Posts Tagged ‘Alan Milburn’

Outrageous! Government Uses Pandemic to Privatise Even More of the NHS

May 7, 2020

So much for the real respect the Tories have for the NHS! Yesterday Mike put up a piece based on a report in the Guardian about the government pushing through the privatisation of even more NHS services through emergency powers designed to deal with the pandemic.

These powers have allowed the Tories to circumvent the usual tendering processes and award contracts to private healthcare companies and management consultants without the usual competition. The Groan reported that doctors, academics, MPs and campaign groups raised their concerns about this after it emerged on Monday that the outsourcing company, Serco, was in the lead to get the contract to supply 15,000 call handlers for the government’s track and trace operation.

And where Serco goes, the other outsourcing companies aren’t far behind. Deloitte, KPMG, Sodexo, Boots, Mitie, as well as Serco and the American data-mining group Palantir have also been given government contracts to run the Coronavirus drive-in testing centres, purchase PPE equipment and build nightingale hospitals.

They’ve also decided to centralise part of the purchasing process and hand it to yet another private company. The Groan stated that it had seen a letter from the Department of Health instructing local hospitals not to buy their own PPE and ventilators. Instead, purchasing of a list of 16 items, including were to be handled centrally. The items include PPE, but also general, high-value equipment such as CT and ultrasound scanners and mobile X-ray machines.

The Groan considered that this would hand more power to Deloitte, as not only was the accountancy and management consultants responsible for coordinating Covid-19 test centres and logistics at three new ‘lighthouse’ laboratories, they were also given a contract three weeks ago to advise the government on PPE purchases. As the provision of PPE has been absolutely deplorable, with equipment needed her exported abroad, insufficient supplies coming late from Turkey and other faults, so that doctors and nurses have been forced to use masks and gowns made by the public, and even bin-bags, Deloitte should be sacked and fined for their massive incompetence.

Mike makes the point that at the time PPE should be available to as many people as possible, the government is actually making it more expensive. He states that if Jeremy Corbyn had won the election, these items would be free. He also makes the point that it is alleged that Corbyn was prevented from doing so because of sabotage from the right-wingers in his own party. A genuinely free, publicly funded and nationalised NHS was one of the things the intriguers didn’t want. Presented with the evidence of this plotting and sabotage, one Labour MP remarked that it explained why he experienced so much resistance to his attempts to have it accepted as Labour policy that NHS services should be taken back in house. Alan Milburn, Tony Blair’s health secretary, wanted the NHS fully privatised so that it would become simply a logo for services provided by private healthcare companies for the state.

This shabby policy also shows how desperate the Tories are to give rewards to their own donors. a few weeks ago Zelo Street posted up a piece about how one company, which was set to supply ventilators for the government were told that this was off. Instead, the order went out to Dyson, who’s donated something like £10 million to the Tory coffers. This does not seem to be a coincidence.

I also came across a report somewhere that said that the big accountancy firms, Deloitte, KPMG, whatever Anderson Consulting is now, were in trouble. Most of their money comes from consultancy work, but this has dried up since the lockdown. Good! I’m still angry with these parasites for the way they trashed the inland revenue and DHSS for the Tories in the 1980s and ’90s. I don’t think any of them should be given any kind of government contract whatsoever.

It is thanks to the NHS and not a private healthcare system like America’s that the death toll from Boris’ idleness and incompetence isn’t massively higher. It’s a savage indictment of ten years of Tory privatisation and underfunding as it is. This is another example of how much the Tories ‘treasure’ the NHS. They will treasure it right up to the time they sell the last piece of it off.

See: https://voxpoliticalonline.com/2020/05/06/tories-are-accelerating-destruction-of-the-nhs-just-when-we-really-need-it/

Alan Milburn Attacked Cameron for Not Going Further in NHS Privatisation

February 8, 2020

Here’s a piece from Private Eye from 9 years ago, in the edition for 24th June to 7th July 2011. And it shows exactly why the Blairites should not be allowed back into power. It’s about an article Alan Milburn, the former Health Secretary under Blair, wrote in the Torygraph in which he actually criticised David Cameron for not having privatised the NHS enough. And it exposes Milburn’s own personal connections to private healthcare firms eager for a piece of NHS action. The article runs

Alan Milburn was characteristically modest in last week’s Telegraph when he attacked the coalition for backpedalling on NHS reform: “When I introduced private sector providers, some claimed it would be the end of the health service as we had known it. In fact, they strengthened it.”

Labour’s former health secretary wanted and expected more of the same from Andrew Lansley and David Cameron. Instead, he wrote: “Every single local decision-maker will read [the U-turn] as a signal to weaken competition, not strengthen it, and to protect the public sector incumbent over the private or voluntary sector insurgent. The debacle has set back for a generation the cause of market-based NHS reform… GPs’ ability to drive more services out of hospital and into the community has been severely compromised.”

At no point in this tirade did Milburn or the Telegraph decide that etiquette demanded he declare his financial interest. As the Eye has regularly pointed out, Milburn is now the chairman of the European advisory committee at Bridgepoint Capital Limited, whose website drools in the prospect of “excellent growth prospects and consolidation opportunities for those private sector players that can offer flexible, efficient and innovative business models in this evolving environment. Bridgepoint has long experience of investing successfully across the European healthcare sector.”

He is also a member of the healthcare advisory panel at Lloydspharmacy Limited, whose managing director Richard Smith indicated his firm’s enthusiasm for driving more services out of hospitals when told the Times in 2009 that “the pharmacy is the frontline in the NHS, but we have to change mindsets about it being part of the NHS. I believe that the pharmacy giving a solution is better value than a doctor.”

Milburn’s concern for the nation’s wellbeing extends only so far, however. He also happens to be a member of the advisory board at Pepsico, whose portfolio includes such healthy delights as Walkers Crisps and Sugar Puff.

Milburn wanted to reduce the NHS to a kitemark for services provided by private healthcare companies. As Jacky Davis and Raymond Tallis show in their excellent NHS – SOS, private healthcare companies are less efficient than state hospitals and healthcare, not more. Furthermore, instead of cutting costs the inclusion of private sector companies has actually increased it by 6 per cent. And the end point of all this privatisation is an American-style system funded by private health insurance. And under that system, if you can’t pay, you don’t get treated. or just received minimal treatment in the Emergency Room. Millions of Americans can’t afford their health insurance and 40,000 people every year die because they can’t afford medical treatment in the Land of the Free.

This is what will come if the Tories are allowed to privatise the NHS. And by pushing privatisation and competition, Blair, Milburn and their wing of the Labour party will have helped them.

The Tories and Blairites Cannot Be Trusted to Defend the NHS from Trump

June 11, 2019

Last week the orange generalissimo managed to cause massive offence and outrage on his state visit here. And it wasn’t just for merely being present, although that was certainly a major factor in the protests his visit provoked. No, Trump and his spokesman were touting for a trade deal with Britain after Brexit. And he demanded that ‘everything should be on the table’, including healthcare.

Which means the NHS.

MPs from all sides of the House immediately swung into action to condemn the Fascist cheeto’s demands that the NHS should be opened up to private American healthcare companies. There were a string of high profile Tory MPs, including former health secretary Andrew Lansley, loudly denouncing Trump’s demand, and stating that they weren’t going to include the NHS as part of the Brexit deal and were going to defend this most precious of British institutions. Lansley in particular was scathing about Trump’s opposition to the way the NHS controlled drug prices. He was afraid that if Trump has his way, this would be discarded to allow predatory American pharmaceutical companies to charge excessive and unaffordable prices for needed drugs.

He’s absolutely right.

One of the current scandals with the American private, insurance-driven healthcare system is that the drug companies can and do charge whatever they like for their products, which means that these are often beyond the ability of ordinary Americans to afford. I’ve blogged on here about a piece from The Young Turks about how Americans are hoarding drugs or buying those intended for animals from vets because they can’t afford them. And the worst example of a drug company actually raising prices is the case of Martin Shkreli. When he took over one company, he raised the price of an anti-AIDS drug to well over $300 a pill. He said he only wanted rich Americans to be able to use it, not poor Indians. He was rightly massively vilified for his gross racism and profiteering, but continued to defend himself, as he really couldn’t see that he had done anything wrong.

But while it’s heartening to see all these politicians stand up to defend the health service, I don’t believe them. With one exception, of course: Jeremy Corbyn. The Tories and the Blairites simply can’t be trusted to defend the NHS because they haven’t done it up to now. Indeed, they’ve done the exact opposite, all the while denying it.

Remember how Maggie Thatcher loudly declared that the NHS was ‘safe with us’, and she would keep her wretched claws off it. She even put it in her memoirs, denouncing the claims of the Labour party that she was planning to privatise the health service as lies. But she herself was lying. Cabinet minutes released a couple of years ago showed that she very much wanted to privatise the NHS. She was only stopped because of a massive cabinet revolt and the fact that her Personal Private Secretary, Patrick Jenkin, had visited the US and had seen personally what a travesty American private healthcare was.

So she satisfied herself with cutting its budget and trying to encourage Brits to take out private health insurance instead. She was aiming for about 11 per cent of the British population to take out such insurance.

She was followed by John Major, whose health secretary Peter Lilley was, I believe, one of the others who attacked Trump’s demand for a slice of NHS action. But Lilley was responsible for the Private Finance Initiative, under which private firms were to be allowed to bid for NHS contracts and building and running hospitals in partnership with the government. It was deliberately introduced with the intention of opening up the health service to private healthcare companies. And Lilley was advised in his health policies by John Lo Casio of the American private health insurance fraudster, Unum.

Well, the government changed with Labour’s 1997 electoral victory, but the Thatcherite privatisation of the NHS remained on course. Blair was an unashamed Thatcherite, and she had reciprocated his feelings by calling him and New Labour her greatest achievement. Blair also took over Lo Casio and Unum as his advisers on health policy, and continued the stealth privatisation of the NHS. The Community Care Groups of GPs he set up to contract in healthcare services were given the power to purchase it from the private sector and to raise funding privately themselves. The health centres and polyclinics he set up were to be run by private healthcare firms, like Circle Health, BUPA and Beardie Branson’s Virgin Health. NHS contracts, including out of hours services in many regions were privatised and the contracts awarded to private healthcare firms.

And yes, American healthcare firms were among them. Private Eye reported how Blair was surrounded by American public sector contractors, all lobbying for their share of British state business. Like the private American prison company, Wackenhut. And this included private healthcare companies. Blair was particularly impressed by the private American healthcare provider, Keyserpermanente, which he thought provided better value for money than the traditional NHS structure. It doesn’t, but that was ignored, and the American company provided the model for his NHS reforms. His health secretary, Alan Milburn, wanted the NHS to become nothing but a kitemark for services provided by private companies.

And this continued under David Cameron and Tweezer. Despite the loud shouts by Lansley and Jeremy Hunt that they ‘treasure’ the NHS, both of them preferred private healthcare and previously stated that they wanted the NHS effectively abolished and the lines blurred between state and private provision. There’s also a solid block of Tory politicians that would like the NHS sold off completely. Like the Devon Tory MEP, Daniel Hannan, dubbed by Guy Debord’s Cat ‘the Lyin’ King’ because of his gross mendacity. The majority of NHS contracts are being awarded to private healthcare firms, rather than kept in-house, and they have been angling to win the contracts for whole regions. Which brings the complete privatisation of the NHS even closer.

Andrew Lansley’s convoluted Health and Social Care Act of 2012 also enabled its privatisation by removing the obligation of the health secretary to provide healthcare to everyone in the UK, which had been a statutory requirement since the founding of the NHS in 1948. The Tories have also consistently voted to introduce charges for certain NHS services. Mike over at Vox Political has frequently given the voting record of some of the worst Tories, who have not only done this, but also supported other attacks on the poor like cutting welfare services, raising tuition fees and supporting the bedroom tax.

And I don’t trust the Lib Dems either. They went into coalition with the Tories and did absolutely nothing as their partners in government continued to attack the welfare state and the NHS. Indeed some of them, like the former MP for Taunton Dean, strongly supported it.

I have to say that I think that the outrage from the Tories at Trump’s demands is largely hypocritical. They’d very much like to make a deal with Trump, that includes the NHS along with other essential services that should only be run by the state. But, as with the cabinet revolt against Thatcher, they’re afraid that if they agree, they will be voted out in a devastating landslide, possibly never to get back into power.

The only person, who can be trusted to defend the NHS and keep it safe from Trump and the other privatisers, is Jeremy Corbyn.

Don’t trust the Tories. They still want to and  are privatising the NHS. Nor the Lib Dems or ‘Centrist’ Labour, who are exactly the same. The only real hope of defending and reviving the NHS is with Corbyn and the victory of a genuine, socialist Labour party at the next election. 

Private Eye on ChangeUK MP Stephen Dorrell’s Role in Disastrous and Exploitative Tory Policies

May 1, 2019

This fortnight’s Private Eye, for 3rd – 16th May 2019 has an article about the major role the former Tory MP Stephen Dorrell played in creating and promoting the disastrous Tory policies of rail privatisation, the Private Finance Initiative and the privatisation of the NHS. These are policies which the magazine speculates will make him unpalatable to those centrist Labour voters that ChangeUK hopes to appeal to. The article runs

The adoption of former Tory health secretary Stephen Dorrell as a Change UK candidate in the European elections may be a Tory too far for ex-Labour voters wanting to switch to the centrist cause.

Dorrell’s Tory CV harks all the way back to the dying days of the Thatcher era when he was a whip – a supposedly “wet” Tory helping push through her ultra “dry” policies.

Under John Major, he became a Treasury minister, active in the Rail Privatisation Group behind the sale of the railways. Against expert advice, Dorrell was one who pushed for separation of responsibility between trains and track – with dire results. Railtrack, the privatised track operator, eventually collapsed after lethal crashes caused by poor maintenance.

As health secretary it was Dorrell who began the 20-year disaster of the private finance initiative (PFI) in the NHS. “I am a strong supporter of the PFI,” he told the Commons, calling PFI “the best opportunity that we have had in the history of the NHS” to “deliver the best healthcare.” It wasn’t. And it didn’t.

Dorrell launched a failed bid for the party leadership in 1997 and never held a ministerial job again. Later, under the coalition, he was seen as a critic of Andrew lansley’s NHS reforms – but not too loud a critic.

Having left parliament in 2015, he has kept up his interest in giving corporations access to the NHS, chairing Public Policy Projects, a subscription-based outfit “focused on the big issues in health and social care”. His group arranges breakfasts and receptions for businesses to meet political and NHS insiders. Recent events have included meals iwth health secretary Matt Hancock, housing and communities secretary James Brokenshire, Treasury committee chair Nicky Morgan and top NHS officials.

Dorrell has also worked as a healthcare and public services adviser to KPMG since 2014; and last year became an “associate” of Cratus Communications, a lobbyist for developers. If Change UK really wants to fix the UK’s “broken politics”, it may have to cast its net a little wider. (P. 7).

These are all very good reasons why genuine Labour voters shouldn’t vote for him. But they’re also reasons why traditional Labour voters shouldn’t vote for any of the former Labour MPs in Change UK. All of the so-called Labour ‘centrists’ are really nothing of the sort. They’re red Tories, as fanatically keen on privatisation and the dismantlement of the NHS for the profit of private healthcare firms as the Conservatives. Blair was responsible for the introduction of much of the legislation allowing the NHS to purchase services from private healthcare providers, including the operation of the health centres and polyclinics, which he hoped would be run by private firms. His health secretary, Alan Milburn, wished the NHS to become simply a kitemark for services provided by private healthcare firms.

The real centrists and moderates are Jeremy Corbyn and his supporters, who wish to renationalise the NHS, the rail companies, water and part of the national grid. These are policies both the Tories, Change UK and the Labour ‘centrists’ loathe and detest. Just as they loathe and detest his plans to renew and strengthen the welfare state and give workers back proper employment rights and powerful trade unions able to defend them.

As Mike, Zelo Street and the various other left-wing bloggers have described on their sites, Change UK and its mixture of former Tory and Blairite Labour MPs shows that there really isn’t any difference between the two.

Private Eye’s article is thus a very good reason not to vote for Dorrell personally nor his wretched party in general. And the solid support for Blair’s own privatisation and destruction of the welfare state by Change UK’s former Labour MPs and their fellows still in the Labour party also demonstrates why working people need to see a genuine socialist Labour party under Jeremy Corbyn once again in power and winning elections, from the European all the way to Westminster.

Bernie Sanders Launches ‘Medicare for All’ Plan in US

April 11, 2019

Great news from across the Pond. According to today’s I for Thursday, 11th April 2019, the left-wing Democrat senator, Bernie Sanders, has launched his ‘medicare for all’ scheme to replace America’s current insurance-driven healthcare system with one in which the American state would pay people’s medical fees. The I’s report, ‘Sanders launches ‘healthcare for all’ plan, on page 25 runs

The US presidential hopeful Bernie Sanders revealed his “Medicare for All” plan yesterday, shaking up the 2020 election by reopening the debate over his call to eliminate private health insurance.

Four of the senators who are rivalling Mr Sanders for the Democratic Party nomination are set to sign on to the updated single-payer healthcare proposal. The bill’s reintroduction promises to shine a light on Democratic presidential candidates’ disparate visions for the long-term future of American healthcare.

Some Democratic contenders, including former Colorado Governor John Hickenlooper, have criticized Sanders’ measure, which they say is political infeasible.

Under Medicare for All, Americans would no longer pay premiums or face insurance deductibles as the government-run system replaced private health insurance offered through employers.

This really is what America needs. Badly. Something like 20 per cent of all Americans can’t afford medical insurance, and, according to the statistics cited by Sanders in his book, Our Revolution, every year 40,000 Americans die because they can’t afford medical treatment. In some parts of the US, people are hoarding medicine because they have difficult affording it, and even use medicines prescribed by vets for animals. They’re even heading over the border to Mexico for dental treatment because it’s much, much cheaper over there. And medical bills are the leading cause of bankruptcy in the Land of the Free. The progressive American Left have been wondering for a long time why it is that the other nations of the Developed World can afford universal healthcare, but American can’t.

Opposing him, naturally, is the American private healthcare industry, the Republicans, and the Corporate, Clintonite Democrats. I think Hillary Clinton said several times that the country couldn’t afford state medicine, parroting the ideas of the Republicans. And if she didn’t say, her daughter, Chelsea, certainly did. And over here, the Tories and Blairite Labour, as well as the ‘Centrist’ Change UK, also want to privatise the NHS. Blair’s health secretary, Alan Milburn, wanted to see the NHS reduced to a kitemark on services provided by private healthcare providers. I don’t think Bernie Sanders wants to nationalize the American healthcare system. He just wants the state to pay for its citizens’ healthcare, as Germany has done for its people since Bismarck’s ‘Socialist Law’ of 1871 or so. And one of the reasons that there has been such opposition in British politics to Jeremy Corbyn is because he has promised to renationalize the NHS. Corbyn’s policies are massively popular, which is why the Right, both within and outside the Labour Party, has been reduced to smearing him as a Communist, or a supporter of Irish Republican terrorism – as we’ve seen from the Tories, the Right considers Loyalist terrorists perfectly acceptable – and now a raging anti-Semite, despite the plentiful evidence to the contrary.

The NHS is being destroyed before us, and if this continues, we will reach a situation like America, where it’s increasingly unaffordable to all but the very affluent. We need Jeremy Corbyn in No. 10 in Britain, and Bernie Sanders over in America. A transatlantic partnership that would roll back the horrors of neoliberalism, and start giving working people in both countries the healthcare they need and deserve.

Right-Wing Shill Charlie Kirk Personally Experiences Failures of America’s Private Medicine

January 26, 2019

Charlie Kirk is an American Conservative mouthpiece. A little while ago he got very angry at some public meeting his was holding with The Young Turks Cenk Uygur. Uygur committed the terrible crime of asking him how much money he was making. This set Kirk off ranting that ‘He lived like a capitalist every single day’ before rushing off the stage and apparently challenging Uygur to a fight, asking him if he ‘wanted to go’. Fortunately, he managed to calm down and return to the stage without engaging in fisticuffs.

Kirk’s on record as saying that ‘Healthcare is not a right’ and raving about how wonderful America’s private medical system is. It’s therefore highly ironic that he should have experienced its failings first hand. A few days ago Kirk’s mate, Kyle Keshuv, sent a tweet stating that he was outside Cedar Sinai hospital in LA with Kirk. Kirk had put his back out, gone down to the hospital seeking help, only to be told there were no beds available and he’d have to wait on a bench outside. The tweet carried a photo of Kirk lying on said bench, and ended with ‘Cedar Sion Hospital – Disgrace’.

In this video from The Young Turks, hosts Uygur and Ana Kasparian discuss the incident, laughing at Kirk and his comments about the superiority of American healthcare. They state that they’re only doing so because Kirk is actually now well. Sam Seder also carried the story on his show with the news that Kirk was now in the hospital. He was confined to bed, couldn’t physically stand, but still stood for freedom. The Turks in this video comment on Kirk’s apparent sense of entitlement – he doesn’t believe that people have a right to healthcare, but when it’s him in trouble, he wants to be first in the queue. He also believes that the American healthcare system could be made better through more competition lowering costs. They point out that LA has many excellent hospitals. He could, using his own logic, have gone elsewhere, and then written a bad review of his treatment at Cedar Sion hospital on Yelp.

Uygur and Kasparian defend the hospital, saying that it’s a good one. Uygur himself has taken his child down there many times. But you do have to spend a long time in queues. He also makes it clear that its failings of the American medical system that makes him support Medicare for All. He points out that the system exists in Norway and Northern Europe, and that it’s part of a mixed economy. America also has a mixed economy. Uygur also points out that he’s a capitalist, but it’s because, as a progressive, he wants everyone to have access to good healthcare that he supports Medicare for All and believes medicine should be in the state part of the equation. Everyone, even Charlie Kirk, should have proper medical care. Although Kasparian states that she thinks Kirk shouldn’t have it so much as everyone else.

I’m putting this up because it shows the failures of the American healthcare system, a system which the Tories and New Labour wish to import to Britain. Thatcher wanted to privatise the NHS completely, but was only stopped by a massive backbench rebellion. And the fact that her personal private secretary, Patrick Jenkin, returned from America pointing out how rubbish it was. But she still wanted a certain percentage of Brits to have private health insurance. And the Tories and their counterparts in the Labour party, the Blairites, have been determined to privatise the health service ever since. Alan Milburn wanted to reduce the NHS to nothing but a kite mark for privately provided services.

According to the privatisers swarming around Thatcher, Major, Blair, Cameron and Tweezer, private industry always provides better quality service than the state, even in healthcare. If you believe some of the twaddle coming from American supporters of their rubbish system, the healthcare is wonderful and you don’t have to wait to be seen. The truth is, it’s expensive, millions of Americans can’t afford private health insurance. I understand the figure is now up to 20 per cent of the population. 40,000 Americans die each year because they can’t afford proper medical care.

But you won’t hear any of this from Nuffield Health or BUPA and their adverts on the TV, nor from Virgin Healthcare or the other private healthcare firms trying to get a piece of that sweet NHS action. Nor will you hear it from Tory health secretaries, like Andrew Lansley or Jeremy Hunt. Or even from Lib Dems like Nick Clegg, who claimed that privately run healthcare, as on the continent, was associated with excellent health outcomes. Or some similar piece of bullsh*t managerial jargon.

The whole Tory/Lib Dem idea has been to run down the health service to the point where the middle class will start turning to private healthcare. The endpoint of that is the American, for-profit system, where if you’re poor, you go the Emergency Room or a charity hospital. And that’s it. It’ll return the healthcare in this country to the appalling state it was in before the Second World War. But who cares if millions of poor suffer and die through disease, so long as the private healthcare company they and their donors head makes big bucks.

Don’t believe their lies, and don’t believe that they’re not trying to privatise the health service. Stop them. Get Tweezer and the rest of the loathsome Thatcherites out, and Jeremy Corbyn and Labour in.

Don’t Let Theresa May Privatise the NHS

June 8, 2017

This is the text of one of the self-published, table-top produced pamphlets I created a few years ago, and which are advertised on one of the other pages of this blog.

As you can see, it was written a year or so ago when David Cameron was in power. Nevertheless, it is still as valid now as it was then. Theresa May has not changed the Tory policy of privatising the NHS one whit.

So, please, read this article, and then vote for Jeremy Corbyn to preserve this most precious of British institutions.

Don’t Let Cameron Privatise the NHS
David Sivier

Visiting our local health centre the other day, my parents, along with the other local people enrolled there, were handed a letter, explaining that due to funding cuts the health centre was having to cut back on services. It also advised its patients that if they wanted to raise their concerns about the restriction in their service they could contact:-

1. NHS England at FAO Linda Prosser, Director of Assurance and Delivery, NHS England South West (BNSSG), 4th floor Plaza, Marlborough Street, Bristol BS1 3NX
2. your local MP at the House of Commons, Westminster, London SW1A 0AA

Unfortunately, this is happening to the NHS and GPs’ services all over the country. It is no accident, and it is certainly not the fault of the many dedicated doctors, nurses and other health professionals working in the NHS.
It is the result of over 30 years of privatisation begun with Margaret Thatcher. Thatcher and her former Chancellor, Nigel Lawson, denied that they wanted to privatise the NHS. They merely stated that they wanted to include more private provision in the NHS. This is a lie. Released cabinet minutes showed that Thatcher and Geoffrey Howe wanted to privatise the NHS along with abolishing the rest of the welfare state. They were only prevented from doing so because the rest of the cabinet realised that this would be the death knell for the Tory party. And a fact-finding mission to the US to see how their private healthcare system worked by Patrick Jenkin showed that it was massively inefficient.

Nevertheless, the amount of private healthcare in the NHS was expanded, and state provision duly cut by successive governments. It was Maggie’s government in 1989 that ended the state support for care for the elderly in nursing homes. As a result, the families of those, who need this kind of care, are forced to fund it themselves, often through selling or remortgaging their homes because of the immense expense. It was also Maggie’s government that ended free eye tests, and picked a feud with the doctors that saw the majority of them leave the NHS.

This privatisation has continued under Tony Blair, Gordon Brown and now David Cameron and Jeremy Hunt. Blair and Brown were deeply impressed with American private healthcare firms such as Kaiser Permanente, and wished to reform the NHS on their model. The ultimate intention was to replace the publicly owned and operated NHS with private healthcare funded by the state, but administered by private health insurance companies. As a result, NHS work has been given to private hospitals and clinics, and private healthcare companies have been given NHS hospitals to manage. Alan Milburn, Blair’s health secretary, wanted the NHS to become merely a kitemark – an advertising logo – on a system of private healthcare companies funded by the government.

This has been carried on the current Conservative government. And they have used the same tactics Margaret Thatcher did to force private healthcare on this nation. The dispute with the doctors over contracts a few years ago was part of this. It has left the majority of NHS GPs wishing to leave. Yet elements within the Conservative networks responsible for foisting these demands have seen this as an opportunity for forcing through further privatisation. Penny Dash, of the National Leadership Network, and one of those responsible for the NHS privatisation, has looked forward to the remaining GPs forming private healthcare companies. Furthermore, an report on the Care Commissioning Groups now in charge of arranging healthcare in the NHS by one of the private healthcare companies also suggested that they could form private healthcare companies, and float shares on the stockmarket.

Further privatisation has come with Andrew Lansley’s Health and Social Care bill of 2012. This exempts the state and the Secretary of State for Health from their statutory duty, as the ultimate leaders of the NHS, to provide state health care. It is carefully worded to disguise its true meaning, but that is what has been intended by the bill. Dr David Owen, one of the founders of the SDP, now part of the Lib Dems, has tabled amendments trying to reverse this despicable bill. He and many others have also written books on the privatisation of the NHS. One of the best of these is NHS SOS, by Jacky Davis and Raymond Tallis, published by Oneworld.
This process cannot be allowed to continue, and I strongly urge everyone to resist the creeping privatisation of the NHS, Britain’s greatest public institution.

In the last government, there were 92 Conservative and Lib Dem ministers, who advocated the privatisation of the Health Service, and who stood personally to gain from it. They included Iain Duncan Smith, the minister for culling the poor, the sick and the old. Andrew Lansley, the health minister, openly stated he is in favour of privatising it. So has Nigel Farage, and the Unterkippergruppenfuhrer, Paul Nuttall.

Farage in particular follows the Tory policy going all the way back to Thatcher of promising to defend it while secretly plotting how to sell it off. Thatcher ‘s review into the NHS and its funding in the 1980s. so alarmed Labour’s Robin Cook, that he wrote a Fabian pamphlet, Life Begins at 40: In Defence of the NHS, attacking possible proposals to privatise the Health Service.

Previous reviews had given the NHS a clean bill of health. The extremely high quality of the NHS and its doctors was recognised by the heads of American healthcare firms: Dr Marvin Goldberg, chief executive of the AMI health group, told a parliamentary select committee that the Health Service Provides ‘outstanding health care and British NHS hospitals are at least as good as those in America while British doctors are better.’

The then Conservative MP for Newbury, Michael McNair-Wilson, also testified to the effectiveness of the NHS. He had suffered kidney failure. He had private health insurance, but it did not cover operations such as the one he needed because of the expense. He said ‘I have cost the NHS tens of thousands of pounds – much more than I could have afforded privately … Had my treatment depended on my ability to pay, I would not be alive today.’

Pre-NHS Britain: Some Areas Completely Without Hospitals

Cook’s pamphlet also graphically described the patchwork state of healthcare in Britain before the NHS. In London, where there were plenty of paying customers, there could be hospitals in neighbouring streets. Out in the poorer British provinces, there were hardly any, and many operations were carried out not by surgeons but by GPs. He cites Julian Tudor Hart’s book, A New Kind of Doctor, to show how bad this could be. Hart described how he joined one of those practices in Kettering. One patient was left under anaesthetic as the London specialist operating on him was called away to continue a stomach operation on a London patient, which the operating GP had been unable to complete.
Cook was deeply concerned that the Tories’ review would not be at all interested in improving quality, only in opening up the NHS to the market and privatisation.

Cook on Private Health Insurance

One of the issues he tackled in the pamphlet was the possibility of the introduction of private health insurance. This covers two pages and a column and a bit in the original pamphlet. This is what he wrote, though emphases and paragraph titles are mine.

The mechanism proposed to square the incompatibility of health care with the market is insurance. All market approaches to the NHS submitted to the Review stress the case for much wider private insurance and almost as frequently propose subsidies to boost it.

Insurance-Based Systems Encourage Expensive Treatment

The first thing to be said is that private insurance does not offer
to health care the alleged benefits of the discipline of the market place. At the point when the individual requires treatment he or she has already paid the premiums and has no incentive not to consume as expensive a treatment as can be reconciled with the policy. The position of the doctor is even more prejudiced in that he or she has every incentive to obtain as much as possible from the insurance company by recommending the most expensive treatment. Both patient and the doctor are in a conspiracy to make the consultation as costly as possible, which is a perverse outcome for a proposal frequently floated by those who claim to be concerned about cost control.

Insurance-Based Systems Encourage Unnecessary Surgery

The compulsion in an insurance-based system to maximise the rate of return is the simple explanation why intervention surgery is so much more often recommended in the United States. For example, the incidence of hysterectomy there is four times the British rate. This is unlikely to reflect higher morbidity rates but much more likely to reflect the greater willingness of doctors on a piece-work basis to recommend it, despite the operative risks and in the case of this particular operation the documented psychological trauma. I can guarantee that an expansion of private insurance will certainly meet the objective on increasing expenditure on health care, but it is not equally clear that the money will be spent effectively.

Insurance-Based Systems Require Expensive bureaucracy to Check Costs

One direct diversion of resources imposed by any insurance-based scheme is the necessity for accountants and clerks and lawyers to assess costs and process claims. The NHS is routinely accused of excessive bureaucracy, frequently I regret to say by the very people who work within it and are in a position to know it is not true. Expenditure in the NHS is lower as a proportion of budget than the health system of any other nation, lower as a proportion of turnover
than the private health sector within Britain, and come to that, lower than the management costs of just about any other major enterprise inside or outside the public sector. I am not myself sure that this is a feature of which we should be proud. ON the contrary it is evidence of a persistent undermanaging of the NHS, which is largely responsible for its failure to exploit new developments in communication, cost control and personnel relations. Nevertheless, there is no more pointless expansion of administrative costs than the dead-weight of those required to police and process and insurance-based system. These costs would be considerable.

Forty per cent of personal bankruptcies in the US are attributable to debts for medical care

Part of this additional cost burden is incurred in the task of hunting down bad debts, which does not contribute in any way to the provision of health care. Forty per cent of personal bankruptcies in the US are attributable to debts for medical care, a salutary reminder of the limitations set to insurance cover. These limitations have three dimensions.

Insurance Cover Excludes Chronic and Long-Term Sick, and the Elderly

First, insurance cover generally excludes those conditions which are chronic and therefore expensive or complicated and therefore expensive. Standard exclusions in British insurance policies are arthritis, renal dialysis, multiple sclerosis or muscular dystrophy. Most people do not require substantial medical care until after retirement. Most insurance cover excludes the very conditions for which they are then most likely to require treatment. Short of retirement, the most expensive health care required by the majority of the population is maternity care, which is also excluded by the majority of insurance policies.

Private Healthcare Limits Amount of Care due to Cost, not Need

Secondly, insurance cover is generally restricted by upper limits which are arbitrary in every sense other than financial. I recently met a psychiatric consultant to a private clinic, who was prepared to discuss candidly the ethical dilemmas of treating patients whose financial cover is fixed at five weeks of residential care, but whose response to treatment may indicate that a longer period of hospitalisation is desirable.

Private Health Care Geared to Selling to Healthy not Sick

Thirdly, insurance cover is further limited by exclusion of those most likely to claim on it. I am often struck at the sheer healthiness of the patients who illustrate the promotional literature of BUPA and PPP who appear in such pink of good cheer and fitness that it is difficult to figure out why they are in a hospital bed. These models are though in a sense most suitable for the purpose as the objective of insurance companies is to attract the healthy. They therefore claim the right to screen for the unhealthy and reject them from cover. This discriminatory approach was defended earlier this month by the managing director of WPA, Britain’s third biggest health insurer, on the principled grounds that it meant ‘essentially healthy people are not penalised by unhealthy people.’ This statement has the advantage of originality in that it perceives healthy people as the vulnerable group and proposes a market remedy that protects them from the inconvenient costs of the unhealthy.
Given this limited character of health insurance in Britain, the private sector is patently not in a position to substitute for the NHS and to be fair most directors of BUPA or PPP would be horrified at the notion of accepting the comprehensive, open-ended liabilities of the NHS. It is therefore perplexing that so much effort in and around the Review appears to be addressed to the issue of how the private sector may be expanded rather than how the public sector may be improved. Two major devices are being canvassed to boost private cover-tax relief on private cover or opt-out from public cover, or for all I know both of them together. Both would be a major mistake.

Tax Relief on Private Healthcare

Tax relief is open to the obvious objection that it targets help most on those who need it least – the healthy who are most likely to be accepted for private cover and the wealthy whose higher tax rates make relief most vulnerable. These are curious priorities for additional health expenditure.

Tax Relief Does Not Create Higher Spending on Health Care

Moreover, even in its own terms of stimulating higher spending on health, tax relief is likely to prove an ineffective mechanism. If for example the average premium is £200 pa the cost of tax relief for 6 million insured persons will be £300 million. The numbers under insurance need to increase by a third before the increased spending on premiums matches the cost of the subsidy and provides any net increase in health spending. Up to that point it will always produce a larger rise in health spending to increase the budget of the NHS by a sum equivalent to the cost of tax relief.

It is apparently being mooted that these objections could be circumvented by limiting the tax relief to the elderly. At this point the proposal moves from the perverse to the eccentric. This restriction targets help for private insurance on the very group for whom private cover is most inappropriate as their most likely health needs are the ones most likely to be excluded from cover. Only a moment’s reflection is required on the multiple ways in which we need to expand our health provision for the elderly to expose the hopeless irrelevance of tax relief as the solution for them.

Opt-Out Penalises those who Remain in the System

Opt-out is even more objectionable. The basic problem with opt-out is that it requires the payment towards the NHS of every individual to be expressed in a manner that gives him or her something to opt-out from. The principal attraction to Leon Brittan of his proposal for an NHS insurance contribution appeared to be precisely that it paved the way for opting out (A New Deal for Health Care, Conservative Political Centre,, 1988). Nor is this inconvenience confined to the need for a whole new element in the tax system. If one in ten of the population chose to opt out, it would be remaining nine out of ten who would have to prove they were not opted-out when they went along to seek treatment. With the new contributions comes a requirement to maintain a record of payment of them, and presumably a mechanism for credits to those not in work but who do not wish to be counted has having opted out of the NHS.

Private Healthcare Undermine NHS as Universal System

The more fundamental objection both these proposals is they explicitly threaten the NHS as universal health service catering for everyone. Moreover, they threaten its universality in the worst possible way, by encouraging those with higher incomes and lower health needs to get out, leaving behind the less affluent and the less fit. In this respect such an approach to the NHS would be a piece with the Government’s strategy of erosion towards the rest of the social services-housing, pensions, and now education, where the Government has encouraged those who could afford it to opt-out of public provision, leaving behind the poor who could be expected to put6 up with a poor service.

This is the reality of the private healthcare system which Cameron, Clegg, Farage and the rest of the Right wish to introduce. It is expensive, bureaucratic, does not stimulating further spending, and excludes those with the most acute and expensive medical need, especially the elderly.
And the Tories and their counterparts in UKIP and the Lib Dems know it. Why else would the Tories spend their time trying to deny what they’re doing? Why does Farage appear to be advocating retaining the NHS, while arguing for an insurance based system, like America? It’s because they know that private medicine does not provide the solutions they claim. It is only source of further enrichment to them and their corporate donors.

And since Cook wrote that pamphlet, more than 20 per cent of all Americans can no longer afford their healthcare. It’s why the firms are trying to get their feet under the table over here. Don’t let them. Ed Miliband and now Jeremy Corbyn have promised to reverse the privatisation of the NHS. Please support them.

My YouTube Video Urging People to Vote Labour to Defend the NHS

April 30, 2017

I’ve had my own YouTube channel for a few years now. I haven’t posted anything on there for quite a while, and most of the stuff I have posted up there is about archaeology, early musical instruments and few home-made space videos. However, today I put up a video urging people to vote for Jeremy Corbyn’s Labour to prevent the Tories privatising the NHS.

I state that it began when Margaret Thatcher came to power as part of her campaign to dismantle the welfare state, but that Thatcher was stopped from doing so by her a cabinet revolt and her Personal Secretary, Patrick Jenkin. The cabinet realised that if she did privatise the NHS, it would immediately result in the Tories losing an election. Also, Jenkin went to America and realised just how bad the American system of private healthcare was. So Maggie settled for trying to expand private healthcare in Britain, aiming to have 25 per cent of the British people take out private health insurance.

A few years later in the 1980s there came a dispute between her and the dentists, which resulted in very many of them leaving the NHS. The result of that is that, while there still are NHS dentists, you need to look for them. And private dental care is not cheap. So people are going without proper dentistry.

After that, Peter Lilley in John Major’s administration introduced the Private Finance Initiative, under which private corporations build and manage hospitals for the NHS. It’s essentially a scheme to keep the costs of construction and management off the books. In practice it’s massively more expensive than simply having them build by the state. Those hospitals, clinics and other medical services built through it also tend to be smaller than through ordinary hospitals built by the state. See the chapter in George Monbiot’s Captive State. This was all done to open up the NHS to private investment.

This programme was expanded by Tony Blair, as he, like the Tories, was approached by private healthcare firms such as Unum, Virgin Health, Circle Health and BUPA to privatise more NHS services. His health secretary, Alan Milburn, wished to reduce the NHS to a kitemark for services provided for the state by private healthcare companies. He split the NHS up and handed its management to CCGs – Community Care Groups. This was supposed to be giving doctors greater freedom and more choice. However, it doesn’t do this as most doctors simply don’t have enough time to spend on administration. The CCGs were given the power to raise money privately, and commission services from private healthcare providers. Again, hospitals and the health centres or polyclinics Blair also built were also to be managed by private companies.

This programme did not stop when David Cameron’s new Conservative government was voted into power in 2010. Cameron had claimed that he going to stop further cuts in the NHS. He didn’t. He expanded the privatisation programme even further. The 2012 healthcare act formulated by his health minister, Andrew Lansley, is a convoluted document, but it removes the Health Secretary from having to provide medical services. Furthermore, the Tories have also passed legislation allowing the NHS to charge for services, even ambulance care. And this is still going ahead under Theresa May.

There is a real danger that the NHS will be abolished, and the country will return to the way it was before the Labour government introduced it. Private healthcare is not more economical and efficient than state healthcare. Private insurance companies and hospitals spend much more on management, including advertising, legal teams and simply trying to raise money from investors, to make sure their shareholders see a profit. There are about 50 million Americans without health insurance. 33,000 Americans die every year from lack of medical care. And it was like that before the NHS, when the charity hospitals, where people were sent if they didn’t have private health insurance, or weren’t covered by the state health insurance scheme, spent much of their time trying to raise money. And millions of people were denied healthcare, because they couldn’t afford it.

Jeremy Corbyn has said that he will renationalise the NHS. Dr. David Owen has also sponsored a bill to renationalise the NHS. They need our support. And so, if you want to keep the NHS, you should vote for Jeremy Corbyn.

For further information, see the following books:
NHS-SOS, edited by Jacky Davis and Raymond Tallis (London: OneWorld 2015)
Dr. Youseff El-Gingihy, How to Privatise the NHS in 10 Easy Steps (Zed Books)
and my own, Privatisation: Killing the NHS, published by Lulu.

Vox Political: Hospitals Overstretched, but Chief Nursing Officer Wants Beds Cut

January 7, 2017

Yesterday Mike also put up a story commenting on a tweet by Clive Peedell, of the NHS Action Party. Peedell was justifiably outraged by the attitude of the Chief Nursing Officer, Janet M. Cummings. At a time when the NHS is seriously overstretched because of a shortage of beds, Cummings decided that the number of Acute beds should be cut. Peedell stated that she should resign. Mike concurs, but asks if anyone knows the procedure for how to make the public’s feelings known about this.

http://voxpoliticalonline.com/2017/01/06/hospitals-warn-over-patient-numbers-while-nursing-officer-wants-bed-numbers-cut-contradiction/

Unfortunately, Cummings isn’t the only senior official within the NHS, who seems determined to destroy public healthcare. Back when Blair was P.M., the head of NHS strategy was Dr Penny Dash, who was as keen as Blair was to privatise the health service. In 2002 she wrote an article in the Graun about how the government should encourage consultants, surgeons

and indeed other groups of doctors, to form their own companies (or join existing private health providers) to sell their services back to the NHS.

She continued

Freed from the stifling grip of the NHS, these would be able to perform procedures in either the NHS or private hospitals, and would be able to form businesses of their own, raise capital, invest in new technology, or join up with the suppliers of such, and then would be able to offer a ‘full service solution’ to failing NHS hospitals. This, she claimed, could be the development that Blair and Milburn really wanted. (See Stewart Player, ‘Ready for Market’, in Jacky Davis and Raymond Tallis, NHS-SOS, pp. 46-7). You won’t be surprised to learn that after leaving the Department of Health, Dash went off to work for McKinsey, the American private insurance giant. She played a leading role in producing the two ‘Darzi’ reports recommending limiting NHS provision in London, and the system of privately run polyclinics. (p. 60).

And then in 2006, there was the establishment of the National Leadership Network of 150 health policy makers, management consultants, NHS Trust and private healthcare executives, as well as medical professionals, leaders and regulators, to ‘provide collective leadership for the next phase of transformation, advise ministers on developing policies and promote shared values and behaviours.’ And one of the first documents they produced, recommending the introduction of privatised services shared between the NHS and private sector, was Strengthening Local Services: The Future of the Acute Hospital. It seems to me that Cummings is a product, one way or another, of that network.

Mike wrote an article earlier this week stating very clearly that there was a toxic culture at the top of the NHS. It started with Blair, and its grown and expanded with Cameron, May and the Conservatives, aided by the Lib Dems. The only person, who has shown they genuinely want to roll back the privatisation of the NHS to Jeremy Corbyn.

He needs our support.

And the others need to be kicked out.

Pro-NHS Political Comment in Paul McAuley’s ‘Something Coming Through’

December 27, 2016

something-coming-pic

One of the books I’ve been reading this Christmas is Paul McAuley’s Something Coming Through (London: Gollancz 2015). McAuley’s a former scientist as well as an SF writer. Apart from novels, he also reviewed books and contributed short stories to the veteran British SF magazine, Interzone. He was one of the writers who created the gene punk genre, sometimes also called ‘ribofunk’. This was the genetic engineering counterpart to Cyberpunk, where, instead of using computers, individuals, criminals and corporations used genetic engineering to redesign new forms of life, or spread invasive memes throughout the population to control the way people thought. Back in the 1990s he was one of the guests on the BBC Radio 3 series, Grave New Worlds, in which computer scientists, writers and artists talked about the transhuman condition. This was back when everyone was talking about cyborgisation, and the potential of contemporary technology to produce new varieties of humanity. Apart from McAuley, the guests also included J.G. Ballard and the performance artist Stelarc, who has personally explored the implications of cybernetics for the human body in a series of performances. In one of these he had a mechanical third arm, operated through electrical signals picked up through the stomach muscles. He also gave a modern music performance, in which he was wired up to the internet via galvanic stimulators. A search engine then went about finding images of body parts on the Net. When it found one, that part of the body was electronically stimulated so that it moved. There were also booths in three cities around the world, where participants could also press buttons to move Stelarc via electric impulses. Apart from Kevin Warwick, the professor of robotics at Warwick university, is the person who’s come the closest to being Star Trek’s Borg.

McAuley’s Something Coming Through and its sequel, Into Everywhere, follow the fictional universe he created in a series of magazine short stories about the alien Jackaroo and their impact on humanity. Following a short period of warfare, including the destruction of part of London with a nuclear bomb by terrorists, the Jackaroo turned up and declared that they wish to help. These aliens bring with them 15 artificial wormholes, which act as gateways to 15 worlds, which the Jackaroo give to humanity. Humanity isn’t the only race that the aliens have helped, and the worlds they give to humanity are covered with the ruins and artefacts of previous alien civilisations, now vanished. The Jackaroo themselves are never seen. They interact with humanity through avatars, artificial beings that look like human men. These have golden skin and features modelled on a number of contemporary celebrities. They’re also bald, wear shades, and dress in black track suits. Their motives for helping humanity are unclear. They claim they just want to help, and that it is up to humanity themselves how they use the worlds they have given them. But they are widely suspected of having their own agenda, and despite the protestations of non-interference they are suspected of subtly manipulating humanity.

Accompanying the Jackaroo are the !cho, another alien race, who are equally mysterious. They move about the world in opaque tanks supported on three skeletal legs. Nobody has ever managed to open one up, or scan the tanks using X-rays or ultrasound. It is, however, widely believed that the !cho are sentient colonies of shrimp. Their motives, and their relationship with the Jackaroo, are also unknown.

Something Coming Through follows the adventures of Chloe Millar, a researcher for a company, Disruption Theory, in London, and Vic Gayle, a cop on Mangala, one of the Jackaroo gift worlds. The objects and ruins left from the Jackaroo’s previous client civilisations can be highly dangerous. Some of them are still active, despite the many thousands, or hundreds of thousands, or millions of years of abandonment and decay. These can infect humans with memes, algorithms that alter psychology and behaviour. The strongest, most intact of these become eidolons, artificial entities that can take possession of their human hosts. Disruption Theory is a company specialising in researching the effects of these memes as they break out to infect people in Britain. This often takes the form of small sects, whose leaders speak in tongues, uttering nonsense as they try to put in human terms the alien concepts running their consciousness. Millar, the heroine, is investigating a couple of orphaned Pakistani children, who have apparently been infected by an eidolon from one of the gift worlds. Out on Mangala, Vic Gayle is also investigating the murder of a man, who has recently arrived aboard one of the Jackaroo’s shuttles.

Unlike much SF, the book doesn’t indicate how far in the future the story’s set. This is, however, very much a world not too far from the early 21st century of the present. The political structures are much the same, with the exception that the gift worlds are under the control of the UN. People still work in recognisable jobs, and shop and purchase the same brands of clothing. Complicating relations with the Jackaroo is a British politician, Robin Mountjoy and the Human Decency League. The League objects to contact with the Jackaroo as a danger to the dignity of the human race. Their leader, Robin Mountjoy, is described as being ‘in his mid-fifties, a burly man with thinning blond hair and a florid complexion, dressed in an off-the-peg suit. Although he was a multimillionaire, having made his fortune constructing and servicing displaced-persons camps, his PR painted him as a bluff, no-nonsense man of the people whose common sense cut through the incestuous old boys’ networks of the Westminster village’. (p. 51). The League isn’t strong enough to form a government of its own, and so has gone into a coalition with the Conservatives. While Mountjoy is clearly fictional, he does seem to be inspired by Nigel Farage and UKIP, with Britain attempting to gain independence from smooth talking mysterious aliens rather than the EU.

One of the other characters is Adam Nevers, a cop with the Technology Control Unit. This is the branch of the British police tasked with protecting the country from dangerous alien technology. Nevers is described as coming from the entitled upper ranks of society, who go straight from university into high ranking jobs. Which looks to me very much like a comment on the privileged upbringing and expectations of absolute deference and entitlement from certain members of the British upper classes.

Apart from the social and psychological disruption caused by alien contact, this is also a world wear the NHS has finally been privatised. McAuley shows the practical impact this has people’s lives. Without the safety net of state healthcare, people are dependent on their employers to help pay their medical bills, or borrowing money from friends. In his acknowledgements, as well as the many other people who helped him with the book, McAuley also thanks ‘the NHS for life support’. (p. 375). Which suggests that he’s also suffered a period of illness, and is very much aware how much he and everyone else in the country needs the NHS.

I liked the book for its convincing portrayal of the world after sort-of personal contact with an alien civilisation, and the frontier societies that have emerged as Mangala and the other gift worlds have been settled and colonised. I was also fascinated by McAuley’s description of the alien life-forms, and the archaeological exploration of the remains of the planets’ previous civilisations for the technological advances these artifacts offer. I was also drawn to it as it offered a different take on the old SF trope of alien contact. The appearance of the Jackaroo is described as an ‘invasion’, but it’s not really that. The aliens have a ‘hands off’ approach. They haven’t conquered the Earth militarily, and political power is still exercised through traditional human institutions and parties, like the UN and the Tories. Nor are they more or less at our technological level, like many of the alien races in Star Trek, for example. We don’t form an interplanetary federation with them, as they are clearly extremely far in advance of humanity, which is very much the junior partner in this relationship.

It’s not really a political book, and really doesn’t make any overt party political statements. With the exception that rightwing xenophobes would probably form a party like UKIP to join the Conservatives against pernicious alien influence, just like the Kippers under Farage came very much from the right wing, Eurosceptic section of the Tories. But its comments on the class nature of British society does bring a wry smile, and its advocacy of the NHS is very welcome. It doesn’t preach, but simply shows the fear the characters have of sickness or injury in its absence.

And with all too real terrestrial morons like Daniel Hannan, Jeremy Hunt, Dave Cameron, Theresa May, Tony Blair, Alan Milburn and the rest of the right-wing politicos, who have done and still are doing their best to undermine the health service, such comments are badly needed throughout the British media.