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How to Dismantle the NHS in 10 Easy Steps: The Blueprint That The Government Does Not Want You To See
Events have spiralled since the first edition of How to Dismantle the NHS in 10 Easy Steps. The junior doctors' strike, the Conservative victory in the 2015 general election, the Corbyn phenomenon, the unexpected Brexit vote and the arguably even more unexpected loss of the Conservative majority in 2017. Further, since writing the first edition, Dr. Youssef El-Gingihy found himself stricken with a life-threatening illness and the NHS doctor became the NHS patient. The fight to save the NHS transformed into a fight for his own life. Now, fully recovered, Dr. Youssef El-Gingihy returns to his 10 Easy Steps in order to strengthen his original argument and continue what Labour leader, Jeremy Corbyn, deems 'one of the most fundamental battles we face in a struggle for a British society that works for the many'. In the year of the 70th anniversary of the NHS, Dr El-Gingihy's insights have never been more vital as our national health service continues to be hit by the privatisation of public services. New expanded second edition with chapters on junior doctor's strikes and plans for US-style healthcare.
146 pages, Kindle Edition
First published July 31, 2015
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201 people want to read
About the author
Youssef El-Gingihy
3 books9 followersYoussef El-Gingihy is a GP in Tower Hamlets, London. He has written on the NHS crisis for The Guardian, The Independent, Huffington Post, Pulse and New Internationalist. He has collaborated on a documentary on the NHS called Sell-Off: The Abolition of Your NHS.
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Displaying 1 - 11 of 11 reviews
December 30, 2018
An urgent, timely and rather scary book about what successive neoliberal governments under Thatcher, Major, Blair and Cameron (and, since the book's publication, May) have done towards the goal of converting the NHS from a tax-funded service provider, free at the point of use, to an insurance-funded coordinator of privatised services.
Realistically, saving the NHS will require two things: 1) vast numbers of people in the streets demanding privatisation be rolled back; 2) the election of a radically anti-neoliberal government. Both are realistic, and the prize is certainly worth it.
As it stands, most people understand little of what's happening to the NHS. El-Gingihy's book, short and understandable, is a valuable contribution towards resolving that.
Realistically, saving the NHS will require two things: 1) vast numbers of people in the streets demanding privatisation be rolled back; 2) the election of a radically anti-neoliberal government. Both are realistic, and the prize is certainly worth it.
As it stands, most people understand little of what's happening to the NHS. El-Gingihy's book, short and understandable, is a valuable contribution towards resolving that.
November 5, 2016
Short, simply and clearly written, very much to the point. Sets out exactly how the coalition government sneaked the process of privatising the NHS past the electorate (even many Tory voters don't actually realise what has happened). I like the way the author uses the Telegraph and Mail to back his facts, although the message doesn't seem to have got through to their readers. Read this and be angry (or, if you live in Scotland, be thankful). Paints a grim picture (and the previous administration doesn't get off lightly either, with its PFI hospital building scheme which saddles hospitals for years to come with debt, high interest rates and expensive contractual obligations - all of which reduce the money available for actual needs like beds and nurses). The author is a GP in a deprived area of London.
October 20, 2015
Great short book written by Tower Hamlets GP documenting how red and blue Tories have destroyed the NHS. The fact that the MP's that made the legislation that has opened up the NHS to be decimated have previously worked for a Private Health company or have went on to work for one is the sort of conflict of interest that should be all over the media. Instead they want to make out the corruption that Sepp Blatter is up to within FIFA somehow is more worthy of our attention than items such as the content of this book and TITP which is going to affect everybody and there families daily life in the future.
February 15, 2019
The book's title suggests a how to guide for wanna-be corporations looking how to gain easy access to parts of our NHS and in essence, it's what has already happened. The book is quite short to read and not jargon-heavy. The title of this is speaking retrospectively and starts with turning our NHS into an 'internal market', firstly dividing the NHS up into Primary Care Trusts (PCT's) and NHS hospitals trusts . Under John Major, PCT's became the purchasers of services and NHS hospital trusts became the providers of services, thus hospitals had to start competing with each other as we were told the public sector was far too inefficient and the private sector brings innovation and cost saving measures.
This public-private partnership was introduced further after Tony Blair, (despite pledging to abolish the internal market within our NHS), went further in New Labour's, NHS Plan 2000 & NHS Improvement Plan 2005, both Plans brought more privatization and saw more services offered such as an MRI, would sometimes be carried out by a private operator who would then bill the NHS. Those services which were outsourced were still allowed to use the NHS logo given the illusion the treatment was being carried out by the NHS.
New Labour adopted John Major's Private Finance schemes (PFI's), and these schemes were used to build roads, prisons, schools and of course, hospitals. The message given was these schools and hospitals were badly run down due to being in public sector hands so the projects were tendered out to bankers, construction firms, and other assorted management consortia in which the PFI model was later exported globally.
Instead of borrowing money from central government at zero/low interest, these loans for PFI constructions were borrowed at high interest rates with high charges for repair and maintenance costs.These high costs went on to bankrupt some hospitals, or forced them to lay off staff, reduce services, merge with other hospitals, or close down completely and sell off the NHS land.
Dr El-Gingihy is a GP who trained at the Royal London Hospital, which is part of Barts Health Trust. He writes: "This is the largest trust in the country and accordingly has the most expensive PFI scheme, which is one of Innisfree's flagship projects. Innisfree - a fund management company in the City of London - is one of the biggest players in the PFI market".
The great big sell off of our NHS is by dividing into two further categories, Primary Care (GP & other Community Services), and Secondary Care (our hospitals). Whilst reading this book you will come across dozens of acronyms and the easiest way to view these is to understand them all as a way of deliberating obfuscating and basically carving up and selling off more and more of our NHS. Primary Care became a way of buying in services from outside companies such as GP's, medical examiners, etc, by private firms such as United Health, Atos, Virgin, Serco, G4S, Harmoni, Take Care Now (I kid you not), which would include many of the Out of Hours services.
From 2003, Foundation Trusts were set up so our hospitals could act as semi-independent businesses allowing them financial and other freedoms. Time and again the likes of Serco, Harmoni & Take Care Now had been falsifying data and overcharging for services provided. Polyclinics emerged as a way of combining serviced with Primary Care such as mental health, maternity care, diagnostics and more, however they are all inextricably linked to private finance and would become very expensive to run and are running into financial trouble.
All of this privatization would not have been possible without the revolving door of health ministers who seem to have links with the private sector. Alan Milburn went to become an advisor for Bridgepoint Capital. Andrew Langlsey went on to advise pharmaceutical giant Roche and others, Patrica Hewitt, went on to advise private equity firm which bought 25 of Bupa's hospitals - Cinvern. Hewitt also went on to be a special consultant of Alliance Boots. Over 200 parliamentarians have had recent financial links in private healthcare providers.
To make privatization easy, you would need to run a smear campaign against our NHS. In the wise words of Noam Chomsky, "That’s the standard technique of privatization: defund, make sure things don’t work, people get angry, you hand it over to private capital". The smear campaign has been running for decades saying that public healthcare is too expensive, services inadequate, public sector is too inefficient, best to hand it over to private capital for efficiency and competitiveness. Dr El-Gingihy demonstrates that our NHS is in fact the least expensive and one of the best in the world and the envy of the world. It's the deliberate under-funding and unnecessary debts that have been its biggest burden.
Legislating to dismantle our NHS. After a 2010 Conservative manifesto of stopping a top-down reorganisation of our NHS, and stating, "the NHS is safe in our hands", the Conservatives went into a coaliton government with the Liberal Democrats and imposed 'The Health & Social Care Act'. This piece of legislation has been described as the "biggest act of privatization ever seen in our NHS".
To plot against our NHS is step seven in this book. The plotting has been going on since the early 1980s where a Central Policy Review drew up plans to bring in an insurance-based health service, whereby the bulk of medical facilities would be privately owned and run, and those who need it would pay for it as in the USA.
Step eight is to help brew the perfect storm to make this all happen. Never let a good crisis go to waste and the financial crisis of 2008 was the perfect timing to bring in austerity measures. Those measures have allowed maternity ward closures, walk-in centre closures, GP surgery closures, A&E closures, recommendations of axing 10% NHS workforce - 135,000 jobs, closure of wards, district & community nurses have halved since 2010 and one in five hospitals are threatened with closure and the land sold off.
Step nine is to redesign the workforce. Between 2015-2016, junior doctors took part in demonstrations to oppose the imposed plans of removing safeguards from working excessive hours, reduce their pay, increasing their hours and punishing them for taking time off work - mostly aimed at women. This unrest enabled the government and certain parts of the media to demonize the doctors claiming they were putting the public's health at risk.
Last but not least, step ten is the introduction of US-style health care in the UK. As the chapter heading suggests, this has been on the agenda since 1982 and is now being put into practice. The profitable parts of our NHS have and are being handed over to private companies over the years and the non-profitable bits will be met by the public purse.
The afterword by the author says all of this is reversible but it needs the political will to do and more people need to know that this is all going on so awareness of this wholesale privatization should be imperative whatever your political persuasion if we want to save our NHS, after all we've paid for it (and continue to do so), with our National Insurance contributions, as have our parents and grandparents.
This public-private partnership was introduced further after Tony Blair, (despite pledging to abolish the internal market within our NHS), went further in New Labour's, NHS Plan 2000 & NHS Improvement Plan 2005, both Plans brought more privatization and saw more services offered such as an MRI, would sometimes be carried out by a private operator who would then bill the NHS. Those services which were outsourced were still allowed to use the NHS logo given the illusion the treatment was being carried out by the NHS.
New Labour adopted John Major's Private Finance schemes (PFI's), and these schemes were used to build roads, prisons, schools and of course, hospitals. The message given was these schools and hospitals were badly run down due to being in public sector hands so the projects were tendered out to bankers, construction firms, and other assorted management consortia in which the PFI model was later exported globally.
Instead of borrowing money from central government at zero/low interest, these loans for PFI constructions were borrowed at high interest rates with high charges for repair and maintenance costs.These high costs went on to bankrupt some hospitals, or forced them to lay off staff, reduce services, merge with other hospitals, or close down completely and sell off the NHS land.
Dr El-Gingihy is a GP who trained at the Royal London Hospital, which is part of Barts Health Trust. He writes: "This is the largest trust in the country and accordingly has the most expensive PFI scheme, which is one of Innisfree's flagship projects. Innisfree - a fund management company in the City of London - is one of the biggest players in the PFI market".
The great big sell off of our NHS is by dividing into two further categories, Primary Care (GP & other Community Services), and Secondary Care (our hospitals). Whilst reading this book you will come across dozens of acronyms and the easiest way to view these is to understand them all as a way of deliberating obfuscating and basically carving up and selling off more and more of our NHS. Primary Care became a way of buying in services from outside companies such as GP's, medical examiners, etc, by private firms such as United Health, Atos, Virgin, Serco, G4S, Harmoni, Take Care Now (I kid you not), which would include many of the Out of Hours services.
From 2003, Foundation Trusts were set up so our hospitals could act as semi-independent businesses allowing them financial and other freedoms. Time and again the likes of Serco, Harmoni & Take Care Now had been falsifying data and overcharging for services provided. Polyclinics emerged as a way of combining serviced with Primary Care such as mental health, maternity care, diagnostics and more, however they are all inextricably linked to private finance and would become very expensive to run and are running into financial trouble.
All of this privatization would not have been possible without the revolving door of health ministers who seem to have links with the private sector. Alan Milburn went to become an advisor for Bridgepoint Capital. Andrew Langlsey went on to advise pharmaceutical giant Roche and others, Patrica Hewitt, went on to advise private equity firm which bought 25 of Bupa's hospitals - Cinvern. Hewitt also went on to be a special consultant of Alliance Boots. Over 200 parliamentarians have had recent financial links in private healthcare providers.
To make privatization easy, you would need to run a smear campaign against our NHS. In the wise words of Noam Chomsky, "That’s the standard technique of privatization: defund, make sure things don’t work, people get angry, you hand it over to private capital". The smear campaign has been running for decades saying that public healthcare is too expensive, services inadequate, public sector is too inefficient, best to hand it over to private capital for efficiency and competitiveness. Dr El-Gingihy demonstrates that our NHS is in fact the least expensive and one of the best in the world and the envy of the world. It's the deliberate under-funding and unnecessary debts that have been its biggest burden.
Legislating to dismantle our NHS. After a 2010 Conservative manifesto of stopping a top-down reorganisation of our NHS, and stating, "the NHS is safe in our hands", the Conservatives went into a coaliton government with the Liberal Democrats and imposed 'The Health & Social Care Act'. This piece of legislation has been described as the "biggest act of privatization ever seen in our NHS".
To plot against our NHS is step seven in this book. The plotting has been going on since the early 1980s where a Central Policy Review drew up plans to bring in an insurance-based health service, whereby the bulk of medical facilities would be privately owned and run, and those who need it would pay for it as in the USA.
Step eight is to help brew the perfect storm to make this all happen. Never let a good crisis go to waste and the financial crisis of 2008 was the perfect timing to bring in austerity measures. Those measures have allowed maternity ward closures, walk-in centre closures, GP surgery closures, A&E closures, recommendations of axing 10% NHS workforce - 135,000 jobs, closure of wards, district & community nurses have halved since 2010 and one in five hospitals are threatened with closure and the land sold off.
Step nine is to redesign the workforce. Between 2015-2016, junior doctors took part in demonstrations to oppose the imposed plans of removing safeguards from working excessive hours, reduce their pay, increasing their hours and punishing them for taking time off work - mostly aimed at women. This unrest enabled the government and certain parts of the media to demonize the doctors claiming they were putting the public's health at risk.
Last but not least, step ten is the introduction of US-style health care in the UK. As the chapter heading suggests, this has been on the agenda since 1982 and is now being put into practice. The profitable parts of our NHS have and are being handed over to private companies over the years and the non-profitable bits will be met by the public purse.
The afterword by the author says all of this is reversible but it needs the political will to do and more people need to know that this is all going on so awareness of this wholesale privatization should be imperative whatever your political persuasion if we want to save our NHS, after all we've paid for it (and continue to do so), with our National Insurance contributions, as have our parents and grandparents.
November 21, 2016
I hadn't realised the extent of the privatisation of the NHS. It's a bit frightening, but I guess that's the point of the book.
October 12, 2017
Essential reading for anyone wanting to get a clear picture of what is happening to our health service.
March 7, 2020
If like me you have had recourse to use our fantastic NHS - I'd be dead or bankrupt or both without it, you will want to read this account written by a doctor. Privatisation isn't a plan, it is happening and will result in a dismantling sooner rather than later. I read it in an hour and vowed to make the fight to stop privatisation and protect the NHS one in which I will be involved in. Health is not a commodity to make money out of.
November 18, 2021
Everyone working in healthcare should read this book. It is indispensable for going beyond media PR to reveal the long-game privatising agenda, and how to resist it democratically, supported by empirical evidence.
June 3, 2024
A nice basic primer on how the capitalist class has privatised the NHS by stealth. Definitely interesting in reading more about this with the upcoming Starmer government planning to go further than New Labour when it comes to our NHS.
April 3, 2018
I’m fuming. I’m furious. If you want to know what’s happening to the NHS then look no further. I’m warning you though: a fire will be lit & I hope it means we can take back what’s ours.
March 1, 2025
Instructive
Displaying 1 - 11 of 11 reviews