HEALTHCARE: The world's first universal public health service, the NHS today is under threat of being sold off and converted to a free market model.
Carmen Gray
Freelance film critic and regular contributor to Modern Times Review.
Published date: April 23, 2020

As the #coronavirus hit the #UK, residents went to their windows and doorsteps to applaud the sacrifices and dedication of healthcare workers in fighting the pandemic in orchestrated «Clap For Our Carers» gestures. But the shows of appreciation were bittersweet, even controversial for many, who realised that true support and valuing of the National Health Service (NHS) has to be evidenced not just in a PR-friendly spectacle of public emotion, but the adequate resourcing and funding that has been lacking so desperately. And that is assured not by claps but political action and votes, as the current #Tory government flirts ever closer to a catastrophic sell-off, and a reformation of Britain’s health system more in line with the American model. #COVID-19 has exposed stark global inequalities and the shortcomings of #capitalism like never before, and the #NHS is no exception, as a system already on its knees due to decades of stealth privatisation and pressure toward its full dismantling struggles to cope with the crisis in a nation on-track to record, uncoincidentally, the highest death toll in #Europe from the virus.

How heartbreaking and fitting, then, to watch John Pilger’s The Dirty War on the NHS during these strange and frightening days. The veteran journalist and documentarian, an unflinching leftist advocate of #social justice#, made the film prior to the global health crisis, which has brought the life-or-death dependence of the population on effective healthcare provision into devastating and, at times, utterly tragic, clarity.

A basic right

Pilger sets out the way in which the publicly funded NHS has been dragged ever-further from its founding principle that good healthcare is a basic right of all, regardless of wealth, in the decades since its founding in 1948 as the world’s first health service completely free at the point of use. «Britain’s deadly disease was class,» we hear of an era prior to the establishment of a #welfare state#, when #poverty was rife and many in Britain died from Dickensian maladies. Ever since the NHS came into being, however, governments from both sides of the political spectrum have sought to repurpose it from public service to profit extraction, chipping away on the sly in cautious awareness of its wide popularity, and readying it for the more brazen moves of corporate raiders.

The moves to return the NHS to the private sector by stealth are charted, from Margaret Thatcher’s intention in the ‘80s to make hospitals like hotels where patients were charged a daily rate, to the use of private finance initiatives for building hospitals under #Tony Blair# and #New Labour#, which burdened them with heavy debt repayments that moved money away from the delivery of care. The ramping up of reforms over the last decade has seen the NHS throw away hundreds of millions on management consultants, who have ironically made efficiency worse rather than improving it.

A dehuman diagnosis

Some NHS operations are now outsourced to private facilities, many of which don’t have the same levels of quality or expertise. The failings of privatisation are encapsulated by the debacle of Hinchingbrooke, a small general hospital in Cambridgeshire that was the first to be passed to private management — a move reversed prematurely in 2015 after a damning Care Quality Commission report. An emotional testimony from a lead nurse with decades of experience describes how her dedication and love for her job was compromised by pressure to facilitate a high turnover of patients, getting them out quickly to bring more money in, and the destruction of cohesion between nurses by performance assessments and competition. The enthusiasm of current health secretary Matt Hancock for technological solutions threatens to see face-to-face time with GPs replaced by video consultants and apps in a dehumanised diagnosis process with no hope of recognising non-verbal communication cues, let alone the basic warmth of human connection so essential to the concept of care and wellbeing.

Surely these nurses and their patients deserve a great deal more than the government’s hollow applause.

While the current, semi-privatised state of the NHS comes across as alarming and fraught with weaknesses, the real warning bells of the film come with its journey through dark corners of the U.S. health system, or rather, places where the system is conspicuously absent in its profit priorities and social neglect — an American state of affairs dominated by insurance companies which stands as a likely model for a future private health landscape in Britain. Medical bills are the most common cause of bankruptcy in the States, and we peek into a possible future English #dystopia when we visit a free charity pop-up clinic in #Appalachia, #Virginia, where impoverished locals have camped out overnight to not miss the only chance for medical treatment, eye tests and dental work they have year-round. Even more shocking is the widespread practice of patient dumping, which sees patients (from those with psychiatric problems to people who’ve undergone heart surgery) turfed onto the doorsteps of city shelters in the middle of the night so that their beds can be freed up for new admissions — a practice that has now arrived in Britain. In the wake of the brutal hand of #austerity, even some NHS workers and carers are sleeping rough in the UK, it’s mentioned in a detail that says it all. Surely these nurses and their patients deserve a great deal more than the government’s hollow applause.