The celebrations for the 70th birthday of the NHS bring welcome, renewed energy to the fight to protect our health service from austerity and creeping privatisation.
But while we push back against the erosion of our public services, our struggle is mirrored by the hundreds of millions of people in the global south. They face threats to their health and are denied access to basic healthcare. The same things that are damaging our NHS – privatisation, inadequate public spending and unaffordable medicines – are often the same factors that weaken health systems around the world.
In the UK this is a result of ideological, pro-corporate decisions taken by our government. Likewise, the crumbling health systems many poor countries are left with today are also a result of ideological choices imposed from above, often from global north to south.
Throughout the 1980s and 90s, many of the world’s poorest countries had a neoliberal policy prescription of privatisation and cuts to public spending, forced on them by international financial institutions and so-called ‘donor’ governments as a condition for receiving loans.
The results were deadly. Citizens of countries who faced the greatest pressures from these policies – like much of sub-Saharan Africa – experienced stark declines in life expectancy.
Yet instead of recognising the failures of this deadly dogma, the government is taking our worst example of public-private partnerships – the failed PFI model shadow chancellor John McDonnell rightly labelled a “scandal” due to its costs to the taxpayer and huge profits for private companies – and exporting it to some of the world’s poorest countries.
The British Embassy in Liberia, for example, held training on public-private partnerships for Liberian government officials even as the country was recovering from the Ebola epidemic.
In Zambia, aid money was used to run a similar workshop at the British High Commission. The acting high commissioner in Zambia at the time said that “Zambia needs to continually look for alternative sources of funding for infrastructure development in order to spur its economic development”. Yet if our experience of PFI has taught us anything, it’s that this ‘alternative funding’ comes at an incredibly high cost.
The evidence against PFI doesn’t just come from the UK’s own experience. In Lesotho, one of the first PFI hospitals in Africa is costing three times more than the old public hospital it replaced. As Oxfam and the Consumers Protection Association of Lesotho exposed, it eats up over half of the total health budget of the government of Lesotho.
Instead of pushing failed attempts at privatisation, we do have a major export we should be strengthening and promoting: the NHS. As the last 70 years have shown, publicly funded healthcare, free at the point of need, transforms communities and lives. We should be helping countries build sustainable public health systems, not undermining them.
As we celebrate the NHS here, we must not underestimate its symbolism beyond our borders. As the People’s Health Movement, the global network of health activists, made clear in evidence to my recent consultation, the health service does not just impact on the lives of people in the UK. It is a beacon of hope to millions of people around the world who are fighting for their own access to healthcare. Its very existence demonstrates that universal, publicly funded healthcare is possible.
This was always its intention. As Nye Bevan said on the day the NHS was brought into existence: “The eyes of the world are turning to Great Britain. We now have the moral leadership of the world.”
A Labour government will restore that moral leadership envisaged by Bevan. Our commitment to ending the rigged economic system run for corporations, banks and elites will help create the funding we need to maintain the public services we deserve. We will reverse the cuts to the NHS and at the same time champion the movement for free, high quality and gender-responsive public services overseas.
We will invest in public health-driven research and development to find effective and affordable treatments for diseases. We will promote fairer international patent regimes so that patients in poor countries accessing the medicines they need is prioritised over big pharma profits – I recently launched a consultation looking at how Labour can best do this.
What people need and want in the UK, people need and want everywhere. And the injustices that affect us, affect people everywhere. Whether in London or Lesotho, poverty, poor health, inequality, and injustice, are not natural: they are a result of political and choices.
As the NHS turns 70, we must fight to ensure that it exists in another 70 years. And we must also commit to doing everything we can to address the ideological drivers and root causes that undermine health, both in the UK and around the world.