This article was recently written by Dr Julian Tudor Hart.

NHS Wales and Scotland: money-changers dismissed from the temple

Here are some quotes from One Wales, the policy statement agreed 
by Wales Labour and Plaid Cymru in the new government of the 
Wales Assembly:

“We firmly reject the privatisation of NHS services or the 
organisation of such services on market models. We will 
guarantee public ownership, public funding and public control 
…We are resolved to keeping the NHS publicly owned, funded and 
managed… We will move purposefully to end the internal market…We 
will eliminate the use of private sector hospitals by the NHS in 
Wales by 2011…We will rule out the use of Private Finance 
Initiative in the Welsh health service...We will end competitive 
tendering for NHS cleaning contracts…We will maintain free 
prescriptions…We will build on existing workforce plans to 
include all care staff, with a strong emphasis on work-based 
training to enable individuals to gain qualifications on the 
basis of their practical skills and to develop those skills 
further…  “

And so on.  If Rhodri Morgan had gone into the recent Wales 
Assembly elections with this programme, and if Tony Blair had 
not invited himself to come and blight its campaign in the eyes 
of Welsh voters, Labour might still have a majority.  But then 
we wouldn’t have entered this exciting period of new 
opportunity, bringing together the real socialists to be found 
both in both parties, Labour and Plaid.  This has thrown some of 
their more fossilised members and more lickspittle MPs into 
confusion.

Something similar is happening in Scotland, where the SNP’s new 
health minister Nicola Sturgeon told the NHS Confederation 
annual conference:

“Before the election, a poll showed that voters’ top concern was 
of creeping privatisation of schools and hospitals.  The 
Scottish public expects public money to support public services 
rather than the private sector.  They believe that public 
services should be delivered by public servants…We reject the 
very idea that markets in healthcare are the route to 
improvement.  We believe, instead, that it comes through the 
collective energy and ideas of committed staff, working with 
patients, and the communities they serve.”

The Labour-Liberal Democrat government in Scotland had already 
ended the purchaser-provider split, the foundation on which all 
plans for NHS privatisation rest, but still loudly proclaiming 
loyalty to Blair and all his works.  So, as in Wales, Labour’s 
traditional voters were determined to teach its representatives 
a lesson.  Proportional representation helped them to do so 
without handing power to their oldest enemy, the Conservative 
Party.  One party rule is finished in Celtic Britain, and good 
riddance to it.

Meanwhile, the NHS in England is falling apart.  The promise of 
greater efficiency has not been delivered.  The profitable 
procedures contracted out to private companies have not been 
profitable enough to satisfy investors, and even after trebling 
NHS spending, there’s not enough left to pay for the 
unprofitable emergency and chronic care which the NHS will never 
be able to evade.  A new study by the NHS Commercial Directorate 
shows that private sector hopes are receding.  For the NHS to 
attract the big multinational corporations Blair wanted, between 
450,000 and 500,000 procedures needed to be contracted out from 
the NHS each year.  Even if contracts still under negotiation 
are included, this figure now seems unlikely to reach even 
300,000.  This is because most doctors and most patients want to 
use the local NHS hospitals they know and which operate as 
public services, not what many see as slick new operators 
working for profit.

New Labour’s electorally disastrous policy of privatising public 
services won’t go away by itself.  Desperately trying to hang on 
to private investors with growing doubts about quick profit from 
this field, government is now subsidising bidders.  A 
disappointed bidder for a Private Finance Initiative contract 
for work on two hospitals for the North Bristol Trust complained 
the company would lose millions already spent in preparing its 
bid.  Interviewed by the journal Health Matters, a spokesperson 
for the Trust said compensation around £6m was being considered 
to offset this loss.  Interest in PFI has been declining 
steadily over the past three years for similar reasons.  To 
maintain this originally Conservative policy, government must 
steadily shift the financial risks of competitive investment 
away from investors back to the taxpayer.  This will continue 
until the policy itself is abandoned.

Wales and Scotland are showing that marketisation of health care 
and education was not just unprincipled, for leaders who claimed 
to be socialists, but grossly inefficient, because it assumes 
that the only reason anyone does anything is to make more money 
for themselves.  This is insulting and demoralising to health 
workers and teachers.  At its worst, it becomes a 
self-fulfilling prophecy.  Above all, it ignores the huge, still 
largely unused, contributions to health and education which can 
be made by patients and students themselves, once they feel that 
these services belong to us all, rather than to remote officials 
from some other planet.  We know this is true, because we see it 
every day, in the NHS and in schools and universities still 
struggling to uphold the spirit of public service.  In this 
respect, Wales and Scotland, with their loosened-up parties and 
politics, promise to become liberated areas.  When will England 
follow?

Dr Julian Tudor Hart, Swansea