NHS foundation trusts and patchwork privatisation

The NHS is something us Brits regard very highly – it’s a public service that we’re all proud of. Almost everybody in the UK is opposed to the abolishment of the National Health Service, and the vast majority oppose privatizations. Perhaps this is why even Margaret Thatcher dared not to touch the NHS? Despite all of this, David Cameron has begun the biggest wave of restructuring the health service has ever seen – in the form of the Health and Social Care Act passed in 2012. The financial crisis has created the perfect scenario for massive restructuring, and scary changes are being made amid a complicated re-arrangement of the NHS. These changes involve ‘patchwork’ privatization. Unlike sales of the energy companies, the privatization of our NHS is being done both slowly and painfully. It began in the eighties, with the health service contracting out simple work to agencies such as cleaning and portering.

Patchwork privatization went up a notch in the 90s, when more complex roles began to be contracted out to private companies. Soon enough, it wasn’t rare for private workers to be found in the diagnostics and logistics departments of health trusts across the UK. This narrative has continued on a slow but steady pace throughout Thatcher’s Premiership, right up until the current Tory government. With the rise of New Labour, not a single Prime Minister has even addressed privatization and over-reliance on agencies as a concern for the public. In 2013, the situation is far worse. The growing demand cannot be facilitated by the current state of the NHS, and instead of making significant additions to the public budget, Cameron is pushing a restructuring process that will simply see our hospitals replaced as market-driven foundation trusts.

So what are foundation trusts? In accordance to the Health and Social Care Act of 2012, all NHS hospitals should be turned into foundation trusts. Foundation trusts are not like ordinary hospitals. They’re independently-ran institutions with complete freedom to manage their own finances; allowing them to report profits and encourage private investment. Instead of the democratically-elected government being their sole creditor, these foundation trusts will be given the flexibility to seek funds from banks and other private borrowers. With this freedom, it is expected that foundation trusts will sell contracts which private providers will then compete for. As long as it can be financed, even if through private debt, it can almost certainly be done in a foundation trust – as long as it has got the backing of local ‘stakeholders’ of course.

Stakeholders are the trusts’ equivalent of shareholders or directors. The board of local stakeholders will be a central part in the management of our new foundation trusts, however their power seems to stretch too far. All NHS property, including land and equipment, will become under the complete ownership and control of the local foundation boards. We, the British people, are going to lose control of our NHS over to independent boards. Suddenly, our NHS will become outside of the control of democracy. It will be hard to undo the changes made by Cameron’s government, however there is still time to stop the creation of these foundation trusts. The opposition to privatization is growing, and Cameron won’t be able to stand off the rising discontent forever. It’s now up to the British people to reclaim their independence from private corporations.

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This article has been cross-posted from the Critical Proletariat. [You must be registered and logged in to see this link.]