The old myth that foreigners are coming to take your jobs has a new rival – Americans are coming to steal the NHS. Both are equally silly.
Why the immigration myth is nonsense
One of the great myths spread by right wing politicians is that somewhere in the world there is a hoard of foreigners who, given the slightest opportunity, will swarm over here taking our jobs and our women.
It’s always “our women” who need protecting, never “our men”. The need to protect the purity of white women is almost universal among racists.
The myth is so pervasive that it has taken hold in parts of the UK where there is no immigration whatsoever. In the 1992 General Election I knocked on a door in Quarrington to be confronted by the claim that Labour, if elected, would ship masses of non-white immigrants from the beaches of the Carbibbean to the rainy slopes of Quarrington. No matter how much I pointed out the stupidity of this statement the belief was unshakable. Finally in desperation the local Councillor who was with me pointed out that the resident himself was an immigrant who had migrated to Quarrington.
From Cassop. A distance of over 2 miles
This is not to say that immigration doesn’t happen, it clearly does, but that the negative consequences of immigration are deliberately and wildly overstated by a particular group of right wing politician to scare people into voting for authoritarian policies.
Why American’s aren’t coming to take over the NHS
Over the last year a new myth has taken hold, this time among my middle class college graduate friends; The Americans are coming to privatise the NHS.
The basic version of this story is that the Tories have a sinister plan to sell off the NHS to US healthcare companies who will do unspecified but awful things to it. Before we know it the NHS as we know it will be gone. Like the anti-immigrant narrative is is immune to truth or logic, and exists independent of facts
Just like the chap who is terrified of immigrants but lives in a place with no immigrants the people who are most scared of American healthcare companies have never met one.And just as the anti-immigrant myth is used by cynical right wing politicians, so is the US healthcare scare used to give moral urgency to a brand of left wing politics which has lost it’s momentum.
The NHS isn’t a particularly attractive market for US Healthcare companies. Their cost base is much higher than their UK competitors public and private, and they can’t make a profit on what the NHS pays.
Back in early C21st the then Labour Government had a very large number of patients who needed treatment that they had inherited from the previous Conservative Government. They wanted to buy additional capacity from the private sector to cut waiting lists and times, and they tried to attract foreign healthcare companies to the UK through the Independent Sector Treatment Centres programme.
South African, Australian and Canadian companies got contracts, however not one went to a US firm, for the rather obvious reason that no US firms bid for them. Some US provider healthcare firms did set up London Offices; Humana, and United had an attempt at the UK market, as did Kaiser Permanente to a lesser extent.
As an NHS CEO I spent a lot of time working with United on a project to identify older persons at risk of hospital admission, but a re-structure came along, I got moved to another job, and the project folded without my support.
The 2013 Health and Social Care Act was designed to increase private sector involvement in the NHS. The act was badly designed and added lots of cost and bureaucracy to administer the bidding process. The tendering process was just as expensive for the bidders, and as a consequence all of the US healthcare companies left the UK market.
Right now there are no US healthcare providers bidding for NHS services, and I don’t know any of them who have plans to do so in future. United, Humana, KP, all closed their operations, as did McKesson, who provide healthcare transactions processing. United’s consulting arm Optum still have a UK presence, but they don’t provide patient care services, and have no plans to do so.
There are US pharmaceutical companies working on R&D in the UK, and there are US companies who own private healthcare subsidiaries in the UK, but even they are pretty rare – Aspen are the only one I know of.
What is true is that the 2003 Act removed the protections that the NHS had enjoyed with regard to public procurement regulations. Recently this has been reversed, and no political party has any intention to change it back.
Just in case you haven’t got the message – the idea that there are shit loads of US healthcare companies about to swarm over here privatising our hospitals is total bollocks. Just as stupid as the hordes of immigrants heading towards Cassop and Quarrington. The likelihood of NHS privatisation has been deliberately and wildly overstated by a particular group of left wing politician to scare people into voting for authoritarian policies. Right now the amount of NHS funding which goes to the private sector for patient care is falling. The NHS spends less with the private sector now than it did when Nye Bevan was Secretary of State for Health.
Watching Labour supporters chant “Not For Sale” at rallies, in the manner of Trump fans chanting “Build the Wall” is a depressing reminder that neither side has a monopoly on gullibility.