With the Conservatives facing what is set to be a disastrous result at the next general election, the Labour Party is positioned to take over government after fourteen years of Tory administration.
Despite this, the state of crisis Britain finds itself in will not show significant improvement.
Already, before even entering government, Labour under Keir Starmer has fully rid itself of any semblance of anything even slightly progressive or at all associated with the Corbyn-era, purporting to be a party of business and ‘law and order’. This is seen more subtly in the recent Financial Times interview with the shadow health secretary Wes Streeting.
The NHS in the last number of years has seen a great decline in quality of service. Streeting himself comments on the long waiting lists, shortage of both technology and staff, and the “actually appalling” speeds at which the NHS processes and utilises patient data.
Luckily, he promises a greatly improved health service should Labour be elected, with funding for all the required staff and new technologies necessary to improve care quality and slash wait times. He addresses the concerns over privatisation and even promises such improved quality and efficiency that ‘the public never need go private’.
But of course such funding will not be easily given as Streeting also promises ‘ruthless pragmatism’. On the surface, this pragmatism is presented as a reasonable approach, being mainly focused on the rollout and adoption of new technologies which will help achieve his promises of an improved service.
Of course the reality of what this ruthless pragmatism will entail quickly becomes clear. Streeting pre-emptively attempts to shift blame, arguing that those concerned about the use of the private sector in the health service should focus their energy on the doctors who choose to work privately rather than publicly.
The required roll out of new technologies would require an increase in the private sector’s already existing role within the NHS. There is already a significant number of public-private partnerships (PPPs) – over 130 already such projects – with the interview showcasing the use of Google’s Deep-Mind AI project to scan retinal images.
This example suits Streeting well as it demonstrates his vision of private sector technologies assisting the NHS in improving its services. An issue for this is what he views as the unorganised nature of the NHS when it comes to the preexisting PPPs.
The interview mentions how many companies are ‘”frustrated by having to deal with multiple NHS entities to get their products or solutions” into the service, with Streeting commenting that these companies should not have to “tout wares from trust to trust”. To achieve his promises for the NHS, they will need to create a “single front door” for private investment so they can easily access the entire system.
It is here where the reality of his vision starts to become clear. While he focuses entirely on the integration of new technologies, the extent of even pre-existing PPPs goes beyond a few specialised technologies, from the design, construction and maintenance of entire hospitals to the planning of departments and management.
While Streeting may focus on just the use of new technologies, there are no guarantees of how this “single front door” for capital will be used by the private sector to further entrench itself within the NHS.
This becomes especially concerning when you take into account Labour’s £2.6 billion ‘blackhole’ in its budget required to meet its promises once in government. Thanks to the very rational nature of the bourgeois democracy, Labour can no longer use their ‘flagship policy’ of closing a tax loophole which was ‘nabbed’ by the Tories, leaving Labour with a lacking budget.
Of course under a capitalist system this would be simply resolved with further austerity, but with Streeting’s “ruthless pragmatism” in forcing these changes on the NHS in order for them to secure funding, it would mean either a private sector encroachment far beyond just technology or a further lack of NHS funding, or both.
In practice this would gradually make the NHS ever more dependent on the private sector across all aspects of the system, turning it into what is essentially a giant subsidy for transferring public money into private hands, as fell as laying the foundations and justifications of privatising the entire system when the service’s lack of funding and private sector dependence reaches a tipping point.
Thatcher’s claim that New Labour was her greatest achievement is clearer than ever in Starmer’s Labour, and this interview demonstrates that perfectly. While promising not only to keep it public but to improve the service, the methods Streeting proposes involves the strengthening of the existing hold the private sector has and paves the way for these new encroachments and foundations for eventual privatisation.
Streeting’s real ultimatum to the public in the interview is clear: if you want healthcare, you must accept these foundations, you must come to terms with the further withering of public services.