The commercialisation and undemocratising of the NHS: the commodification of patients

Last September, I wrote an article entitledJobseekers are being coerced into experimental drug trials dressed up as “job opportunities” .

I reported that David Cameron had announced that it was: “simply a waste to have a health service like the NHS and not use the data it generatedLet me be clear, this does not threaten privacy”, he reassured us, “it doesn’t mean anyone can look at your health records, but it does mean using anonymous data to make new medical breakthroughs”.

Cameron often inadvertently signposts the coming of a diabolical lie with the phrase “let me be clear”, as we know. We also know that so-called anonymisation of data offers no protection at all to identities and personal details. Campaigners described the plan as an”unprecedented threat” to confidentiality, Health Secretary Jeremy Hunt says, rather worryingly, that it will be a boon to research.

It’s common knowledge that many Coalition MPs and Peers are heavily financially invested in pharmaceutical and health care companies. Over 200 parliamentarians have recent past or present financial links with, and vested interests in companies involved in healthcare and all were allowed to vote on the Health and Social Care Bill. The Tories have normalised corruption and made it almost entirely legal. Our democracy and civic life are now profoundly compromised as a result of corporate and financial power colonising the State, and vice versa.

The Health and Social Care Bill, 2012, has a telling insert: The Secretary of State’s duty as to research, which is “In exercising functions in relation to the health service, the Secretary of State must promote – (a) research on matters relevant to the health service, and (b) the use in the health service of evidence obtained from research”.

And also very worryingly: (1) The National Patient Safety Agency is abolished. (2) The National Patient Safety Agency (Establishment and Constitution) Order 2001 (S.I. 2001/1743) is revoked. (3) In section 13 of the NHS Redress Act 2006 (scheme authority’s duties of co-operation), omit subsection (2)

So we must ponder just how coincidental it is that Jobseekers are now being coerced into experimental drug trials, or risk benefit sanctions, as the trials are being dressed up as “job opportunities”.

People claiming Jobseekers Allowance while searching for new employment are being forced to accept ever worsening working conditions or join exploitative Government work programmes in desperate attempts to survive, as our civilised social safety nets and lifeline benefits are being torn away by a draconian and authoritarian Government.

The rising number of unemployed and underemployed citizens of the UK are having their desperation to survive exploited, enticed into zero hour contracts, workfare and now, clinical trials. My revulsion at this Government is at an all time absolute.

Jobseekers using the Government’s  job website – the Universal JobMatch – have been receiving multiple messages from the service inviting them to apply for jobs, only to find that these “employment opportunities” are actually clinical trials.

Drug companies are also to be given provisional approval to treat the severely ill with new drugs and use the data in later licence applications In other words, our government is permitting pharmaceutical companies to experiment using severely ill people.

Behind the scheme is a Tory concern that the UK is no longer a favourite location for the drug companies to develop and trial new medicines – “Making Britain the best place in the world for science, research and development is a central part of our long-term economic plan,” said Health Secretary, Jeremy Hunt.

George Freeman, Conservative MP for Mid-Norfolk, who has long campaigned for the scheme, said: “it would benefit small biotech companies and charities, which may have breakthrough drugs that they cannot afford to take all the way through the long and expensive regulatory process – increasingly the source of innovative medicines which are then bought up by big pharma.

They would get their drugs into NHS patients, hopefully giving them positive data which would attract investors for the large-scale clinical trials.”

So not this is not actually about patient welfare, as Hunt had initially claimed. If it were, then there would have been no need for the abolition of The National Patient Safety Agency, or the revoking of The National Patient Safety Agency.

In 2011, an influential report written by Colin Haslam, Pauline Gleadle and Nick Tsitsianis entitled UK bio-pharma: Innovation, re-invention and capital at risk concludes by presenting the case for innovative short and medium term government-led policy initiatives for the sector and highlights four central areas in which the current bio-pharma business model could evolve. The study concludes by presenting the case for innovative short and medium term government-led policy.

The acknowledgement reads: “in order to complete our research work we have obtained the support of a number of senior executives in private and publicly quoted SME bio-pharma companies and also industry experts in big-pharma. We would like to thank this group for giving up their time to be interviewed for this research project.”

One of the key recommendations of the report is: access to NHS clinical datasets to provide a significant knowledge resource to strategically drive UK drug discovery.

The report is primarily concerned with “the evolution of the bio-pharma business model.”

Reuters reports that the UK is currently one of the only markets in the world in which pharmaceutical companies are free to set prices for their drugs. At the moment, the UK Pharmaceutical Price Regulation Scheme (PPRS) regulates profits, not prices on sales to the NHS, whilst the National Institute for Health and Clinical Excellence (NICE) assesses if drugs are cost effective.

However, this is set to change with the introduction of the “Programme for Government” document indicating that the coalition would “reform NICE and move to a system of value-based pricing”. This would lead to changes in the way that drug prices are determined.

The Association of British Pharmaceutical Industry has stated that it will be keeping an open mind ahead of talks with the government.

“Valued-based pricing is one way of doing it,” said spokesman Richard Ley. “We are not opposed to the principle. It is a question of how it is achieved to get it right.” By that, he means how to make it very profitable, of course.

“The regulatory process is inefficient,” according to one leading biotech investor.From a business side of things these products stop being developed in the UK when they get into later stage because the UK is not a very good market for pharmaceuticals.”

Drug companies have for years strongly criticised the National Institute for Health and Care Excellence (Nice), the UK pricing regulator, which they believe is blocking new and innovative medicines by complicated approval processes and a heavy emphasis on cost control.

Steve Bates, chief executive of the Biotech Industry Association, said: “It’s fantastic and very important that there is a new designation and an “all hands on deck” approach.

“The Coalition Government is determined to secure and expand the UK’s position as an international hub for innovation, medical science and research and in the last 12 months has generated more than £1 billion industry and private sector investment. The Prime Minister will use his visit to the US to meet with CEOs and senior figures from leading pharmaceutical companies, including Johnson & Johnson, Baxter, Covance and Pfizer. The meeting will focus on the UK’s life sciences sector and initiatives such a genomics and dementia research”.

A key policy advisory group – The Ministerial Industry Strategy Group – is co-chaired by the Secretary of State for Health and the Chairman of the British Pharma Group, and aims to promote a “strong and profitable UK-based bio-pharmaceutical industry capable of sustained research”.

The Deregulation Bill is wide-ranging in scope. It’s when we look at what it might mean for the NHS that we see why so much of the contents are very worrying.

This Bill imposes a new duty on non-economic regulators to promote economic growth, for example. What exactly would that mean for the Care Quality Commission? How would the Medicines and Healthcare Regulatory Agency, which regulates the pharmaceutical industry, promote growth?

The bill also imposes a new “growth duty” on watchdogs as well as regulators. Currently, such bodies exist to monitor particular sectors – like health – and take action in the best interests of the public according to the relevant law.

But Clause 58 of the Deregulation Bill puts a responsibility on regulators in England so that when they take regulatory action it has to be with regard to “promoting economic growth”, and not to promoting the best interests of the public. The Bill was quietly tabled in draft by Ken Clarke and Oliver Letwin, and didn’t Letwin say back in 2004 that the “NHS will not exist within five years of a Conservative election victory”?

Regulation evolved to “help build a more fair society and even save lives”, but regulation is often considered a hindrance by business. So this is all about The Coalition making it easier for big profits to be made out of the NHS by private healthcare multinationals. True to Tory form, it’s another policy which is designed to facilitate the exploitation of the vulnerable by the wealthy.

It’s also worth noting that last week, two of the government’s top health and work advisers stated they believed in the merits of “prioritising NHS treatment for working people”, and this needs to be seriously discussed.

If that isn’t further clear evidence of the relentless Tory drive towards economic reductionism and determinism, I don’t know what is.

I need not go on to discuss the religion of the Pope or the toilet habits of bears, I suppose.

Further reading:

Profit before human need  – “The drug companies will get away with whatever they can get away with within the law to look after the interests of their shareholders. But they couldn’t get away with these things were it not for members of my profession being willing to collude with them and put patients in second place”: unfavourable results from medical trials are being withheld, MPs warn


13 thoughts on “The commercialisation and undemocratising of the NHS: the commodification of patients

  1. Reblogged this on Vox Political and commented:
    The news that Jeremy Hunt is planning to allow drugs companies to test their products on people with serious illnesses is of serious concern to anyone with an interest in decent healthcare in the UK. Here, Kitty S Jones clarifies exactly what’s going on and how the NHS is being changed to put profit before people.


  2. It’s already started: My wife received a letter informing her that the needles, that she attaches to her injection Pen for her insulin, are to be changed. This can only be on Cost Grounds.

    With the Abolition of the National Patient Safety Agency, it can only be a matter of time before we see a repeat of the Thalidomide disaster

    (for those who are too young to remember, Thalidomide was a drug prescribed for Morning Sickness in Pregnant Mothers during the 1950’s and 1960’s. Many of the children born to mothers who had taken the drug were born with malformed or missing limbs: )


  3. Reblogged this on Beastrabban’s Weblog and commented:
    This is immensely important, as it shows the commercial interests behind the government’s campaign to make untested drugs available to patients on the NHS. This was what was being celebrated yesterday as a big victory for desperately ill people denied potentially valuable medicine through the regulatory bureaucracy. The real truth is that the pharmaceutical companies see the regulators as an obstruction to maximising profits. I wonder just how long we will have to wait before one of the patients – or their families – who have been killed rather than cured through an experimental drug – tries to sue the drug companies. It further shows the commodification of human life and the human body for medical research under the government. Hunt has sold confidential NHS medical records. Blair began the process by selling donated blood. Moreover, the government is forcing the unemployed to find work as experimental subjects for drug companies. It is not a remotely far step from that to the medical experimentation on political prisoners, and the consequent attitude towards them as ‘stock’ shown in the film ‘V for Vendetta’, based on the comic strip and graphic novel by Alan Moore.


  4. Very very well argued Sue. The effort you put into these reports is amazing but sadly necessary. I for one would love to read what you had to say on Popes religion and the toilet habits of bears :-))


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