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I rise to speak as a former public health consultant and the chair of a primary care trust.
I want to start by recalling a conversation I had with Brenda Rustidge, a constituent of mine. She was born in the 1930s, and she described to me what it was like living in a pre-NHS world. Her father, who had just been demobbed after the war, was unemployed. She had a number of brothers and sisters, and they used to have to hide under the window when the doctor’s secretary called round on a Friday night to collect the money. She described the real fear and shame that she felt as a result. Of course, all that changed nearly 70 years ago when the NHS was created. Brenda and her family have thrived because of that.
This debate is not about scaremongering. It is about raising awareness of the real concerns not just of political parties but of clinicians, academics and experts across the country and across the world about what privatisation means. Okay, it is on a small scale, but in terms of spending it has increased from about 2.8% in 2006 to over 7.5%—over 10% if we include not just private providers but all non-NHS providers.
I want to reflect on a point made by my hon. Friend Dr Williams: we have within the NHS a system that provides universal, comprehensive and free healthcare. That is something we should be very, very proud of. We are seeing that being eroded. For example, private providers of knee and hip replacements exclude certain people. They do not want the complex cases because they are too time-consuming and costly. I take issue with the point that Sir Nicholas Soames made, because it does entirely matter who provides the care that we get. There is a slow and steady erosion of the NHS as the sole provider.
In 2014, I conducted an inquiry into the international evidence on the effect of privatisation, marketisation and competition across different health systems. We commissioned a review of reviews, which is the strongest type of evidence, on the impact on health services, particularly looking at equity and quality. It was submitted to peer reviews and accepted in peer-reviewed journals subsequently, and it showed clearly and conclusively that health equity worsens in terms of not only access to healthcare but health outcomes.
It also revealed that there is no compelling evidence that competition, privatisation or marketisation improves healthcare quality. In fact, there is some evidence that it actually impedes quality, increasing hospitalisation rates and mortality rates. Of course, that was the key argument and the sole reason that the Government put forward for the Health and Social Care Act 2012.
The report found a whole host of other issues. I am sure that Members will go to my website to read about that. The transactional cost was one example—