The NHS is not privatised at all

by Sir Thomas Crapper

Another day, another bloody petition to ‘stop the privatisation of the NHS’. Or, in this case, ‘stop the plans to dismantle our NHS’.

The NHS is funded from tax receipts. It is free at the point of delivery. It is a Public Sector service. Full stop. The NHS is not privatised.

What do we mean by ‘privatise’? When the railways were privatised, they were sold back into the hands of private companies. The idea was that the price of a ticket should be whatever it needed to be, as long as ‘the management’ could no longer come back to the Government, cap in hand, asking for handouts.

As union boss Lew Adams said in 2004: “All the time (rail) was in the public sector, all we got were cuts, cuts, cuts. Today there are more members in the trade union, more train drivers, and more trains running. The reality is that it worked, we’ve protected jobs, and we got more jobs.” And that’s a man who steadfastly opposed the concept of privatisation.

Railways were nationalised in 1948. (And by the way, that means they were taken away from the people who had built them, invested in them, laid the track and connected the country up. Private investment and enterprise delivered our railways, not government).

Anyone using trains through the nearly 50 years they were in public ownership knows they were dirty, dangerous and subject to strikes, cancellations and extreme lateness. That was the argument for privatisation; and it’s the argument against re-nationalisation.

But the NHS is not in private hands. All talk of privatisation and ‘dismantling’ is nonsense.

It also stops the real discussion – what is it we want from our NHS? It’s clear we can’t just go on, ad hoc, throwing more money at it. It used to cost 4.5% of GDP. That has since increased to almost 10%. That’s not just an increase in funding in real terms, it’s a doubling of the percentage of our entire earnings as a nation.

To put it simply:
In 1999, the cost of NHS services was £1bn per million patients per year.

In 2016, it is £2.1bn per million patients per year.

Surely anyone can see that that means something is going wrong? Have your wages doubled in the past 17 years? And one of the things going wrong is the general public.

Three hundred and forty million (yes, 340m) visits to a GP and 13m A&E visits in a year suggest we’ve become a nation of babyish hypochondriacs. But do we see or hear that discussed anywhere? No, we don’t. And why? Because every NHS patient is a potential voter, and no politician wants to tell a possible supporter that they’re a whingeing hypochondriac.

So the first problem to be tackled is getting the public to understand that the NHS isn’t there for every cough, spit and sneeze, not to mention Friday night punch ups.

First step – anyone in A&E because they’re drunk, give ’em the bill. (We used to throw them in the cells till they sobered up, maybe take them to court and fine them).

Second step, adopt something similar to the French model. You pay for a doctor’s appointment. If the doctor finds you’re actually sick, you get the money back.

Whatever, we can’t go on like this. A doubling in cost during a period of low inflation and almost zero interest rates is truly scary.

Common reasons given for the cost explosion include:
An ageing population. But the population isn’t ageing. That’s a myth based on a computer projection which is based on the assumption that our generation – the boomer generation – will live longer. But we’re not. We’re popping off earlier than our parents.
Big pharma leaching on the budget. Pharmaceuticals are restricted to around 10% of the total NHS budget. That doesn’t sound like an opportunity to ‘leach’.
Obesity and its consequences. Well, instead of landing the NHS with a massive bill for treating heart conditions and diabetes that result from over-eating or eating the wrong food, maybe it’s time to push back. A little more personal responsibility on the shoulders of each of us would be no bad thing. Perhaps, whisper it, we should pay for treatment of self-inflicted disease? Ooh, sorry. No. Not allowed to discuss that.
Advances in medical research. Ah, I’ll give you that one – but the unintended consequence of our ability to create pregnancies where nature has failed, prolong the end of life and treat previously terminal cancer, for instance, is a massive drain on the budget and the staff that has never been properly costed. For instance, we consume 90% of our cost to the NHS in the last six weeks of our lives. The NHS was never set up to cope with that.
So, again, there is a problem and there’s no use blaming politicians. The NHS has become a sacred cow and we’re not allowed to criticise it. But unless we do, and decide what exactly it is that we want from it, it will continue to be a financial basket case.
For instance, maybe we might say, as a nation, “Yes, we want you (the government) to finance the NHS to the ultimate ongoing requirement, in perpetuity.” Of course, if we make that decision, we have to realise that we could push the cost up to 20% of GDP. What are we going to sacrifice elsewhere to do that?
We could easily spend a quarter of a trillion pounds (£250bn). It’s already £140bn, it’s in deficit by £8bn, despite this government providing a further £19bbn, and we don’t have enough junior doctors and nurses. It doesn’t take a genius to work out that the budget needs to rise by at least 50% just to sort out the problems that currently exist.
Fine. If that’s what we want. But where will the money come from? Politics without arithmetic is just ranting.
Facebook memes and petitions are fatuous. 
A few memes offering solutions might be a start.

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