Keir Starmer promised ‘change’ at the last election – and sadly, the NHS could be about to feel just how grim that change is.
The now-Prime Minister said last year that his approach to reforms would look like New Labour’s Clause IV moment (when the party moved away from public ownership of utilities) ‘on steroids.’
And it seems like, a year and an election on, Health Secretary Wes Streeting has taken this to heart with plans seemingly afoot for a new round of Private Finance Initiative (PFI) for the health service.
But, just like steroids, any plans for more privatisation in the NHS should come with a health warning: they may be dangerous and cause side effects.
PFI was a policy initiated by the John Major government but was given a major shot in the arm by Tony Blair in the late 1990s and early 2000s.
The idea in a nutshell is: government wants to build more hospitals and health services without spending any money up front; private finance companies are drafted in to put up the funding for the bricks and mortar; local NHS Trusts using the privately built health facilities pay back those costs with interest over decades-long terms, meaning that in the long run the public purse often reimburses the private sector several times over.
Now PFI faces that steroid boost by Wes Streeting as he looks to implement the biggest expansion ever in private involvement in health services.
Private hospital companies and their shareholders must be salivating at the prospect of boosting profits. They are offering to invest £1billion to expand facilities.
To me, it looks worryingly like the PFI deals of old.
NHS Trusts, NHS staff and patients are still paying the price for Tony Blair’s PFI scam – all the more scandalous when you remember he left office over 17 years ago.
This has done huge damage to the entire healthcare system’s ability to provide the care that patients deserve, and staff want to provide.
Research suggests that 78 NHS Trusts with current PFI debt have already paid back more than the initial capital investment.
A 2019 report by the Institute for Public Policy Research (IPPR) found that some NHS Trusts are spending a staggering £1 in every £6 available to them servicing PFI debts. Or, looked at another way, for every £600m these Trusts have, £100m is being syphoned off to private companies.
That’s millions lining the pockets of PFI providers that could instead go into medical supplies and patient care.
One analysis in 2022 found that some NHS Trusts are spending more on PFI debts than on medical supplies.
The impacts of Blair’s PFI were bad enough, but at least at the end of each PFI contract the public received an asset – a hospital for example.
Under Wes Streeting’s apparent plans the long term benefits appear negligible.
This is because the investment will go into building up private sector facilities, not public NHS ones.
This expansion of private provision will ultimately undermine the amount of money available to NHS Trusts for providing patient care.
The more the NHS comes to rely on private providers, the more the latter can charge – and that’s bad value for money.
With the amount of money Streeting has accepted from donors linked to private healthcare, it perhaps shouldn’t be a surprise he apparently finds their work so appealing
The Green Party has always proudly defended the NHS against creeping privatisation and we always will. We are committed to a fully public health service and to keeping the profit motive well away.
As new Green MPs we moved an amendment to the King’s Speech setting out the government’s programme, designed to protect the NHS from privatisation.
In a Commons debate in October, my colleague Adrian Ramsay MP rightly made the point that there are ‘real reasons to keep delivery of the NHS public, and not to outsource it to private providers.’
He called for clarity – which we are still waiting for – on whether plans to use the private sector to reduce waiting lists are short term to help the NHS rebuild or a permanent policy.
Greens would increase taxes on the super-rich to fund our frontline services properly.
We are also up front on the need for the government to borrow to invest in the NHS.
PFI under Blair was a nail in the coffin of the NHS; and Streeting’s desire to use the private sector could see it buried forever.
This country needs a health service that works as a public service for patients, not for private profit. Green MPs will join forces with patients, NHS staff, Hospital Trusts and campaigners to oppose Labour’s plans to adopt this disastrous policy.
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