The rest of the world (at least the rest that stick to Western traditions) were celebrating Christmas and the new year over the last couple of weeks but Virgin group CEO Richard Branson was not so idle. The Guardian reported that the group won 267 out of the 381 private contracts on offer in the British National Health Service (NHS) last year, and the report to which we’ve linked makes it pretty clear that not everybody is happy with this.
One group in particular is concerned at the sheer amount of private contracts being issued and what it believes is the increase in private companies involved in the publicly-owned health service. The principle is simple: private profit, various organisations believe, has no place in the NHS.
Has there ever been a wholly publicly-owned NHS?
This is all very well but there are counter-arguments. First, the notion that health should be paid for without thought of private profit is a political comment rather than a logical one. The pragmatist in many will ask: what is the best way to get the service to the end patient, and does it matter that someone should be making a profit if the patient actually benefits?
Much of the response to this will depend on the political and cultural leanings of the speaker (we could imagine American people, who are used to paying insurance whether compulsorily or otherwise, being baffled by the insistence that it’s instinctive or natural to pay out of the public purse for basic healthcare). There are also questions of just how much of the health service actually is owned by the public. The majority of general practitioners or family doctors are not direct employees of the NHS but contractors (the employee population is increasing as this article from the British Medical Journal illustrates but they are still, as far as we can ascertain, a minority). Drug manufacturers and therefore researchers are inevitably privately-held, and the equipment the doctors use to care for people are purchased from private companies.
None of this invalidates the benefits of a population having the right to insist on healthcare as it is paying for it through its tax systems. What we’d really like to see, though, is an honest assessment of what’s actually private now and better general knowledge among the public of how much has always been private; we might then be able to start a discussion on where we go from here based on facts and good judgement rather than near-religious fervour. Keeping as much of it in the private domain might well be the right thing to do – but we’d welcome a debate that told us why rather than just saying it’s “because”.