Don't be fooled, Matt Hancock will be no better for the NHS than Jeremy Hunt was
A huge apparatus of the corporate and financial elite has hijacked policy making. The hollowing out and co-opting of democratic institutions is one of the ghastly legacies of neoliberalism
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Your support makes all the difference.Jeremy Hunt became a lightning rod for the medical profession’s dissatisfaction and the wider public’s disgruntlement with an NHS pushed to breaking point. He has departed following the announcement of a £20bn NHS birthday funding package and will hope that this enhances his legacy as the longest serving health secretary.
Labour shadow health secretary Jonathan Ashworth took a different view tweeting that Hunt’s toxic legacy includes £9bn of NHS privatisation, 4 million on waiting lists, 100,000 staff vacancies and A&E in a “humanitarian crisis”.
As I wrote last week, the funding package comes with strings attached to a US-style model of accountable/integrated healthcare, with the danger of carving up health and social care multibillion pound 10- to 15-year contracts for private healthcare and insurance companies.
Hunt promoted patient safety as his obsession. And yet since 2010, there have been 120,000 excess deaths in health and social care linked to austerity. In 2015 alone, there were 30,000 excess deaths with the likely main cause being health and social care system failures linked to cuts. Cuts and privatisation are not exactly a recipe for patient safety.
It is likely that Hunt will be remembered for precipitating the junior doctors’ strikes over the imposition of a new contract. Undoubtedly some will have celebrated the departure of Hunt. Don’t be fooled, Hunt was merely a figurehead. His new replacement Matt Hancock is likely to be no better.
Hancock has already waded into controversy over £32,000 in donations from Neil Record – the current chairman of right-wing think tank the Institute of Economic Affairs (IEA) appointed in 2015 after seven years on its board. The IEA describes itself as the original free market think tank. It was instrumental in the emergence of neoliberalism – the free market orthodoxy entailing deregulation, financialisation, privatisation and shrinking the public sector.
Its head of health and welfare Kristian Niemitz is in favour of NHS privatisation and its replacement with an insurance system. Only last week, Kate Andrews from the IEA recorded a video (to coincide with the NHS birthday) for BBC Newsnight arguing for the overhaul of the NHS.
Hancock voted in favour of the Lansley Health and Social Care Act 2012, which has led to NHS outsourcing to the private sector doubling from 4 per cent to 8 per cent between 2009-10 and 2015-16. He also voted in favour of removing limits on how much foundation trust hospitals could earn through private patient income. This little known provision in the Lansley Act means that hospitals are legally enabled to make up to half their income from private patients.
The Lansley Act devolved the control of the NHS to bodies, such as NHS England. If any single person is responsible for the NHS, then it is Simon Stevens, the chief executive of NHS England.
Stevens was health adviser to New Labour health secretary Alan Milburn and then Tony Blair. He was described by the Financial Times as one of the architects of NHS marketisation. Stevens helped expand the limited internal market into an extensive market through public-private partnerships, such as the Private Finance Initiative (PFI), and the expansion of outsourcing in clinical services.
He swished through the revolving door to work for the best part of a decade as a senior executive for UnitedHealth – the largest American private healthcare and insurance corporation. In 2013, he was appointed as chief executive of NHS England.
The Stevens career arc is only part of a much bigger story – the corporate capture of democracy through the revolving door, the encirclement of Westminster by lobbyists and the outsourcing of policy to think tanks. A huge apparatus of the corporate and financial elite has hijacked policy making. The hollowing out and co-opting of democratic institutions is one of the ghastly legacies of neoliberalism.
As a result, big banks – caught red-handed in one nefarious scandal after another – have financed (and in some cases effectively own) NHS hospitals. They are profiting from over £300 billion of PFI debt for the entire UK. Big three management consultancies help write health policy. Big four accountancy firms are paid millions to restructure NHS services through a massive programme of cuts and closures. The creation of chains of super hospitals and networks of GP surgeries paves the way for potential private equity and hedge fund takeovers.
Don’t be fooled, the replacement of Hunt with Hancock merely represents a changing of the guard.
A new, updated and expanded edition of 'How to Dismantle the NHS in 10 Easy Steps' by Youssef El-Gingihy published by Zero books will be out later this summer
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