By Jacob Richardson

No political party could gain power in Britain if it stood on a platform of privatising the National Health Service. This might be why Nigel Farage has backtracked on his past description of the NHS as a “sacred cow” that should be killed off, though Reform UK has not ruled out implementing an “insurance-based” healthcare system either.

However, in recent years there has been – without the consent of the British people – a steady creep of private sector involvement in the NHS, which has accelerated under governments struggling to clear the backlogs caused by the Covid pandemic. According to research by We Own It, NHS contracts with the private sector are worth over £130 billion, generating £10 million a week in private profits from 2012 to 2024.

According to the Centre for Health and the Public Interest, the private health sector has made over £1.6 billion in profits through NHS contracts from 2024-26. It estimates this could have funded the salaries of nearly ten thousand doctors and twenty thousand nurses on the NHS frontline. Yet NHS infrastructure spending and staff recruitment are reined in by austerity.

According to research by Healthwatch, a record number of NHS patients are opting for private healthcare, not simply out of a wish for more exclusive treatment, but out of desperation as waiting lists have risen. There is a perverse incentive for the private sector to extract resources from the NHS and therefore boost uptake of their own services, effectively leading to a hybrid, two-tier healthcare system.

Yet going private does not ensure higher quality care, or even basic safety, for patients. Due to the private sector’s lack of emergency or critical care departments, the NHS is called upon in worst case scenarios. In some cases, this has led to catastrophic outcomes. In 2024 a BBC Panorama documentary highlighted the preventable deaths of patients in the Spire Healthcare chain of private hospitals, who may have otherwise survived under NHS care. Yet Spire is still amongst the many private sector bodies commissioned to deliver NHS services.

I had my own traumatic experience of this systemic failure when in 2022, as I recounted for the Just Treatment campaign, I suffered life-threatening clinical negligence following major surgery at a private hospital. I credit the NHS for saving my life.

As Labour Prime Minister, Andy Burnham has made fixing health and social care a government priority, with an ambitious plan to establish a National Care Service delivering adult social care under the same free-at-the-point-of-need model as the NHS. Social care is an issue not just impacting millions of older people, but also working-age disabled people and millions of unpaid carers picking up the slack of a broken system. 

Burnham himself has faced some scrutiny for his role in implementing NHS private finance initiatives as a Labour Health Secretary in the 2000s, despite his rationale of fast-tracking the construction of new hospitals. PFI led to significant overspending, which serves to demonstrate that outsourcing does not guarantee efficiency as its proponents once claimed.

Key to Burnham’s pitch for a National Care Service is that reforming social care is crucial to improving NHS performance. Inadequate care in the community, for instance, leads to delayed patient discharges that contribute to long waiting times at A&Es and so-called corridor care.

Burnham rightfully emphasises that the social care crisis is not just a national scandal, but an unsustainable false economy, placing immense strain on both the NHS and local government. It’s not just grossly immoral, but economically destructive.

While social care recipients and their families face personal devastation from extortionate care charges, the private sector generates vast profits through a decentralised model of delivery that pushes councils ever deeper into financial crisis. All too frequent instances of abuse and neglect in social care, often of autistic or learning-disabled people, also typify a system with scant oversight or accountability.

Whether on social care, housing, energy or transport, Burnham has shown a promising willingness to challenge the failed models of outsourcing and privatisation, making substance of the Brexit campaign’s pledge to bring back control. He should also apply this mission to the crown jewel of the labour movement and commit to bringing the NHS back into public hands, putting patients, not profit, first.

Jacob Richardson is a Labour Party member and a supporter of the Just Treatment campaign to put patients before profit.

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