Established 2005 Registered Charity No. 1110656

Scottish Charity Register No. SC043760

current issue

February – March 2026 : Progress READ ONLINE

RECENT TWEETS

Health crisis

August 01 2025

A report on the continued privatisation of the NHS, how damaging this is for homeless health services and what can be done about it. By Shakir Razak


They die in doorways, in hostels, in hospital corridors. The most vulnerable members of our society – those experiencing homelessness – are dying at rates that would likely trigger national emergencies if they affected any other population. Yet their deaths barely register in public consciousness, dismissed by some in power as inevitable consequences of “lifestyle choices”, rather than what they truly are: systematic healthcare failures driven by the stealth privatisation of our NHS.

This is not just another policy debate. This is a moral emergency. Every day that NHS services are carved up and sold off to private profiteers, more homeless people die preventable deaths. Every contract transferred from public to private hands means another vulnerable person losing access to the specialised care that could save their life. The evidence is overwhelming. The time for action is now.


The Soho Square scandal

The story of Soho Square General Practice reads like a horror story of modern healthcare. In 2016, Living Care Medical Services (a private company) took over this crucial practice serving some of London’s most vulnerable populations, including significant numbers of homeless patients requiring specialised care.
Within months, the system began to collapse:

  • The practice was losing £10,000 monthly under private management.
  • All Chinese-speaking GPs were lost, abandoning vulnerable local migrant populations.
  • By 2018, the Care Quality Commission rated the practice as “inadequate”.
  • Patients were left without access to essential services.

This wasn’t an isolated incident – it was a preview of what happens when healthcare for the vulnerable becomes a commodity to be bought and sold.


The mortality maths of market medicine

The latest Oxford University research confirms what homeless health advocates have long known: “hospital privatisation almost always results in worse quality care for patients.” But for homeless populations, “worse quality care” can be a death sentence.

The Lancet’s devastating findings reveal the true cost:

  • Each percentage point increase in NHS privatisation correlates with a 0.38% increase in preventable deaths.
  • For homeless populations – already dying at rates five to eight times higher than the general population – this represents a catastrophic acceleration of mortality.
  • Under privatisation, homeless people face an 81% higher risk of death compared to equivalent public services.


What does this mean in human terms?

In cities like Manchester, Birmingham or Leeds, every percentage point of privatisation could mean dozens of additional homeless deaths annually. Across England, we’re talking about hundreds of preventable deaths each year among our most vulnerable citizens.


The American nightmare

The United States offers a chilling preview of where NHS privatisation leads. In American cities:

  • Emergency department costs for homeless patients average $18,500 annually.
  • Frequent users of emergency services cost $44,400 each per year.
  • Homeless mortality rates are three to four times higher than in countries with universal healthcare.
  • Medical bankruptcies and healthcare debt trap the most vulnerable in cycles of poverty and homelessness.

This is the future being built for the UK’s homeless population: a system where poverty becomes a death sentence.


The inclusion health crisis

The 2024 Pathway and Crisis “Inclusion Health Barometer” reveals the devastating reality: “those who are most excluded in our society struggle to access health services due to inflexibility, discrimination and stigma.” This isn’t happening by accident, it’s a predictable result of privatisation.
Specialist homeless health services are being systematically dismantled:

  • GP practices serving homeless populations are being closed or privatised.
  • Specialist mental health services are being cut as “non-profitable”.
  • Addiction services are being fragmented across multiple private providers.
  • Outreach services are being eliminated as “cost-ineffective”.


The Finnish alternative

While England pursues privatisation, Finland demonstrates what’s possible with proper public investment in services for the vulnerable. Finland’s Housing First programme achieved:

  • 75% reduction in homelessness since 2008.
  • €15,000 annual savings per person housed.
  • Dramatic improvements in health outcomes.
  • Reduced strain on emergency services.

The lesson is clear: public investment in comprehensive services costs less than managing crisis after crisis. But privatisation prevents this kind of coordinated, long-term thinking.


The profit motive vs. the Hippocratic oath

Private healthcare companies operate under a simple imperative: maximise profit, minimise cost. For homeless populations, this creates systematic incentives to:

  • Avoid complex cases that require expensive, time-intensive care.
  • Minimise staffing in areas serving difficult-to-treat populations.
  • Focus on profitable procedures while neglecting preventative care.
  • Reduce investment in specialised services for vulnerable groups.

The result is predictable: homeless people are systematically excluded from the care they need.


Privatisation by stealth

Recent analysis reveals that Labour’s government has announced “a massive 20%” expansion of private provision within the NHS, yet no political party has ever won an election on a platform of privatising services for the vulnerable. This fundamental transformation of the UK’s healthcare system is happening without public consent or democratic mandate.

The privatisation of homeless health services represents the ultimate democratic betrayal – selling off care for those who have no voice in the political process.


The ripple effect

When homeless people die from preventable causes, the impact extends far beyond the individuals:

  • Families lose loved ones who could have been saved with proper care.
  • Public health systems become overwhelmed with preventable crises.
  • Emergency services are stretched dealing with avoidable emergencies.
  • Society becomes less compassionate as vulnerable people become invisible.

The privatisation of homeless health services is not just killing individuals, it’s killing our collective humanity.


A campaign is born 

In the face of this crisis, the HSP4NHS campaign stands as a beacon of resistance. This movement recognises that:

  • Healthcare is a human right, not a commodity.
  • The most vulnerable deserve the best care, not the cheapest.
  • Public services must serve public need, not private profit.
  • Democratic control over healthcare is essential for social justice.

The campaign demands:

  1. Immediate moratorium on privatisation of services for vulnerable populations.
  2. Reinvestment in specialist homeless health services.
  3. Integrated care models that treat the whole person, not just profitable conditions, and give  continuity of care.
  4. Democratic oversight of all healthcare contracts and decisions.


The moment of truth

We stand at a crossroads. Down one path lies the continued privatisation of healthcare, the abandonment of the vulnerable and the transformation of the UK into a society where your bank balance determines whether you live or die. Down the other path lies a recommitment to the founding principles of the NHS – that healthcare should be free at the point of use, comprehensive in scope and based on need, not ability to pay.

The evidence is clear: privatisation is a false economy that costs everyone who’s not personally invested, just like the water companies. Between April 2019 and March 2024, 74 children died with temporary accommodation as a contributing factor to their vulnerability, ill-health, or death. How many more children must die before we act? The evidence is overwhelming. The moral case is clear. The time for action is now.

  • Learn more about the HSP4NHS campaign on its website: HSP4NHS.org
< In love and in hope Issue 157 : Comics >
February – March 2026 : Progress

CONTENTS

BACK ISSUES
BACK TO PAGE TOP