Everywhere you look in the health service, the signs of thirteen years of austerity and willful Tory neglect are apparent. The Tories have, throughout their time in government, allowed the National Health Service (NHS) to go to rack and ruin, sending staff morale crashing through the floor and putting patients’ lives at risk.     

The waiting list for surgery or specialist clinical care — partly a consequence of the coronavirus pandemic but exacerbated by years of chronic underfunding — stands at a record high of 7.22 million. Millions of patients, meanwhile, are struggling to get general practitioner (GP) appointments due to the immense pressures on NHS primary care.  

Ambulance waiting times are alarmingly long: in December, response times in England were the worst on record, while the number of patients waiting twelve hours or more to be admitted to accidents and emergency department (A&E) also hit a new all-time high. NHS dentistry, in addition, is in a state of almost-total collapse. 

Both opinion polls and the recent local elections in England indicate that the Tories are on track to lose the next general election. While the differences between Keir Starmer’s Labour and Rishi Sunak’s Conservatives are narrowing all the time, it might at least be expected that the Labour Party would repair the worst of the damage done since 2010. The NHS remains the great survivor of postwar social democracy. But statements from the Labour front bench suggest otherwise. 

There was a major controversy when Starmer’s shadow health secretary, Wes Streeting, first stated last year that a future Labour government would tap spare capacity in the private health sector to reduce NHS waiting times. There he was — not for the first time, it must be said — in full concord with the government, which is already doing the same. Last year, Keir Starmer also reneged on his earlier pledge to end NHS outsourcing. 

This is a strong indication that the fragmentation and encroaching privatization of the NHS — which, after all, accelerated greatly under New Labour with its enthusiasm for outsourcing and the private finance initiative (PFI) — will continue with Starmer as prime minister. 

Since becoming shadow health secretary, Streeting has made a point of picking fights both with his own party’s base and with the health unions. In an interview with the Telegraph last October — gleefully headlined “Labour Vows War on “Hostile” Health Unions” — Streeting rejected nurses’ pay demands and opposed the strike by the Royal College of Nursing.  

In full Tony Blair cosplay mode, Streeting lectured hard-pressed frontline staff about the supposed “something for nothing cultur” in the NHS — which relies on staff routinely going above and beyond the call of duty — and said the health service must “reform or die.” 

The Labour Party’s recent health policy document, Build an NHS Fit for the Future, continues in much the same vein. “Some on the Left too often believe that problems within the NHS can be solved with more spending alone,” the document states. “And some are afraid to confront the failings in the current system for fear people might mistake reform for efforts to undermine the founding principle of the NHS.” 

It complains that the “the NHS is still designed for the world of 1948.” If only it were. After decades of privatization, outsourcing, low wages, and funding cuts, the health service is barely comparable to the world-leading service enjoyed by past generations. 

We may wonder why Streeting has chosen to set his face against health unions, whose calls for fair pay and a properly funded NHS are in the interests of patients as well as staff. Partly, this is what passes for iconoclasm among Blairites — defining themselves against the Left, and against public ownership in particular — and partly a reflection of the Labour Party’s growing reliance on corporate vested interests. 

In January 2022 and April 2023, Streeting accepted donations of £15,000 from hedge fund boss John Armitage for “staffing costs” in his office. Armitage’s interests include a stake, reportedly worth in excess of $500 million, in US private health insurance giant UnitedHealth, America’s largest health insurer.  

But this is far from Streeting’s only link to private health care interests. Campaign group EveryDoctor also raised questions over donations from Peter Hearn, a majority shareholder in a recruitment agency that works with private health care companies, and his affiliated company MPM Connect Ltd. One of these donations topped £80,000, the group said, while another ran close to £50,000. 

Streeting likes to present his planned “reform” as an example of pragmatism over dogma. But as the Socialist Health Association has pointed out, private hospitals contribute little toward clearing the NHS backlog — because the doctors and nurses who work in them are themselves largely drawn from the NHS, which also bears the cost of training them. This amounts to a government subsidy of about £8 billion for private hospitals each year. 

Moreover, there are concerns about patient safety in private hospitals, which are often poorly regulated. In 2018, the Care Quality Commission (CQC) found that two-fifths of private hospitals in England were failing to meet the expected standards. The CQC reported that 41 percent of private hospitals required improvement with regard to patient safety, with 1 percent rated as outright inadequate. Whenever something does go wrong in private hospitals, it all too often falls on the NHS to pick up the pieces. 

Private health firms and their mouthpieces continue to circle like vultures around the NHS. Former health secretary and Ayn Rand devotee Sajid Javid has complained of the “religious fervour” that supposedly surrounds the NHS, claiming that it has become a “barrier to reform.” But if the public at large opposes this “reform,” it is because people know the track record: whatever the “reformers” propose has, almost without fail, been worse for public health care and better for profiteers. 

Under Keir Starmer, Labour is increasingly reliant on wealthy private donors. This is, of course, how the current Labour leadership likes it; as far as they are concerned, this is far better than being accountable to a base of rank-and-file activists demanding a fully public NHS. But these donors didn’t acquire their fortunes by giving something away for nothing. They will expect a return — and there are few parts of the public sector that capital eyes up more greedily than the NHS.