When needs must: politics and healthcare
Back in May, UK politician Wes Streeting made national headlines when he said patient choice was underused. Waiting lists were at a record high so this comment seems so obvious it’s barely worth reporting. Of course the private sector should get involved! And yet because this was the UK, it was worth reporting, not least because Mr Streeting is the health spokesman for the centre-left opposition Labour Party.
This is the same Labour Party which has been accusing the Conservatives of trying to privatise the NHS by the back door for over a decade, and it was now fielding a minister who thought the NHS could use the private sector more actively. This is becoming more common. With healthcare systems around the world struggling to meet demand post-Covid, many other politicians appear to have shed their historical allegiances.
In Valencia, the far-right Vox Party has issued a motion in the town hall seeking to force its regional coalition partner to put the Torrevieja Hospital, which was previously a PPP, back to public tender. The PPP model in Valencia was famously killed off by the previous government, a left-wing coalition. It already looked as if the new right-wing government might bring it back. But while the centre-right wants to wait for the results of a review, Vox wants it now. Party MPs compared healthcare delivery to rubbish collection – whoever can do it reasonably well for cheap should be the ones to do it.
This is surprising because the far-right too can be off-putting for investors due to its propensity to bash PE. Vox’s national leader Santiago Abascal supports cutting public spending and economic liberalism. But his party spouts nationalism and populism, which can sometimes suppress foreign investment as seen in Donald Trump’s protectivist “America First” rhetoric.
Perhaps even more surprising is the far-right in Poland’s relationship with private healthcare. PiS, a party which ran adverts showing uninsured patients being refused service and diverted PPE from the private sector to the NHS, hasn’t created an unwelcoming investor environment in Poland despite fears it would. Not only is Polish hospital American Heart of Poland being bought but it’s being bought by San Donato. The Italian market has a reputation for being less keen on internationalisation than most large European market, which one operator described to us as “an Italian problem”.
Of course there are exceptions. Finland wasn’t keen on public-to-private outsourcing until it voted in a very right-wing government. Neither was Lazio, which is still a difficult regulatory environment but now considered welcoming enough for listed group Garofalo to buy a Roman asset. Meanwhile France still pays for-profit providers less than public or not-for-profits, and even when governments say they will use private providers more. As seen in Hungary, their policies can sometimes make it more difficult for the sector to operate. But when needs must and votes (and lives) are on the line, ideologies get quietly and expediently ushered out via the back door and politicians do whatever they can to secure healthcare services (and votes).
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