Opinion

The push to privatise Scotland’s NHS was launched today – don’t listen

by | 28 Nov 2023

Right wing figures and commercial interests have wanted to privatise the NHS for ages and former NHS boss Paul Gray kicks off their campaign today. There are very good reasons not to listen.

Today an adviser for a commercial lobbying company went on Scotland’s TV and told us we need to start privatising the NHS faster. Except you didn’t know he was an adviser to a top commercial lobbying firm because he was presented under an old job title.

I’m referring to Paul Gray, who today trotted out the usual right-wing mantra of how you’ll all need to start paying for your own NHS operation and everyone should accept that the NHS as we knew it is sort of at an end. He can do this because for five-and-a-bit years he ran Scotland’s NHS.

Yet it was almost precisely six months after he stepped down that he moved to his new role as adviser to Charlotte Street Partners. I can’t remember but I suspect that is the (ludicrously short) ‘cooling off’ period which is supposed to prevent very well-paid senior civil servants from cashing in on crucial insider knowledge.

But first of all, why should we be listening to Mr Gray anyway? Many of the roots of the crises that the NHS faces now are because of things that he did in his time in charge. Over a decade the number of available beds in Scotland’s NHS was literally decimated (which actually meant ‘reduced by ten per cent’). Most happened when he was boss. We are basically 1,500 beds short in the NHS because of his actions.

Another hangover of this time is the complete failure in sufficient workforce planning for the NHS. It’s not just lack of beds, it’s a lack of medics to care for the people in those beds. The shortage of new doctors coming through right now is a result of the failure to plan the workforce properly then.

I didn’t work in health policy at the time he was there; perhaps he did some other wonderful things. It’s just that the hospitals as they are do not show a lot of evidence of it, but they clearly are breaking under the consequences of his regime.

I’d love to be able to tell you if he’s working for Charlotte Street Partners specifically to help their private healthcare clients privatise the NHS, but I can’t, because I don’t know if they have any or who they are. Because Charlotte Street Partners is the only lobbying company in Scotland that refuses to disclose its clients.

But the rate at which Mr Gray was poached after retirement suggests they certainly thought they’d benefit from insider knowledge. And if they do have those clients, Paul Gray is proving to be a good investment for them.

There are three basic takeaways that I hope you find here, and ‘Paul Gray is a bad man’ is not one of them. I don’t know him; perhaps he’s lovely. Perhaps he even thinks in his own mind that he’s helping the NHS. Nor is the take-away that any of this is illegal – because we made all this stuff legal. As I keep explaining, something doesn’t have to be illegal to be corrupt.

The problem isn’t just resources, it’s the Thatcherisation of the service with its management army, internal market, self-defeating bureaucracy and disempowerment and demoralisation of staff

So the first take-away is that this is yet one other example of those frankly corrupt networks in Scotland. One of my missions in running this website is to try to help you understand how much of what you see happening in Scotland is a result of close relationships between people who are supposed to be working for the public good who work unduly closely people whose best interests are served by working against the public good.

I have tried to explain that this means that those at the upper reaches of the civil service have half an eye on how they’re going to make even more money once they ‘retire’, and that they hold opinions and views that are very markedly different than most of Scotland holds. As I’ve pointed out before, I heard senior civil servants saying that the NHS would need to be privatised 20 years ago.

So is this just a group of people doing that thing of ‘never letting a good crisis go to waste’? It looks to me that there is about to be a big push by the corporate right wing to take the next step of dismantling the NHS as we know it, starting with more ‘co-payment’ and more outsourcing.

Co-payment means paying a chunk of your own treatment. It’ll cost you dearly. What I never hear explain is why that is preferable to raising tax. Is there a reason that we should tax people massively when they get ill to avoid taxing them very moderately all the time?

And please don’t be seduced by the idea that ‘well at least I’ll get better healthcare and it’ll be sustainable’. Is that your experience of dentistry in Scotland? Because co-payments in dentistry were introduced in the 1980s. Things did not get better.

As for outsourcing; that is the whole problem. There aren’t lots of ‘extra’ doctors in the private sector, there’s a lot of NHS doctors moonlighting in the private sector. How does paying them more in the private sector and taking them away from the NHS help the problem? It doesn’t. It makes things much worse.

This isn’t good policy, this is what commercial lobbying looks like. Or simply right-wing, Thatcherite ideology. It’s about to happen in England (Starmer’s health front-bencher is Wes Streeting is miles off to the right of the Labour Party and has been promoting widespread NHS privatisation for many years now). We can still stop this in Scotland.

Because the second take-away from this is that none of this is necessary and none of it is going to help. If the NHS needs more money, co-payment is the worst way to do it. Raise tax. If people are put under severe financial duress when they’re ill, faith in the NHS will collapse. Is that the plan? I suspect it may be. Tax now for a better service.

But before you do, fix the NHS. The problem isn’t just resources, it’s the Thatcherisation of the service with its management army, internal market, self-defeating bureaucracy and disempowerment and demoralisation of staff.

Paul Gray had his chance to save the NHS. Not only did he fail, he made it worse. Common Weal will present a coherent plan for how to get our NHS back to how it should be next year. Until then, don’t listen to Paul Gray.

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