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227 pages, Kindle Edition
First published January 1, 2015
An interview with Allyson Pollock, professor of public health research and policy at Queen Mary University of London
TARIQ ALI: How can the health service as it stands today resist the forward march of privatization?
ALLYSON POLLOCK: What is happening now in Europe is that we have got neoliberal policies coming from the US. The health care industry has exhausted the funds of America, where healthcare is running at about 18% of GDP, compared with 9 or 10% average in Europe. So the US health care investors need to find new markets, and they are busy attempting to penetrate and open up the health care systems of Europe. And of course the biggest trophy is the UK NHS, because it was for a long time the most socialized of all the health care systems.
So, since devolution, Scotland, Wales and England all have their own health care services. Scotland and Wales, which are very tiny, covering no more than 8 or 9 million people, have retained a national health service. But England, and many people don't realise this, abolished its national health service in 2012 with the Health and Social Care Act. What remains of the NHS is a funding stream, or a government pair, and the NHS has been reduced to a logo. The government is currently accelerating the breakup of what remains of the NHS under public ownership, closing hospitals, closing services, privatising or contracting out.
So just as we heard about how public lands in Liberia and Guinea are being transferred like enclosures to private owners from abroad, the same thing is happening with our public services. Our public facilities are also being enclosed and given over to private-for-profit investors. And this is happening at an extraordinary speed in England. Faster than anywhere else in Europe. And this is a major global neoliberal project.
TARIQ ALI: To privatise health?
AP: Well, to privatise not just the health care system but also ultimately the funding. Now in the US, just under half of that 18% of GDP is actually paid for by the government, but the government is in effect a taxpayer and then channels the money into private-for-profit corporations.
The government in England introduced the Health and Social Care Act because it wanted to open up new funding streams. It wants to reduce the level of services that are available publically, create a climate of discontent with the NHS, forcing the middle classes to go private and pay either out of their pocket or with their health care insurance, so that we desert, we exit what is left.
But at the same time the government is reducing all our entitlements because there is no longer a duty to provide universal health care. That duty, that had been in place since 1948, was abolished in 2012. It means that now government can reduce all the entitlements, reduce everything that is available, and increasingly we are going to have to pay personally or through private health insurance.
And the private health industry is here. They have come here from the US and they are absolutely gearing up through the new structures that the government has put in place to move into private-for-profit health insurance. And actually the new system the government is putting in place is modelled on the US. That will come at a huge loss, and it will also be a public health catastrophe because it will mean that many, many millions will increasingly go with
out care, and of course markets render people invisible, they are not seen. The doctor in front of you only sees the patient that comes to him; he doesn't see the many tens of thousands who are being denied access to health care, which is why doctors are not out on the street campaigning.
But in the UK the doctors are out on the street campaigning [...] you have to use the parallel of the oak tree: it seems to be blooming and flourishing, but the roots have been severed. It can take many months or years for it to completely decay. And once it has gone, these doctors will no longer be there. They'll be like the doctors in the US, interested in themselves, interested in their own pockets and not interested in universal access to healthcare. [...]
Now we do have a solution: we've written an NHS Reinstatement bill [...]
Yes, we question this democracy because it fails to support popular sovereignty: the markets impose decisions for their own benefit and the parties in Parliament are not standing up to this global fact. Neither in our country nor in the European Parliament are they fighting to put an end to financial speculation, whether in currency or in sovereign debt.
Yes, we question this democracy because the parties in power do not look out for the collective good, but for the good of the rich. Because they understand growth as the growth of businessmen's profits, not the growth of social justice, redistribution, public services, access to housing and other necessities. Because the parties in power are concerned only for their continuation in office ... Because no politician has to live with what they legislate for their 'subjects': insecurity, mortgage debt, uncertainty. We question this democracy because it colludes with corruption, allowing politicians to hold a private post at the same time as public office, to profit from privileged information, to step into jobs as business advisors after leaving office, making it very profitable to be a politician.
Yes, we question this democracy because it consists in an absolute delegation of decision-making into the hands of politicians that are nominated in closed lists and to whom we have no access of any kind. Nor is there proportionality between voters and seats. We question this democracy because it is absurd that the only way to 'punish' a party is to vote for another one with which one does not agree. We question this democracy because the parties in power do not even comply with the social provisions of the Constitution: justice is not applied equally, there are no decent jobs or housing for all, foreign-born workers are not treated as citizens. Excuses are not good enough for us. We do not want to choose between actually existing democracy and the dictatorships of the past. We want a different life. Real democracy now!