The musician and satirist Tom Lehrer famously quipped that satire died the day Henry Kissinger was awarded a Nobel Peace Prize. He might have saved his breath if he had known what was coming. This week, the UK’s Conservative-led coalition government announced plans to export the National Health Service (NHS) brand under the auspices of the private sector in order, supposedly, to raise funds for the NHS at home. The proposals amount to nothing less than the creation of a corporate franchise, using the good name of the NHS and everything it has historically represented – a not-for-profit, socialised healthcare system free at the point of delivery – as the driving force behind a renewed expansion of private sector medical services.
The move comes barely a matter of weeks after Danny Boyle’s pointed tribute to the NHS in the opening ceremony of the London 2012 Olympics, a showpiece event watched by an estimated 900 million people worldwide, and widely lauded as an unqualified success. The director’s tribute was believed to have been intended as a sideswipe at the coalition government, which has targeted the NHS as part of its aggressive programme of public sector cuts. The gesture was warmly received by the general public at home; and obviously someone, somewhere spotted an opportunity. The gall of it is something to behold.
The NHS was founded in 1948 in the face of fierce opposition from the Conservatives. Seven decades later it is, for all its flaws, so popular an institution that no mainstream political party would dare to stand on a platform of earnest, full-scale privatisation. Even the Conservative party, packed though it is with rightwing ideologues who would gladly see the NHS done away with, consistently pays lip service to it in a grudging concession to the popular consensus. Not that this has stopped them from doing their worst: a plethora of private finance initiatives are slowly eating away at the fabric of the institution, which is increasingly taking on the aspect of a public-private hybrid. Indeed, the present proposals are only an extension of existing successful schemes pioneered by Moorfields Eye Hospital and the Great Ormond Street Children’s Hospital.
Despite the risks, it is a comparatively safe bet for the private entrepreneur, who will see their investment effectively securitised by the state. If it works out, a coterie of private management companies, cronies and PR men will stand to make a killing; if it fails, the public will presumably foot the bill. But if this latest initiative represents little more than the continuation of an ongoing agenda – pursued, it has to be said, with almost equal vigour by the Labour governments of Tony Blair and Gordon Brown in the previous decade – the timing is nonetheless instructive. In seeking to cash in on the immense pulling power of the NHS, the technocrats who will make this thing happen are paying an enormous compliment to an institution that reeks of socialism. Its appeal as a ‘brand’ consists in its opposition to everything that neoliberalism stands for – all the more reason, therefore, to seek to exploit that brand and ultimately rob it of all meaning. The Tories cannot kill the NHS outright; they will instead look to re-shape it in their own image. In other words, beyond recognition.
Houman Barekat is a London-based writer and editor of Review 31. He is co-editor, with Mike Gonzalez, of Arms and the People: Popular Movements and the Military from the Paris Commune to the Arab Spring, forthcoming from Pluto Press.