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You’ve probably heard rumbles about NHS privatisation for years. You may have noticed changes to care that don’t feel quite right, but can’t put your finger on why. You hear denials from politicians here, read about hospital closures there, and drown in a spaghetti soup of NHS jargon everywhere: FTs, PFIs, CCGs, STPs, PCNs, ICSs… WTF!

Before Covid, it was already hard to get a GP appoinotment. You had to wait months for a hospital referral. A&E was packed, and the doctors run off their feet but they got to you eventually, didn’t they? So, is there really a problem?

The short answer is yes, there’s a MASSIVE problem. Since the 1980s, our value-for-money, world-beating, public service [1948 diagram] has been slowly unravelled and re-assembled at enormous cost into a broken jigsaw puzzle of regulatory quangos [2013 diagram]. We now have less than half the NHS beds we had when reforms started, many hospital, A&E and GP closures and mergers, a serious shortage of doctors and nurses due to cuts and a growing population! The picture doesn’t make sense, until you realise that some of the pieces are missing. Hidden from view, American private insurance companies have been installed in NHS back rooms and offices over almost 20 years in a stealth privatisation that is almost complete! How on earth did we get here? To cut a long story short…

“Before the Second World War, doctors’ fees were out of most people’s reach. Few could afford operations, so a serious diagnosis was a death sentence. Grandparents who fell ill often took their own life so as not to be a burden on their loved ones. Many children died from treatable illnesses.

During the war, life became even harder. When it was over, people had had enough of heart-ache, pain and bloodshed. They voted in their droves for the Atlee government which offered them something to smile about: a welfare state with nation-wide healthcare funded by the taxpayer, free at the point of delivery and provided as a public service. Everyone, from princess to pauper, would receive the same high quality of care, and the whole of society would share the cost. The profit-motive had been banished from healthcare! Doctors could now make decisions based on a patient’s health needs alone. Families were finally free of the crippling medical bills that had burdened or broken them for so long. Everyone fell in love with the NHS!

Well, nearly everyone. Just not the businessmen who had profited from selling poultices and pills, crutches and casts, stiches and slings to anyone who could scrape enough pennies together. And not the political parties who represented their interests. So, the businessmen and the politicians got together to plot how to undo the NHS. They devised a plan to undermine and run down the service, while putting in place the components of a new private system by stealth, calling it ‘modernisation’ to increase ‘choice’. Then they bided their time.

If they had let on that they wanted to get rid of the NHS (robbing us of life-giving care), we would have been on the streets in our millions in the time it takes to yell, “Hands Off Our NHS!” So, Thatcher’s government began chipping away at the edges, first privatising the bits they thought we wouldn’t notice or care about, like hospital kitchens, porters and cleaners. Next, they cut back on free NHS optician and dental services for many, and brought in charges. Then they set up an NHS internal market, turning hospitals and other NHS bodies into ‘buyers’ and ‘sellers’. The long-term aim was to turn the NHS into a business brand run by private companies.

Had doctors known about the secret privatisation plan, many would have opposed it. Removing cash from care had finally allowed them to practise truly ethical medicine. Gone was the spectre of a personal financial conflict of interests. They were free to serve the patient’s best interest and advocate for their treatment. Most doctors loved this! Aware of a likely backlash, the Thatcher, Major and Blair governments systematically stripped power from doctors; at huge cost, an army of managers and accountants from the business world soon controlled how healthcare was delivered. The NHS was under new management.

Our hard-earned taxes were diverted away from hiring medical staff, providing hospital beds and treating the sick, towards converting the NHS into the privately-delivered system they have in the USA – one which is more than double as expensive; is rife with cost-cutting to boost profits; has less access to highly qualified medical staff; has worse health outcomes; exploits doctors and nurses; is plagued by fraud and fines; sells wealthy patients operations they don’t need; leaves millions of poorer patients with no access to treatment, and where health costs are the Number One cause of personal bankruptcy!

The Major and Blair governments borrowed £billions in eye-wateringly expensive private loans to build new hospitals. We’re still paying them off. Blair brought in private companies to provide NHS treatments, as did the Cameron/Clegg and May governments, who also flogged off our NHS land and buildings to private owners. We now rent back the hospitals we once owned at sky high rates. To cap it all, Cameron & Clegg put a former CEO of America’s biggest health insurance company in charge of NHS England!

With Simon Stevens at the helm, the privatisation went into overdrive. For years, most of us have been walking past GP surgeries and hospitals reassured by the NHS logos on the outside. Government insiders – allies from Big Business and the Big4 Accountancy firms – have quietly hollowed out the NHS ready to be run by money-spinning foreign corporations. Big Data are poised to swoop in and buy up our private medical records.

Johnson’s Health and Care Bill is one of the final pieces of the puzzle. If allowed to become law, it will break the English NHS into 42 easy-to-manage chunks called Integrated Care Systems (ICS). Private companies will be able to sit on ICS boards with the power to decide how our money is spent. The more they cut and deny our care, the bigger the profit they’ll make. They can do this because Cameron and Clegg removed the government’s legal duty to provide us with care. Standards will take a nose-dive. As they do, those who can afford it will get scared and take out private health insurance.

Private US corporations will then control English healthcare. The shift to the two-tier US Kaiser Permanente-style Medicare system will be complete! The hard-up will be left with a rundown, privately-provided, skeleton NHS funded by our taxes. The better-off will have private-health-insurance funded, privately-provided care. And, until that final piece of the puzzle is in place and the 40-year demolition of the English NHS is done and dusted, the Prime Minister will keep reassuring us with his most sincere smile that, “The NHS is safe in our hands!”

This is how the story will end, unless you and I take a stand and together re-write the ending…

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