For as long as the Government fails to deliver on its NHS promises, Labour’s days are numbered.
NHS patients with serious eye conditions, from glaucoma and macula degeneration to retinopathy of prematurity in babies, are at increased risk of losing their sight as a consequence of the massive outsourcing of cataract surgery to the private sector. Five private companies with NHS cataract contracts worth £536 million extracted 32% profits (£169 million) in 2023-24. The Royal College of Ophthalmology warned: ‘Investing so much scarce resource into treating cataracts – a reversible, relatively low-risk condition – in the independent sector has led to funding, workforce and infrastructure being diverted.’
For decades, prime ministers and health secretaries have denied privatisation of healthcare in England despite growing evidence. Ministers’ denials always rely on services still being free at the point of use, but this is disingenuous.
Keep Our NHS Public’s briefing on NHS privatisation, the forms it takes and the impact it has on patients, staff, funding and NHS infrastructure, is there for MPs to look at the evidence, challenge Wes Streeting and his mentor Alan Milburn, and oppose the direction of travel running through the 10 Year Health Plan for England like a stick of rock. We need MPs to oppose this as effectively as they opposed the slashing of disability benefits a few months ago.
Labour’s leaders now increasingly do not deny privatisation but welcome it as the way forward for England’s health system in which ‘the NHS’ would be redefined as a label for the ‘ecosystem’ of healthcare.
After years of denial that the NHS is being privatised, the 10 Year Health Plan, published in July 2025, makes it clear that the NHS now actively welcomes ‘partnership’ with the private sector. Exerting major influence on the plan, Alan Milburn has emerged as Wes Streeting’s main mentor. As health secretary under Blair, he had pushed for NHS privatisation and later went on to direct Ribero Salud, the private accountable care organisation in Spain. Milburn calls for an end to the NHS as the main provider of healthcare and spelled out his views very clearly in an interview with the Health Foundation in August:
“We’ve got to stop viewing the healthcare system in this country as being about a single institution that we happen to call the National Health Service, and instead see it as being an ecosystem of very different providers from tele cos, tech cos, of course private sector providers, at the margins, the public sector.”
The Plan represents a dramatic divergence from the principle of the NHS being a publicly provided national health service. In Streeting’s NHS the private sector plays an increasing role in all areas, 100,000 NHS jobs are shed with productivity delivered by apps, gadgets, private tech and data companies. And a new form of PFI – public-private partnership – will fund new NHS community and hospital buildings, creating long-term indebtedness.
The WHO definition of privatisation is met:
“…a process in which non-government actors become increasingly involved in the financing and/or provision of health care services”
Our privatisation briefing sets out how private organisations have already become involved in the provision of NHS clinical services, support services, financing, management and procurement. The impact of NHS privatisation has been greater cost for services, compromised patient safety, widened health inequality, and negative impact on NHS staffing and training.
With Streeting’s plan, these and other forms of privatisation will be expanded, in the face of evidence proving that, a well-funded publicly provided NHS is the most cost-effective model, free of private involvement.
Privatisation takes different forms
First, there is the transfer of public funding to private companies: outsourcing NHS clinical services for specific groups of patients (such as cataract and joint replacement surgery); outsourcing support services and ‘soft facilities’; NHS trusts creating separate private companies (‘SubCos’); setting up of joint public-private companies (Synnovis, the £2.25bn pathology network in SE London).
Then there is charging for, rationing of, or withdrawal of NHS services. And the threatened return of the PFI scandal from the Blair years, using PPP to fund new NHS build.
Lastly, the ubiquitous private sector involvement in the management of the NHS after 15 years of cuts stripping out the skills, experience and organisational knowledge of NHS estates, procurement, public health planning, leaving trusts heavily reliant on private consultancies and corporate replacements for support services.
In 2022-23, at least 11.2% of the NHS budget was spent on private contracting of patient services. Add to this NHS trusts paying for outsourced cleaning, catering and other soft facilities, private SubCos owned by trusts, high street optometry, dentistry and corporate interests in primary care and pharmacies, and the costs of contracting, legal firms’ and consultancies’ fees.
The well-referenced evidence is damning that privatisation costs more and patient care is compromised. Evidence-based policy must replace policy-based ‘evidence’.
In this Autumn of party conferences, Labour needs to wise up: the public continues to want the NHS and it remains one of the top three important issues. Waiting lists have risen in the last two months and patients struggle to see their GP. For as long as the Government fails to deliver on its NHS promises, Labour’s days are numbered.
MPs, unions and those with political influence must demand a halt to the 10 Year Plan, a halt to the imposition of 100,000 job cuts, an urgent switch of investment from private sector companies to the NHS, and funding to allow the NHS and care systems to succeed in providing health, care and security for the population once again.
Further information:
- Privatisation of the NHS a Briefing by Keep Our NHS Public
- Keep Our NHS Public, campaigning on the NHS since 2005
Dr Tony O’Sullivan is a retired NHS paediatrician, co-chair of Keep Our NHS Public
Image credit: Garry Knight – Creative Commons
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