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The Health and Care Bill will accelerate NHS privatisation – it must be scrapped

Dr Julia Grace Patterson

Dr Julia Grace Patterson

4 min read

Patients do not benefit from NHS service fragmentation, which creates postcode lotteries and inequitable care. We deserve an ambitious vision for the NHS which truly holds patients’ needs as the central priority.

When the proposed Health and Care Bill was announced in February, it was described as a way to “support recovery from the pandemic” and act in ways which will “support our NHS...and lead to direct benefits for patients”. This framing of the Bill, as a support mechanism to new problems facing the NHS as a result of an unprecedented pandemic, is false.

We do indeed have a struggling NHS, a struggling workforce with almost 84,000 staff vacancies, and millions of patients waiting too long for treatment. However, after a decade of government-led NHS cuts in the name of austerity, none of these issues are new.

What will be new, should the Bill pass, is a proliferation of privatisation within the NHS. Private healthcare providers will be introduced with greater ease, allowing profits to be skimmed from provision of public healthcare, and the introduction of these private providers will further fragment and weaken the structure of the NHS. This Bill must be scrapped, and politicians from all parties should re-imagine an honest, ambitious vision for the NHS which truly holds patients’ needs as the central priority. 

Private health companies will play a part in deciding how to spend NHS money

There are numerous concerns with the Health and Care Bill, which have been articulated by many NHS campaign groups in recent months. One is the lack of sufficient focus on the NHS workforce. The Bill does contain a requirement for the Secretary of State to publish a report about the NHS workforce at least once every 5 years. However, this focus will be wholly insufficient given the magnitude of the current NHS staffing crisis; the lack of support for current staff and the complexities of recruitment.

In addition, the proposed Bill seemingly offers the Secretary of State for Health and Social Care a significant degree of control over local NHS decisions. There are concerns that this will both lead to inefficient decision-making and remove mechanisms of local governance which currently exist. However, arguably the most impactful element of this Bill exists not in the outlined deliverables, but instead the overarching aims outlined in the White Paper.

The White Paper informed us that this Bill will “remove much of the transactional bureaucracy” and “set aside bureaucratic rules” within the NHS. These sweeping statements caused concern for campaigners in February, and for good reason. It is apparent from the Health and Care Bill that it will be possible for the newly-formed “Integrated Care Boards” to award and extend contracts for healthcare services of unlimited value, without advertising, including to private companies. Private health companies will be able to be members of these Integrated Care Boards, and will play a part in deciding how to spend NHS money. Money which has come from the taxpayer.

Parliamentary process rightly allows for scrutiny of detail and amendments as the Bill passes through each stage. However, fine-tuning the intricacies of this Bill will not tackle the root of the problem. Profit-making companies have no place in the NHS. Patients do not benefit from PFI debt, which eats into public-spending budgets. Patients do not benefit from NHS service fragmentation, which creates postcode lotteries and inequitable care. And patients will not benefit from a system which has had checks and balances removed. Transparency, scrutiny, and accountability are absolutely essential in a well-run public healthcare system.

Having scrutinised this Bill, EveryDoctor does not think that amendments are sufficient; this Bill must be scrapped in its entirety.

Privatisation has been creeping into the NHS for decades, and this Bill will accelerate it. We believe that the NHS should be brought back to the bold vision of its inception; a re-nationalised, centrally funded health service with no private companies either acting as stakeholders or profiting from the delivery of public healthcare. A system which supports staff and enables them to care for patients well. Over 8000 of our supporters have called upon their MPs in the past 24 hours to resist the progression of the Health and Care Bill. NHS staff and patients deserve better.


Dr Julia Grace Patterson is the Chief Executive of Every Doctor UK. 

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