Mike O’Driscoll on public attitudes to privatisation and rationing in the UK NHS

Mike gave a talk based on initial findings of his PhD work at the series ‘Scholars at Work’ at Middlesex University in January 2021. See the video here.

Title of presentation:Attitudes of public staff and other key stakeholders to privatisation in the general public

Brief Outline: I will present the initial exploratory findings from the first data collection of my Doctoral research – an online survey with a sample of the general public in England (n=220) regarding their attitudes to privatisation and rationing in the NHS (especially since the Health and Social Care Act 2012 which radically changed the structure of the NHS) .  

The fundamental problem which inspires this research is an apparent contradiction between the views of the public regarding how the National Health Service (NHS) of the U.K. should be run and the way in which the service is actually run, in terms of recent reforms and its apparent future trajectory.

The NHS has been described as the closest thing the UK has to a national religion and opinion polls suggest that it is the most valued and trusted public service (King’s Fund / MORI 2018)  and one of the UK’s greatest national achievements. Research suggests that a majority of  people are opposed to privatisation of the NHS, regardless of political affiliation or demographic profile and yet most governments from Thatcher’s onwards have, in one way or another, sought to impose market models and privatisation on the NHS and this reached unprecedented levels with the Health and Social Care Act (2012) which was described by a senior Department of Health official as ‘‘the only change management system you can actually see from space – it is that large’’(Timmins 2012).

This Act abolished Primary Care Trusts and forced GPs to take the lead for commissioning healthcare services by coming together in clinical commissioning groups (CCGs). CCGs were obliged by the Act to tender healthcare contracts externally, so that ‘any qualified provider’ (public, private or third sector) could bid and also removed the responsibility of the Secretary of State for Health to provide a universal healthcare service, granting CCGs considerable discretion to choose which services to provide and who to provide them to. This has led to an increase in private sector provision and rationing of healthcare with many CCGs choosing not to offer, or to severely limit, varicose vein removal, cataract removal, IVF and many other procedures or treatments (Heneghan 2017).

These changes have attracted relatively little media coverage and awareness of them amongst the general public (and indeed amongst health professionals) seems to be low although there does not seem to be any published research on this point (one of the gaps in the literature which I hope to fill).

Furthermore, both COVID and Brexit may lead to further NHS privatisation. The current government’s approach to managing the COVID pandemic has been heavily focussed on the private sector in terms of track and trace,  test laboratories, PPE procurement and  the use of private hospital facilities (Wrigley 2020; The Guardian 2020). The EU referendum was allegedly ‘won’ by the Leave campaign on the promise of dramatically increase NHS funding (London Economic 2017) but many fear that Brexit may in fact lead to further privatisation as part of a trade deal with the US.

Short Biography:  Mike O’Driscoll is a mixed methods researcher with a particular interest in the use of IT in social research. His first degree was in Sociology and Social Policy and has an MSc in research methods and is currently a Doctoral student at Middlesex.  Mike O’Driscoll has worked in many research environments including local government, charities and academia and has considerable experience in evaluations, particularly  in health and education settings (this link to publications gives an idea of his research interests  https://orcid.org/0000-0001-9221-6164).

Leave a Reply

Your email address will not be published.