I sometimes wonder whether some of the Guardian’s regular contributors secretly despise their readers, given how easily they believe obvious nonsense as long as it confirms their fashionable, high-status beliefs. If I were Allyson Pollock, a professor of Public Health at Newcastle University, I certainly would.
Prof Pollock has been writing guest contributions for the Guardian for over twenty years. On the face of it, she has written dozens of articles, but it is really just one single article, which she keeps writing over and over and over again. More specifically, every time there is a major or minor health reform (or sometimes even when there is none), Prof Pollock reliably pops up to claim that it is a Trojan Horse, which will lead to the privatisation of the NHS. Her latest article, on the Health and Care Bill 2021, is no exception:
“The new bill will continue the dismantling of the NHS […] by adopting more features from the US health system. For anyone who cares about the NHS, this should set off alarm bells.”
Now, Prof Pollock is by no means the only writer in the country who has a particular pet obsession, and who sees everything that happens in the world through that lens. Nor is she the only one who keeps repeating a familiar argument. However, in some cases, the mere fact that you keep repeating the same argument over an extended period of time is, in itself, an indication that there must be something fundamentally wrong with that argument.
A privatisation is a one-off process. It can, of course, be spread out over a number of years; for example, the privatisation of British Telecom took over a decade to complete. But even then, it is a process with a well-defined endpoint. You cannot keep privatising the same institution forever. There comes a point when it is – you know – private. We can argue where exactly that point is – no healthcare system is 100% private or 100% public – but there can be no doubt that we are very, very far away from that point. The vast majority of healthcare in the UK is both publicly funded, and publicly provided, and there is no indication that this is currently changing, or is about to change.
So what happened to all those earlier prophecies of the NHS’s imminent privatisation? Prof Pollock already claimed in 2001:
“Labour has continued to sell off NHS hospitals and services with gusto […]
[P]rivatisation […] is now being extended throughout the NHS.”
In 2002, when the Blair government reorganised the healthcare commissioning process, Prof Pollock warned that this would set us on a path towards the US health system:
“The government’s modernisation plans for the NHS have all the hallmarks of the US model […]
If the government persists in […] importing US models of care, they will import the US care crisis and all the inequities which follow.”
In 2003, the New Labour government decided to give some NHS hospitals greater operational autonomy by giving them the status of Foundation Trusts. In response, Prof Pollock wrote an article with the self-explanatory title “Foundation hospitals will kill the NHS – Don’t be fooled by the rhetoric: this is about privatisation”:
“[T]his is simply a fig leaf for privatisation […]
Foundation status is part of a broader pattern of health service privatisation under New Labour. […]
Today MPs will vote on a bill, which, if passed, will effectively privatise NHS hospitals.”
In 2004, she published her book with the, again, unambiguous title NHS plc: The privatisation of our healthcare, in which she argued:
“What is occurring is an accelerating erosion, and increasingly a reversal, of what the NHS was created to achieve: making healthcare a right, and no longer something that could be bought or sold. [p. 15]
With each new insertion of private provision into the NHS the political clout of the private providers increases, and the dominant culture shifts still further into a private enterprise direction, while the structures of national control are being progressively dismantled. [p. 84]”
“Market mechanisms must be abolished. […] If this does not happen, the NHS in England is destined to become no more than a logo attached to a group of corporate chains, while all the old health inequalities and fears return.”
In 2007, Michael Moore’s movie Sicko, an indictment of the US healthcare system, made a big splash. Supporters of the NHS could (and mostly did) use the movie as an occasion for being self-congratulatory about their own preferred system, but Prof Pollock used it as an occasion for issuing yet another privatisation warning:
“The film is very much made for a US audience. Moore does not go into […] the new, privatising project going on here. […] [T]he British government […] is actively trying to remodel the NHS along American lines. All the reforms carried out by the government over the past few years have been aimed at that.”
In 2008, this time for no obvious reason, Prof Pollock wrote:
“Lord Darzi, the unelected health minister, has signalled that Labour will continue to dismantle and privatise the NHS delivery system, its staff and services – handing taxpayers’ funds to multinational companies, and remodelling the service along the lines of US healthcare. […]
Darzi provides the clearest sign yet that Labour is planning to introduce charges for healthcare, crossing the final rubicon of NHS privatisation”
We could easily carry on in the same vein the whole day, perhaps in the format of a pub quiz, in which the reader is presented with a series of Pollock quotes, and has to guess what year they are from. But suffice it to say that a decade and a half after her book NHS plc: The privatisation of our healthcare had predicted the imminent privatisation of the NHS, Pollock went on to publish another book, The End of the NHS: Why the Government Wants to Destroy the Health Service. “The end of the NHS”, as it happens, is reminiscent of the subtitle of an article Pollock wrote in 1993, “The end of health for all?”.
I have no doubt that in a decade’s time, the NHS will still be there – and so will Prof Pollock, still warning us regularly about its imminent demise. Nor do I have any doubt that her readers will continue to lap it up.