David Osland draws some conclusions for the Labour front bench after reading Critical: Why the NHS is being betrayed and how we can fight for it, by Julia Grace Patterson, published by HarperCollins.

I wish I could start this article with a resounding call to vote Labour to reverse the privatisation drift in the National Health Service. Unfortunately – as Shadow Health Secretary Wes Streeting has repeatedly made clear – that isn’t the agenda.

Streeting agrees that the NHS faces the biggest crisis in its history. Many people have to wait weeks for a GP appointment; ambulances are taking hours and sometimes days to reach desperately ill patients; 500 people a week that could be saved are dying in A&E; seven million people plus are facing extended periods of discomfort and pain before they can see a consultant; and teenagers are taking their own lives for want of mental health services.

It’s just that the answers he offers sometimes don’t amount even to dressing the wounds when life-saving surgical procedures are necessary.

Labour has made some progressive promises, including a welcome commitment to training an extra 7,500 doctors and 10,000 nurses and midwives a year. But that is not the main thrust of what politicians euphemistically refer to as ‘the offer’.

The real centrepiece of Streeting’s plan is an expansion of private sector input, including greater use of private hospitals to treat NHS patients.

And what’s wrong with that, the left is often asked. Why don’t we just get over our antiquated Bevanite big state hang-ups and get with the programme?

The short answer is that private hospitals, of course, do not have any additional doctors. They are staffed by NHS doctors working in their spare time.

The private sector contributes nothing to their training, so effectively it’s being subsidised by the state to the tune of billions of pounds a year.

There are only a certain number of healthcare professionals to go round, and conducting operations on private rather than NHS premises will not significantly expand the number of operations that can be conducted.

But it will significantly expand profits at private hospitals, which is what seems to count here.

The longer answer can be found in a recent book-length polemic from Julia Grace Patterson, a former junior doctor who set up the EveryDoctor campaign in 2019.

Critical: Why the NHS is being betrayed and how we can fight for it is an extended plea for what might be called “NHS constitutionalism”.

“Because there is a clearly-stated NHS constitution that sets out the aims of our public healthcare system, our politicians should be governed and directed in their decision making by these objectives: a healthcare service that provides comprehensive care, equitable care, and care that is free at the point of access to everyone,” she writes, in what constitutes a recurring theme.

What we get is a broad statement of principle rather than a manifesto, a detailed policy blueprint or a history of the health service in its 75th anniversary year.

I don’t know whether Patterson is a Labour Party member or not – I suspect she isn’t, although she has contributed to the Labour List website –  but the book generally avoids partisanship.

Labour’s timidity on the NHS, she tells us, is “extremely disappointing”. But numerous politicians from all governments since Thatcher come in for deserved criticism.

The last 40 years have seen various cack-handed attempts to introduce internal markets, outsource many ancillary and clinical services, and drastically cut bed and staff numbers.

The PFI programmes introduced under New Labour did result in an increase in spending, at least in book-keeping terms. But much and perhaps most of that money lined the pockets of the firms that run such schemes rather than filtered through to patient care.

PFI, Patterson tells us, saw an ‘investment’ in the NHS of £12.8bn, at a cost of £80.7bn. That statistic alone should underline to Streeting that private sector involvement is more often wasteful than a sane use of taxpayer cash.

Dr Patterson’s prescription is a return to NHS basics, and that necessitates an injection of resources. The NHS, she tells us, faced a funding hole of up to £9.4bn in 2022.

That is a lot of money for an incoming Labour government to find. But the NHS is one of the relatively few durable achievements of Labour’s 123-year history, and hugely popular with the public.

That can be seen from the widespread support for recent industrial action from nurses, ambulance workers and both junior and consultant doctors. This isn’t just a bid to restore pay packets after decades of substantial real terms erosion. It is a fight for the NHS itself.

There is no way round spending a lot more, and spending it on the NHS rather than private sector healthcare.

Labour should say so openly. After all, there’s no point endlessly repeating the mantra that ‘we can’t just throw money at the NHS’ and then throw money at BUPA and Nuffield instead.

David Osland is a member of Hackney North & Stoke Newington CLP and a long-time leftwing journalist and author. Follow him on Twitter at @David__Osland