In a factually truthful account of how we have tried to exclude inefficiencies, improve purchasing and delivery, Ian Birrell points out that we have outsourced many services. Many firms, including both domestic, and foreign ones based overseas, make profits from “patients’ misery”. All healthcare for curative services has an element of pain or misery, and once extended to prevention becomes part of the “worried well” psyche prevalent in our affluent society. Anyone would think it was wrong to earn a living or make a profit out of health related services. Does it matter if the profit goes overseas if the provider is more efficient than our own? Should the longer term implications of delegating more and more to overseas businesses be discussed?
The response could not have been clearer when Woody Johnson, US ambassador to Britain, suggested that American firms would want access to the NHS in any post-Brexit trade deal. “The NHS is not for sale,” thundered the health secretary, Matt Hancock. “The NHS as a publicly run, publicly owned institution is part of our DNA,” added his predecessor, Jeremy Hunt, now foreign secretary.
This was a predictable response as political rivals seized on the ambassador’s “terrifying” comments, especially when both men are engaged in a leadership battle. But it is also untrue. Lucrative chunks of the NHS have already been handed to rapacious American healthcare giants with disastrous consequences. And this pair of posturing politicians have done little to thwart them.
Remember Winterbourne View, where the BBC exposed abuse of patients with autism and learning disabilities in a secure hospital unit eight years ago? The response was unequivocal: such people should not be held in these places since community care tends to be cheaper, kinder and more effective. Yet efforts to end such abusive detention failed. For as the NHS pulled out, private firms muscled in on contracts worth up to £14,000 a week, while many staff continue to be paid little more than minimum wage and there is no real accountability.
More than 2,200 such patients remain trapped in assessment and treatment units and the proportion in privately run beds rose from a fifth to more than half in a decade. Acadia, a Tennessee healthcare firm, spent £1.3 billion on the Priory Group, which takes £720 million annually from taxpayers. Universal Health Services, another US firm, recently snapped up psychiatric services including Danshell, owner of a Durham hospital that just featured in another Panorama exposé of abuse. Its UK operations are run by Cygnet Health Care, which having tweeted it was “shocked and deeply saddened by the allegations” nonetheless boasts in its latest accounts of revenues from 220 NHS purchasing bodies and profits surging to £40.4 million.
It is shameful that our fellow citizens can still be stuffed in places where they are subjected to solitary confinement, violent restraint, hatch feeding and forced sedation. The legacy is damaged minds, devastated families, sometimes even death. This scandal offers frightening insight into wider failures in psychiatric services. It is taking place in secretive units — scores of them owned by American firms and funded by the state.
The private sector is not solely to blame. But instead of posing as valiant guardians of the NHS, how much better if we could trust a health secretary to protect patients from foreign firms making profits from their misery.