Yes, we should be terrified of US healthcare firms – but wait till you see what’s happening to the NHS already

Privatising the NHS is wrong. It’s wrong because it wastes billions of pounds of taxpayers’ hard-earned money, it’s wrong because it has been proven to be less efficient, and it’s wrong because services inevitably suffers when costs are cut and profits come before patients.

Privatisation has been on the increase since 2013 when the implementation of the Health and Social Care Act dramatically changed the rules. It became virtually compulsory to contract for clinical services through market tendering and NHS foundation trusts were encouraged to earn up to 49 per cent of income from private sources. A wasteful and costly system of commissioning has expanded NHS running costs by at least £4.5-10bn per year.

Although it isn’t all doom and gloom, the threat of privatisation and the scale at which it is increasing is very real. Seven per cent of NHS clinical services that commissioners’ contract for are now held by private providers. According to the Centre for Health and Public Interest, there are now 53,000 contracts with the private sector. The amount the NHS spends on the private sector is increasing all the time – it is now around £10bn a year.

Most of these are smaller community and support services contracts. In the five years to 2015 private providers have been handed: 86 per cent of pharmacy contracts, 83 per cent patient of transport contracts, 76 per cent of diagnostics contracts, 25 per cent of mental health contracts, 69 per cent of GP out of hours and 45 per cent of community health contracts. PFI annual repayments are £2bn on £11bn worth of contracts for new hospitals, estimated to cost £80bn over the lifetime of the payment.

Private companies are notoriously unreliable. They have a history of walking away from failed contracts, leaving the NHS to pick up the pieces (and the bill). Carillion famously went bust in January 2018 leaving £900m in debt and two hospitals half-built.

And they sue the NHS when they can’t get their own way. Virgin notably settled out of court in Surrey for £2m when their contract was not renewed. Private companies are a threat to the financial stability of the NHS – once they get their foot in the door, it is very hard to shift them without hefty penalties.

This government are the happy enablers of an insurance-based system, regardless of what Trump decides he wants to do. The offer of a deal appears to be there. The prime minister has repeatedly refused to rule out a US trade deal to include the NHS, and why would she?

For all his talk of “no privatisation on my watch” her own health secretary Matt Hancock has still recently presided over £127m worth of privatisation and has links to educational charity and think tank, the Institute of Economic Affairs who openly advocate for the demise of a public system.

We cannot trust a government who have underfunded and understaffed the NHS for the past 9 years not to use the NHS, this jewel in our crown, as a cheap bargaining chip in order to curry favour with Donald Trump; just as we clearly cannot trust them to be straight with us about the true extent of privatisation happening right now in our own back yard.

I was an NHS doctor for 40 years. I believe then and now in the right of good quality healthcare for all, regardless of background or ability to pay. It is heartbreaking to watch the NHS that I know and love run down and neglected by a government that prioritises business interests over the needs of patients and staff. And it’s tragic that this neglect will naturally result in increased opportunities for private entities to profit from sky-high waiting lists and a lack of beds.

With the impact of underfunding and 100,000 staff vacancies, many wealthier patients are now choosing to opt for private healthcare whilst the poorer must suffer in silence. The two-tier health system has already arrived – the more patients continue to access private medical care as an alternative, the more the issues of underfunding in the NHS will go largely unaddressed.

It sickens me that corporations are rubbing their hands together over a system where NHS hospitals must outsource elective operations due to a lack of beds and staff. With people on the surgical waiting list heading towards 5 million, now 30 per cent of private hospital income comes from the NHS, and without drastic action this will only rise.

Trump’s American corporations pose a threat we should rally against, but they aren’t the only ones who want to get their hands on our NHS. There are real and increasing threats closer to home, ones that pass by under the radar without the pomp and ceremony of a state visit, but ones that are just as real, and just as damaging to the future of a public system.

Tony O’Sullivan is a retired consultant paediatrician and co-chair of Keep Our NHS Public – an organisation that campaigns against cuts, closures and privatisation in the NHS