From addictive foods to lifetime drugs, corporations are profiting from your ill-health, and the NHS is left to foot the bill. This is how neoliberalism is eating the state from within.

This is the audio version:

This is the transcript:

Is the NHS eating the state in the UK?

It's a weird question to ask, and yet it's one that I think is entirely appropriate.

The Guardian newspaper ran an article recently based on a report by the Resolution Foundation, which suggested  that by 2030, half of all government spending in the UK could be on the NHS, and that's an extraordinary situation to develop.

Rachel Reeves is putting forward ideas about well-being on the basis that people  are better off as a consequence of the additional spending that she claims that she's making. But my question to you at the start of this video is, is the spending in question actually really improving our wellbeing, or is it, in fact, tackling the fact that the neoliberal state is making us worse off?

Let's look at some data here. The NHS and care costs are, in fact, rising towards 50% of total UK government spending. That is extraordinary, and it is because care costs are going up by a higher rate than every other type of government spending, so as we see that trend continuing, it is entirely possible that this ratio of 50% of all government spending going on healthcare could be achieved.

Now, when Rachel Reeves tells us that this is a benefit to us and sells the idea that we'll feel better off as a result, what she's really doing is saying that we get a benefit in kind as a consequence of the expenditure that she's incurring on the NHS. And what that implies is that she  and Wes Streeting, the Health Secretary, think that we feel better off  because the NHS is spending more on us.

Well, that's first of all, a difficult claim to make because although the spend is going up, the actual level of spend doesn't match the demand for NHS expenditure created by people turning up at doctors' doors. So there is a real doubt as to whether more NHS spending does actually equate to improved living standards.

And we also know that those increased NHS costs are giving rise to cuts elsewhere. Let's not pretend that there isn't austerity in the UK right now because there clearly is.

The Justice Ministry has seen its budget cut by 16% since 2010.

Housing and local government have seen their budget cut by 50% since 2010.

And we are seeing current measures such as Liz Kendall's reforms to the personal incapacity payment, which are going to mean that maybe 400,000 people with some form of disability might see the income on which they rely cut to the point that they will be in absolute poverty.

So, it is actually the case that every pound that is now spent on the NHS does, because of the way in which Rachel Reeves insists the government must budget, crowd out other government services; and crowding out, in this sense simply means that if you actually choose one thing, and you treat the government's expenditure as a whole, as a fixed sum, there must be something that's given up as a consequence, and that is happening. So we have a crisis caused by the need for more expenditure on the NHS, but why do we need so much more expenditure on the NHS? That is the question which I don't think politicians are asking, and which has continually frustrated me.

Now, I should put this in context. I am married to a retired GP who is a bit of a health geek. I think it's fair to say she might be retired, but she still reads vast quantities of papers on the causes of health inequality in the UK, in particular. And as a consequence, I am pretty influenced in my thinking by what she comes up with. But the point she makes, and the point a lot of people are now making, is that the NHS is actually not solving the problem of sickness in the UK economy. Instead, what it's doing is simply managing the ill health that people have within the UK economy.

And this is extraordinarily important because we aren't actually making people better as a consequence of all their spending. And the reason why is that neoliberal pharmaceutical companies don't actually want to solve anybody's illnesses. If they make somebody better, they've got no further demand for their products. No further drugs to supply to that person. No further things that they will have to go to see a GP about. No further prescriptions to write. And that isn't what the pharmaceutical industry wants.

What they love are things like statins that somebody's put on at the age of 40 to deal with some form of cardiovascular complaint, and from then on, they'll be stuck on that drug for life. That's the money spinner that the pharmaceutical industry wants, and as a consequence, we treat symptoms and not causes.

What we know they do create is drug dependency, and we know that this risk of being dependent upon drugs is growing. For example, there is an obesity crisis in the UK. We know that ultra-processed foods produced by our large food companies are designed to be addictive so that we keep on going back for more and more and more. Hence, we have an obesity crisis which is creating not just type two diabetes, but a whole load of other cardiovascular diseases, cancer and dementia. There are positive links in every one of those cases to that type of food.

The industry profits, and now we get the second fallout for the NHS. Not only has it got to deal with drug companies who don't want to cure illnesses, but now it has to solve the problem of other parts of the neoliberal hierarchy creating products that are addictive, for which the NHS has to pick up the price.

The rise in spending does, in other words, mask failing health and declining well-being. That's the reality that we are facing. We are actually looking at engineered scarcity in resources designed to ensure that whilst the NHS gets more, the rest of the state does not. And the pharmaceutical companies and the people who own them, including the large pension funds who represent 10 to 15% of the wealthiest people in the UK in terms of the share ownership in those entities, are living well whilst the rest of the country is living in the insecurity that is created by their ill health.

Stress, anxiety, depression, and other conditions are rising sharply, and that's partly because of the side effects of these drugs, drug dependency, and the dependency on things like ultra-processed foods, and now the drugs for them. That is all absolutely manufactured dependency, as is the health crisis that follows.

The pharmaceutical industry wants us to be ill, and because they demand more and more money, we create more and more problems. There is a culture of cutting costs in local government, in housing, in social care and other things, and as a consequence, we have a lower quality of life and the cycle of generating more illness because of the stress that creates, just goes on and on.

We have a false economy, in other words, with real human costs, and we have the state now being asked to pick up the damages that this false economy is creating.

Neoliberalism is literally eating our wellbeing and is destroying the state's capacity to manage the consequences of that. But nowhere have we got politicians who are saying this truth. They will instead tell us that the reality is they're being generous in increasing healthcare spending because that will make us better. But it isn't. It's not making us better because the problem is designed by the combination of the food industry and the healthcare industry to make sure that we remain hooked on the products which are making us ill.

This is the real crisis we're facing, and it's not just threatening our health, but it's threatening everything about what the state can supply for our wellbeing.

My suggestion is that you need to talk about this, research it, share this, and demand something better, including by writing to your MP and asking what are you going to do about it?

Taking further action

If you want to write a letter to your MP on the issues raised in this blog post, there is a ChatGPT prompt to assist you in doing so, with full instructions, here.