Facts on the ground, such as private companies’ 44% share of child mental health spending, make a mockery of ministers’ promises
The gap between what the government is saying about the NHS and what is actually happening is growing. When the health secretary, Matt Hancock, declared in January that there would be “no privatisation on my watch”, he was not announcing a change in policy but a continuation. Andrew Lansley’s 2012 reorganisation is recognised by Theresa May’s government as a failure, and ministers support NHS England’s goal of abolishing the compulsory tendering that it ushered in.
Whether a government led by Boris Johnson sticks by this policy remains to be seen. But even it does, the willingness to rein in profit-seeking companies by restricting competition is far from the whole story. Analysis of recent figures reveals a 14% rise in the amount of money going to profit-making companies over the past four years, up to a record £9.2bn in 2018-19 (a rise of more than £1bn from the £8.1bn spent on private healthcare in 2014-15). In some sectors the proportion of private spending is many times the overall average of 7.3%, with 44% of all spending on child and adolescent mental health going to private providers, and 30% of mental health budgets overall. In the controversial area of “locked ward rehabilitation”, where people are held as psychiatric inpatients, sometimes against their will and for years at a time, the private sector has held a share of the market as high as 97%.