NHS, plc: The Privatisation of Our Health Care

by Allyson M. Pollock, Colin Leys

Universal, comprehensive health care, equally available to all and disconnected from income and the ability to pay, was the goal of the founders of the National Health Service. This book, by one of the NHSs most eloquent and passionate defenders, tells the story of how that ideal has been progressively eroded, and how the clock is being turned back to pre-NHS days, when health care was a commodity, fully available only to those with money. How this has come about to the point where even the shrinking core of free NHS hospital services is being handed over to private providers at the taxpayers’ expenseis still not widely understood, hidden behind slogans like “care in the community,” “diversity” and “local ownership.”

Allyson Pollock demystifies these terms, and in doing so presents a clear and powerful analysis of the transition from a comprehensive and universal service to New Labour’s “mixed economy of health care,” in which hospitals with foundation status, loosely supervised by an independent regulator, will be run on largely market principles. The NHS remains popular, Pollock argues, precisely because it created the “freedom from fear” that its founders promised, and because its integrated, non-commercial character meant low costs and good medical practice. Restoring these values in today’s health service has become an urgent necessity, and this book will be a key resource for everyone wishing to to bring this about.

Genres: Medicine, Nonfiction, Politics, Current Affairs, Medical

272 pages, Hardcover

First published September 1, 2004

About the author

Prof Allyson Pollock is director of the Institute of Health and Society at Newcastle University. She set up and directed research and teaching units at Queen Mary University of London and the University of Edinburgh, establishing some of the UK’s leading undergraduate and postgraduate teaching in global health, and prior to that she was Head of the Public Health Policy Unit at UCL and Director of Research & Development at UCL Hospitals NHS Trust.

She trained in medicine in Scotland and became a consultant in public health medicine in 1991. Her research interests include regulatory science and access to medicines; health service reorganisation, marketisation and PFI / PPPs; and childhood injuries and the epidemiology of trauma.

She is the author of NHS plc and Tackling rugby, and co-author of The New NHS: a guide.

Reviews

[Simon Wood · Rating 5 out of 5]

NEW LABOUR, NEOLIBERALISM AND THE NHS

Despite spending long years in opposition quite rightly defending the NHS, and winning the 1997 election in part on a promise to save it, New Labour developed a set of reforms that brought private interest into the NHS in a manner that went well beyond the already demented dreams of Margaret Thatcher. Allyson Pollocks brilliantly argued and well sourced book describes how this happened, the forces that were behind the "modernisation" policy, and the short term and long-term ramifications of it for the NHS, in a prose that is clear and comprehensible for the general reader.

When the Labour party was voted into office in 1997 there was absolutely no way that the vast majority of those who elected them were voting for this policy of piece-meal break-up and privatisation of the NHS. The Orwellian nature of the language that was used to mask the realities of the "modernisation" project; the plethora of public relations personnel and endless spinning involved; the bullying and cajoling of opponents of the reform (including Allyson Pollock herself) all speak volumes for the lack of any popular mandate. So much for British democracy.

Pollock details the growing effects of "modernisation" on many NHS services including hospitals, GP's, and long term care for the elderly, and makes a cogent case for the negative effects that the marketisations, commodifications, and privatisations have had on the viability of our National Health Service. In short, the private sector wanted, and largely got, a cut of the NHS's revenues to boost their turnover and profits without incurring even a minimal amount of risk. In a way it is rather reminiscent of the cost-plus contracts that the Bush administration awarded by the bucket load in Iraq. The whole edifice has undoubtedly been kept on it's feet by the increase in funding for the NHS - God alone knows what will happen as public spending stagnates in the coming years?

"NHS plc" is a damning indictment of the New Labour project, and contains more commitment to public service than Blair, Brown, et al exhibited in their thirteen years of power. Well recommended and vital reading.

[Gill Mclauchlan · Rating 4 out of 5]

Good read, but market in the NHS has evolved further since 2005 when this book was published. It was good to see how it all began, reflect where we are now and think what the NHS will look like 20 years from now. it is interesting to see which policy agendas, personalities and health care models are leading today's health system.

[Aurélien Thomas · Rating 4 out of 5]

Have you ever wondered why the NHS got so messed up despite all the taxpayers' money being thrown at it and, all the politicians' babbling to supposedly reform it? Well here we are: Allyson Pollock's book tells the baffling, shocking and scandalous saga of the NHS betrayal, if not programmed downfall. Starting timidly with the privatisation of its ancillary services in the 1980s, she tells how the system has gone completely mad once the internal market's logic has been introduced and pushed forward with full force (if without our consent) in all its crucial aspects -from the buildings of hospital to some clinical care and, even, long term care. Reflecting the triumph of our management and business culture (perhaps relevant in the private sector, certainly not when it comes to such an important right as health care services) health has slowly been taken away from concerned professionals, to be entrusted into the hand of profits obsessed economists (bureaucrats, consultants and other venture capitalists) whose thinking is aeons away from what Bevan's ideal was all about. Thus, suffering under burdening and costly administrations, hospitals are now run like supermarkets, health turning into a 'commodity to be bought, rather than a right', with all the disastrous consequences it has -unequal access to services of disparaging qualities, terrible impact on its frontline staff, costly for taxpayers etc. Surely, some will find it easy to dismiss such a book as being politically driven (she bangs mercilessly on New Labour's policies) or, mock her concerns regarding the potential derives and abuses to come. Yet, well researched, fully detailed and clearly referenced, the whole paints a damning picture of the inefficiencies of a whole system that, anyone who has been involved with the NHS, even as a simple patient, will relate to in some way or other. About, some chapters make for a powerful and revolting read, like the ones dedicated to long term care and, how more elderlies are being treated. It's a tough read but, absolutely necessary to anyone wishing to understand how the dismantling and growing privatisation of most of the NHS has been leading to the failing of many of us in one of our basic right: access to a decent and efficient health service when needed.