Inside Health
The vultures are cirlcing the NHS so be very afraid, warns Harry Burns
Many years ago, I was invited to speak at a conference at Stanford University in the US. The meeting was being held to discuss the future of the US health system.
I had been invited because of work we had done to improve the outcome of breast cancer care in Glasgow.
One of the organisers was Alain Enthoven who helped Mrs Thatcher introduce the internal market of purchasers, providers and selfgoverning trusts to the NHS. I was introduced by the chairman who expressed his disdain for the NHS by saying, “the UK NHS is an information-free zone except in Glasgow where this guy knows what he is buying”.
I expected a meeting of academics, focused on improving health and well-being of the population. Instead, it was more of a business meeting with most of the delegates being senior managers and politicians.
After two days, I got into the car taking us back to San Francisco Airport with the only other European at the meeting, a medical academic from Maastricht.
As the car pulled away, we looked at each other and said: “What on earth was that all about?"
After much shaking of heads, we agreed that they thought the future of the US healthcare system lay in getting the World Trade Organisation to deregulate healthcare in other countries so that US corporations could tender to run them! We laughed. The EU would never allow that!
Within days of the end of the Brexit transition period, Tory MPS voted to remove protection for the NHS in trade negotiations, overturning a House of Lords amendment that would have provided protection.
The US system, driven as it is by profit, overtreats people and, although it spends more on healthcare than any other country, it has the lowest life expectancy and the highest suicide rate in the OECD group of countries. It also has one of the highest rates of hospitalisations from preventable causes and the highest rate of avoidable deaths. Amongst developed countries, the US has the highest death rate of mothers during childbirth.
The Commonwealth Fund reviews health system performance in developed countries.
It assesses quality, access, efficiency, equity and life expectancy. The UK, Australia and the Netherlands are top performers while the US consistently ranks last of the seven countries reviewed. Why on Earth would we want them running our system?
In the first few months of the Covid outbreak, ministers awarded £1.5 billion of contracts to companies with links to the Tories. The National Audit office has described a "high priority lane" for companies recommended by politicians and officials.
These companies were ten times more likely to win a contract than those not in the priority lane. Could it be that the Tories who voted to put the NHS on the open market see more profit on the horizon for their friends and benefactors?
Obviously, they will deny that the NHS is up for sale or that they will entertain bids from abroad to run the NHS. However, it looks like WTO rules mean they must allow bids from the US if any NHS service has previously been competitively tendered. If that happens, an independent Scotland within the EU will sound very appealing to many more voters.
Sir Harry Burns is a professor at Strathclyde University and a former Chief Medical Officer for Scotland