The business of delivering NHS care is booming apparently, as Virgin Care reportedly did £1billion worth of it in 2017. This is the same Virgin Care of course who, in a move worthy of Mr Burns, also sued the NHS. That is akin to having a one night stand with someone, getting up in the middle of the night to urinate in their airing cupboard, then getting back in to bed as if nothing has happened. The sad thing of course, is that the NHS is probably so desperate, it will call them the next day and ask if they fancy doing it again sometime, even with the smell of heated urine still wafting around the room and assailing its nostrils.
There are other reasons to be uneasy about Virgin having such a big hand in our health care. Richard Branson is a man who famously said “If somebody offers you an amazing opportunity but you are not sure you can do it, say yes - then learn how to do it later”. Thankfully, this is not currently an approach that is favoured amongst the medical profession. I don’t think I’m going out on a limb by saying we should probably keep it that way. No one is going to benefit from someone muddling their way through a kidney transplant reassuring everyone “I mean it’s all just plumbing isn’t it – how hard can it be?”.
Public perception of Virgin will always be coloured by the romantic image cultivated by its flamboyant founder. It’s hard to imagine him being responsible for anything too sinister, as he grins affably like Falkor the Luck Dragon from The Never Ending Story. It’s difficult to say what proportion on that smile is due to the knowledge that, according to previous investigations, Virgin Care hasn’t had to pay a great deal in tax. The company apparently runs at a loss, and its parent company is based in the British Virgin Islands – the place Richard Branson unwinds by kite surfing draped in nude models. One could view operating at a loss one of two ways – either they are genuinely terrible at running a business, or more cynically, it helps minimise the tax bill. Neither of these possibilities is a ringing endorsement for handing them responsibility for healthcare.
This is all against a backdrop of fears (backed by evidence in the form of increased spending) of creeping increases in privatisation in the NHS, despite assurances to the contrary. Perhaps the resurgent Star Wars franchise has inspired Jeremy Hunt. His use of the Jedi Mind Trick of saying something isn’t happening, even when it clearly is, has gone in to overdrive of late. To be fair to him, it does seem to work, and people are apparently (with a few exceptions) happy to let him get away with it.
Is it rational to be quite so afraid of privatisation in the NHS? I will confess to having only a limited grasp of the theory behind the arguments for and against the involvement of private companies in health care in the UK. Instead, a little more empirically, I like to ask the question: “when the word ‘private’ has been associated with public services in the past, how well did that go?”. Virgin’s East Coast train line is being bailed out at a cost of millions (depending on who you ask), and PFI in hospitals led to everyone’s favourite headline grabbing “£333 to change a light bulb” figure. So they’ve been nailing it yeah? Nothing to worry about, clearly.
There is already evidence of private companies doing what you might describe as “less than a bang up job” in the NHS. It’s bad for business to keep doing something difficult that doesn’t make you any money. Unsurprisingly then, companies have tended to stop doing anything tricky or expensive (apparently medicine is supposed to be cheap and easy) – finishing contracts early and leaving others to with the clean up. If only the sick could show the same sort of initiative and stop selfishly staying ill. For now, patients had better just hope that their particular illness is one that it’s possible to get a good return on.
Amongst all of this I think we all need to remember what we truly need to fear. Virgin Trains toilets feature a sign that reads “Please don’t flush nappies, sanitary towels, paper towels, gum, old phones, unpaid bills, junk mail, your ex’s sweater, hopes, dreams or goldfish down this toilet”. This sort of corporate enforced zaniness (see wackaging) may prove to be the straw that breaks the camels back when it comes to morale. Struggling services in the NHS run on the goodwill of staff, often staying late and working beyond their remit. This may be a little less forthcoming when it is replaced. Who knows what will prove to be affordable (read profitable) then.