Going..........Going..........

 In 1970, the singer Joni Mitchell released a song called “Big Yellow Taxi”. It included the lyrics “Don’t it always seem to go that you don’t know what you’ve got till it’s gone.”

The National Health service was formed in 1948, so pre NHS days are remembered by precious few people in the UK.  Prior to 1948 patients were required to pay for their treatment, resulting in huge inequalities in the provision of healthcare, and effectively depriving the poor of access to healthcare altogether. It was a case of pay or die. Aneurin Bevan said “No society can legitimately call itself civilised if a sick person is denied medical aid because of a lack of means.” But it wasn’t long before politicians began to realise, first, that this service was expensive to provide, and second, ripe for corrupt self enrichment.

It was not the only progressive new service to be eyed avariciously in this way. Free education, all the way through to university, introduced in 1962 didn’t last long, being lost in 1998. And it was taken away by a Labour government under Tony Blair. It has resulted in the present situation where graduates start their working life with massive debts to service, up to £100,000. Debts many can never hope to pay off, and which will cripple their standard of living well into later life. Higher education has been privatised, to the detriment of students and the benefit of the providers of loans, accommodation, and even the universities themselves. And it took just 36 years.

Any UK government that overnight privatised healthcare and healthcare funding through private insurance companies would be committing political suicide. The backlash from the public would make the poll tax riots look like a picnic. But there’s more than one way to skin a cat.

The first stage is to reduce public confidence in the NHS. Steady gradual defunding will eventually restrict services and cause dissatisfaction. Applying this principal to staff pay will have the same effect. Repeatedly awarding pay rises below the rate of inflation, even by a small amount will cause a cumulative and ongoing effect which is bound to result in staff unrest when staff eventually realise how much their pay has dropped over the years. Exactly the situation we have today.

This results in governments asserting that the NHS in it’s present form is failing and must be “reformed” in order to maintain services.

The next stage is commoditisation. Not privatisation, but certainly farming off some services to the private sector. Sound familiar? And step by step commoditisation opens the door to full privatisation.

To get an idea of what full blown privatisation of health services looks like we only need to look across the Atlantic. This article is an appalling illustration of what happens when people are not patients, but cash cows. And when doctors themselves are presented with the choice between doing the best for their patients, and riding the gravy train. Spoiler alert, as Bevan knew the best way to overcome the resistance of the medical profession is to “stuff their mouths with gold”.

So the new private hospitals clean up, the massively expanded BUPA, PPP, and others pick and choose who they will cover and the rest can fuck off and die. And the politicians take their bribes beyond the dreams even of their massive avarice.

And the NHS is gone forever, and we finally realise, once it’s gone, what we had.