Why Did the Tories Pledge to Protect NHS Spending?

Tom has already written an excellent blog on the NHS, but I think it’s important to look in more detail at why the Conservatives pledged to protect NHS spending before the election. After all, it’s a distinctly anti-Conservative standpoint.

Firstly, and most obviously, it is an example of cynical and opportunistic electioneering. It was an attempt to win votes and reassure people they wouldn’t dismantle the NHS. Globally, only the Chinese People’s Liberation Army, Wal-Mart and the Indian Railways employ more people than the NHS – that’s a significant proportion of the franchise and, understandably, they wouldn’t vote for a party that threatened their livelihood.

The second reason is much more Machiavellian. As Labour blogger Hopi Sen highlighted in a blog this week, Cameron pledged there would be “no more pointless re-organisations” of the NHS. Of course the key word here is "pointless" and the implication now is that the current re-organisation is necessary.

Re-organisations – particularly when nearly two million people are involved – cost money. According to the BBC, the Tory re-organisation proposals will cost £1.7bn at least – probably closer to £3bn. Therefore, the Conservatives needed to protect NHS spending, not because of altruism, but to fund their ideologically motivated dismantling of the NHS – something which didn’t appear in their manifesto.

So who will our taxes go to in order to pay for this stealth privatisation? And who will deliver these ‘commissioned’ services? Health Secretary Andrew Lansley seems to suggest that it will be charities, voluntary sector groups and SMEs in what would represent “the largest social enterprise sector in the world". This could work because third sector organisations would no doubt have unparalleled local knowledge and insight, but Lansley’s statement amounts to little more than a hollow promise. The same guarantees were given in Welfare to Work, but it has now emerged that there will be no money available upfront for new contracts and organisations will only be paid on sustainable outcome. This means that small, local organisations – often surviving hand-to-mouth but with peerless local knowledge – cannot bid for Welfare to Work contracts. The inevitable result is that they will be awarded to large, faceless corporations with little regional knowledge and little appreciation of local labour markets. The most third sector organisations can hope for is to be sub-contractors of gargantuan money-making machines – and this will inevitably be the case for the NHS too.

So who will these private health giants be? Organisations like UnitedHealth UK, Tribal Newchurch, Humana, Bupa, Care UK and Aetna UK have already been mentioned. Don’t worry if you haven’t heard about them though, Health Minister Andrew Lansley has been bankrolled by Care UK for some time – so at least they’re familiar to the Conservatives. And in case you’re unaware of the other providers, most are major players in the US – so rest assured our public health service is in safe hands. In fact, Aetna have nearly 200 years experience of providing a range of consumer directed health care insurance products. They even had the foresight to issue life insurance policies to slave-owners covering the lives of their slaves – so they’ll definitely have patients at the centre of their service.

In conclusion, the Conservatives protected NHS spending to bankroll its own demise – like putting aside money in your will to pay for your own funeral. It also means they can use tax payers’ money to line the pockets of private companies. There will always be costs associated with administration, management and bureaucracy – but this will now be executed by the private sector at huge public cost. Whereas a unified NHS can provide necessary services which run at a loss, the private sector is motivated entirely by profit.

The ConDems do not have a mandate for this re-organisation and it should be fought at every stage. If you haven’t already, please sign up to Keep Our NHS Public. Let’s show the Coalition that, unlike their principles, the NHS is not for sale.

Cartoon courtesy of Private Eye