In 2012 the Health and Care Act took away the Government’s ultimate responsibility to provide an NHS for all. That opened the way to changing the way the NHS was managed and allowed NHS trusts to contract out services to private providers.
What has the NHS ever done for us?
When the NHS was first launched in 1948 it was described and defined to the UK public thus:
“It will provide you with all medical, dental and nursing care. Everyone - rich or poor, man, woman or child-can use it or any part of it. There are no charges, except for a few special items. There are no insurance qualifications. But it is not a "charity". You are all paying for it, mainly as tax payers, and it will relieve your money worries in time of illness.”
Meaning that the NHS is:
- Obliged to fulfil all health needs
- Available to all
- Free at the point of use
- Not an insurance-based system
- Paid for by tax-payers.
Methods of privatisation
While attacks on the basic tenets of the NHS have been made since its inception, attempts to privatise the NHS have occurred in recent years in the following ways:
- Removing duties of government to provide NHS services through the Health and Social Care Act 2012
- The tendering of contracts for services, and making them available to private companies
- Private financing, such as PFIs, with no guarantee hospitals paid for in this way will be in public ownership when they are paid off with tax payer money.
- Inclusion of health and patient data in trade deals
- Sending patients to private hospitals
- Migrant charging.
Is privatisation of the NHS expanding?
Attempts have been made to introduce charging in the NHS since it was founded, and attempts to further privatise services have been ongoing since the 80s and 90s. This era saw hospital car parks, cleaning, portering and catering.
PFI was introduced in the 90s, but it was the 2012 Health and Social Care Act that has opened up the NHS to privatisation like never before. It was this Parliamentary Act that demanded all NHS contracts were put on the ‘open market’ for the first time. The changes since then have been dramatic, and often unseen.
While most hospital clinical care is still in public NHS hands many are unaware of the inroads privatisation has made in winning smaller community contracts since the 2012 Act came into force. In 2018/19 and 2017/18 7.3% of CCG commissioned clinical contracts were in private hands (down from 7.7% 2016/17).
In the five years to 2015 the private sector was awarded the following:
- 86% pharmacy contracts
- 83% patient transport contracts
- 76% diagnostics contracts
- 69% GP out of hours
- 45% community health contracts including children and AWLD
- 25% mental health contracts
Next section: Private Finance Initiatives
In this section Keep Our NHS Public has created a number of articles to help you explore the different ways the NHS is being privatised.
You can find a summary of these on our page: How is the NHS being privatised?
Read in more detail about the different mechanisms being used to privatise the NHS:
- Public Finance Initiatives
- Health and Social Care Act 2012
- Cuts and underfunding
- Cuts and underfunding
- Outsourcing staff
- Migrant charging
- Trade deals and data privacy
- Integrated Care Systems
- Private hospital beds
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