In this moment of crisis, we have a choice: either protect private profits, or save lives.
One of the major lessons emerging from the Italian experience of the coronavirus pandemic is that the capacity of the healthcare system is a key factor determining the percentage of people who die after developing COVID-19. When hospitals and intensive care units (ICUs) become overwhelmed by the number of patients, then mortality rises sharply.
At the moment, the only successful strategy adopted internationally to cope with the disease has been ‘social distancing’, which aims to prevent a peak in cases which exceeds the capacity of the healthcare system. By ‘flattening the curve’, this approach saves lives.
However, there is also another way to improve the situation: by increasing the capacity of the healthcare system so that more cases can be dealt with at once. The UK, unlike China, might not be able to rapidly build entirely new hospitals. But there is another option: bringing all private hospitals into emergency public ownership.
In 2017, the NHS had 2.5 beds for every 1,000 people – almost half the OECD average. Right now, the NHS in England has 128,000 overnight beds at 89% occupancy. We are particularly short of ICU beds. At the moment, the NHS in England has just 4,048 – four times fewer than Germany. After a decade of austerity, the capacity of our health system is at rock bottom. But there is another source of capacity.
The exact number of beds in private hospitals is unknown, but in 2012 it was at least 11,200. The private healthcare sector has grown by up to 53% in the period since. If the growth in the sector is commensurate with the growth in the number of beds, that would mean private hospitals now contain 17,000 beds. Some hospitals, such as The London Clinic, even advertise substantial ICU wards.
If we incorporated all those private beds into the NHS, total bed capacity would increase by between 8.5% and 13%. Such an increase would mean that our healthcare system would be able to massively expand triage, isolation and treatment capacity and general bed availability. It would save lives.
Patients already in those hospitals would come under NHS care, and staff and resources could be immediately redirected to our collective response. The NHS would be put in charge of all healthcare resources in the country in order to plan the most efficient emergency response possible. There would be no two-tier healthcare system based on the ability to pay, but instead one system that recognises that until we’re all safe, no one is safe.
The situation we are facing is grave. Boris Johnson’s government has been accused by Professor John Ashton (previously regional director for Public Health England) of ‘behaving like 19th-century colonialists playing a five-day game of cricket’. But it is not just the Tories’ pandemic response which has been a failure. The entire last decade of cuts and cruelty has brought us to this point. Over and over, the Tories have proven to us that they are more interested in protecting an economy run by the rich, for the rich, than they are in the lives of ordinary people.
The very idea of maintaining a private healthcare system, with its border guarded by a credit card machine, during the worst pandemic any of us have ever faced is criminal. So let’s jettison the profit of giants like BUPA and Virgin for the sake of those whose lives are on the line. There are no non-radical options. Either we decide that lives matter more than profits, or we don’t.
Our NHS was already at breaking point, and now, if we do nothing, it will break – and the vulnerable will be the ones to bear the terrible cost.
That is a cost that I, for one, will not accept, We have to bring all private hospitals into emergency public ownership, now. No ifs, no buts, now.
Callum Cant is the author of Working for Deliveroo and a PhD student at the University of West London.