Matt Hancock's Scrapping Of Public Health England Reignites Debate Over NHS Privatisation

The government has been accused of putting "profiteering and corporate greed" before public health.
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Matt Hancock’s decision to scrap Public Health England in the middle of the coronavirus pandemic has sparked fresh claims the Tories are privatising the NHS and putting “profiteering and corporate greed” over the wellbeing of the nation.

The new National Institute for Health Protection (NIHP) will take in some of PHE’s responsibilities along with the NHS Test and Trace programme and the work of the Joint Biosecurity Centre.

The organisation, headed by Tory peer Dido Harding, will respond to health threats including infectious diseases, pandemics and biological weapons.

But critics fear it will present further opportunities to privatise parts of the NHS despite recent history showing the results of this process can be disastrous.

“It’s immoral for private companies to be making a profit from healthcare and outsourcing and privatisation has done untold damage to the sector,” a spokesperson for campaign group We Own It told HuffPost UK.

“This is hard-wired into the Conservative Party’s DNA, the ideological idea that the public sector is bad, private sector is good and you get significantly more efficiency and expertise in the private sector.

“But what we’ve seen is actually the exact opposite of that is true.”

The NHS – some basics

The NHS was founded in 1948 on the principles that its services should be comprehensive, universal and free at the point of delivery. There are separate and independent systems in England, Wales and Scotland.

It is funded mostly through taxation and national insurance contributions, with a small portion collected through charges to patients, such as paid-for prescriptions. 

The NHS is immensely expensive to run – the total budget allocated for the NHS in England 2018/19, for example, was £126.4bn and nearly 10% of the UK’s gross domestic product (GDP) goes towards healthcare expenditure.

What does privatisation of the NHS actually mean?

Those who raise concerns about the privatisation of the health service are in essence saying they are concerned about how much of these vast sums of money are given to private companies to provide services, rather than being given to NHS bodies.

Why are people against this?

Critics argue that because private companies are driven primarily by profit, they will only take on services that will make them money, and quality of service could be put at risk.

This has been thrown sharply into focus during the coronavirus pandemic as pressure on the NHS mounted to near breaking point and the government looked to the private sector to ease the burden.

The timing of Hancock’s announcement has also raised eyebrows.

Labour MP Claudia Webbe told HuffPost UK: “Abolishing PHE is a desperate attempt to distract from the government’s own abysmal record on the coronavirus.

“There’s been no scrutiny of what they’re doing. They’ve announced it during recess and that is not the way to do things in a transparent manner.

“If this isn’t about privatisation through the back door then why not be open and allow scrutiny.”

What has already been privatised?

Dentistry, optical care and pharmacies have been run by private companies for decades and most GP surgeries are private partnerships.

Both Labour and Conservative governments have outsourced various functions of the NHS to private providers.

2019 study by The King’s Fund estimated that, in 2017/18, about a quarter of the NHS’s budget was spent on the private sector.

But during the coronavirus pandemic, large and crucial parts of the country’s response have been outsourced to private companies with abysmal results.

Despite its name, NHS Test and Trace was largely contracted out to Serco in a deal worth £45.8 million.

The system – which Boris Johnson promised would be “world-beating” – has been a failure and NHS leaders earlier this month said it was not “fit for purpose, let alone world class”.

Shadow health secretary Jon Ashworth, added in a post on Twitter: “Test & Trace isn’t world beating as promised. It’s spent millions on outsourced Serco call centres & private labs when everyone advised them to put local health experts in lead.

“Cash would be more effective if given to local public health. Serco shouldn’t receive a penny more.”

Even the discussions about possible options for Test and Trace was outsourced to a private company.

A reported by the FT, consultancy firm McKinsey was hired for £563,400 to submit a document that outlined the “mission and vision” of a proposed new organisation by the end of June.

In a statement to HuffPost UK, the government defended Test and Trace, saying: “Collaboration with public and private sector partners has been an important part of the pandemic response and helped us rapidly build the largest diagnostic testing network in British history.”

A spokesperson for the Department of Health added: “The NHS is not and never will be for sale.”

What other areas have been outsourced?

A HuffPost UK investigation this week highlighted the “scandalous and shocking” revelations about the way taxpayers’ money was handed out to private firms to produce much-needed PPE in the early days of the pandemic.

Contracts worth millions of pounds were handed out to companies with links to pro-Brexit lobby groups and others with no previous experience of producing what they were paid to make. 

“That demonstrates a clear contempt for our most treasured institution, the NHS,” said Webbe.

“In services essential to human life, profiteering and corporate greed should be off limits.”

Will more be up for grabs?

In relation to the establishment of the NIHP, nothing official has yet been confirmed but when announcing the news this week, Hancock praised partnering with private firms as “the best way through” the pandemic and urged them to “join us”.

“The devil will be in the detail but the real worry is there will be more involvement of companies such as Serco, especially as it’s being billed as a merger of the ‘NHS Test and and Trace system’ which is run by private companies,” We Own It said.

“And with what Hancock said during his announcement, that essentially we’re going to see more and more of PHE’s work being siphoned off to private companies.”