If you want a lesson in how not to deliver health care, look at the broken American health care system. But since Brexit and talk of a US trade deal, American corporations and insurance companies have had their eye on one of the greatest British social achievements, the NHS. In the documentary film, The Great NHS Heist, producer, campaigner and NHS doctor, Bob Gill explains not only how the UK government are deliberately running down the NHS, but how they are already well advanced in smashing it apart.
Renegade Inc. host Ross Ashcroft met up with Dr.Gill to get the low down on the core issues in the film which are driving one of the world’s leading free at the point of delivery healthcare systems into the hands of corporate profiteers.
A cautionary tale
The main mission behind Dr. Gill’s making of The Great NHS Heist was to highlight how the introduction of an insurance based market system into the NHS could lead to the kinds of harrowing scenes depicted in the film where people in desperate need are forced to turn to the charitable sector in order to receive vital treatments. The film, in other words, is a cautionary tale about the dangerous direction of travel that government reforms are taking us.
Gill argues that the UK governments aim is to replicate a dysfunctional and expensive US system that denies treatment even to those people who have taken out the requisite insurance. With free trade and the circumvention of democracy necessitating such a system, successive UK governments have opened up the NHS to be subject to precisely the kind of bilateral trade deal that Johnson and Trump want.
Gill says, “We’re seeing bigger corporations moving in and exerting a powerful influence on the NHS, for example, United Health, America’s biggest private insurer. They have their man at the top of the NHS. Simon Stevens. He’s shaping and restructuring the NHS to replicate the American model. We are seeing the number and extent of services provided within the NHS shrink already. And that’s when you start to get this middle class drift towards the private health insurers.”
Privatization by stealth
As The Great NHS Heist shows, the privatization agenda is a deliberate stealth proceeding strategy. “Unfortunately”, says Gill, “most of the profession and people within the NHS do not quite see or don’t want to believe the final destination.” The introduction of an insurance based system as a core mechanism in the delivery of public health is integral to the final destination, the motivation of which is profit.
According to Gill:
“The way you make profit is through the denial of care or introducing barriers to accessing your insurance policy, whereas a public health system is there to deliver the best health outcome for the patients without the additional bureaucracy of an insurance based system.”
This is reflected in the comparative administrative costs which under the pre-privatised NHS amounted to less than 5 percent. By contrast, US administrative costs are in excess of 30 percent. In addition, the insurance based system encourages perverse incentives for doctors to deny care to their patients. This will fundamentally break the doctor/patient relationship.
In response to the argument that the private sector is more efficient and can deliver better outcomes, Gill says,“There is no privatized health service in the world that delivers universal health care. The market is not interested in the sickest (most expensive) patients and actively avoids them to maximize profit”.
Back to the future
Despite the flaws, the British political class seem intent to want to return to a 19th century national insurance-style system of healthcare provision of a kind that predated the universal system that came into being in the UK in 1948. Gill says the public are being set up to believe the NHS is inherently flawed and that privatization is the way forward.
“The NHS they’re experiencing now is not the NHS as it should and could be. If we weren’t wasting money lining the pockets of people like Richard Branson through outsourcing to Virgin Care, that money would go into the delivery of care. If we weren’t wasting money on PFI and the cost to the bureaucracy, we could deliver the best health service in the world. But the patients are being denied that very deliberately so that their confidence and trust in the model is broken”, says Gill.
The campaigner adds:
“What’s happening to the NHS is a crime against the nation. We have our government liberating our national assets for raiding by international corporations so that our wealth will be siphoned away from the country and the wealthy that will avoid paying taxes. It’s a complete leaching of the system.”
Gill says that the scandal surrounding PFI which has saddled the NHS with a debt burden in order to justify the sale of debt free publicly owned assets, has also been detrimental to the NHS. The end result is that the ownership of newly built PFI hospitals are transferred into the private sector. This process of public asset grabs not only achieves privatization, but enriches bankers and ‘revolving door’ politicians. Alan Milburn, Patricia Hewitt and Stephen Dorell have all been working for companies involved in benefiting from the privatization of the NHS.
“Westminster has been captured by the corporate lobby. They’re doing the bidding of the financial sector, the banks. There is nothing that I’ve seen in the NHS looking at policy over the last 30 to 40 years that has been directed to improve patient care”, says Gill.
So pernicious is the corruption within the system that the ability for the public to push back in any meaningful way would seem limited. However, Gill, who cites the jilets jaunes movement in France as an illustration of the kind of mass movement required, believes push back is possible under circumstances in which a sufficient critical mass of informed people are willing to stick their heads above the parapet.
“We are very close to losing the NHS and having the corporate capture locked in legislation and locked in international trade law that will make it very difficult to reverse. Still, there is time for us to become active and stop the flow of our assets overseas into corporations and shareholders profits. And the sooner we get on the job collectively, the better”, says Gill.