “operating 12 hours a day, seven days a week, meaning up to 440,000 more appointments a year. More of those appointments, tests and checks will be carried out in community settings.”
Siva Anandaciva, chief analyst at the King’s Fund health thinktank, commented simply, “Where are the staff going to come from? The NHS still has about 100,000 vacancies. The government have talked a lot about their ambitions for these two types of facilities but not said much about who exactly will staff them.”
There were 32,000 nurse vacancies last year alone, according to NHS England, and almost 16 percent fewer qualified GPs in Britain than comparative countries. As for Labour’s magic bullet of shifting hospital treatment into the community, the number of nurses working in the community in the UK fell by at least 5 percent between 2009 and 2023.
Streeting’s answer is to “drive up productivity”—annual increases of 2 percent—among already exhausted staff, working overtime in crumbling buildings and without the right equipment and facilities, after a decade in which UK capital spending in healthcare fell hundreds of billions behind its European counterparts. Labour’s funding for the NHS in its October budget allows it to stand still at best.
The reality is that these conditions have made it impossible for the NHS to run the services required by a nation of over 69 million people.
This was rammed home the very day after Starmer’s speech, with a report that no less than nine hospitals across five NHS trusts in England—including in major cities, Birmingham and Liverpool—had to declare critical incidents over the previous week. The Royal Liverpool University Hospital patients were advised they faced a 50-hour wait in A&E, with one patient at the hospital waiting almost four days (91 hours).
The situation has been fueled by a “quad-demic” of illness as outbreaks of flu (around 5,000 hospitalisations a day), COVID-19, norovirus and RSV exacerbate a now normalised winter health crisis.
Streeting, for once, was truthful, telling LBC radio, “We are taking people in ambulances to emergency departments to die because then there isn’t the right care available”. This is the same man who previously denounced the NHS for its “begging bowl culture” and its workers as “obstacles” to “reform”.
