UK: Record £9.2 billion of NHS budget handed to private firms

By Ben Trent
17 August 2019

The Department of Health and Social Care’s annual report reveals that last year saw a record £9.2 billion of the National Health Service (NHS) budget going to private investors, such as Virgin Care and Priory mental health group.

The figures sink the claim made by Matt Hancock, the secretary of state for Health and Social Care, that “there is no privatisation of the NHS on my watch.”

There has been a continued expansion within the NHS of the private sector. The £9.2 billion last year compares with £8.1 billion in 2014-15 and £8.77 billion in 2017-18.

Paul Evans, director of the monitoring organisation NHS Support Federation, said, “In response to criticism, failures and waste, the health secretary promised no further privatisation. But since then the outsourcing of NHS services has rolled on and more services have become reliant on the private sector to deliver their core services.”

Evans noted that a third of hip replacements carried out in the NHS are now done privately and that community health and mental health provision have seen five years of continual gains by the private sector. The “accounts of the Priory Group, the largest mental health provider, show that 52 percent of its income of almost £800 million comes from the NHS.”

There are claims that in real terms the amount spent on the private sector has fallen, comparative to the overall NHS budget, from 7.7 percent to 7.3 percent. But this only reflects the slightly inflated and temporary budget increase under the Conservative’s Long-term Plan (LTP), which the government claims is a lifeline for the NHS. It conceals the fact that the LTP has been specifically designed to blur the lines between the public-sector and private-sector NHS contracts, through the use of Integrated Care Plans (ICPs).

Dr. John Lister, secretary of Keep Our NHS Public, gave further details on the scale of the operation of the private sector within the NHS. “Last year, roughly 30 percent of all mental health spending was in the private sector and 44 percent of spending on child and adolescent mental health goes to private providers. Private sector domination is most complete in the provision of controversial ‘locked ward rehabilitation,’ in which a massive 97 percent of a £304 million market in 2015 was held by private companies.”

Writing in the Guardian last month, prior to Boris Johnson replacing Theresa May as prime minister, Lister warned, “The full picture is much more alarming with the added prospect of a Johnson government putting the NHS ‘on the table’ in any future US trade negotiations.”

The latest corporation to get its tentacles into the NHS is Amazon, one of the largest private sector firms on the planet, owned by Jeff Bezos, the world’s richest individual. Amazon’s Alexa technology is to be used to give health care advice to users in their home. Alexa is the voice-activated intelligent personal assistant accessed via Amazon’s Echo smart speaker device.

The government announced last month that Amazon would be collaborating with the NHS to allow the Alexa assistant, through algorithms, to answer health-related queries via the NHS website. The partnership has been touted by the Department of Health as having the potential to greatly reduce the strain on the overburdened and underfunded NHS.

Matthew Gould, chief executive of the digital wing of the NHS (NHSX), said, “Part of our mission at NHSX is to give citizens the tools to access services and information directly, and partnerships such as this are an important part of achieving this.”

Health Secretary Hancock, stated, “We want to empower every patient to take better control of their healthcare.”

With recent research suggesting that by 2020 over half of all online searches will be conducted by voice-assisted devices, the move has been championed by the government as a world first. Professor Helen Stokes-Lampard, Royal College of GPs, however, aired concerns that default use of the device could “prevent people seeking proper medical help and create even more pressure.”

Elliott Singer, a GP partner in East London and Medical Director for London-wide LMCs [Local Medical Committees], said, “The difference is that the tech we’ve got at the moment, it doesn’t have that ability to really differentiate between an isolated symptom and when that symptom is a sign of a minor illness, or when that symptom actually could suggest a more significant underlying illness that needs further investigation or treatment.”

Singer added, “The technology and the algorithms it uses are pretty basic and cannot make situational judgments to enable you to differentiate between minor illnesses and a serious illness.”

Amazon’s involvement raises critical issues of the seizure by the state and corporations of the personal data of the entire population. The recent ban on the use of facial recognition technology in Oakland, California and the revelation that the FBI and ICE are scanning drivers licences with facial recognition technology highlight the systematic link-up between powerful surveillance systems across an increasing number of countries around the world.

With the use of artificial intelligence systems developed by the likes of Google and Amazon, the latest development has a still darker side. Earlier this month, Belgian broadcaster VRT NWS reported that Google hires third party contractors to listen to recordings from the Google Assistant software, available on smartphones, security cameras and home speakers. The broadcaster, with the help of a whistleblower, was able to obtain over 1,000 recording excerpts. The recordings from the devices are sent to third party contractors to be transcribed, ostensibly for the purpose of improving speech recognition.

“In these recordings, we could clearly hear addresses and other sensitive information. This made it easy for us to find the people involved and confront them with the audio recordings,” stated the report.

VRT NWS said the recordings were in some cases done without the “wake word” (the word used to activate the personal assistant) being used.

Google tried to defend itself stating that only 0.2 percent of recordings were transcribed for use, but the implications are clear. Google stated, “The company has launched an investigation because the contractor breached data security policies.”

This follows a report in April by Bloomberg News that the Alexa personal assistant also records dialogue, and the subsequent recordings are then distributed to Amazon employees for transcribing. In that case also, Amazon sought to downplay the severity of the revelations and detrimental impact on the privacy rights of potentially millions of people.

The potential of such technology to assist with medical based queries is significant, but used within the constraints of the financially driven interests of corporations with increasing ties to the security-intelligence apparatus of numerous countries worldwide, most notably the US, the reality is akin to that explored in George Orwell’s novel 1984. As written in the opening chapter, “Any sound that Winston [the book’s protagonist] made, above the level of a very low whisper, would be picked up by it [the telescreen] … How often, or on what system, the Thought Police plugged in on any individual wire was guesswork.”

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