Here are some quotes from One Wales, the policy statement agreed by Wales Labour and Plaid Cymru in the new government of the Wales Assembly:
“We firmly reject the privatisation of NHS services or the organisation of such services on market models. We will guarantee public ownership, public funding and public control …We are resolved to keeping the NHS publicly owned, funded and managed… We will move purposefully to end the internal market…We will eliminate the use of private sector hospitals by the NHS in Wales by 2011…We will rule out the use of Private Finance Initiative in the Welsh health service…We will end competitive tendering for NHS cleaning contracts…We will maintain free prescriptions…We will build on existing workforce plans to include all care staff, with a strong emphasis on work-based training to enable individuals to gain qualifications on the basis of their practical skills and to develop those skills further… “
And so on. If Rhodri Morgan had gone into the recent Wales Assembly elections with this programme, and if Tony Blair had not invited himself to come and blight its campaign in the eyes of Welsh voters, Labour might still have a majority. But then we wouldn’t have entered this exciting period of new opportunity, bringing together the real socialists to be found both in both parties, Labour and Plaid. This has thrown some of their more fossilised members and more lickspittle MPs into confusion.
Something similar is happening in Scotland, where the SNP’s new health minister Nicola Sturgeon told the NHS Confederation annual conference:
“Before the election, a poll showed that voters’ top concern was of creeping privatisation of schools and hospitals. The Scottish public expects public money to support public services rather than the private sector. They believe that public services should be delivered by public servants…We reject the very idea that markets in healthcare are the route to improvement. We believe, instead, that it comes through the collective energy and ideas of committed staff, working with patients, and the communities they serve.”
The Labour-Liberal Democrat government in Scotland had already ended the purchaser-provider split, the foundation on which all plans for NHS privatisation rest, but still loudly proclaiming loyalty to Blair and all his works. So, as in Wales, Labour’s traditional voters were determined to teach its representatives a lesson. Proportional representation helped them to do so without handing power to their oldest enemy, the Conservative Party. One party rule is finished in Celtic Britain, and good riddance to it.
Meanwhile, the NHS in England is falling apart. The promise of greater efficiency has not been delivered. The profitable procedures contracted out to private companies have not been profitable enough to satisfy investors, and even after trebling NHS spending, there’s not enough left to pay for the unprofitable emergency and chronic care which the NHS will never be able to evade. A new study by the NHS Commercial Directorate shows that private sector hopes are receding. For the NHS to attract the big multinational corporations Blair wanted, between 450,000 and 500,000 procedures needed to be contracted out from the NHS each year. Even if contracts still under negotiation are included, this figure now seems unlikely to reach even 300,000. This is because most doctors and most patients want to use the local NHS hospitals they know and which operate as public services, not what many see as slick new operators working for profit.
New Labour’s electorally disastrous policy of privatising public services won’t go away by itself. Desperately trying to hang on to private investors with growing doubts about quick profit from this field, government is now subsidising bidders. A disappointed bidder for a Private Finance Initiative contract for work on two hospitals for the North Bristol Trust complained the company would lose millions already spent in preparing its bid. Interviewed by the journal Health Matters, a spokesperson for the Trust said compensation around £6m was being considered to offset this loss. Interest in PFI has been declining steadily over the past three years for similar reasons. To maintain this originally Conservative policy, government must steadily shift the financial risks of competitive investment away from investors back to the taxpayer. This will continue until the policy itself is abandoned.
Wales and Scotland are showing that marketisation of health care and education was not just unprincipled, for leaders who claimed to be socialists, but grossly inefficient, because it assumes that the only reason anyone does anything is to make more money for themselves. This is insulting and demoralising to health workers and teachers. At its worst, it becomes a self-fulfilling prophecy. Above all, it ignores the huge, still largely unused, contributions to health and education which can be made by patients and students themselves, once they feel that these services belong to us all, rather than to remote officials from some other planet. We know this is true, because we see it every day, in the NHS and in schools and universities still struggling to uphold the spirit of public service. In this respect, Wales and Scotland, with their loosened-up parties and politics, promise to become liberated areas. When will England follow?
Dr Julian Tudor Hart, Swansea 2007