Our country has a problem.

The past few years have seen the NHS dominate the headlines. Words like ‘overcrowding’ and ‘understaffing’ have become synonymous with our healthcare system, whilst stories of scandals and negligence seem to be appearing more frequently. Backlogs, excess deaths and insufficient care feel like our new normal. To top it off, the country is now dealing with historic strike action from healthcare staff fed up with substandard working conditions. Short of imploding entirely, things certainly feel as if they couldn’t possibly get any worse


‘Hard Decisions’ Cause Cracks

This isn’t a sudden affliction, even though it might seem like it. We’ve been heading in this direction for a while. Thirteen years, to be precise.

Since coming to power in 2010, the Conservative policy of austerity slashed at any and every public service it could get its hands on. The NHS was not spared. The decade that followed saw the lowest NHS budget since its inception, and that came with very predictable consequences. Lack of investment in buildings, machinery and other capital resulted in outdated and poor-quality infrastructure. Per head, the UK spent 18 per cent less on healthcare than the EU14 average. There was a 27 per cent decrease in the number of people who received social care between 2005/06 and 2013/14. When looked at in isolation, these factors were what the Conservative Party justified as ‘hard decisions’ — tough, but ultimately necessary to repair Britain after the economic crash. The NHS was still, just-about standing.

The only problem is, when you spend ten years chipping away at the foundations of something, all it really needs is a light tap to make it topple completely. And Covid-19 proved to have a mighty swing.

A Clash of Interests?

As things currently stand, we have an institution that’s evidently on its knees. The absence of a robust social care network means that 1 in every 3 hospital beds is occupied by those who are fit to be discharged. A long-term lack of funding means that over 7 million people are stuck in limbo, waiting for treatment. The list goes on and on. Is it any wonder that our nurses are taking a stand and striking? Yet the real issue is that this government doesn’t seem all that bothered.

It comes down to a fundamental clashing of interests. Right-wing politics favours individual control over state intervention. The NHS, on the other hand, is the living embodiment of state intervention, and subsequently relies entirely on the government to survive. But what happens when the ruling government rejects the basic ideals that formed the NHS? Well, you get policies and attitudes that simply do not allow room for a nationalised system to function efficiently. After all, why bother spending money on a national health service when you could do business with the private health sector and receive over £800,000 in donations from them while you’re at it? That’s far more in line with average Tory values. Existence is pointless if it’s unprofitable.

These Conservative-backed private firms have been waiting in the wings for years; watching the NHS be starved and strangled. Now, it’s go-time. Between 2019 and 2022, self-pay admissions into private clinics increased 114 per cent in Wales and 76 per cent in the East Midlands. These figures are only expected to replicate across the country as people become desperate to jump the ever-growing queues and waiting lists. And with the government gladly granting contracts to these for-profit healthcare services and outsourcing more and more work in a pathetic sticking-plaster exercise — instead of fixing the NHS system — the private sector will only grow in power. And what other choice will people have? This isn’t just politics. Access to healthcare is often a life-or-death matter. When your child urgently needs a brain scan to detect a cancerous tumour sitting an inch above his eye, you’re simply not going to accept the weeks or months-long NHS waiting list. No. You’re going to pay through the nose for the same doctor to do it in the same, or different hospital, but in a tenth of the time.

That, to put it bluntly, is how the NHS dies. Once enough people opt out of the service, the ‘universal’ part of universal healthcare ceases to exist. Questions will inevitably arise as to why people have to pay a tax for something they no longer use. The government will note the drop in usage and cut funding accordingly. Less funding will weaken the NHS further — pushing even more people into the arms of private healthcare. And so, the vicious cycle will continue until the British public wake up one day and realise they’ve walked blindly into a two-tier healthcare system. A largely defunct health service that the rich can buy out of and the poor must endure is already in progress.

The Real Threat

As we continue to grapple with the many issues that blight our NHS, it’s important to remain vigilant about what is and isn’t cause for concern. Privatisation per se is not our biggest threat. With the general election approaching, even the most brazen Conservative wouldn’t dare further dismantle the NHS. Indeed, the total collapse of our national healthcare system is not something that we need to worry about — just yet. Rather, it’s the gradual, systematic restructuring of British healthcare as a whole that will have the most profound impact on people’s lives over the coming years.

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