For a government seemingly incapable of even the most basic public health strategy, so roundly defeated by Covid-19 that Britain has second highest number of coronavirus deaths per capita in Europe, Operation Moonshot sounds like a pipe dream.
The transport secretary has admitted the technology for the ambitious testing programme does not yet exist. Nevertheless, £100bn funding and an aim of testing 10 million people per day by early next year have been announced.
There has been much speculation about whether this is the next experiment in herd immunity, or whether it’s simply a distraction from the grim reality of rising infection and unemployment rates. Given the Tories’ track record, both during the pandemic and long before, whether or not the public ever benefits from Operation Moonshot, the private sector will undoubtably profit.
Last month, Health Secretary Matt Hancock made the surprise announcement that Public Health England – the government body primarily responsible for pandemic response – would be scrapped and replaced by a National Institute for Health Protection (NIHP), drawing NHS Test and Trace and the Joint Biosecurity Centre under its remit.
While it was immediately obvious that the government was making PHE “the fall guy” for its own failures, Labour MPs and Unite, the union representing PHE (and now NIHP) staff, have also warned that this structural reorganisation of public health is a step towards privatisation. Unite national officer for health Jackie Williams said, “We think that the underlying agenda here is the future privatisation of PHE’s national infection service – the Tory government is obsessed with NHS privatisation which has been shown to be highly flawed and not a good use of taxpayers’ money.”
Baroness Dido Harding has been appointed to the top job in NHIP. The Baroness has overseen the outsourced NHS Test and Trace service since its inception in May and has so far failed to deliver a functioning system. Hundreds of millions have been handed to companies such as Serco, Deloitte and Amazon, yet many find the only available test appointments are hundreds of miles away, contract tracing is ineffective and the “world beating” app is yet to be launched. When considering why PHE rather than NHS Test and Trace took the fall for the government’s poor handling of the pandemic, one must consider whether this latest experiment in outsourcing is simply too strategically and ideologically important to fail.
Throughout the course of the pandemic, a critical public health emergency, the Tories’ commitment to bringing the private sector into healthcare has far outstripped their dedication to saving lives. Companies with no assets or experience were contracted to provided PPE to the NHS. In a nationalist twist, British companies were commissioned to design entirely new ventilators, and the opportunity to purchase them from abroad ignored, while people lay dying in hospitals. Issues of data and privacy aside, the government ignored the offer of assistance from Apple and Google in creating a track and trace app, before U-turning months after millions had been wasted on an unusable app.
Successive governments have sought out ways to introduce market competition into the NHS. Thatcher introduced the internal market in 1990 – splitting the NHS into commissioners and providers. While some private sector involvement in – and profiting from – the NHS was introduced by various administrations (e.g. the Blair government’s use of PFI contracts), the internal NHS market was truly opened up to external competition by the Conservatives via the 2012 Health and Social Care Act. This act encouraged competition and allowed private sector providers to tender alongside NHS providers, cherry-picking the most profitable treatments and services and leaving the NHS to provide the rest at a “loss”. The proportion of the NHS budget handed over to the private sector continues to rise, reaching a record £9.2bn in 2018/19. No doubt 2020/21 has already smashed that record.
In the pandemic, the Tories saw an opportunity for the private sector to take on a more significant role in public health and healthcare. Despite repeated failures and colossal waste, they are still committed to outsourcing and privatisation. As NHS campaign group We Own It said in response to the disbanding of PHE, “This is hard-wired into the Conservative Party’s DNA, the ideological idea that the public sector is bad, private sector is good and you get significantly more efficiency and expertise in the private sector. But what we’ve seen is actually the exact opposite of that is true.”
In the hands of the Tory party, the NHS will continue to be undermined and underfunded. It is being sold off piece by piece, under-funded to the point of collapse then blamed for not only its failures but also those of the private companies that hide behind its name.
The NHS pay campaign shows that there are health workers willing to fight, but to halt and reverse the privatisations and internal market, to win the funding necessary to undo the damage of austerity we cannot rely solely on those who work in the NHS. While for the Tories, the pandemic presented an opportunity to further their privatisation agenda, for the workers’ movement it presents an opportunity to campaign to save the institution that has saved so many lives.