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The UK National Health Service (NHS), one of the most efficient and value-for-money healthcare organisations in the world is no more. We may still talk about it as if it were around but the final blow to its existence, appropriately delivered on April 1st Fools Day in the form of the Health and Social Care Bill, is now working its destructive power, as anticipated.
How can this happen in a “democracy”. How can an institution, much loved by the majority of a country’s population, suffer such onslaught by its “elected” representatives? Here are some of the strategic points that led to this disaster:
- Media Campaign to make people believe it’s not working well: This began in the 70’s during Margaret Thatcher’s government and has not stopped, even if Labour rule increased NHS funding.
- Images of private medicine as nice and clean, NHS hospitals dirty and full of treatment resistant bugs
- Only NHS mistakes reported
- Permanent state of reorganization that makes workers and patients confused and distressed.
- Cuts in funding that lead to overworked staff making mistakes, then present them as inherent failings of the NHS
- Stimulate competition between provides to make “value-for-money” and “savings” the main objective, rather than people’s health
- Get private providers steadily increase their funding of political campaigns, offer shares to politicians so that when the Bill finally reaches its final stage in Parliament a majority of MPs have a personal interest in the privatization process. See some figures
- Get the lawyers out to grab a piece of the cake: Already millions of pounds are being drained from the NHS budget by legal challenges from private providers to force local health authorities open the tendering process.
- Hide your plan, don’t’ even mention it in your election manifesto: Michael Portillo : “They did not believe they could win an election if they told you what they were going to do because people are so wedded to the NHS.”
- Entertain the population with bread and circus (including extolling the NHS in the Olympics opening, royal weddings, babies, etc) so that most people lose interest in real news
- Put pressure on the most widely respected Media outlet (e.g., the BBC) to report a distorted picture of the process: “There was overwhelming opposition [to the Bill] from the medical profession (eg: from the British Medical Association and all but one of the 26 royal medical colleges), though this impression was not communicated by the mainstream media, particularly the BBC. Although the NHS affects every man, woman and child in England, most remain in the dark about what has happened. The government has played a big role in this”.
- Repeat ad nauseam the neoliberal mantra: “there is no alternative, there is no alternative, there is no alternative…”
- Keep talking about “free at the point of delivery” as if the cherry picking and selective NHS closure of “unprofitable” services were not part of the plan to make people take private health insurance: NHS services must be put out to tender. The core business of the transnational corporations that are bidding is winning government contracts, as they have the experience, deep pockets and legal expertise to do so. Small enterprises and local GPs cannot compete with them in tendering for services as has already been seen in the Virgin takeover of community services in Surrey and children’s’ services in Devon.
- When staff go on strike to save the healthcare system make it appear as another reason to go private
- Make the process irreversible: If an NHS provider loses its contract to a private one, it simply disappears, a hospital closes down, a clinic becomes an office and staff go elsewhere, so that when a new tendering process begins the original NHS facilities are no longer there to compete.
- Discuss the need to save money in health funding as part of the austerity drive as if money were not being wasted (in fact several times over what the NHS would need to function at its best) in wars, useless nuclear weapons and allowing the super-rich to evade tax through loopholes and tax havens