The Dirty War on the NHS

The Dirty War on the National Health Service, written and directed by the BAFTA and Emmy award-winning journalist and film director John Pilger.

The Dirty War on the NHS was first broadcast in Britain on the ITV Network on 17 December, 2019. It was shown following the general election that saw Boris Johnson become prime minister – even though the future of the NHS was a major issue in the campaign, the Tories constantly denied further opening up of the NHS to privatisation and the American private health care system with big Pharma digging into the billions the public fund the NHS with.

The remarkable prescience of the film became clear when the COVID pandemic struck, and the NHS, crippled by bed shortages, the starvation of resources and accelerating privatisation, could not cope. This was the film’s warning – a warning also delivered in 2016 when a full ‘drill’ for a pandemic showed the NHS would barely survive such an emergency. The politicians and managers did nothing; the report of the results of the drill was suppressed.

The ideological assault on the world’s first public health service continued at the height of the COVID crisis with inept private firms given lucrative contracts for PPE and mass testing. The Health Secretary, Matt Hancock, an arch privatiser, announced in August 2020 that in future most GP consultations would be online. Hancock’s association with the tech company, Babylon Health, is dealt with in The Dirty War.

Britain’s National Health Service, the NHS, was the world’s first universal public health service. Designed to give millions of people “freedom from fear”, the NHS today is under threat of being sold off and converted to a free market model inspired by America’s disastrous health insurance system, which results in the death every year of an estimated 45,000 people.

The following review by Jean Shaoul appeared on the World Socialist Website

The Dirty War opens with scenes shot in the US of “patient dumping,” by which patients, discharged from hospital in the middle of the night—one was severely disabled, another had had open heart surgery just nine days earlier—are thrown onto the streets or into some refuge without so much as informing the care workers, much less asking for their consent. It is nothing short of barbaric. This was in order to make way for new patients and additional income.

Switching to Britain, a homeless charity says this is happening here as hospitals need a rapid turnover of patients in order to make a profit.

Pilger shows that the creeping privatisation of the NHS in Britain meant an early death for a worker when a private ambulance came with a non-functioning defibrillator and was unable to contact anyone at the company’s call centre to obtain another. In another case, in which the NHS had subcontracted a surgical procedure to a private hospital, the patient had to be blue lighted [rushed by ambulance] to an NHS hospital because, when things go wrong, the private hospital has no back-up facilities. The writer-director points out that the system designed to give us all “Freedom from Fear” has been attacked by every political party on behalf of big business.

Privatisation by stealth began in the 1980s under Conservative Prime Minister Margaret Thatcher, who commissioned a report from McKinsey’s, the consultants, that led to the creation of the “internal market” in 1991. In 1988, Conservative MPs Oliver Letwin and John Redwood had proposed a switch to an insurance-based system, in a pamphlet titled, “Britain’s Biggest Enterprise: ideas for radical reform of the NHS.”

But it was Tony Blair’s Labour government that set it all in motion with the Private Finance Initiative (PFI), whereby the private sector built, owned and operated hospitals, using private finance. So expensive were these new hospitals, despite being considerably smaller than the ones they replaced, that many other hospitals were closed, and land was sold to pay for them. Despite this, the commissioning trusts were soon in financial distress. Since they could not be allowed to fail, the non-PFI trusts were sacrificed to bail out the PFI hospitals.

After 2010, the “reforms” speeded up. David Cameron’s Conservative-Liberal Democrat coalition escalated the privatisation process, introducing the disastrous 2012 Health and Social Care Act, removing the duty of the Health Secretary to “provide” health care for the population and “freeing up providers to innovate”—that is, opening the door to private healthcare companies and management consultants.

The Dirty War shows privatisation continuing under the Conservative government of Boris Johnson, with Matthew Hancock, the current health secretary, waxing lyrical about a smartphone self-diagnosis app called Babylon: no doubt a mechanism for eliminating whole swathes of GPs and nurses. A Babylon spokesperson has the gall to tell Pilger its diagnoses are “100 percent safe, but not all of the time.”

There is a revolving door between government, public officials and the private health care sector. Alan Milburn, Labour’s Secretary of State for Health, on leaving government in 2013, became chair of PricewaterhouseCoopers’s UK Health Industry Oversight Board, whose purpose is to engineer the privatisation of the NHS, and help PwC increase its share of the “health market.” He also joined the private equity firm Bridgepoint Capital, whose activities include financing private health care companies providing services to the NHS, including Care UK.

In a sign of the NHS’s intended trajectory, its current head is Simon Stevens, who spent 10 years as a senior executive at UnitedHealth Group in the US, becoming CEO of UnitedHealthcare’s $30 billion Medicare business.

Pilger makes clear that the dirty war on the NHS is aimed at giving free rein to the corporate sector, who cannot wait to get their hands on the service’s £120 billion a year funding, with author and Spinwatch campaigner Tamasin Cave describing the NHS as a “£120 billion opportunity” for the powerful healthcare corporations. It will mean a healthcare system that will deliver profits, not treatment and care for those who need it.