Intended for healthcare professionals

Observations NHS Reforms

Further privatisation is inevitable under the proposed NHS reforms

BMJ 2011; 342 doi: (Published 17 May 2011) Cite this as: BMJ 2011;342:d2996
  1. Clive Peedell, co-chairman, NHS Consultants’ Association, and consultant clinical oncologist, James Cook University Hospital, Middlesbrough
  1. clive.peedell{at}

The government’s health reforms fulfil commonly accepted criteria for privatisation

Repeated government denials about NHS privatisation don’t stand up to scrutiny. In response to widespread criticism of the proposed reforms of the NHS in England, the health secretary, Andrew Lansley, the prime minister, David Cameron, the deputy prime minister, Nick Clegg, and the chancellor of the exchequer, George Osborne, have repeatedly claimed that there will be no privatisation of the NHS in England. The Department of Health website even states that “Health Minsters have said they will never privatise the NHS” ( However, these claims and promises fail to acknowledge the evidence that privatisation is an inevitable consequence of many of the policies contained in the Health and Social Care Bill.

The meaning of privatisation is complex, covering a range of ideas in law, politics, economics, and philosophy. However, the World Health Organization has defined privatisation in healthcare as “a process in which non-governmental actors become increasingly involved in the financing and/or provision of healthcare services” (J Muschell, Technical Briefing Note on Privatization in Health, 1995, WHO/TFHE/TBN/95.1).

So the government’s attempt to deny privatisation of the NHS by claiming that NHS services will remain publicly funded and free at the point of delivery does not escape the WHO definition if services are delivered by non-governmental actors, such as private and …

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