How can we measure the result of privatising NHS England?
HOW surprising to see in The Guardian the usual moan about how flogging off the NHS is a very bad idea indeed. Which it might actually be but the really interesting question is how would we find out?
As for public accountability, there is none. Commercial contracts are redacted so that crucial financial information is not in the public domain. Government departments and companies refuse to release the necessary information on the grounds of commercial confidentiality and allow companies to sequester their profits in offshore tax havens. NHS staff transferred from the public to the private sector see their wages and benefits eroded. But all this is nothing compared with what is in store for patients.
In the new world it will no longer be possible to measure coverage or fairness. Former NHS hospitals, free to generate half their income from private patients, will dedicate their staff and facilities to that end, making it impossible to monitor what is public and what people are paying for.
Well, yes, that is actually a problem. It is very difficult indeed to measure what we are doing against what we might have been doing otherwise. So, given that NHS England is being sold off to the multi-nationals, competition is being introduced, how are we going to work out whether it’s a good idea or not? Not in theory you understand, but how are we going to look at the actual effects in the real world?
From 2013, there will be no National Health Service in England, and tax funding will increasingly flow to global healthcare corporations. In contrast, Scotland and Wales will continue to have a publicly accountable national health service.
Oh, that’s how we’ll do it!
We’ll look at how much health care costs in Scotland and Wales, we’ll look at how good health care is in Scotland and Wales, and we’ll compare that to the costs and quality in England. Excellent, now we have a method that we can use. And so we can, after a few years, work out which system works best, one with competition in it or one without. Which would be nice, wouldn’t it? We’d no longer be arguing about angels on pinheads, theory only, but have some real facts to use.
The thing is though, we’ve already done this comparison. For competition (on quality, not price, grounds) was introduced to NHS England a few years back. And not to NHS Wales or NHS Scotland. And pound for pound NHS England got better than the other two. And that’s the reason why we’re doing this current change: because we’ve already the evidence that competition works.
Image: FIRST BABIES BORN ON THE NHS (NATIONAL HEALTH SERVICE) UNDER THE NEW HEALTH ACT – 05/07/1948