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Editorial: The Health & Care Bill can be beaten if Labour is bold enough

PETITIONS NHS staff and campaigners presented to the government today calling for an end to NHS privatisation have been signed by over 300,000 people.

Trade unions rallying outside Parliament to oppose the Health and Care Bill speak for hundreds of thousands of staff while the stellar cast of public figures backing the campaign speaks to the unique place that defence of the NHS holds in public consciousness — especially almost two years into a global pandemic.

It is vital that Labour doesn’t just use this opportunity to hammer the government’s Bill — it must push back against a decades-long trend of privatisation and outsourcing.

It’s therefore welcome that shadow health secretary Jonathan Ashworth’s article on LabourList today points out that “there are no safeguards in the government’s plans to prevent private involvement in healthcare.” 

It’s significant because Labour’s record on NHS privatisation is not much better than the Tories’: it was Tony Blair’s government that first championed private providers being allowed to deliver services under the NHS brand. 

Ashworth’s acknowledgement that “private involvement in healthcare” undermines the service is testament to the way Jeremy Corbyn’s socialist Labour leadership changed the political conversation in Britain. 

So is the government’s own propaganda on the Bill: even the Tories now recognise the depth of public hostility to NHS privatisation, and depict their reform as about abolishing the wasteful internal market inherited from previous administrations. 

Like so much of this administration’s rhetoric from “levelling up” to climate change, this is not “spin” in the old sense of artful presentation to highlight some aspects of a policy while downplaying others, but more akin to a lie. 

The Bill doesn’t abolish the market by kicking out private-sector delivery: it removes accountability by allowing contracts to be awarded without tendering processes. It fragments NHS England by dividing it into 42 “integrated care systems” and, through allowing these to run independently of each other, risks a postcode lottery when it comes to accessing care. 

Labour’s successes in opposing the Bill’s passage through the Commons – most notably the government’s concession in September that individuals with private healthcare interests will be barred from sitting on integrated care partnership boards – are a sign that ministers realise how incendiary the issue of health privatisation is. 

The Tories have the parliamentary numbers to ignore Labour. They daren’t, because they know a political confrontation in which the opposition is the unambiguous party of renationalisation puts scores of Tory seats in danger.

This is doubly the case if Labour can drive home the connection between privatisation, corruption and the mishandling of the Covid crisis. Ashworth is right to point to the huge sums squandered on private providers during the pandemic. But to build a nationwide campaign strong enough to roll back the legislation it must do more.

One, Labour should make it clear that it is now a party opposed to all private-sector involvement in the NHS. Shadow chancellor Rachel Reeves’s promise to conference that it was the party of “insourcing” should be built into a campaign to raise awareness of just how many NHS services are already in private hands on a hospital-by-hospital and trust-by-trust basis, directly putting pressure on local Tories. It should explicitly distance itself from Blair-era policy in this field.

And two, Labour will not convincingly lead a national NHS campaign unless it can regain the trust of NHS workers. 

In 2019 over 80 per cent of polled NHS workers said they would vote Labour: by the local elections of spring this year, that had fallen to 32 per cent, behind the proportion who planned to vote Conservative (40 per cent). 

A clear commitment to booting out the private contractors will help here, but Labour should also stop trying to second-guess the Tories on pay and throw its weight behind the justified pay demands of health workers’ unions.

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