Published in Kensington, Chelsea & Westminster Today (March 2016)
‘Infrastructure’ is a polite word for services that we the public own or once owned – hospitals, schools, railways, utilities. Last year I spoke to a Big Beast of the debt markets. He’d started an infrastructure financing company, the kind that feeds off the publicly-owned assets and services handed over to the private sector by successive UK governments. I wanted an insider’s perspective on the crippling costs of the Private Finance Initiative (PFI) hospital projects that have landed the taxpayer with debt repayment costs of £80 billion on private sector investments in the NHS of only £11.6 billion.
For the private investor/financier this is a lot more lucrative than investing in the stockmarket and it’s low-risk given the consistent demand for healthcare. But for the taxpayer the PFI debt repayments are far higher than for State financing of the NHS. Tory and Labour governments wanted ‘experts’, the Big Beast explained confidently; “It’s the old story that if a government drives a business it will drive it into bankruptcy. Governments don’t know how to run projects.” As for the taxpayer? “You’re stuck with it. You can’t get out of it. That’s the beauty of the capitalist system! There’s always somebody on the right side of the trade and somebody on the wrong side!” he concluded brightly.
The PFIs are just part of the government’s ongoing dismantling of the NHS and the surrendering of its profitable services and assets to private companies such as Virgin, Serco and US giant United Health who hide behind the NHS logo. Valuable NHS buildings and land are being sold off to property developers, often as a result of the exorbitant costs of paying for new hospitals built under PFI.
But privatised services cost the NHS and taxpayer far more than when provided by our publicly-owned and publicly-run NHS. That’s because public health systems don’t seek profits. They don’t need to pay dividends to shareholders. They don’t have the management fees that private companies charge. And they don’t have the added costs of private sector borrowings. The State can finance at lower interest rates, even at near zero rates if they deploy ‘quantitative easing’, the money-printing scheme with which they’ve bailed out the bust banks.
A public NHS also doesn’t have the huge marketing and contract administration costs using extra lawyers, accountants, consultants and management that privatisation incurs. A conservative estimate puts these at £4.5 billion annually and rising. The Shaping A Healthier Future (SaHF) plans for ‘reshaping’ our local health and care services involve mega business consultants like US corporate squid McKinsey who are being used to oversee NHS privatisation. The costs of the SaHF plans have escalated from £112 million in 2012 to £1 billion, including spiralling consultancy and management fees, according to the recently published Mansfield Commission report on NW London healthcare. Just cutting costs like these, not NHS services, would go a long way to cover the shortfall between government underfunding and the needs of the NHS over the next 5 years. Our local hospitals would not need the SaHF cuts in staff, beds and services, the A & E closures, the selling-off of their buildings and the desertion of doctors, nurses and GPs from a public service whose vocational work we rely on and cherish.
NHS services – including A & E, maternity and provision for children and the elderly – have been deliberately underfunded since 2010. The comprehensive care we’ve had continues to be cut back. The huge commercial costs and the chaos caused by the ongoing NHS fragmentation are the direct result of privatisation and a stark refutation of the Big Beast’s claims of the free market’s superior efficiency. This is endangering the quality and safety of our public healthcare. NHS privatisation isn’t just bad for our pockets. It’s bad for our health.
It’s also bad for other services, assets and amenities which we value for their benefits to our society and communities across the social spectrum – the BBC, schools, social housing, libraries, public spaces. These are actually our services and our assets. We the public own them. And they’re being handed over to the private sector without a proper mandate from us, even when there is clear support for their public ownership – polls repeatedly show that most of us want to keep our NHS.
That’s why protesters and campaign groups need to band together to oppose the onslaught of the privatisers with their schemes for the NHS, the Paddington Pole/Shard 2, Chelsea Crossrail and public housing. Central & West London Action/CAWLA (www.cawla.wordpress.com) is a Chelsea and Fulham 38 Degrees Group initiative providing a non-party forum for combined public actions on key local issues.
38 Degrees HQ say that the NHS is their members’ major issue. Campaigners are rallying to the NHS Reinstatement Bill (www.nhsbill2015.org) which provides the legislation needed to remove the costs and waste of privatisation and to restore the NHS as a publicly-funded and publicly-run NHS. Green MP Caroline Lucas has presented it to Parliament with the cross-party support of 76 MPs. The growing number of objectors to unfettered privatisation can sign the 38 Degrees petition Support The NHS Reinstatement Bill To Bring Back Our NHS. They can pressure their MPs to support the Bill and to act on other issues which matter to them. They can take their resistance to the streets, council chambers, privatisers HQ’s and mayoral hustings. The Skyline Campaign’s recent success in obstructing the Paddington Pole/Shard 2 plans shows that people power can have an effect. Don’t just seethe. Do something!