England, Wales and Scotland section of International Socialist Alternative

Tory Health Bill: further privatisation on the agenda

The Tory government has announced that the NHS in England is to be reformed so health and care services can work more closely together. A closer look at the available detail tells a different story.

This white paper is a power grab by ministers, further reducing democratic control over services by proposing to remove all local health scrutiny powers from local councils and will consolidate and encourage privatisation, as we have recently seen with the scandal of contracts issued to private companies during the pandemic. This will give big multinational health companies a way to access a seat at the top table where decisions about national contracting out of health services can be made.

There will be no extra funding for social care and health services, which have been devastated by over a decade of austerity. This new legislation seems to be aimed at delegating responsibility for the next round of cuts to the proposed ‘Integrated Care Systems’ (ICS). These local bodies will be tasked with doling out the misery, especially in the areas hardest hit by austerity, where there was already a deepening health emergency even before the pandemic. NHS and Local Government will pool their diminishing resources to deal with the crisis.

The Labour Party have done nothing but question the timing of the announcement, during a pandemic, rather than the substance, the profit driven ideology behind it and the lack of funding detailed in the legislation.

Tory Ministers say the changes will put the NHS in a better position to cope with an ageing population and a rise in people with complex health conditions. One-in-three patients admitted to hospital as an emergency have five or more health conditions, such as diabetes, obesity or asthma –  up from one-in-ten a decade ago. These figures are a damning indictment of the previous ten years of Tory austerity policies  – directly linked to the government’s promotion of  the privatisation agenda in Health and Social Care services.

We are facing a period of mass unemployment, where the capitalist system will be unable and unwilling to take the measures necessary to defend jobs, terms and conditions and services. They will look to make working-class communities pay for the economic recession and pandemic. It will mean a deepening of the poverty of many working class areas, already reeling from a decade of Tory attacks, and the proposed ICS will be the new agent for delivering this.

Integrated Care Systems: embedding privatisation 

The plans involve embedding the private sector further in the delivery of services and NHS England has already approved a list of over 80 providers, including many American companies. There will be two ICS boards, one for NHS commissioning and the other an ‘ICS Health and Care Partnership’ board, which would include private companies, but they use the term ‘voluntary and independent sector partners’ to hide their true aims.

We recognise these Tory proposals as more of the same: a continuation of the privatisation agenda in the health and social care sector, further erosion of democratic control and scrutiny and more cuts to vital services.

Nigel Edwards, of the Nuffield Trust (private healthcare provider) think tank, said the changes would be a “re-wiring behind the dashboard” and should not be too noticeable to patients. We do not need more tinkering with “the wiring behind the dashboard”. Big business and big pharma need to be prevented from strengthening their stranglehold on health and social care services.

We can do this by building a mass, national campaign to stop these cuts and attacks, which demands:

  • An end to the attacks of cuts and privatisation
  • Full funding for our health and social care services, with democratic control by workers and service users
  • A decent pay rise for the key workers that are keeping the country going during the pandemic
  • Nationalisation of the pharmaceutical companies under democratic workers’ control and management


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