Rebuild NHS, roll back contracting-out

Whatever it does elsewhere, the 30 October Budget is set to grant more money to the NHS than the Tories had scheduled.

But the new money will be much less than needed to fix an NHS which Health Minister Wes Streeting himself describes as “broken” after years of being starved of funds since 2010. According to the King’s Fund, the NHS has a £13.8 billion backlog in maintenance of buildings and equipment alone, even before counting the cost of new equipment, new preventive-medicine work, and restoration of NHS workers’ real pay to catch up with inflation and fill vacancies.

Wes Streeting talks of cutting the waiting list — over 7.6 million cases — by contracting out more work to the private sector.

That is unlikely to work even in crude terms. The proportion of total NHS spending on non-NHS care has been about 20% since 2009-10. There has been an uptick since the Covid lockdowns ended, but it is smaller than the increase in private care paid for privately. Private health-care seeks profit, and private payers yield bigger profits to it than NHS patients.

Worrying, the Good Law Project reports that more than 60% of money donated to Streeting since he entered parliament in 2015 has come from firms and people with links to private health.

The largest donations have come from firms run by Peter Hearn, which work on “senior NHS executive recruitment and help private sector providers recruit healthcare professionals”.

Before the election, Labour promised much “in-sourcing” across the public services. The manifesto said Labour would “end the Tories’ ideological drive to privatise our public services... The next Labour government will also examine public services that have been outsourced... Before any service is contracted out, public bodies must carry out a quick and proportionate public interest test, to understand whether that work could not be more effectively done in-house”.

We must demand a comprehensive renewal of the NHS as a public service, publicly-operated.

Private health-care facilities and staff should be requisitioned to rebuild the public service.