The Fate of the NHS
Updated: May 17
The 2019 election in the United Kingdom was one of the most pivotal elections in recent memory. Over 47 million voters lined up to decide the future of the country, with the prospect of an impending Brexit fresh in their heads, leading to the largest conservative party majority in the parliament since Margaret Thatcher’s government. All this and more is why many will remember this as the Brexit election, and while this title isn’t exactly inaccurate , Brexit played a big part in every party’s manifesto and definitely influenced the voting decisions of the public, but there is a lot to be said about the role of the National Health Service (NHS) and how it influenced the policy of the political parties, especially the two largest parties, the Conservative party and their largest competitors, Labour.
The NHS is the public healthcare system in the UK. Founded in 1948 by the government, the NHS provides free healthcare for anyone living in the UK, and free medication for anyone living in Wales, Scotland and Northern Ireland. The NHS has been ‘free at the point of use’ but has been paid for with tax money for almost 72 years, but in recent times has been a popular point of discussion for political parties, especially the idea of privatising the NHS. The NHS gets it’s funding from government revenue, the British government handles the NHS in England, and the NHS in Wales, Scotland and Northern Ireland is handled by their respective governments. The concept of privatization would entail the NHS being fully or at least mostly funded by private companies not associated with the government. In the 2019 elections, the notion of privatizing the NHS was entertained by many politicians and voters, especially those aligned with the conservative party.
However, the Covid-19 pandemic has changed everything. The very idea of privatization of the NHS has had a fundamental shift in recent months and the pandemic is the main reason for that. The healthcare staff in the UK have been stretched thin, protective equipment is extremely hard for hospitals to receive, with NHS hospitals saying they need 150,000 gowns a day, and over 50 NHS workers passing away from Covid-19. In fact the prime minister of the UK, Boris Johnson spent time in the intensive care unit of an NHS hospital after contracting the coronavirus. All this and more changes the discussion entirely, so we ask the question, should the NHS be privatized?
For starters, the NHS is not currently completely publicly owned, somewhere around 6 percent of the NHS is privately owned, a big part of that is due to Cygnet Healthcare who own many of the NHS’ mental health hospitals (most mental health facilities in the UK are privately owned.) Despite this private ownership, NHS England still sends plenty of money to Cygnet Healthcare for the running of these hospitals and local authorities also bankrolling social care beds. However, these mental health hospitals weren’t the best in terms of patient care (to put it lightly,) there were many patients of autism and learning disabilities with heavy complaints regarding their treatment, and the Care Quality Commission found large problems within Cygnet Healthcare. That is all representative of a larger fear held by people against the privatization of the NHS, that private healthcare does not equate to better healthcare, especially when you remove or even reduce public accountability, a very valid fear, as the evidence suggests. The fact that NHS England still sends money to the private firms that fund NHS hospitals also shows that an increase in privatization of the NHS may not reduce it’s burden on government expenditure as much as the supporters of privatization may suggest.
However, as mentioned, the aforementioned pandemic has changed a lot, especially the public perception towards the NHS as a whole. It is almost clear to see that the NHS has been struggling for funding and equipment, and the British government has been unable to cope during these times, and while many are choosing this time to question and criticize the amount of expenditure the government allocates to the NHS, many are using this to make a strong case for the privatization of the NHS. Privatization would mean a more stable liquidity and possibly larger cash flow for the hospitals in the UK, which could help the ever-struggling NHS, and the endless strain on their budget. Despite this strong argument, many people could suggest that rather than relying on the private sector to fund the NHS, the UK could increase progressive taxation and dedicate more of the public budget towards funding the NHS.
In order to better understand how the doctors within the NHS feel about this situation, I had the opportunity to sit down with Dr.Jayanthi Simon, a fellow of the Royal College of Pathology and I asked her a few questions to gain her insight. The transcript of the interview follows:
Q: How long did you work for the NHS?
A: I worked in the NHS for thirty-six years.
Q: Do you think the political situation in the country affects the operation of the NHS?
A: Yes, the NHS is a public sector organization , so it is therefore funded by the government, and as a result of this the political situation in the country can affect the NHS. The service is free at the point of delivery, and it’s resources are finite while it’s demands are infinite. So, whichever political party is in power has to fund the NHS adequately and has to know how much funds are required and how to obtain the funding.
Q: Have there been other times where the NHS has felt underfunded? And do you think privatizing it would help it overall?
A: Yes, almost always the NHS feels underfunded. This is because of the infinite demands on the NHS. Year on year the workload in the NHS increases. The value of the work done in all sectors of the NHS keeps steadily increasing and advancing. Every year there are more methods of treatment, methods of disease prevention and more essential research being conducted. Hence a lot more complicated work is being done and people are living longer as well. All these require more funding year on year. In addition, the cost of living increases every year and the NHS has a large workforce who need to be paid a reasonable wage at least. I do not think total privatising of the NHS will help and should not be done. On the other hand, revenue generation within the NHS can be done and used for expanding the excellent work done by the NHS. Also, in certain selected areas and in times of severe stress on the NHS, they can work in collaboration with the private sector, like for example, during the current pandemic the NHS can collaborate with the private sector, to help receive the funding necessary to fight it.
There we have it, from the insight of a doctor. So we can conclude that the political situation in the UK fully affects the operation of the NHS, and that despite the positives of privatizing especially with regards to financial stability, there are alternative ways for the government to fund it or for the NHS to raise funds without sacrificing the quality and accountability that makes the NHS as reliable as it is. However, until parliament makes up it’s mind and until the current situation calms down, the fate of the NHS hangs in the balance.rr
Author : Niranjan Sridhar