Matt Hancock’s Health Legacy of Market Autocracy Must Not Be Overlooked
Like his predecessors, the departed Health and Social Care Secretary tried to sell the soul of the NHS to the private sector, says Maheen Behrana
Matt Hancock’s Cabinet career is over for now. Disgraced by leaked CCTV footage showing him in a compromising position with his old friend Gina Coladangelo, who also happened to be a Department of Health and Social Care advisor, Hancock bowed out of the role he has held throughout the Coronavirus pandemic.
Hancock’s reputation among the British public has always been mixed. Previous Conservatives health secretaries have plundered the depths of public unpopularity – levels to which Hancock arguably hasn’t sunk. Certainly, his conduct with Coladangelo (and in particular his breach of social distancing regulations) has given rise to censure, but Hancock remains Britain’s fourth most-popular Conservative politician. Not a ringing endorsement of Hancock’s credentials, perhaps, but not a sign of public loathing either.
In some ways, Hancock’s personal reputation benefitted from the crisis. His persona as the scapegoated ‘door Matt’ – popularised in John Crace’s Guardian columns – has likely been his saving grace. People ultimately felt sorry for Hancock – epitomised by the Queen’s remark last week to the Prime Minister, when she called the then Health and Social Care Secretary a “poor man”.
But Hancock is not a weepy wet-lettuce. Just like his predecessors, he has spent a sizeable chunk of his time in office systematically undermining the structural integrity of the NHS – and weakening it in ways that are more insidious than have previously been trialled.
Of course, Hancock’s legacy been hidden behind incredibly generous levels of public spending, which the pandemic has necessitated. Yet his record of public investment is overshadowed by a warped obsession with the private sector.
In 2018, for example, Hancock came under fire for his over-zealous promotion of the healthcare app, Babylon, which offers virtual consultations on the NHS through its ‘GP at Hand’ service. Seeming to break the Ministerial Code by promoting a private company reliant on Government funds, Hancock repeatedly sung the praises of Babylon.
Fast forward to 2021, and the details are even more suspicious. It seems that Hancock endorsed Babylon publicly without declaring that the company’s investors had donated £200,000 to the Conservative Party.
This endorsement typifies Hancock’s behaviour as Health and Social Care Secretary. While he presided over public spending on the NHS that would have been unthinkable from the Conservatives in normal times, he has nevertheless championed (albeit subtly) NHS privatisation.
He was unequivocal, in public statements, on the subject of NHS privatisation, declaring in 2019 that he would not stand for it. And yet, in his first year in the role, he presided over record levels of private outsourcing in the NHS. The abolition of Public Health England has also widely been seen as another route for private companies to infiltrate NHS operations.
Hancock’s most recent predecessors, Jeremy Hunt and Andrew Lansley, were widely reviled for what were seen as attempts to privatise the NHS. Yet Hancock appears to have been let off the hook. This is because, using the pandemic as a shield, he was careful to mask privatisation behind a veneer of public duty.
The nation’s testing and contact-tracing programme is branded as ‘NHS Test and Trace’ – despite at least 50% of its staff being contracted from private sector firms. All the while, regional public health teams have been kept out of the loop – playing second fiddle to a heavily centralised and privatised system.
Hancock’s approach to the private sector has certainly not been cautious or reluctant. His tenure has been marked by the mass outsourcing of Government work and the uninhibited deployment of contracts without competition. He even has a shareholding in a family firm with NHS contracts.
The reason that most Conservatives claim to favour the private sector is a belief that competition breeds efficiency. Yet Hancock’s methods of privatisation often involved the eradication of competition. Instead of displaying a fervour for capitalism at all costs, Hancock demonstrated distinct leanings towards market autocracy when it comes to the NHS.
He behaved as Hunt and Lansley did in many respects. He undermined those who work in the NHS by failing to offer them a proper pay rise, just as Hunt undermined junior doctors by imposing contracts on them against their will. Despite promises to the contrary, Hancock’s NHS reform proposals are sketchy on detail when it comes to social care – a continuation of past inaction.
But, unlike Hunt and Lansley, Hancock championed an ominous centralisation of NHS control – a consolidation of power in the hands of the Health and Social Secretary. This notion is clearly articulated as part of his NHS reform proposals – and epitomises the kind of NHS Hancock was hoping to forge.
This NHS would be one that outwardly serves public interests while shipping out work to the private sector; in which decisions are taken in the name of emergency measures, with these used as excuses to override fairness and transparency. However awkward and incompetent Hancock has managed to appear, we must not forget his real legacy when it comes to the NHS. We must also not forget the staggering death toll from COVID-19 that occurred on his watch.
Whether Hancock’s successor Sajid Javid will overturn these reforms remains to be seen – but it is doubtful that he will make the necessary changes to a system that is now geared to protect private interests as a public duty.
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