Editor: the reader might wonder at the opening paragarph of Mr. Colviles broadside of the NHS. A member of The Gentry opines via a sterotype !
Here’s a very old joke about an Irish yokel giving directions to a tourist: “Well, I wouldn’t start from here.” It’s so old I hesitate to use it. Except that it also happens to be the best possible description of how you’d reform the NHS.
Editor: The NHS has been under attacks by Thaterites and the acolites of her Deity Hayek yet…
An offhand Twitter joke and some pushback I got led me to look up what Hayeks’ The Road to Serfdom says about universal health care. Some interesting stuff on Page 125 of the edition that’s in Google books:
Nor is there any reason why the state should not assist individuals in providing for those common hazards of life against which, because of their uncertainty, few individuals can make adequate provision. Where, as in the case of sickness and accident, neither the desire to avoid such calamities nor the efforts to overcome their consequences are as a rule weakened by the provision of assistance, where, in short, we deal with genuinely insurable risks, the case for the state helping to organise a comprehensive system of social insurance is very strong. There are many points of detail where those wishing to preserve the competitive system and those wishing to supersede it by something different will disagree on the details of such schemes; and it is possible under the name of social insurance to introduce measures which tend to make competition more or less ineffective. But there is no incompatibility in principle between the state providing greater security in this way and the preservation of individual freedom.
What might The Reader make of the above? The Reader in regaled by Mr. Colevile’s remaining 1110 word evaluation of the failures of the NHS. Yet what of the following from 1985?
Britain’s National Health Service (NHS) has encountered difficult times under the government of Prime Minister Margaret Thatcher. A conservative who shares many of the philosophical tenets that guide President Reagan, Thatcher has sought to force the NHS to make tougher choices. She also has told the electorate bluntly that the health service does not represent a free lunch. Thatcher declared herself pointedly in this regard during the Conservative Party’s annual conference in October 1983. “Let us never forget this fundamental truth: the state has no source of money other than the money that people earn themselves…. Let me take the subject on which there has been so much debate —the health service. People talk about a free service. It isn’t free. You have to pay for it.” Nevertheless, Thatcher and her party colleagues, not unlike all successful politicians in the United Kingdom, seem duty-bound not to be seen as attacking the NHS. After her support of it became an issue in 1982, Thatcher declared at the party’s annual conference that year that the service is “safe in our hands”—a comment that helped her win reelection by a landslide. In 1982, the NHS consumed 6.3 percent of Britain’s gross national product, compared with 10.6 percent for personal health services in the United States in the same year. On a per capita basis, medical care expenditures in the United Kingdom were $390 versus $1,265 in the United States. Rudolf Klein, a professor of social policy at the University of Bath, explains in this essay why so socialistic an instrument as the NHS enjoys the support of the Conservative Party. Klein, a former journalist, has written widely on the NHS and is regarded as a leading British commentator on the health service. His recent book, The Politics of the National Health Service , is a primer on the evolution and status of Britain s most popular social program.
The book is the result of a quest by the researcher and author to answer the question: how much of the UK is owned by the USA?
The answer is difficult to answer (the UK government does not keep statistics), but it is possible to piece together because the US government and European governments do.
The purpose is not to reject American values and democracy, which helped us fight two world wars and keep the peace (mostly, in the UK that is) but to act as
“a call to action to stop further transfers of parts of the economy to powerful and unaccountable American owners and to reset Britain on a course for more economic independence”
Hanton points out the dominance of US business in public discourse. When we talk about “big tech” we mean “US tech”. When we talk about private equity we mainly mean US private equity. When we talk about multinationals, it’s in the main US multinationals.
Plus, when we talk about the ‘special relationship’ and partnership he asks ”What sort of partnership is it with the mightiest superpower in history, which holds an overwhelming stake in the UK economy?”
It is a paradox that having rejected the EU as a strategic partner in the name of ‘taking back control’ the UK has willingly foregone control over vast swathes of the UK economy. It is unusual for countries to allow such penetration of their home markets to a single country, located thousands of miles away.
In table 1 of the book, he compares figures about the sales of US multinationals in the UK and other leading European countries. It’s 25% in the UK but only 5-9% in Italy, Spain, France and Germany. The net result is a significant amount of profit is extracted, and repatriated to the US, and tax is routinely avoided on these sales. 1,256 multinationals with sales of over $850m operated in the UK in 2020.
It’s a further paradox that the US itself will oppose other countries buying and owning strategic industries, whereas the UK government has seemingly willingly presided over the sell-off of the UK economy. Ex-Chancellors and prime ministers earn good money by facilitating this according to the book.
When even Joe Biden endorsed putting America First the possible consequences of a further Trump Presidency must surely call for a re-think.
How does this affect the NHS?
This question is answered in a Chapter entitled “the NHS Cash Cow”. It covers how US multinationals maneuvered to obtain the vast majority of Covid funding for its vaccines when cheaper UK vaccines could have been used.
Half of all Covid contracts went to US companies. The contract for PPE storage was given to a US company in 2018 and was sold in April 2020.
According to the sources quoted in the book however, it was not just around Covid that NHS reliance on US suppliers became evident. Tony Blair’s Labour Government started outsourcing elective procedures in 2002 and the aim, according to the book was to increase private provision to up to 40% of operations. The book states that US companies have obtained the lion’s share of these new and existing contracts for this work.
Three of the biggest UK private hospital operations are US-owned, American suppliers now provide one in seven psychiatric beds, diagnostics supplies come from predominantly US Companies, the major drug companies are predominantly American – as are seven of the top ten medical device companies, including Medtronic, DaVita, GE Healthcare, Stryker, Johnson & Johnson and Cardinal Health.
The US Portman Dental Care organisation owns 350 clinics. In IT, Oracle, Palantir, eMed, Apple, Alphabet, and Amazon are poised to scoop up contracts that can never be removed once the supplier is embedded in the business processes of the NHS.
In the words of Hanton,
“It will be easy for these and other companies to click into the NHS network because it has already been reshaped to fit more neatly with American business models”.
This includes preventative overprescribing of drugs, excessive testing, and excessive intervention according to the ability to pay.
…
Editor: Mr. Colvile is a Political Opportunist and Political Romatic infatuated with Mrs. Thatchers romance with her Hayek, made to measure !
Rootless cosmopolitan,down at heels intellectual;would be writer.
'Polemic is a discourse of conflict, whose effect depends on a delicate balance between the requirements of truth and the enticements of anger, the duty to argue and the zest to inflame. Its rhetoric allows, even enforces, a certain figurative licence. Like epitaphs in Johnson’s adage, it is not under oath.'
https://www.lrb.co.uk/v15/n20/perry-anderson/diary
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