00:00:04.944 --> 00:00:09.739
♪ And did those feet in ancient time ♪

00:00:11.800 --> 00:00:16.595
♪ Walk upon England's mountains green ♪

00:00:17.492 --> 00:00:22.287
♪ And was the holy lamb of God ♪

00:00:23.672 --> 00:00:27.988
♪ On England's pleasant pastures seen ♪

00:00:30.018 --> 00:00:32.233
- It happens late at night,

00:00:32.233 --> 00:00:35.070
after 10:00 and before 4:00.

00:00:35.070 --> 00:00:36.852
It's called "patient dumping."

00:00:38.093 --> 00:00:40.206
- [Cameraman] Wait, so y'all
just leave this lady out here

00:00:40.206 --> 00:00:41.587
with no clothes on?

00:00:46.619 --> 00:00:47.878
That is not okay.

00:00:49.209 --> 00:00:50.273
- [Security Guard] You
don't know the circumstances

00:00:50.273 --> 00:00:51.072
of what it was.

00:00:51.072 --> 00:00:53.217
- [Cameraman] Then you all
need to call the police.

00:00:55.653 --> 00:00:57.207
So you all are just gonna leave this lady

00:00:57.207 --> 00:00:59.080
out here like this?

00:01:00.392 --> 00:01:04.182
Are you in pain?
[woman shrieking]

00:01:08.514 --> 00:01:12.110
- For any society just
to drop somebody off

00:01:12.110 --> 00:01:14.815
in the middle of the night,
especially with a disability,

00:01:14.815 --> 00:01:17.404
and expect them to fend for themselves

00:01:17.404 --> 00:01:18.529
is really barbaric.

00:01:22.199 --> 00:01:24.702
And if a hospital wants
to make the most profit--

00:01:24.702 --> 00:01:27.580
they want to get the most
number of people in the beds,

00:01:27.580 --> 00:01:30.629
so to get somebody out and
get the next person in--

00:01:30.629 --> 00:01:32.816
find a place, dump them off.

00:01:32.816 --> 00:01:37.295
Because if your heart really
is to help those in need

00:01:37.295 --> 00:01:39.376
on the one hand, but on the other hand

00:01:39.376 --> 00:01:42.387
somebody else's heart is profit,

00:01:42.387 --> 00:01:44.442
how can you reconcile those two?

00:01:45.874 --> 00:01:48.432
[ominous booming tone]

00:01:55.583 --> 00:01:59.362
- We've had people who have
arrived literally in scrubs

00:02:00.490 --> 00:02:04.416
and open-toed sandals
from mental health units

00:02:06.056 --> 00:02:08.329
where there's been a
sort of discharge meeting

00:02:08.329 --> 00:02:10.257
at sort of ten o'clock in the morning.

00:02:10.257 --> 00:02:12.501
Five o'clock in the afternoon
they're put in a taxi

00:02:12.501 --> 00:02:14.352
and sent down to us.

00:02:14.352 --> 00:02:18.629
Last year we had a man
who had been discharged

00:02:18.629 --> 00:02:20.979
from the local hospital nine days

00:02:20.979 --> 00:02:22.814
after having open-heart surgery.

00:02:24.323 --> 00:02:26.881
[ominous booming tone]

00:02:36.961 --> 00:02:39.249
- Hi I'm Emily, a talent community manager

00:02:39.249 --> 00:02:40.745
at United Health Group.

00:02:40.745 --> 00:02:43.593
Here at United Health Group,
we're providing healthcare

00:02:43.593 --> 00:02:46.633
to over 90 million people worldwide.

00:02:46.633 --> 00:02:51.045
- Hi, I'm Allison, and I just
became eligible for Medicare,

00:02:51.045 --> 00:02:54.037
so I signed up for a
Humana Medicare Advantage

00:02:54.037 --> 00:02:57.113
and prescription drug plan.
I'm excited.

00:02:57.113 --> 00:02:59.590
[exhaltant instrumental music]

00:03:07.331 --> 00:03:10.648
- The NHS has been repurposed
from a public service

00:03:10.648 --> 00:03:13.256
to something for profit extraction.

00:03:13.256 --> 00:03:17.073
And all the changes we have
seen have just been about

00:03:17.073 --> 00:03:19.758
liberating up these potential assets

00:03:19.758 --> 00:03:22.751
for the corporate raiders
to take them over.

00:03:22.751 --> 00:03:24.266
- [Pilger ] Healthcare is...

00:03:24.266 --> 00:03:26.692
- A multitrillion-dollar opportunity,

00:03:26.692 --> 00:03:28.698
if you listen to any of the lobbyists.

00:03:28.698 --> 00:03:29.497
It is.

00:03:29.497 --> 00:03:31.260
I mean globally, if you look at it,

00:03:35.992 --> 00:03:40.080
it is a huge, huge
market-- potential market.

00:03:40.080 --> 00:03:41.490
And the NHS stands out

00:03:42.829 --> 00:03:47.503
as a £120-odd billion pound opportunity.

00:03:47.503 --> 00:03:50.227
Lobbyists normally lobby
for one of two reasons:

00:03:50.227 --> 00:03:51.272
a threat or an opportunity.

00:03:51.272 --> 00:03:54.361
And the NHS is a nice, juicy opportunity.

00:03:54.361 --> 00:03:57.554
- We share in the risk
of ill health together.

00:03:57.554 --> 00:04:00.220
It's a joint project. We fund it together.

00:04:00.220 --> 00:04:04.903
We share that cost fairly.
That's the essence of the NHS.

00:04:06.118 --> 00:04:09.139
What's truly worrying about the way

00:04:09.139 --> 00:04:11.077
in which the NHS is moving is that

00:04:11.077 --> 00:04:15.738
that whole essence is being
fractured and undermined

00:04:15.738 --> 00:04:17.713
by the involvement of the private sector

00:04:18.634 --> 00:04:21.242
and by the underfunding process.

00:04:21.242 --> 00:04:22.902
- If things continue unchecked,

00:04:22.902 --> 00:04:24.311
and this really is a juggernaut

00:04:24.311 --> 00:04:27.956
which is accelerating and seems
to be in its final stages,

00:04:27.956 --> 00:04:30.296
then we will end up, I
think, and we already are,

00:04:30.296 --> 00:04:33.048
in a situation where there
is a two-tier system.

00:04:33.048 --> 00:04:34.499
We will never abolish the NHS.

00:04:34.499 --> 00:04:36.462
The NHS simply becomes eventually,

00:04:36.462 --> 00:04:40.695
ultimately, a third-class basic service.

00:04:43.684 --> 00:04:46.273
- The biggest open secret in Britain

00:04:46.273 --> 00:04:50.052
is that the National
Health Service, the NHS,

00:04:50.052 --> 00:04:51.884
is under attack.

00:04:51.884 --> 00:04:56.574
This war on a unique
institution is not new,

00:04:56.574 --> 00:04:59.844
but has entered a dangerous new stage.

00:04:59.844 --> 00:05:04.255
In 2019 more of the NHS was sold

00:05:04.255 --> 00:05:07.957
to private firms than ever before.

00:05:07.957 --> 00:05:11.841
The term "privatization" is seldom used,

00:05:11.841 --> 00:05:15.879
its reality concealed in corporate spin,

00:05:15.879 --> 00:05:20.674
in deceitful words like
"reform" and "partnership."

00:05:20.828 --> 00:05:24.347
Of course the NHS may
look and feel the same,

00:05:24.347 --> 00:05:27.282
and it works-- often brilliantly.

00:05:27.282 --> 00:05:28.608
But it's changing fast,

00:05:29.622 --> 00:05:32.163
with hospitals forced to compete

00:05:32.163 --> 00:05:36.959
and profit-making companies
cutting back on vital services,

00:05:37.141 --> 00:05:39.206
especially to the vulnerable.

00:05:40.008 --> 00:05:43.893
This film is a tribute to an institution

00:05:43.893 --> 00:05:47.249
that gave freedom from fear to millions.

00:05:47.249 --> 00:05:50.261
The first of its kind in the world,

00:05:50.261 --> 00:05:54.969
a last bastion of true public service.

00:05:54.969 --> 00:05:57.475
It's also a film about democracy.

00:05:58.336 --> 00:06:00.698
Above all, it's a warning.

00:06:04.013 --> 00:06:06.881
This is Michael and Mathew Moncrieff,

00:06:06.881 --> 00:06:10.490
who lost their father,
Trevor, to a heart attack.

00:06:11.791 --> 00:06:14.419
Aged 66, Trevor Moncrieff

00:06:14.419 --> 00:06:16.752
lived in Melton Mobury, in Leicestershire.

00:06:17.737 --> 00:06:22.158
He died after an ambulance
from a private company, Amvale,

00:06:22.158 --> 00:06:25.175
answered a 999 call to his home.

00:06:25.175 --> 00:06:28.421
[sirens wailing]

00:06:28.421 --> 00:06:31.202
- The ambulance pulls up and
they've gone into the house

00:06:31.202 --> 00:06:32.765
and seen Matthew performing

00:06:32.765 --> 00:06:35.856
some rudimentary first aid on my father,

00:06:37.676 --> 00:06:39.939
at which point they've
taken out their machine,

00:06:39.939 --> 00:06:43.554
taken out their
defibrillator, charged it up,

00:06:43.554 --> 00:06:45.194
things look like they're going okay.

00:06:45.194 --> 00:06:49.059
And at the point in which they
try to administer a shock,

00:06:49.059 --> 00:06:53.557
the defibrillator fails,
causing great consternation

00:06:53.557 --> 00:06:57.211
amongst the staff and that
they need a new defibrillator

00:06:57.211 --> 00:07:00.731
on-site as soon as possible.

00:07:00.731 --> 00:07:02.889
But they're unable to
get ahold of the people

00:07:02.889 --> 00:07:04.605
who can dispatch that.

00:07:04.605 --> 00:07:07.118
A text is sent to their call center...

00:07:07.118 --> 00:07:09.257
- They left messages with the call center

00:07:09.257 --> 00:07:12.306
and texts in the middle of an emergency?

00:07:12.306 --> 00:07:15.078
- Absolutely, so no one
directly spoke to someone

00:07:15.078 --> 00:07:18.473
who would actually be able
to dispatch a new ambulance

00:07:18.473 --> 00:07:20.055
with a working defibrillator.

00:07:20.055 --> 00:07:22.923
The ambulance staff
recommend that my brother

00:07:22.923 --> 00:07:26.836
calls the fire service to
get a defibrillator on-hand

00:07:26.836 --> 00:07:29.636
because they are known to
keep them on their trucks.

00:07:29.636 --> 00:07:33.079
And the fire service is
dispatched to my father's address,

00:07:34.115 --> 00:07:36.666
and they arrive and they
do have a defibrillator.

00:07:36.666 --> 00:07:38.440
But obviously this is all contributing

00:07:38.440 --> 00:07:41.691
to a general scene of chaos.

00:07:41.691 --> 00:07:44.070
This is all valuable time that's been lost

00:07:44.933 --> 00:07:48.232
in an extremely critical
period of a heart attack,

00:07:48.232 --> 00:07:51.196
and we still yet to hear back

00:07:51.196 --> 00:07:52.797
from the call center at this point.

00:07:52.797 --> 00:07:55.578
So the situation has kind of descended

00:07:55.578 --> 00:07:59.063
into a harrowing farce.

00:08:00.441 --> 00:08:03.721
- [Pilger] There followed
confusion about which hospital

00:08:03.721 --> 00:08:05.869
to take Mr. Moncrieff.

00:08:05.869 --> 00:08:09.724
He was taken first to
Grantham and stabilized,

00:08:09.724 --> 00:08:12.553
then to Lincoln, a
heart specialist center,

00:08:12.553 --> 00:08:14.724
a journey of 45 minutes.

00:08:15.824 --> 00:08:18.797
- Every subsequent action
kind of went wrong.

00:08:18.797 --> 00:08:20.696
Feels as if there was nothing in place

00:08:20.696 --> 00:08:22.911
to account for this eventuality.

00:08:22.911 --> 00:08:25.433
And from that point
onwards we just entered

00:08:25.433 --> 00:08:27.792
this kind of Kafka-esque nightmare

00:08:27.792 --> 00:08:31.542
of poor decision after poor
decision after poor decision,

00:08:31.542 --> 00:08:34.509
which we are certain led
to his untimely passing.

00:08:35.402 --> 00:08:37.172
[ominous ambient droning]

00:08:37.172 --> 00:08:40.471
- [Pilger] A report by
a leading cardiologist

00:08:40.471 --> 00:08:44.806
found that Trevor Moncrieff
most likely would have lived

00:08:44.806 --> 00:08:48.204
had he received the proper emergency care.

00:08:52.670 --> 00:08:55.528
- What we have here is defibrillators

00:08:55.528 --> 00:08:57.398
that have been bought second-hand,

00:08:57.398 --> 00:08:59.796
that haven't been tested
effectively or properly

00:08:59.796 --> 00:09:03.047
for many a month because
they haven't purchased

00:09:03.047 --> 00:09:05.646
the devices with the
manufacturer's guidelines--

00:09:05.646 --> 00:09:07.343
which smacks of cutting corners.

00:09:07.343 --> 00:09:12.139
It smacks of people trying to cut costs,

00:09:12.685 --> 00:09:13.858
to make profit,

00:09:14.805 --> 00:09:16.192
and not to provide the best care

00:09:16.192 --> 00:09:18.951
for people who desperately need it.

00:09:20.453 --> 00:09:24.385
- [Pilger] In 2018, the NHS in England

00:09:24.385 --> 00:09:27.589
spent more than £92 million pounds

00:09:27.589 --> 00:09:31.667
on private ambulances
and taxis for patients.

00:09:34.312 --> 00:09:38.544
Many carry the NHS logo, but look closely.

00:09:41.332 --> 00:09:43.566
Often unknown to the public,

00:09:43.566 --> 00:09:47.856
private ambulances are
frequently sent to emergencies.

00:09:48.966 --> 00:09:53.214
In 2019, the Care Quality Commission

00:09:53.214 --> 00:09:57.533
warned that patients were put
at risk by private ambulances.

00:09:59.141 --> 00:10:03.581
East Midlands Ambulance
Service, which employed Amvale,

00:10:03.581 --> 00:10:05.637
apologized to the family.

00:10:07.149 --> 00:10:09.291
They declined to give an interview.

00:10:11.263 --> 00:10:15.589
A Freedom of Information
search has since revealed

00:10:15.589 --> 00:10:17.996
that Amvale was still in service

00:10:17.996 --> 00:10:22.398
in the East Midlands in 2017,

00:10:22.398 --> 00:10:26.083
three years after the
death of Trevor Moncrieff.

00:10:30.540 --> 00:10:33.062
Keith Salt waited almost a year

00:10:33.062 --> 00:10:35.498
for a gallbladder operation.

00:10:35.498 --> 00:10:37.592
He was in constant pain.

00:10:39.210 --> 00:10:44.005
In 2013, he was offered the
procedure in a private hospital,

00:10:44.868 --> 00:10:46.952
Spire Parkway in Solihull.

00:10:48.296 --> 00:10:49.983
The NHS would pay for it.

00:10:53.356 --> 00:10:56.962
A feature of privatization
is that thousands

00:10:56.962 --> 00:11:01.757
of NHS operations are
outsourced to private hospitals,

00:11:02.160 --> 00:11:06.955
many of which do not have the
same facilities as the NHS,

00:11:07.521 --> 00:11:11.750
the same expertise, and
the same responsibility

00:11:11.750 --> 00:11:13.278
if something goes wrong.

00:11:16.286 --> 00:11:21.081
Unlike the NHS, private
hospitals like Spire Parkway

00:11:21.561 --> 00:11:23.846
have slick corporate advertising.

00:11:26.634 --> 00:11:29.252
When did you find out
that something was wrong?

00:11:29.252 --> 00:11:32.993
- When I actually came
'round in intensive care

00:11:32.993 --> 00:11:37.251
and they were standing-- a
consultant was standing over

00:11:37.251 --> 00:11:40.723
saying they had experienced problems,

00:11:40.723 --> 00:11:44.770
and that was the reason
for why I was where I was.

00:11:44.770 --> 00:11:48.059
- What was the result of this mistake?

00:11:48.059 --> 00:11:50.361
- He nipped the bile duct.

00:11:50.361 --> 00:11:54.024
It was a 75% cut in it,

00:11:54.024 --> 00:11:56.719
and I had one of the worst injuries

00:11:56.719 --> 00:11:58.388
of a bile duct that you could have

00:11:59.414 --> 00:12:02.809
without, I suppose, dying.

00:12:02.809 --> 00:12:07.182
When I did delve into what

00:12:07.182 --> 00:12:09.609
these kind of injuries do,

00:12:09.609 --> 00:12:14.123
a lot of people a few
years back was quite bad

00:12:14.977 --> 00:12:18.988
and a lot didn't survive beyond 12 months

00:12:19.803 --> 00:12:21.434
with this kind of injury.

00:12:21.434 --> 00:12:22.585
- I'll just get this right.

00:12:22.585 --> 00:12:27.380
Dr. Merser, the specialist
who rescued the situation,

00:12:28.540 --> 00:12:32.463
I suppose, he came from the NHS hospital.

00:12:32.463 --> 00:12:34.760
- The QE, yes.
- Yeah, the QE.

00:12:34.760 --> 00:12:35.774
- The Queen Elizabeth.

00:12:37.536 --> 00:12:40.624
It is isn't until later
that you suddenly realize

00:12:40.624 --> 00:12:44.796
that unlike an NHS hospital,
when there is a problem

00:12:44.796 --> 00:12:47.414
they haven't got the backup to call on

00:12:47.414 --> 00:12:51.298
at that particular time
as you do in NH hospital,

00:12:51.298 --> 00:12:55.345
where they've got probably
several in the same field

00:12:55.345 --> 00:12:58.529
that they can call on at that time.

00:12:58.529 --> 00:13:01.934
- Had you known this before,
would you have gone over to it?

00:13:01.934 --> 00:13:04.840
- I was desperate at that
time to just get it done.

00:13:04.840 --> 00:13:06.959
Yeah, I was in that much pain.

00:13:06.959 --> 00:13:10.076
- Do you think the NHS should send

00:13:10.076 --> 00:13:13.589
patients like yourself
to private hospitals?

00:13:16.029 --> 00:13:16.940
- Well I thought--

00:13:18.295 --> 00:13:20.108
I thought it was good at the time.

00:13:20.108 --> 00:13:23.196
I mean I was quite, I must
say, I was quite impressed

00:13:23.196 --> 00:13:26.783
in the fact that going
into a private hospital

00:13:26.783 --> 00:13:30.581
as opposed to, when you saw the
surroundings and what was...

00:13:30.581 --> 00:13:32.173
- [Pilger] Why were you--
why were you impressed?

00:13:32.173 --> 00:13:35.376
- Just simply because the difference in

00:13:35.376 --> 00:13:39.327
what you were getting for even the rooms,

00:13:39.327 --> 00:13:42.693
the reception areas, the facilities.

00:13:42.693 --> 00:13:45.484
It was just so impressive
for somebody who only ever

00:13:45.484 --> 00:13:49.157
went to an NHS hospital
as to what suddenly

00:13:49.157 --> 00:13:50.615
you were being given.

00:13:50.615 --> 00:13:51.699
- So it looked good?

00:13:51.699 --> 00:13:52.852
- It looked good, yeah.

00:13:55.516 --> 00:13:59.614
Didn't end up being good,
but it looked good. [chuckles]

00:14:01.817 --> 00:14:06.477
- [Pilger] In 2015, following
Keith Salt's operation,

00:14:06.477 --> 00:14:10.688
the Care Quality Commission
published this report

00:14:10.688 --> 00:14:12.302
on Spire Parkway.

00:14:15.147 --> 00:14:19.751
Four years later, Spire
Parkway's safety in surgery

00:14:19.751 --> 00:14:24.386
were rated good but the hospital
still requires improvement.

00:14:26.136 --> 00:14:28.977
Did Spire Parkway Hospital
ever apologize to you?

00:14:28.977 --> 00:14:29.775
- No.

00:14:30.943 --> 00:14:32.659
- [Pilger] Did the surgeon who did it?

00:14:32.659 --> 00:14:34.638
Did he ever apologize to you?

00:14:34.638 --> 00:14:35.437
- No.

00:14:38.634 --> 00:14:41.845
- [Bevan] I'm proud we've got
a National Health Service.

00:14:41.845 --> 00:14:44.791
It's a piece of real socialism.

00:14:44.791 --> 00:14:48.627
And there is nowhere in
any nation in the world,

00:14:49.611 --> 00:14:54.007
communist or capitalist, any
health service to compare.

00:14:58.900 --> 00:15:00.750
- [Pilger] The National Health Service

00:15:00.750 --> 00:15:02.949
was not a gift from above.

00:15:04.170 --> 00:15:07.357
It was conceived in the
blood, sweat and tears

00:15:07.357 --> 00:15:11.376
of ordinary people who had
built the imperial might

00:15:11.376 --> 00:15:12.766
and wealth of Britain,

00:15:14.675 --> 00:15:17.440
and yet often lived in abject poverty.

00:15:25.100 --> 00:15:29.895
In the 1920s and '30s, modern
healthcare was a luxury.

00:15:31.736 --> 00:15:34.894
Children died from Dickensian diseases.

00:15:37.836 --> 00:15:40.399
Women still died in childbirth.

00:15:42.631 --> 00:15:46.381
Infection ravaged slums
without running water

00:15:46.381 --> 00:15:47.180
and sanitation.

00:15:56.566 --> 00:16:00.002
Britain's deadly disease was class.

00:16:06.108 --> 00:16:09.752
The Second World War was
a political awakening

00:16:09.752 --> 00:16:12.278
for millions of ordinary men and women.

00:16:14.960 --> 00:16:18.259
In 1942, a committee chaired by

00:16:18.259 --> 00:16:21.136
the economist William Beverage

00:16:21.136 --> 00:16:25.140
warned that the war was
a revolutionary moment.

00:16:25.140 --> 00:16:27.778
[crowd cheering]

00:16:32.961 --> 00:16:34.508
The elite were worried.

00:16:37.018 --> 00:16:40.214
What would happen when
the soldiers came home?

00:16:41.525 --> 00:16:45.055
For many Britons, the war had been fought

00:16:45.055 --> 00:16:49.294
not only against fascism,
but for a new Jerusalem

00:16:49.294 --> 00:16:53.392
of decent homes and
jobs and healthy lives.

00:16:55.153 --> 00:16:58.999
The Beverage Report
proposed a welfare state

00:16:58.999 --> 00:17:02.615
and the world's first
National Health Service.

00:17:02.615 --> 00:17:06.492
Winston Churchill and the
Conservatives opposed it.

00:17:07.859 --> 00:17:11.889
In the 1945 General Election campaign,

00:17:11.889 --> 00:17:15.926
the war hero Churchill
was not always welcomed

00:17:15.926 --> 00:17:17.483
in the industrial heartland.

00:17:18.513 --> 00:17:20.034
- [Winston Churchill] Can you hear me?

00:17:20.034 --> 00:17:23.359
[crowd jeering]

00:17:23.359 --> 00:17:27.943
When we are on, what is our policy,

00:17:27.943 --> 00:17:32.738
I can only tell you that
an enormous mass of work...

00:17:34.639 --> 00:17:37.197
[crowd jeering and chanting]

00:17:41.187 --> 00:17:43.904
...and substantial
advances in the human heart

00:17:43.904 --> 00:17:47.028
and the human head will have to be made

00:17:47.028 --> 00:17:51.823
before we can adopt the
full glorious utopias

00:17:52.590 --> 00:17:56.122
which the socialist
woolgatherers place before us.

00:17:58.865 --> 00:18:00.848
- [Pilger] The utopian woolgatherers

00:18:00.848 --> 00:18:03.801
would soon have their
say at the ballot box,

00:18:03.801 --> 00:18:06.566
representing the majority of Britons.

00:18:07.810 --> 00:18:10.515
The soldier's paper, the Daily Mirror,

00:18:10.515 --> 00:18:12.903
called for a vote "for them,"

00:18:12.903 --> 00:18:16.375
meaning the men and
women who had won the war

00:18:16.375 --> 00:18:19.415
and the right to a new
freedom, said the Mirror,

00:18:19.415 --> 00:18:22.956
of equal opportunities and robust health.

00:18:27.394 --> 00:18:30.753
Labour's landslide victory was a shock.

00:18:32.136 --> 00:18:36.639
And the tremors didn't stop
there and became open rebellion.

00:18:36.639 --> 00:18:40.715
In the Far East, 50,000
airmen went on strike

00:18:40.715 --> 00:18:44.311
in more than 60 Royal Air Force bases--

00:18:44.311 --> 00:18:47.709
the greatest mass mutiny
in British history.

00:18:51.533 --> 00:18:56.328
The issue was democracy and
the right to be demobilized

00:18:56.386 --> 00:19:01.181
and not to be part of an
imperial presence east of Suez.

00:19:03.061 --> 00:19:05.477
- Arrested and court-martialed,

00:19:05.477 --> 00:19:09.927
the strike leaders were set
free after a public outcry

00:19:09.927 --> 00:19:14.294
that symbolized a Britain
that was now changing fast.

00:19:18.252 --> 00:19:23.047
On July 5th, 1948, the most
momentous social change of all

00:19:24.601 --> 00:19:28.938
was announced by this leaflet
delivered to every household.

00:19:29.885 --> 00:19:32.388
- [Reporter] This leaflet is
coming though your letterbox

00:19:32.388 --> 00:19:36.483
one day soon, or maybe you
have already had your copy.

00:19:36.483 --> 00:19:38.650
Read it carefully.

00:19:38.650 --> 00:19:42.017
It tells you what the new
National Health Service is,

00:19:42.017 --> 00:19:44.168
and how you can use what it offers.

00:19:44.999 --> 00:19:48.392
Study the leaflet, then keep it by you.

00:19:48.392 --> 00:19:51.231
You'll need it for reference.

00:19:51.231 --> 00:19:54.108
[rumbling percussion]

00:19:59.481 --> 00:20:02.185
- The NHS was founded in 1948

00:20:02.185 --> 00:20:04.314
to give people freedom from fear.

00:20:04.314 --> 00:20:07.527
Freedom from fear of healthcare bills

00:20:07.527 --> 00:20:10.702
at a time of great need and distress.

00:20:10.702 --> 00:20:14.835
And that fundamental
principle of freedom from fear

00:20:14.835 --> 00:20:17.559
on the basis of a National Health Service

00:20:17.559 --> 00:20:22.354
providing healthcare for
all throughout the UK--

00:20:22.392 --> 00:20:25.097
on the basis of need, not ability to pay

00:20:25.097 --> 00:20:26.903
and free at the point of delivery--

00:20:27.734 --> 00:20:30.583
that's been an enormous, an immense

00:20:30.583 --> 00:20:32.501
and an important achievement.

00:20:32.501 --> 00:20:36.653
- I mean, my father was a
general practitioner in the '30s.

00:20:36.653 --> 00:20:39.665
He became absolutely
convinced that that system,

00:20:39.665 --> 00:20:43.683
which was effectively a market
in health, people had to pay.

00:20:43.683 --> 00:20:46.637
He hated asking for payment from people

00:20:46.637 --> 00:20:47.960
he knew couldn't do it.

00:20:47.960 --> 00:20:51.125
He looked on 1948 as a day of freedom,

00:20:51.125 --> 00:20:54.635
and he no longer had to ask people to pay.

00:20:54.635 --> 00:20:58.788
We had something principled

00:20:58.788 --> 00:21:00.975
and almost lovely.

00:21:00.975 --> 00:21:04.792
There was a relationship between
the doctor and the patient,

00:21:04.792 --> 00:21:07.745
the one-on-one,
all-important relationship.

00:21:07.745 --> 00:21:11.514
Nurse and patient, which
is really the essence

00:21:11.514 --> 00:21:15.609
of healthcare was one that there
was no market interference,

00:21:15.609 --> 00:21:17.163
no market exchange.

00:21:17.163 --> 00:21:19.004
- Creating an ethos that you were part of

00:21:19.004 --> 00:21:20.647
something greater than yourself,

00:21:22.073 --> 00:21:25.852
it is actually a collective act of genius

00:21:25.852 --> 00:21:28.911
from 1948 to '58 to '68.

00:21:28.911 --> 00:21:32.479
I was born in '68,
and I was born in a country

00:21:32.479 --> 00:21:35.558
with almost the best infant
mortality rate in the world.

00:21:35.558 --> 00:21:36.418
The best place to be born.

00:21:36.418 --> 00:21:38.665
I was born in a city which had

00:21:38.665 --> 00:21:41.513
the first baby incubators,
you know, there.

00:21:41.513 --> 00:21:45.023
We were at the very forefront of health.

00:21:45.023 --> 00:21:48.303
[ominous ambient droning]

00:21:48.303 --> 00:21:52.638
- [Pilger] But in the 1970s,
a secret plan to sell off

00:21:52.638 --> 00:21:55.295
nationalized industry was drawn up

00:21:55.295 --> 00:21:58.731
as Margaret Thatcher
prepared to take power.

00:22:00.042 --> 00:22:04.818
Nicholas Ridley, a close ally
of Thatcher on the far-right,

00:22:04.818 --> 00:22:07.657
advised a "preparation for return

00:22:08.625 --> 00:22:11.467
"to the private sector by stealth."

00:22:13.651 --> 00:22:17.755
In the same year, the American
management consultants

00:22:17.755 --> 00:22:22.550
McKinsey & Company
proposed that NHS hospitals

00:22:22.656 --> 00:22:27.451
should be like hotels and
charge patients a daily rate.

00:22:31.028 --> 00:22:34.232
What is the history of this revision,

00:22:34.232 --> 00:22:35.779
revisionism of the NHS?

00:22:36.763 --> 00:22:40.043
- The real attack, the real decimation

00:22:40.043 --> 00:22:43.486
started in the late '80s
under Margaret Thatcher

00:22:43.486 --> 00:22:47.284
and her two advisors, Oliver
Letwin and John Redwood.

00:22:47.284 --> 00:22:49.605
- [Pilger] How did they express that?

00:22:49.605 --> 00:22:51.398
- They produced a document called

00:22:51.398 --> 00:22:53.336
Britain's Biggest Enterprise,

00:22:53.336 --> 00:22:56.903
and this set out how to
get from a public service

00:22:56.903 --> 00:22:59.186
to an insurance-based system.

00:22:59.186 --> 00:23:01.583
They knew that whatever
they did to the NHS,

00:23:01.583 --> 00:23:03.501
if they took it away
from a public service,

00:23:03.501 --> 00:23:06.273
there would be a huge backlash.

00:23:06.273 --> 00:23:09.246
So key to the plan was to
do it very surreptitiously

00:23:09.246 --> 00:23:11.781
and covertly and over
a long period of time.

00:23:12.833 --> 00:23:14.972
- [Pilger] But it was
the New Labour government

00:23:14.972 --> 00:23:18.657
of Tony Blair that
accelerated the sell-off.

00:23:19.565 --> 00:23:21.896
Blair used an accountancy trick

00:23:21.896 --> 00:23:25.984
called private finance initiative, or PFI.

00:23:27.823 --> 00:23:30.585
New hospitals were effectively owned

00:23:30.585 --> 00:23:32.781
by the companies that built them

00:23:32.781 --> 00:23:35.575
under disastrous pay-later terms.

00:23:37.998 --> 00:23:39.777
- The effect of PFI has been

00:23:39.777 --> 00:23:42.707
to deliberately burden hospitals

00:23:42.707 --> 00:23:44.903
with huge debts, and these
debts were structured

00:23:44.903 --> 00:23:47.943
in such a way that they would
become more onerous over time.

00:23:47.943 --> 00:23:50.715
And what that does, it removes money away

00:23:50.715 --> 00:23:51.847
from the delivery of care

00:23:51.847 --> 00:23:55.664
because PFI repayments are ring-fenced,

00:23:55.664 --> 00:23:58.426
ao money has to go to pay the PFI

00:23:58.426 --> 00:24:01.485
above any other call on that money.

00:24:01.485 --> 00:24:05.158
So you end up having the
servicing of the debt

00:24:05.158 --> 00:24:07.824
in preference to the providing
of care for patients.

00:24:07.824 --> 00:24:10.941
And we've seen hospitals close down.

00:24:10.941 --> 00:24:13.502
Neighboring hospitals
which don't have a PFI debt

00:24:13.502 --> 00:24:18.297
have been sacrificed to bail
out hospitals with PFI debts.

00:24:19.026 --> 00:24:22.843
So if you look at the total
PFI debt within the NHS,

00:24:22.843 --> 00:24:24.694
we've borrowed about £11 billion,

00:24:24.694 --> 00:24:26.458
and we're going to be
paying back in excess

00:24:26.458 --> 00:24:29.751
of £80 billion over 30 to 40 years.

00:24:31.724 --> 00:24:34.169
- [Pilger] And much of
this was secret, wasn't it?

00:24:36.733 --> 00:24:41.343
- The way PFI was introduced,
it was never explained

00:24:41.343 --> 00:24:44.076
in a way that the public
could understand what a con,

00:24:44.076 --> 00:24:45.937
what a fraud this was.

00:24:45.937 --> 00:24:48.334
- At one point, though,
the Labour government

00:24:48.334 --> 00:24:50.348
at one point was looking
at-- actually I think it was

00:24:50.348 --> 00:24:52.679
about a third of the NHS
assets were going to be

00:24:52.679 --> 00:24:56.080
effectively privatized in this
way and handed over to PFI.

00:24:56.966 --> 00:25:00.265
- And were these deals
accountable? Publicly accountable?

00:25:00.265 --> 00:25:01.540
- They were profoundly secretive.

00:25:01.540 --> 00:25:02.796
I mean you couldn't get any access

00:25:02.796 --> 00:25:03.775
to what was going on at all.

00:25:03.775 --> 00:25:06.182
They were all behind closed doors.

00:25:06.182 --> 00:25:10.967
- It's an enormous,
appalling pubic scandal.

00:25:10.967 --> 00:25:15.676
124 hospitals and more are now built--

00:25:15.676 --> 00:25:20.472
designed, built, and operated
using private finance.

00:25:20.961 --> 00:25:24.116
And remember, it's accompanied by one of

00:25:24.116 --> 00:25:27.463
the biggest hospital closure programs

00:25:27.463 --> 00:25:29.758
and land disposal programs.

00:25:31.107 --> 00:25:35.145
- [Pilger] In the late 1990s,
Labour's health secretary,

00:25:35.145 --> 00:25:39.928
Alan Milburn, declared his
undying love for the NHS.

00:25:42.098 --> 00:25:45.704
- This is a once-in-a-lifetime
opportunity for the NHS

00:25:45.704 --> 00:25:49.003
to redesign its services
around its patients.

00:25:49.003 --> 00:25:51.679
We've got more money going in,
and that will allow us now

00:25:51.679 --> 00:25:54.633
to get the basics right, to
get more nurses, more doctors,

00:25:54.633 --> 00:25:55.870
more beds in the system.

00:25:55.870 --> 00:25:57.749
But if we're going to get
the best from the money

00:25:57.749 --> 00:25:59.428
and we've going to get
the best for the patient,

00:25:59.428 --> 00:26:01.931
then there has to be some big changes.

00:26:01.931 --> 00:26:04.022
- [Pilger] What the changes concealed

00:26:04.022 --> 00:26:06.707
was the beginning of a sell-off.

00:26:06.707 --> 00:26:09.680
The Blair government
pushed through Parliament

00:26:09.680 --> 00:26:12.375
a series of bills that opened the door

00:26:12.375 --> 00:26:15.437
to private business and PFI.

00:26:18.973 --> 00:26:22.579
Having overseen the changes to the NHS,

00:26:22.579 --> 00:26:25.830
Alan Milburn left the government

00:26:25.830 --> 00:26:29.398
and later joined the board
of Bridgepoint Capital,

00:26:29.398 --> 00:26:31.232
a private equity company.

00:26:33.742 --> 00:26:35.277
- [Announcer] Welcome to Care UK.

00:26:36.543 --> 00:26:41.338
- [Pilger] In 2010,
Bridgeport bought Care UK,

00:26:41.424 --> 00:26:43.898
one of the biggest healthcare companies

00:26:43.898 --> 00:26:46.306
contracted to the NHS.

00:26:46.306 --> 00:26:48.483
- [Announcer] ...which
balances making a profit

00:26:48.483 --> 00:26:51.324
and delivering quality NHS services.

00:26:53.038 --> 00:26:55.196
- [Pilger] This is Simon Stevens,

00:26:55.196 --> 00:26:57.795
Tony Blair's health advisor.

00:26:57.795 --> 00:27:02.590
In 2004, Stevens stepped
into the revolving door

00:27:02.945 --> 00:27:06.468
and was hired by the American
health industry giant,

00:27:06.468 --> 00:27:07.506
UnitedHealth.

00:27:08.862 --> 00:27:11.241
- UnitedHealth Group believes
that businesses and consumers

00:27:11.241 --> 00:27:13.370
will want to do business with us

00:27:13.370 --> 00:27:17.983
because we hold integrity
at such a high level.

00:27:17.983 --> 00:27:21.848
- Integrity isn't hard.
It's living our beliefs,

00:27:21.848 --> 00:27:24.907
it's being ethical, it's being honest.

00:27:24.907 --> 00:27:29.040
- [Pilger] Honesty? Integrity? Maybe.

00:27:29.040 --> 00:27:32.867
But UnitedHealth has another reputation.

00:27:32.867 --> 00:27:36.598
Its former chief
executive, William Maguire,

00:27:36.598 --> 00:27:41.319
known as Dollar Bill, was
forced to give back $620 million

00:27:43.349 --> 00:27:47.140
in the biggest share scandal
in corporate history.

00:27:48.498 --> 00:27:51.616
[audience applauding]

00:27:51.616 --> 00:27:54.206
After ten years with UnitedHealth,

00:27:54.206 --> 00:27:58.847
Simon Stevens was brought back
by the coalition government

00:27:58.847 --> 00:28:02.207
as head of the National
Health Service in England.

00:28:05.321 --> 00:28:07.872
Under the coalition government,

00:28:07.872 --> 00:28:11.564
the budget of the NHS
was cut from an average

00:28:11.564 --> 00:28:16.008
annual increase of 4% to 1%.

00:28:17.980 --> 00:28:22.440
Thousands of doctors and
nurses have left the NHS,

00:28:22.440 --> 00:28:26.787
which now has one of the lowest
bed capacities in Europe.

00:28:29.916 --> 00:28:32.633
[exhaltant instrumental music]

00:28:34.370 --> 00:28:39.165
In the NHS today, one
American company stands out:

00:28:39.501 --> 00:28:42.781
McKinsey, the management consultants

00:28:42.781 --> 00:28:46.962
with a worldwide reputation
for helping governments

00:28:46.962 --> 00:28:49.564
reform public services.

00:28:54.385 --> 00:28:56.428
- If you look at the
documents that I've got

00:28:56.428 --> 00:29:00.264
from around 2010, 2011--
so this is when they really

00:29:00.264 --> 00:29:04.359
ramp up the privatization,
the reforms of the NHS--

00:29:04.359 --> 00:29:06.613
and you look at McKinsey's
involvement there,

00:29:06.613 --> 00:29:09.126
they are attending meetings
of the management board,

00:29:09.126 --> 00:29:11.054
the steering group that sets up

00:29:11.054 --> 00:29:13.317
these new structures within the NHS.

00:29:13.317 --> 00:29:17.786
This McKinsey document is
about designing the new system,

00:29:17.786 --> 00:29:21.028
and they have set the agenda here.

00:29:21.028 --> 00:29:24.039
This is a great document,
this is them discussing

00:29:24.039 --> 00:29:25.756
the new organizational design.

00:29:25.756 --> 00:29:27.990
So you have an American healthcare model,

00:29:27.990 --> 00:29:30.158
so they're looking at Kaiser Permanente.

00:29:30.158 --> 00:29:32.498
There's lots of glossy
pictures of Kaiser Permente,

00:29:32.498 --> 00:29:34.601
smiling patients and doctors.

00:29:36.171 --> 00:29:37.629
- I think the management of the NHS

00:29:37.629 --> 00:29:40.084
have become dependent on
the management consultants.

00:29:40.084 --> 00:29:42.481
I think they've--
it seems to be no longer

00:29:42.481 --> 00:29:44.301
does the management ever sit down

00:29:44.301 --> 00:29:45.809
and actually draw up its own plan.

00:29:45.809 --> 00:29:48.101
So you actually bring in somebody else.

00:29:48.101 --> 00:29:51.755
And at the end of the day all
you're getting is, you know,

00:29:51.755 --> 00:29:54.949
the management consultancy
kind of approach in which

00:29:54.949 --> 00:29:58.881
you come along, you ask your
management consultant the time,

00:29:58.881 --> 00:30:00.358
he borrows your watch, tells you the time,

00:30:00.358 --> 00:30:02.036
charges you a thousand pounds.

00:30:02.036 --> 00:30:03.954
And we've got that right across the NHS.

00:30:05.873 --> 00:30:08.431
[ominous booming tone]

00:30:28.918 --> 00:30:31.853
- [Pilger] This is the center
of Britain's democracy:

00:30:31.853 --> 00:30:32.901
Westminster.

00:30:35.363 --> 00:30:37.338
Unknown to many of us,

00:30:37.338 --> 00:30:40.398
a network of pressure groups, lobbyists

00:30:40.398 --> 00:30:42.709
and right-wing propagandists

00:30:42.709 --> 00:30:46.500
have their offices in the
streets that border Parliament.

00:30:47.504 --> 00:30:50.729
Their target is the
National Health Service.

00:30:52.625 --> 00:30:55.678
Tamasin Cave and I are taking a tour.

00:30:56.980 --> 00:31:01.775
Okay, and this humble abode
just 'round from Parliament

00:31:02.024 --> 00:31:06.011
is the Institute of Economic
Affairs. Tell me about them.

00:31:06.011 --> 00:31:08.996
- The IEA is an incredibly
effective propaganda machine.

00:31:08.996 --> 00:31:09.795
You look at the size of it.

00:31:09.795 --> 00:31:12.794
It is not a big, massive
advertising company

00:31:12.794 --> 00:31:16.381
or lobbying agency, it's
a small organization.

00:31:16.381 --> 00:31:18.232
But the relationship it has with the media

00:31:18.232 --> 00:31:19.488
is incredibly tight.

00:31:19.488 --> 00:31:22.317
So it manages to get its
messages into the tabloid press,

00:31:22.317 --> 00:31:25.952
it's all over the internet,
but particularly the BBC.

00:31:25.952 --> 00:31:28.810
We do know from other sources
that it has taken money

00:31:28.810 --> 00:31:30.978
from the tobacco companies.

00:31:30.978 --> 00:31:34.238
So for somebody like Philip
Morris, the huge tobacco giant,

00:31:34.238 --> 00:31:37.048
they describe the IEA
as particularly useful

00:31:37.048 --> 00:31:40.127
in getting its messages
out into the public domain.

00:31:40.127 --> 00:31:43.742
The NHS represents everything
that the IEA stands against.

00:31:43.742 --> 00:31:45.603
So it is a public institution,

00:31:45.603 --> 00:31:49.672
but right now it has some
friends in very high places.

00:31:52.380 --> 00:31:54.282
- [Pilger] Okay, we're
now in Tufton Street.

00:31:54.282 --> 00:31:56.002
- It's worth noting that
Tufton Street is kind of like

00:31:56.002 --> 00:31:59.730
this epicenter for these
kind of think tanks.

00:31:59.730 --> 00:32:03.873
You've got the, you know,
low tax advocates over there,

00:32:03.873 --> 00:32:05.781
you've got your climate
change deniers over there,

00:32:05.781 --> 00:32:08.246
you've got your privatizers
over there, your de-regulators.

00:32:08.246 --> 00:32:10.116
They're all here, it's brilliant.

00:32:10.116 --> 00:32:11.142
And in the middle of it you've got

00:32:11.142 --> 00:32:12.245
the Centre for Policy Studies, which--

00:32:13.292 --> 00:32:16.836
this was Margaret Thatcher's think tank.

00:32:16.836 --> 00:32:18.191
[both chuckling]

00:32:18.191 --> 00:32:22.689
So these are the offices of
another free market think tank,

00:32:22.689 --> 00:32:24.876
big business lobby group.

00:32:24.876 --> 00:32:26.036
It's called Reform.

00:32:26.036 --> 00:32:29.316
And this is one-- it's sort of
a younger version of the CPS,

00:32:29.316 --> 00:32:32.011
basically, and it was set up specifically

00:32:32.011 --> 00:32:35.444
to lobby for privatization
of public services--

00:32:35.444 --> 00:32:38.906
so not just the NHS, but education
and justice and the like.

00:32:38.906 --> 00:32:41.946
The brilliant thing about
Reform, very clever this,

00:32:41.946 --> 00:32:44.536
they set up a kind of front group.

00:32:44.536 --> 00:32:46.684
So it wasn't enough that
they were then saying

00:32:46.684 --> 00:32:49.417
the corporate messages in the press,

00:32:49.417 --> 00:32:50.578
they set up another group.

00:32:50.578 --> 00:32:52.908
They set up a thing
called Doctors for Reform,

00:32:52.908 --> 00:32:55.785
which brilliantly was led by a GP--

00:32:55.785 --> 00:32:58.586
one who specialized in Botox, but...

00:32:58.586 --> 00:32:59.765
- Distinguished specialist.

00:32:59.765 --> 00:33:02.144
- Exactly, and he can
reach parts of the media

00:33:02.144 --> 00:33:04.002
that a think tank can't.

00:33:04.002 --> 00:33:06.031
- They're all 'round the
honeypot, aren't they?

00:33:06.031 --> 00:33:10.267
They're all close to power
because just down the road there

00:33:10.267 --> 00:33:12.406
is the Department of Health.

00:33:12.406 --> 00:33:13.777
- Yeah, I mean we are...

00:33:14.870 --> 00:33:16.616
Imagine the corporate interests lined up.

00:33:16.616 --> 00:33:19.090
They are literally behind
the Department of Health.

00:33:19.090 --> 00:33:20.560
It's very, very handy.

00:33:24.007 --> 00:33:26.753
- Okay, and here we are
in Bressenden Place,

00:33:26.753 --> 00:33:29.016
just off Victoria Street.

00:33:29.016 --> 00:33:31.222
Portland House, what's in there?

00:33:31.222 --> 00:33:35.202
- This is the office of the trade body

00:33:35.202 --> 00:33:38.012
for all the companies--
all the other companies

00:33:38.012 --> 00:33:40.975
that are looking to get
their hands on NHS money.

00:33:40.975 --> 00:33:42.203
So, all the big outsourcers.

00:33:42.203 --> 00:33:43.996
You've got in there Care UK,

00:33:43.996 --> 00:33:47.411
biggest NHS contractor
there is at the moment.

00:33:47.411 --> 00:33:50.048
You've got Virgin. They've
picked up £2 billion pounds

00:33:50.048 --> 00:33:52.656
worth of NHS contracts
in the last five years.

00:33:52.656 --> 00:33:54.186
You've got Bupa in there,

00:33:54.186 --> 00:33:56.147
hundreds of millions pounds of NHS work.

00:33:56.147 --> 00:34:00.943
And there's the arm of the
biggest U.S. health insurer,

00:34:01.902 --> 00:34:05.690
which is called UnitedHealth.
Their tech arm, Optum,

00:34:05.690 --> 00:34:07.886
is a member of this organization as well.

00:34:07.886 --> 00:34:11.626
It's called the NHS Partners
Network, and it paints itself

00:34:11.626 --> 00:34:14.551
as kind of part of the NHS family.

00:34:14.551 --> 00:34:18.445
They are investing in
influencing the government.

00:34:18.445 --> 00:34:19.903
It is an investment they make--

00:34:19.903 --> 00:34:22.591
a tactical investment,
because it delivers a return.

00:34:26.741 --> 00:34:30.225
- I spoke to a leading
lobbyist, Andrew Holdenby.

00:34:31.591 --> 00:34:34.176
The Health Service is a public service.

00:34:34.989 --> 00:34:37.866
Why should it be privatized?

00:34:37.866 --> 00:34:41.232
- I think the health service is a lot more

00:34:41.232 --> 00:34:45.941
of a public-private mix than
people may sometimes think,

00:34:45.941 --> 00:34:48.875
and actually was right
back at the beginning.

00:34:48.875 --> 00:34:53.671
So GPs, a very, very crucial
part of the health service,

00:34:54.428 --> 00:34:59.111
have always been independent
contractors, in effect.

00:34:59.111 --> 00:35:01.218
They have their contracts with the NHS,

00:35:01.218 --> 00:35:03.079
But in many ways, the
main thing I have to say

00:35:03.079 --> 00:35:07.155
is that the health service is this mix.

00:35:07.155 --> 00:35:09.562
It's a mix of public financing

00:35:09.562 --> 00:35:12.286
and a lot of private
delivery one way or another.

00:35:12.286 --> 00:35:14.923
That has built the health
service we have today

00:35:14.923 --> 00:35:18.234
with its strengths and
weaknesses, and I think--

00:35:19.124 --> 00:35:20.831
I really strongly think
that it should continue

00:35:20.831 --> 00:35:22.308
to be that mix going forward.

00:35:22.308 --> 00:35:25.568
- But reformers advocated, for example,

00:35:25.568 --> 00:35:30.268
the introduction of payment
in the health service--

00:35:30.268 --> 00:35:32.982
I think you called it
a membership charge--

00:35:32.982 --> 00:35:37.777
and that people staying
overnight in NHS hospitals

00:35:37.892 --> 00:35:41.153
should pay a hotel charge.

00:35:41.153 --> 00:35:44.624
- The idea of a sort of membership fee

00:35:44.624 --> 00:35:49.074
was put forward by Norman
Warner, who was a Labour peer.

00:35:49.074 --> 00:35:51.098
Well, he was trying to
answer the question,

00:35:51.098 --> 00:35:52.626
in a pamphlet for us,

00:35:53.668 --> 00:35:58.377
how do we get citizens of this country

00:35:58.377 --> 00:36:00.851
to take their health more seriously?

00:36:00.851 --> 00:36:05.004
So he suggested, just as an
idea, a £10 pounds a month,

00:36:05.004 --> 00:36:06.969
if you like, "membership fee."

00:36:06.969 --> 00:36:09.686
Which is not a huge amount,

00:36:09.686 --> 00:36:11.612
but it would be enough
to sort of give people,

00:36:11.612 --> 00:36:13.549
if you like, a sort of personal stake

00:36:13.549 --> 00:36:15.937
in thinking about their own healthcare.

00:36:15.937 --> 00:36:18.143
Certainly if we think of
something like technology,

00:36:18.143 --> 00:36:21.327
which will be absolutely
core-- it's already core,

00:36:21.327 --> 00:36:23.245
always has been core.

00:36:23.245 --> 00:36:24.795
But going forward it's very exciting

00:36:24.795 --> 00:36:26.247
to think what new technology can do

00:36:26.247 --> 00:36:27.762
to the delivery of healthcare.

00:36:27.762 --> 00:36:30.419
That, you know, at present,
can only be really be done

00:36:30.419 --> 00:36:32.100
in partnership with the private sector.

00:36:32.100 --> 00:36:35.645
- The new IT system in the
health service was installed

00:36:35.645 --> 00:36:38.276
by private companies and
was a total catastrophe.

00:36:39.894 --> 00:36:44.008
- Yes. I think there may be
one minor thing that came out

00:36:44.008 --> 00:36:46.361
of it, so we can say
nearly a total catastrophe.

00:36:48.870 --> 00:36:52.692
- [Pilger] All this wheeling
and dealing behind closed doors

00:36:52.692 --> 00:36:57.252
fed into the 2012 Health
and Social Care Act,

00:36:57.252 --> 00:36:59.813
which promoted privatization

00:36:59.813 --> 00:37:02.990
and changed the NHS as never before.

00:37:04.273 --> 00:37:08.895
- It's a very large act,
it's over 450 pages long.

00:37:08.895 --> 00:37:11.542
And it's really the act that enables

00:37:11.542 --> 00:37:13.949
both the dismantling of the old system

00:37:13.949 --> 00:37:16.874
that was in place from 1948,

00:37:16.874 --> 00:37:21.670
and a switch to a newer system
which is much more modeled

00:37:21.746 --> 00:37:26.302
on the U.S. healthcare
system-- systems of the U.S.

00:37:26.302 --> 00:37:29.438
- [Pilger] See, people watching
this will be shocked to hear

00:37:29.438 --> 00:37:32.162
that their health service has been

00:37:32.162 --> 00:37:34.828
and is being dismantled.

00:37:34.828 --> 00:37:37.081
- One of the founding duties

00:37:37.081 --> 00:37:40.217
on the Secretary of State in 1948

00:37:40.217 --> 00:37:43.373
was the duty to secure and
provide health services

00:37:43.373 --> 00:37:45.946
throughout England for everybody.

00:37:46.777 --> 00:37:49.779
And that's the duty
that has been abolished.

00:37:49.779 --> 00:37:52.985
That duty to provide has gone.

00:37:53.970 --> 00:37:55.946
The Secretary of State
has a much weaker duty

00:37:55.946 --> 00:37:58.650
to promote a comprehensive healthcare,

00:37:58.650 --> 00:38:01.786
but the duty to provide services

00:38:01.786 --> 00:38:05.124
in accordance with the act has gone.

00:38:05.124 --> 00:38:09.919
And as well as that,
there is now a requirement

00:38:10.398 --> 00:38:14.944
to contract, a duty to
arrange services instead,

00:38:14.944 --> 00:38:17.898
which is really legalese for contracting.

00:38:17.898 --> 00:38:21.408
And the way in which our
government and NHS England

00:38:21.408 --> 00:38:25.292
is choosing to interpret it
as commercial contracting.

00:38:25.292 --> 00:38:29.934
- This external market
created by the Conservatives

00:38:29.934 --> 00:38:32.936
and Liberals in the
Health and Social Care Act

00:38:32.936 --> 00:38:35.314
was a monstrous piece of legislation.

00:38:35.314 --> 00:38:39.604
It was also a grotesque, a grotesque lie

00:38:40.589 --> 00:38:41.644
on the British public.

00:38:41.644 --> 00:38:45.480
Both the Conservative
Party and the Liberal Party

00:38:45.480 --> 00:38:49.038
went out of their way in the election

00:38:49.038 --> 00:38:51.023
to say that they were not going to have

00:38:51.023 --> 00:38:53.936
another top-down health service.

00:38:53.936 --> 00:38:57.132
And they produced the biggest
and the most revolutionary

00:38:57.132 --> 00:39:00.278
change in the National Health
Service throughout its history

00:39:00.278 --> 00:39:02.992
in the 2012 act.

00:39:02.992 --> 00:39:06.819
Cameron went on to say it's
the biggest mistake he made.

00:39:06.819 --> 00:39:09.744
And here it is, six years later,

00:39:09.744 --> 00:39:13.781
still creating serious
damage to the health service.

00:39:13.781 --> 00:39:18.452
- The biggest lie is that somehow markets

00:39:18.452 --> 00:39:22.355
and competition will improve healthcare.

00:39:22.355 --> 00:39:25.117
We know from all the
evidence that's available

00:39:25.117 --> 00:39:27.150
that the more you privatize a system,

00:39:27.150 --> 00:39:28.781
the more you introduce waste

00:39:28.781 --> 00:39:31.533
and you introduce conflicts of interest.

00:39:31.533 --> 00:39:33.068
So that is a big lie.

00:39:33.068 --> 00:39:35.417
The NHS, prior to the Thatcher reforms,

00:39:35.417 --> 00:39:39.666
the administrative costs were
estimated to be less than 5%,

00:39:39.666 --> 00:39:41.603
but we know now best estimates are

00:39:41.603 --> 00:39:44.145
that the costs of the market bureaucracy

00:39:44.145 --> 00:39:46.715
is running in the order of 20%.

00:39:46.715 --> 00:39:51.500
So that is 15% diverted away
from the delivery of care.

00:39:51.500 --> 00:39:55.078
The beauty of the NHS
came from its simplicity,

00:39:55.078 --> 00:39:57.964
and you had money coming from the Treasury

00:39:57.964 --> 00:40:00.870
to health authorities
and this was divided out

00:40:00.870 --> 00:40:03.354
between the hospitals and the GPs.

00:40:03.354 --> 00:40:05.320
There was no need for this army

00:40:05.320 --> 00:40:07.200
of intermediaries we now have.

00:40:07.200 --> 00:40:09.895
- The NHS crisis-- which is
no longer a winter crisis,

00:40:09.895 --> 00:40:11.950
it's an all-year 'round crisis,

00:40:11.950 --> 00:40:14.959
and that's how privatization is manifest--

00:40:14.959 --> 00:40:17.126
but it's very convenient
because it looks like

00:40:17.126 --> 00:40:19.054
it's the NHS that doesn't work.

00:40:19.054 --> 00:40:23.849
It looks like it's the
principle of publicly-funded

00:40:23.935 --> 00:40:26.707
provided and owned healthcare
which doesn't work.

00:40:26.707 --> 00:40:28.328
What people can't see is everything

00:40:28.328 --> 00:40:30.370
we've discussed behind the scenes,

00:40:30.370 --> 00:40:33.487
that it doesn't work
because tens of billions

00:40:33.487 --> 00:40:36.412
are being siphoned off to
running a market system,

00:40:36.412 --> 00:40:40.469
to PFI debt, to outsourcing profits,

00:40:40.469 --> 00:40:43.711
to management consultants.

00:40:43.711 --> 00:40:46.099
- So two and a half thousand years ago

00:40:46.099 --> 00:40:49.139
this woman was walking
on the streets of Babylon

00:40:49.139 --> 00:40:51.965
and she sees a frog and the frog says,

00:40:51.965 --> 00:40:53.838
"Lady, please pick me
up and give me a kiss.

00:40:53.838 --> 00:40:55.382
"I will turn into the most beautiful,

00:40:55.382 --> 00:40:58.288
"handsome prince you've ever seen."

00:40:58.288 --> 00:41:03.083
- [Pilger] This is Ali Parsa,
a former Goldman Sachs trader

00:41:03.122 --> 00:41:07.044
and super salesman,
who claims he is starting

00:41:07.044 --> 00:41:10.573
a world revolution in healthcare.

00:41:10.573 --> 00:41:13.182
- We are about to change
everything about healthcare.

00:41:15.014 --> 00:41:17.239
It's going to become
completely democratized,

00:41:17.239 --> 00:41:19.243
maybe not in the next five years

00:41:19.243 --> 00:41:20.797
but certainly next ten years.

00:41:20.797 --> 00:41:22.063
It's going to become accessible,

00:41:22.063 --> 00:41:24.969
it's going to be affordable,
it's going to be everywhere.

00:41:24.969 --> 00:41:28.354
- [Pilger] Ali Parsa became
a national figure in Britain

00:41:28.354 --> 00:41:31.797
when his company,
Circle Health, won a contract

00:41:31.797 --> 00:41:36.592
to run Hinchingbrooke Hospital
in Cambridgeshire from 2012.

00:41:38.587 --> 00:41:41.934
It was an historic moment for the NHS--

00:41:41.934 --> 00:41:46.729
the first NHS hospital to
be effectively sold off.

00:41:48.158 --> 00:41:51.630
- We were classed as a failing
hospital so we were informed

00:41:51.630 --> 00:41:55.555
that this great businessman was coming in.

00:41:56.782 --> 00:41:57.581
- Ali Parsa.

00:41:57.581 --> 00:42:01.182
- Yes, and I must admit when
I first met him I thought,

00:42:01.182 --> 00:42:05.028
what a charismatic,
inspiring man we have here.

00:42:05.028 --> 00:42:07.157
You know, that's how he came across.

00:42:07.157 --> 00:42:09.900
And he said, "So you have my expertise,

00:42:09.900 --> 00:42:14.282
"and I am going to take this
hospital to great heights.

00:42:14.282 --> 00:42:17.629
"You are going to be the
best hospital in the UK."

00:42:17.629 --> 00:42:20.353
"Dream the impossible,"
that's what he kept saying.

00:42:20.353 --> 00:42:22.363
- [Pilger] He kept saying,
"Dream the impossible?"

00:42:22.363 --> 00:42:24.208
- "Dream the impossible," yes.

00:42:24.208 --> 00:42:25.244
- Okay.
- Yes.

00:42:25.244 --> 00:42:27.325
We had a meeting where Vince Cable,

00:42:27.325 --> 00:42:29.848
the then-business secretary, attended,

00:42:29.848 --> 00:42:32.571
and he was obviously very,
very friendly with Ali Parsa.

00:42:32.571 --> 00:42:34.173
They came up together.

00:42:34.173 --> 00:42:37.724
And Mr. Cable came, he sat opposite me,

00:42:38.805 --> 00:42:41.836
and he was talking
very, very business-like

00:42:41.836 --> 00:42:44.300
and he said to me, "Do not have any doubts

00:42:44.300 --> 00:42:45.940
"about Mr. Parsa's ability.

00:42:45.940 --> 00:42:49.872
"He will make this
hospital fly as a business.

00:42:49.872 --> 00:42:52.318
"It will thrive as a business."

00:42:52.318 --> 00:42:55.511
It was all this business, business.

00:42:55.511 --> 00:42:56.775
And I looked at him and I said,

00:42:56.775 --> 00:43:00.268
"You know, I don't mean
to be rude or anything,

00:43:00.268 --> 00:43:03.174
"but this is a hospital, it's the NHS,

00:43:03.174 --> 00:43:05.166
"I don't see it as a business."

00:43:05.994 --> 00:43:07.077
- And what reaction did you get?

00:43:07.077 --> 00:43:11.198
- He said, "Yes it is,
my dear. It is a business."

00:43:14.040 --> 00:43:17.330
- [Pilger] We asked Vince
Cable for a response.

00:43:17.330 --> 00:43:20.977
He says he has no recollection
of the conversation.

00:43:23.525 --> 00:43:26.239
The selling of Hinchingbrooke Hospital

00:43:26.239 --> 00:43:28.323
is a story of propaganda.

00:43:29.807 --> 00:43:32.550
This is how the BBC's Newsnight

00:43:32.550 --> 00:43:35.379
reported the exciting prospect

00:43:35.379 --> 00:43:40.116
of Britain's first
privatized NHS hospital.

00:43:40.116 --> 00:43:43.358
- For the first time in the
UK, a district general hospital

00:43:43.358 --> 00:43:47.290
was given over to a private
sector organization to manage.

00:43:47.290 --> 00:43:49.275
Six months on from the
start of that experiment,

00:43:49.275 --> 00:43:51.548
Newsnight has been given exclusive access

00:43:51.548 --> 00:43:54.703
to Hinchingbrooke to find
out's what's changed.

00:43:54.703 --> 00:43:56.144
- So in one of our wards in here,

00:43:56.144 --> 00:43:59.527
we're getting 100%
satisfaction of our patients.

00:43:59.527 --> 00:44:01.292
- [Grossman] There is still a way to go.

00:44:01.292 --> 00:44:03.757
Nevertheless, at Hinchingbrooke
they are celebrating

00:44:03.757 --> 00:44:07.238
the six month milestone with cupcakes.

00:44:07.238 --> 00:44:08.466
- We are feeling that now,
we are satisfied

00:44:08.466 --> 00:44:10.921
with looking after every
single one of our patients.

00:44:10.921 --> 00:44:13.270
- [Grossman] These partner
meetings are a big part

00:44:13.270 --> 00:44:14.699
of the turnaround strategy.

00:44:14.699 --> 00:44:17.308
They're called "partner
meetings" because the staff

00:44:17.308 --> 00:44:20.099
now own 49% of the company.

00:44:20.099 --> 00:44:21.561
That's part of the plan--

00:44:21.561 --> 00:44:25.182
reigniting and then harnessing
their creative enthusiasm.

00:44:25.182 --> 00:44:27.742
- Our response to that
was that every person

00:44:27.742 --> 00:44:30.687
that worked at that hospital
and the local community

00:44:30.687 --> 00:44:33.995
already had a stake in that hospital.

00:44:33.995 --> 00:44:36.086
They didn't need to become shareholders

00:44:36.086 --> 00:44:37.975
in some fantasy scheme.

00:44:37.975 --> 00:44:40.325
- And to be honest, I didn't
want to be a part of that.

00:44:40.325 --> 00:44:44.545
That didn't sit right with me,
and I actually said that.

00:44:44.545 --> 00:44:46.683
I said, "I don't want to have shares."

00:44:46.683 --> 00:44:50.603
I said, "This is the NHS.
I just want to do my job."

00:44:51.410 --> 00:44:52.418
- It was a ten-year contract.

00:44:52.418 --> 00:44:55.689
They promised absolutely
astonishing levels of savings.

00:44:55.689 --> 00:44:57.089
It was absolutely incredible.

00:44:57.089 --> 00:44:59.132
It was something in the region

00:44:59.132 --> 00:45:02.843
of £300 million over ten years.

00:45:02.843 --> 00:45:06.056
They sold this idea they were
going to get all the staff

00:45:06.056 --> 00:45:08.684
working in the new corporate way,

00:45:08.684 --> 00:45:10.285
and so they gave them all-new uniforms--

00:45:10.285 --> 00:45:12.060
so they no longer had NHS uniforms,

00:45:12.060 --> 00:45:14.045
they were Circle Hinchingbrooke uniforms.

00:45:14.045 --> 00:45:16.510
- They decided that as
lead nurses we would then,

00:45:16.510 --> 00:45:20.269
on top of our jobs, we would meet daily

00:45:20.269 --> 00:45:23.846
and go round all of the
wards, our own wards,

00:45:23.846 --> 00:45:26.640
and look very carefully, you know.

00:45:27.538 --> 00:45:31.336
It would take an hour or
so of our working life

00:45:31.336 --> 00:45:34.396
to look into the patients to see

00:45:34.396 --> 00:45:39.047
if we could actually get them out quicker.

00:45:39.047 --> 00:45:43.842
And we used to have to do
that and have our results

00:45:44.350 --> 00:45:47.055
back for Circle by one o'clock every day,

00:45:47.055 --> 00:45:49.484
as to how many patients we could move out

00:45:50.728 --> 00:45:54.574
so that we could accommodate
the planned admissions.

00:45:54.574 --> 00:45:56.214
And the planned admissions are the ones

00:45:56.214 --> 00:45:57.365
that bring the money in.

00:45:59.081 --> 00:46:01.108
And the sad thing was, as lead nurses

00:46:01.108 --> 00:46:04.337
we were all put up against each other.

00:46:04.337 --> 00:46:06.312
So there was six of us
and we all used to work

00:46:06.312 --> 00:46:10.084
really well before Circle, but
because of the nature of it

00:46:11.510 --> 00:46:14.483
it became very competitive, you know.

00:46:14.483 --> 00:46:17.447
In the performance meetings and
in the operational meetings,

00:46:17.447 --> 00:46:19.384
it was a competition.

00:46:19.384 --> 00:46:24.179
And therefore, that cohesiveness
didn't exist any more.

00:46:25.516 --> 00:46:29.198
- So if you still had patients
blocking beds, as they say,

00:46:30.567 --> 00:46:34.892
you would be failing in
this competitive situation?

00:46:34.892 --> 00:46:36.963
- Well yes, yes. And I
was always a failure.

00:46:36.963 --> 00:46:38.651
I was always told that, you know.

00:46:38.651 --> 00:46:41.963
So it gets to you when
you're being told that.

00:46:43.936 --> 00:46:48.068
- [Pilger] But before 2012 was over,

00:46:48.068 --> 00:46:51.119
Ali Parsa had stepped down,

00:46:51.119 --> 00:46:53.986
taking a contractual payment

00:46:53.986 --> 00:46:56.310
of more than half a million pounds.

00:46:57.113 --> 00:47:01.908
In 2015, a Care Quality Commission report

00:47:02.033 --> 00:47:05.629
revealed that the safety of
patients at Hinchingbrooke,

00:47:05.629 --> 00:47:08.595
including children, was at risk.

00:47:10.165 --> 00:47:12.364
Circle disputed the report,

00:47:13.503 --> 00:47:17.716
and says it won a national
award for patient care.

00:47:21.731 --> 00:47:23.985
- The Care Quality
Commission were brought in

00:47:23.985 --> 00:47:27.620
and there was a damning report produced.

00:47:27.620 --> 00:47:29.979
So bad, in fact, that
they put the hospital--

00:47:29.979 --> 00:47:32.290
for the first time that
they had to do this--

00:47:32.290 --> 00:47:33.758
in special measures.

00:47:33.758 --> 00:47:37.584
Circle withdrew from the contract--

00:47:37.584 --> 00:47:42.229
a dramatic failure in terms
of the privatization project.

00:47:43.118 --> 00:47:47.894
- [Pilger] In 2015, Circle
abandoned Hinchingbrooke,

00:47:47.894 --> 00:47:51.014
which returned to NHS control.

00:47:52.699 --> 00:47:56.350
- Why were these people
allowed to run a hospital?

00:47:56.350 --> 00:48:00.237
Because what happened when they withdrew,

00:48:00.237 --> 00:48:03.430
three years into a ten-year contract,

00:48:03.430 --> 00:48:08.226
the NHS was left to pick up
not only the financial damage

00:48:09.137 --> 00:48:11.554
but the damage it caused
to the local community

00:48:11.554 --> 00:48:14.210
and to the staff who
had had to work through

00:48:14.210 --> 00:48:18.353
these three years of incompetence.

00:48:18.353 --> 00:48:21.518
- One day I came into work as usual,

00:48:21.518 --> 00:48:25.220
and my brain had just switched off.

00:48:25.220 --> 00:48:27.167
My bleep kept going off

00:48:27.167 --> 00:48:30.389
and I couldn't remember
how to recall my bleep.

00:48:30.389 --> 00:48:33.797
It was as if my brain had
gone, couldn't function.

00:48:35.558 --> 00:48:38.736
- [Pilger] Ah. So, yeah.

00:48:40.784 --> 00:48:42.462
It's okay, it's okay.

00:48:46.262 --> 00:48:47.351
- Very sad.

00:48:47.351 --> 00:48:50.468
- [Pilger] It's a very painful memory.

00:48:52.661 --> 00:48:54.243
- It is.
- It's a job you loved.

00:48:55.922 --> 00:49:00.276
- It's really sad because
I had worked there so long.

00:49:01.280 --> 00:49:02.392
- [Pilger] How long?

00:49:02.392 --> 00:49:03.843
- 24 years.

00:49:07.933 --> 00:49:10.330
I lost my extended family,

00:49:12.079 --> 00:49:13.910
the patients and the doctors.

00:49:13.910 --> 00:49:17.836
And it was a part of my
life, and it was just gone.

00:49:21.515 --> 00:49:25.048
- Hinchingbrooke and the
Circle debacle should be,

00:49:26.023 --> 00:49:30.156
in stone, given to any
secretary of state for health

00:49:30.156 --> 00:49:34.606
in terms of what could
go wrong, did go wrong.

00:49:34.606 --> 00:49:38.443
Privateers have no place in the NHS.

00:49:38.443 --> 00:49:40.715
They are there to make a profit,

00:49:40.715 --> 00:49:45.511
and patient care and health
is not about making a profit.

00:49:48.392 --> 00:49:51.121
- [Pilger] I asked Ali
Parsa for an interview,

00:49:51.121 --> 00:49:52.994
but his spokesman declined.

00:49:54.928 --> 00:49:57.681
Here is Ali Parsa again,

00:49:57.681 --> 00:50:01.479
promoting what he called
his next project--

00:50:01.479 --> 00:50:03.915
a company called Babylon Health

00:50:03.915 --> 00:50:06.782
and its app, GP at Hand.

00:50:06.782 --> 00:50:11.465
This gives you a doctor on
your smart phone, or a robot.

00:50:14.541 --> 00:50:19.125
This is the Conservative
health secretary, Matt Hancock,

00:50:19.125 --> 00:50:23.735
who believes technology offers
a new utopia for the NHS.

00:50:24.908 --> 00:50:27.577
He's one of Babylon's biggest fans.

00:50:28.648 --> 00:50:30.797
Secretary of State for Health Matt Hancock

00:50:30.797 --> 00:50:32.734
is very keen on this.

00:50:32.734 --> 00:50:36.752
- I suppose he is, but I mean
I don't have much confidence

00:50:36.752 --> 00:50:39.668
in this guy's ability or his
judgment, I mean he just...

00:50:40.798 --> 00:50:42.852
He also appeared in that
crazy advertorial, didn't he?

00:50:42.852 --> 00:50:44.050
I mean that's the other thing,

00:50:44.050 --> 00:50:46.937
a big question about what are
his links to this company.

00:50:46.937 --> 00:50:49.133
He is prepared to appear
in the Evening Standard,

00:50:49.133 --> 00:50:52.346
double spread, paid for by GP at Hand.

00:50:52.346 --> 00:50:53.507
Paid for by Babylon.

00:50:53.507 --> 00:50:55.431
I mean that is just
questionable, I would say.

00:50:55.431 --> 00:50:56.854
You give personal endorsement

00:50:56.854 --> 00:50:59.347
to one particular piece of software.

00:50:59.347 --> 00:51:02.637
- I think if you're looking
at the cost of the NHS

00:51:02.637 --> 00:51:04.235
and somebody comes along and says,

00:51:04.235 --> 00:51:06.674
"I've got a bit of technology
here that can replace

00:51:06.674 --> 00:51:08.698
"an awful lot of expensive clinicians

00:51:08.698 --> 00:51:11.968
"and do their job just as well or better,"

00:51:11.968 --> 00:51:13.653
particularly if you're
already biased towards tech,

00:51:13.653 --> 00:51:16.341
you might be uncritically enthusiastic,

00:51:16.341 --> 00:51:18.109
which I think Matt Hancock has been.

00:51:19.094 --> 00:51:22.604
- [Pilger] In its
long-term plan for the NHS,

00:51:22.604 --> 00:51:26.728
the government wants to
replace thousands of GPs

00:51:26.728 --> 00:51:31.219
with consultations by
video, and app, and robot.

00:51:33.182 --> 00:51:35.273
- [Announcer] This young
woman, let's call her Elly,

00:51:35.273 --> 00:51:37.066
isn't feeling well.

00:51:37.066 --> 00:51:39.349
But she doesn't go to
the doctor's office--

00:51:39.349 --> 00:51:43.264
he comes to her via an
app called Babylon Health.

00:51:44.825 --> 00:51:45.624
- Hello.

00:51:46.426 --> 00:51:48.651
- Hello there, this is
Dr. Butt from Babylon.

00:51:48.651 --> 00:51:49.773
Thanks very much for choosing us

00:51:49.773 --> 00:51:52.679
for your consultation
today, how can I help?

00:51:52.679 --> 00:51:54.933
- [Announcer] Elly explains
that her eyes itch.

00:51:56.161 --> 00:51:59.297
- Why do you think so
many of your colleagues

00:51:59.297 --> 00:52:02.366
in the medical profession have expressed

00:52:02.366 --> 00:52:04.862
quite serious doubts about Babylon?

00:52:05.914 --> 00:52:08.782
- So I think those doubts
will be very quickly dispelled

00:52:08.782 --> 00:52:12.129
by some of the recent reports
that have been published.

00:52:12.129 --> 00:52:16.301
So you may have seen that
there was a report published

00:52:16.301 --> 00:52:18.593
by the regulator, the
Care Quality Commission,

00:52:18.593 --> 00:52:22.697
who inspected our services
and found them to be good.

00:52:22.697 --> 00:52:26.265
There's also been a report
published yesterday.

00:52:26.265 --> 00:52:28.663
This is an NHS England
commissioned report,

00:52:28.663 --> 00:52:32.854
an independent evaluation,
that has shown overwhelmingly

00:52:32.854 --> 00:52:36.949
that patients and GPs are really satisfied

00:52:36.949 --> 00:52:38.857
with these services.

00:52:38.857 --> 00:52:40.478
- I mean, there've been quite some claims.

00:52:40.478 --> 00:52:45.273
The claim that your chat
bot achieved a higher score

00:52:45.273 --> 00:52:48.093
in a medical exam than human doctors,

00:52:48.093 --> 00:52:50.183
I mean, that wasn't true was it?

00:52:50.183 --> 00:52:54.921
- So it was true for the test that we did.

00:52:54.921 --> 00:52:57.424
- The test itself was extraordinary

00:52:57.424 --> 00:53:01.634
according to doctors working
for you, I think, at the time.

00:53:01.634 --> 00:53:05.729
It answered only something
like 15 of 50 questions.

00:53:05.729 --> 00:53:09.978
And yet Babylon claimed
as a result of that,

00:53:09.978 --> 00:53:14.773
that the chat bot had
intelligence equivalence

00:53:15.013 --> 00:53:16.356
with human doctors.

00:53:16.356 --> 00:53:18.590
- What we found, which
was really interesting,

00:53:18.590 --> 00:53:20.844
is actually there's a
huge amount of variation

00:53:20.844 --> 00:53:24.325
in actual human doctor performance

00:53:24.325 --> 00:53:26.320
when it comes to accuracy.

00:53:26.320 --> 00:53:31.115
And that ranged from as
low as 64% right up to 94%,

00:53:31.854 --> 00:53:33.724
with an average of 80%.

00:53:33.724 --> 00:53:37.311
And then when we did the same
testing with our AI products,

00:53:38.174 --> 00:53:42.969
we were able to show that the
AI performed at about 80%.

00:53:43.612 --> 00:53:48.407
- You've said that the majority
of the medical profession

00:53:49.452 --> 00:53:52.505
are, and I think the word
you used was "askance,"

00:53:53.327 --> 00:53:58.113
at Babylon's virtual doctor.

00:53:58.113 --> 00:53:59.487
What's wrong with it?

00:54:01.603 --> 00:54:04.173
- I think probably the bottom line is

00:54:04.173 --> 00:54:07.444
it's a completely mistaken idea.

00:54:07.444 --> 00:54:12.239
So it's based on the
idea that you can reduce

00:54:12.431 --> 00:54:15.643
people's health problems down to perhaps

00:54:15.643 --> 00:54:18.367
some very simple sort of yes-no questions,

00:54:18.367 --> 00:54:20.583
predictably churn those through a machine

00:54:20.583 --> 00:54:23.345
and come up with the
right answer every time.

00:54:23.345 --> 00:54:26.011
And I think there are
two big issues with that.

00:54:26.011 --> 00:54:28.955
Number one, it doesn't
work a lot of the time

00:54:28.955 --> 00:54:31.448
for anything that's more
than very straight forward.

00:54:33.097 --> 00:54:35.035
So when I'm consulting with patients

00:54:37.433 --> 00:54:39.946
they may come with the
same kind of symptom,

00:54:39.946 --> 00:54:42.094
and what I try and do is I
try and understand what it is

00:54:42.094 --> 00:54:45.987
that's worrying them and what
I need to do to be able to

00:54:45.987 --> 00:54:47.589
address their particular concerns.

00:54:47.589 --> 00:54:49.872
So it's less about the symptom

00:54:49.872 --> 00:54:52.509
and more about the person who's got it.

00:54:52.509 --> 00:54:55.357
- I mean, the Advertising
Standards has picked you up

00:54:55.357 --> 00:54:58.407
on a number of things
described as misleading.

00:54:58.407 --> 00:55:01.246
One of them was it was 100% safe

00:55:01.246 --> 00:55:04.612
or 100% the best in the world.

00:55:04.612 --> 00:55:07.086
- So I think sometimes things
are taken out of context.

00:55:07.086 --> 00:55:11.162
And that example that
you cite of 100% safe

00:55:11.162 --> 00:55:14.442
is actually accurate, but it's 100% safe

00:55:14.442 --> 00:55:17.214
in the test that we performed.

00:55:17.214 --> 00:55:18.566
Now that doesn't of course mean--

00:55:18.566 --> 00:55:20.177
- [Pilger] Is anything 100% safe?

00:55:20.177 --> 00:55:23.723
- Well that's a good point, but you know--

00:55:23.723 --> 00:55:25.557
and that's why it's very important that,

00:55:25.557 --> 00:55:26.651
that's why I'm saying, you know,

00:55:26.651 --> 00:55:28.195
that it's all about the detail.

00:55:28.195 --> 00:55:32.405
So actually in the particular
test, the results showed

00:55:32.405 --> 00:55:35.110
it was 100% safe, but that
of course doesn't mean

00:55:35.110 --> 00:55:37.795
it's 100% safe all of the time.

00:55:37.795 --> 00:55:41.794
And as you rightly point out,
can anything be 100% safe?

00:55:41.794 --> 00:55:44.412
- I mean, medicine is a
science but it's an art,

00:55:44.412 --> 00:55:45.623
it's a humanity,

00:55:46.771 --> 00:55:51.145
and machines have no
emotional intelligence--

00:55:51.145 --> 00:55:53.389
they cannot understand people,

00:55:53.389 --> 00:55:55.962
they can't understand
metaphor, they can't...

00:55:58.241 --> 00:55:59.680
You know, probably the majority

00:55:59.680 --> 00:56:01.147
of what my patients communicate to me

00:56:01.147 --> 00:56:03.257
they communicate not in words

00:56:03.257 --> 00:56:07.909
but in what they do with their
body, what they don't say,

00:56:07.909 --> 00:56:10.306
how they choose to answer my question.

00:56:10.306 --> 00:56:13.490
And I'm constantly understanding them

00:56:13.490 --> 00:56:16.588
through communication that's
nothing to do with words.

00:56:16.588 --> 00:56:20.884
And again, a machine cannot understand

00:56:20.884 --> 00:56:23.311
human communication in that way.

00:56:23.311 --> 00:56:25.325
What we say in words is
actually only a very small part,

00:56:25.325 --> 00:56:27.799
a minority of what we're
actually trying to say.

00:56:27.799 --> 00:56:32.489
- I mean Babylon is a
progeny of Circle Health.

00:56:32.489 --> 00:56:37.284
Circle Health has a rather
notorious reputation

00:56:39.068 --> 00:56:41.676
And I don't need to go over the details,

00:56:41.676 --> 00:56:44.640
but it took over Hinchingbrooke Hospital,

00:56:44.640 --> 00:56:48.179
and you talked about the
Care Quality Commission

00:56:48.179 --> 00:56:50.126
giving you a good report.

00:56:50.126 --> 00:56:54.249
Well, it gave Hinchingbrooke,
after Circle had been there,

00:56:54.249 --> 00:56:55.688
its worst report.

00:56:55.688 --> 00:56:58.373
- Of course I can't really
speak on behalf of Circle,

00:56:58.373 --> 00:57:01.464
not having had anything to
do with that organization.

00:57:01.464 --> 00:57:05.853
What I do know is our
founder, Dr. Ali Parsa,

00:57:05.853 --> 00:57:07.676
as you mentioned,

00:57:07.676 --> 00:57:11.925
actually did some really
amazing transformative things

00:57:11.925 --> 00:57:14.456
in Circle and took the
hospital you mentioned,

00:57:14.456 --> 00:57:17.055
Hinchingbrooke, from
being a failing hospital

00:57:17.055 --> 00:57:19.789
to actually being a highly
performing hospital now.

00:57:19.789 --> 00:57:21.467
- No, excuse me.
- But things changed after--

00:57:21.467 --> 00:57:22.930
- Dr. Butt, that's not true.

00:57:22.930 --> 00:57:24.959
It didn't become highly performing.

00:57:24.959 --> 00:57:27.854
- I mean, I can't obviously
specifically comment on Circle,

00:57:27.854 --> 00:57:30.731
but what I can comment
on with great confidence

00:57:30.731 --> 00:57:35.527
is Babylon as an organization.

00:57:35.795 --> 00:57:38.778
And actually, you know,

00:57:38.778 --> 00:57:42.163
I can't commend Dr. Parsa
enough for his leadership,

00:57:42.163 --> 00:57:45.721
if you think about the success of Babylon

00:57:45.721 --> 00:57:47.889
and everything that
we've managed to achieve

00:57:47.889 --> 00:57:52.607
to transform patient care
here in the UK and beyond.

00:57:52.607 --> 00:57:54.381
- You have words, and you have actions,

00:57:56.635 --> 00:58:00.970
and the actions are taking
us further and further

00:58:00.970 --> 00:58:03.521
towards an American model.

00:58:03.521 --> 00:58:06.705
The words keep spouting out the rhetoric,

00:58:06.705 --> 00:58:08.901
but the actions are taking us further away

00:58:08.901 --> 00:58:13.265
from that public good towards
the kind of American model.

00:58:13.265 --> 00:58:16.727
So the actions are what
tell us what's going on.

00:58:18.622 --> 00:58:20.177
[energetic theme music]

00:58:20.177 --> 00:58:22.697
- [Announcer] This is
Chicago's all news station.

00:58:22.697 --> 00:58:24.756
♪ WBBM ♪

00:58:24.756 --> 00:58:29.551
Newsradio 780 and 109.5
FM and cbschicago.com.

00:58:30.853 --> 00:58:33.570
[relaxed jazz music]

00:58:34.719 --> 00:58:36.646
- [Reporter 1] WBBM News, time 10:53,

00:58:36.646 --> 00:58:38.325
the news watch continues.

00:58:38.325 --> 00:58:40.569
- [Reporter 2] Lifting Chicago
several tons at a time...

00:58:40.569 --> 00:58:44.743
- [Pilger] Chicago is one of
America's wealthiest cities.

00:58:47.972 --> 00:58:52.768
Article 25 of the Universal
Declaration of Human Rights

00:58:53.333 --> 00:58:57.524
says that everyone has the
right to a standard of living

00:58:57.524 --> 00:59:01.437
adequate for the health
and well-being of a family,

00:59:01.437 --> 00:59:06.233
including food, clothing,
housing and medical care.

00:59:08.093 --> 00:59:12.508
In the United States, that
right has yet to be granted.

00:59:13.713 --> 00:59:17.271
Instead, a group of
health insurance companies

00:59:17.271 --> 00:59:19.822
dominate the healthcare industry

00:59:19.822 --> 00:59:23.896
and often decide who shall live or die.

00:59:23.896 --> 00:59:27.168
[ominous ambient droning]

00:59:27.168 --> 00:59:30.333
As many as 87 million Americans

00:59:30.333 --> 00:59:32.846
cannot afford health insurance,

00:59:32.846 --> 00:59:36.337
or their insurance is
made virtually worthless

00:59:36.337 --> 00:59:39.927
by excess charges known as deductibles.

00:59:40.816 --> 00:59:45.611
At least 20,000 Americans die every year

00:59:45.812 --> 00:59:47.858
because they can't get treatment.

00:59:50.291 --> 00:59:53.245
This is the system that inspires

00:59:53.245 --> 00:59:56.470
so-called reform of the NHS.

00:59:59.229 --> 01:00:01.140
- It happens late at night,

01:00:01.140 --> 01:00:03.267
after 10:00 and before 4:00.

01:00:03.267 --> 01:00:04.974
It's called "patient dumping."

01:00:04.974 --> 01:00:06.786
- This woman says it happened to her,

01:00:06.786 --> 01:00:10.479
dumped in a homeless shelter
by a nursing home, alone.

01:00:10.479 --> 01:00:14.507
Had you ever heard of
patient dumping before?

01:00:14.507 --> 01:00:16.808
- She says two men in a
white van drove her here

01:00:16.808 --> 01:00:19.705
to the Pacific Garden Mission
and dumped her right here

01:00:19.705 --> 01:00:20.999
at the Mission's front gate.

01:00:20.999 --> 01:00:23.694
It was the middle of the
night, she was in a wheelchair,

01:00:23.694 --> 01:00:25.373
and she didn't have her medication.

01:00:28.739 --> 01:00:32.517
- For any society just
to drop somebody off,

01:00:32.517 --> 01:00:33.966
especially with a disability,

01:00:33.966 --> 01:00:36.565
and expect them to fend for themselves

01:00:36.565 --> 01:00:38.022
is really barbaric.

01:00:38.022 --> 01:00:41.532
And when we saw these things
happening we were appalled

01:00:41.532 --> 01:00:43.441
at that practice.

01:00:43.441 --> 01:00:46.980
- [Pilger] In the United
States, the dumping of patients

01:00:46.980 --> 01:00:51.734
is so common that this hospital
patient was caught on CCTV

01:00:52.993 --> 01:00:55.630
being dumped at a refuge.

01:00:55.630 --> 01:00:58.268
- People just want to
get rid of the person,

01:00:58.268 --> 01:01:01.845
and at whatever cost find some place

01:01:01.845 --> 01:01:03.859
where somebody can go to and just dump 'em

01:01:03.859 --> 01:01:06.784
and get out of there and just
move on to the next person.

01:01:06.784 --> 01:01:09.297
And if a hospital wants
to make the most profit--

01:01:09.297 --> 01:01:12.174
they want to get the most
number of people in the beds,

01:01:12.174 --> 01:01:15.223
so to get somebody out and
get the next person in--

01:01:15.223 --> 01:01:16.995
find a place for a person to go to,

01:01:16.995 --> 01:01:19.194
and if you can't, dump 'em off.

01:01:19.194 --> 01:01:21.908
Because they know that an
organization like ours,

01:01:21.908 --> 01:01:23.826
we wouldn't leave them out there.

01:01:23.826 --> 01:01:27.789
So they're really trusting the
goodwill of the organization.

01:01:27.789 --> 01:01:30.426
[ominous ambient tones]

01:01:48.166 --> 01:01:50.583
- [Pilger] On the other side of Chicago,

01:01:50.583 --> 01:01:55.378
in what is known as Skid Row,
is Franciscan House--

01:01:55.407 --> 01:01:58.831
a former broom factory
that's another refuge

01:01:58.831 --> 01:02:02.699
for the unwanted sick dumped by hospitals.

01:02:05.803 --> 01:02:07.913
They do their best here,

01:02:07.913 --> 01:02:11.915
but it feels like a warehouse
for expendable people.

01:02:15.125 --> 01:02:17.865
When this is full, how many does it hold?

01:02:17.865 --> 01:02:20.048
- [Jaskula] This dorm here is 148.

01:02:22.769 --> 01:02:26.221
- [Pilger] What happens to people who have

01:02:26.221 --> 01:02:29.031
no health insurance or
maybe have health insurance

01:02:29.031 --> 01:02:31.342
but it's not adequate?

01:02:31.342 --> 01:02:34.428
- So it's not like the
hospital calls us and says,

01:02:34.428 --> 01:02:35.770
"You know, this person's coming over."

01:02:35.770 --> 01:02:37.353
- [Pilger] "We're gonna
dump a patient on you."

01:02:37.353 --> 01:02:38.324
- "And this is the--

01:02:38.324 --> 01:02:40.058
"these are the issues, alright?"

01:02:40.058 --> 01:02:41.000
No.

01:02:41.000 --> 01:02:42.861
Their driver's gonna
come by the front door

01:02:42.861 --> 01:02:45.786
and is ready to just drop
them off right there.

01:02:45.786 --> 01:02:48.042
Some of them have
possibly had some surgery,

01:02:48.042 --> 01:02:50.948
some of them might be
psychiatric patients.

01:02:52.595 --> 01:02:54.685
Sometimes we have to call an ambulance

01:02:54.685 --> 01:02:56.795
to have them re-admitted to a hospital

01:02:56.795 --> 01:02:59.183
because they're just not well enough

01:02:59.183 --> 01:03:01.171
to navigate the place on their own.

01:03:02.924 --> 01:03:05.369
But sometimes we're nowhere near the door

01:03:05.369 --> 01:03:07.156
and the person gets dropped off.

01:03:08.088 --> 01:03:09.973
- [Pilger] So they can be very quick and--

01:03:09.973 --> 01:03:11.555
- It doesn't take much to open the door

01:03:11.555 --> 01:03:12.684
and let somebody out.

01:03:14.658 --> 01:03:17.216
[ominous booming tone]

01:03:33.181 --> 01:03:37.334
- Wendell Potter was the Chief
Public Relations Executive

01:03:37.334 --> 01:03:41.583
of CIGNA, a giant health
insurance company.

01:03:41.583 --> 01:03:44.815
His job was to spin the
company's propaganda,

01:03:44.815 --> 01:03:48.644
often, as he describes,
with deadly effect.

01:03:49.725 --> 01:03:51.739
You were the spokesman, the public voice

01:03:51.739 --> 01:03:55.383
for a health insurance industry
whose routine practices,

01:03:55.383 --> 01:03:58.327
and I quote you,
"Amount to a death sentence

01:03:58.327 --> 01:04:00.869
"for thousands of Americans every year."

01:04:00.869 --> 01:04:01.833
- Yeah.

01:04:01.833 --> 01:04:04.142
- [Pilger] That's an
extraordinary statement.

01:04:04.142 --> 01:04:05.676
Could you talk a little about that?

01:04:05.676 --> 01:04:07.716
- It's not extraordinary when you look at

01:04:07.716 --> 01:04:10.469
the reality of our healthcare system.

01:04:10.469 --> 01:04:12.838
That happens all the time.

01:04:12.838 --> 01:04:16.568
Every day decisions were made
by insurance company employees

01:04:17.576 --> 01:04:22.342
as to whether or not you'll
get some life-saving care.

01:04:22.342 --> 01:04:23.809
There was one case in particular,

01:04:23.809 --> 01:04:28.604
it involved a 17-year-old
girl in Los Angeles

01:04:29.467 --> 01:04:31.884
who needed a liver transplant.

01:04:31.884 --> 01:04:36.653
And her doctors at UCLA Medical
Center said they felt it--

01:04:38.885 --> 01:04:42.280
the chances were significantly good,

01:04:42.280 --> 01:04:45.848
that she would come through the
surgery and live many years.

01:04:45.848 --> 01:04:47.363
- [Pilger] Just remind me of her name?

01:04:47.363 --> 01:04:48.946
- Her name was Nataline Sarkisyan.

01:04:49.972 --> 01:04:53.328
And there was a medical doctor at CIGNA,

01:04:53.328 --> 01:04:55.899
2,500 miles away in Pittsburgh,

01:04:55.899 --> 01:05:00.138
who looked at the request
for prior authorization--

01:05:00.138 --> 01:05:04.933
which is, again, a term that
is prevalent in our system.

01:05:04.933 --> 01:05:08.932
Doctors have to ask insurance
companies in advance

01:05:08.932 --> 01:05:11.732
for permission to proceed
with the procedure

01:05:11.732 --> 01:05:13.468
or at least to get coverage for it,

01:05:13.468 --> 01:05:15.568
as some insurance that
it will be paid for.

01:05:15.568 --> 01:05:19.558
So that was what happened,
the doctors who attended

01:05:19.558 --> 01:05:24.231
and were going to be doing
the surgery asked CIGNA,

01:05:24.231 --> 01:05:26.521
and a medical director
said he didn't think

01:05:26.521 --> 01:05:29.264
it was medically appropriate for Nataline.

01:05:29.264 --> 01:05:31.642
- What did that mean,
medically appropriate?

01:05:31.642 --> 01:05:34.874
- Well even though the
policy covered transplants,

01:05:34.874 --> 01:05:39.669
in his subjective opinion
he said he did not think

01:05:40.197 --> 01:05:42.057
that her doctors were correct.

01:05:42.057 --> 01:05:45.222
He had never seen Nataline,
he had never examined her.

01:05:45.222 --> 01:05:47.677
Keep in mind that a perfect
match had been found,

01:05:47.677 --> 01:05:51.226
and the liver-- the
transplant had been scheduled.

01:05:51.226 --> 01:05:54.170
And the family came into the hospital

01:05:54.170 --> 01:05:57.526
on the morning that the
transplant was to have been done

01:05:57.526 --> 01:05:59.454
thinking that it would be done.

01:05:59.454 --> 01:06:03.098
But instead, one of the
doctors took the family aside,

01:06:03.098 --> 01:06:04.994
took the parents aside and said,

01:06:04.994 --> 01:06:08.773
"We're sorry but we've not
gotten clearance from CIGNA."

01:06:09.610 --> 01:06:12.276
So the family decided they would

01:06:12.276 --> 01:06:14.943
try to make a big media case out of this.

01:06:14.943 --> 01:06:16.420
- So what happened?

01:06:16.420 --> 01:06:19.297
- It became very clear to the company

01:06:19.297 --> 01:06:21.196
that this was not a media story

01:06:21.196 --> 01:06:23.603
that was just going to go away quietly,

01:06:23.603 --> 01:06:26.943
as I was often able to make them go away.

01:06:28.312 --> 01:06:33.030
They, within an hour or so,
convened-- they being the CEO

01:06:33.030 --> 01:06:37.003
and the president of
our healthcare division,

01:06:37.950 --> 01:06:40.398
the chief medical officer
and a few others--

01:06:41.383 --> 01:06:45.152
on a conference call, decided
well maybe in this case

01:06:45.152 --> 01:06:47.070
we can make an exception.

01:06:47.070 --> 01:06:50.264
She was getting sicker by the day,

01:06:50.264 --> 01:06:54.139
her other organs began to shut down,

01:06:55.174 --> 01:06:59.567
and she died about five hours after CIGNA

01:06:59.567 --> 01:07:02.147
said it would pay for the transplant.

01:07:02.147 --> 01:07:06.309
And I just said, I am in
the wrong line of work.

01:07:06.309 --> 01:07:07.776
I can't keep doing this.

01:07:07.776 --> 01:07:12.571
My job was to help perpetuate
a very, very unfair,

01:07:12.600 --> 01:07:15.554
expensive and dysfunctional system.

01:07:15.554 --> 01:07:18.201
- What kind of wealth did that company

01:07:18.201 --> 01:07:20.196
have at its disposal then?

01:07:20.196 --> 01:07:22.833
- There are a lot of executives
close to the CEO level

01:07:22.833 --> 01:07:25.023
who make millions of dollars a year.

01:07:26.602 --> 01:07:28.885
Billions of dollars flow
through these companies.

01:07:28.885 --> 01:07:31.790
They make billions of dollars in profits

01:07:31.790 --> 01:07:35.847
off of that revenue partly
to reward shareholders,

01:07:35.847 --> 01:07:38.322
or largely to reward shareholders.

01:07:38.322 --> 01:07:42.935
But a lot of the money is
skimmed off or made available

01:07:42.935 --> 01:07:46.927
to conduct PR campaigns
and lobbying campaigns.

01:07:49.475 --> 01:07:53.244
- [Pilger] In 1996, Dr. Linda Peeno,

01:07:53.244 --> 01:07:56.889
who worked for the insurance giant Humana,

01:07:56.889 --> 01:07:59.708
appeared before a congressional committee

01:07:59.708 --> 01:08:01.955
with this remarkable confession.

01:08:04.062 --> 01:08:08.848
- I am here primarily today
to make a public confession.

01:08:08.848 --> 01:08:12.972
In the spring of 1987, as a physician,

01:08:12.972 --> 01:08:16.280
I denied a man a necessary operation

01:08:16.280 --> 01:08:19.285
that would have saved his life,
and thus caused his death.

01:08:21.584 --> 01:08:25.286
No person and no group has
held me accountable for this,

01:08:25.286 --> 01:08:27.866
because in fact what I
did was I saved a company

01:08:27.866 --> 01:08:30.343
a half a million dollars for this.

01:08:32.057 --> 01:08:35.567
And furthermore, this particular
act secured my reputation

01:08:35.567 --> 01:08:38.137
as a good medical director

01:08:38.137 --> 01:08:40.314
and it ensured my continued advancement

01:08:40.314 --> 01:08:42.270
in the healthcare field.

01:08:42.270 --> 01:08:44.562
I went from making a few hundred dollars

01:08:44.562 --> 01:08:46.327
a week as a medical reviewer

01:08:46.327 --> 01:08:50.204
to an escalating six-figure
income as a physician executive.

01:08:51.563 --> 01:08:54.421
In all my work, I had one primary duty,

01:08:54.421 --> 01:08:57.394
and that was to use my medical expertise

01:08:57.394 --> 01:08:59.006
for the financial benefit

01:08:59.006 --> 01:09:01.490
of the organization for which I worked.

01:09:01.490 --> 01:09:05.422
This was one of those cases
where the request came in--

01:09:05.422 --> 01:09:07.896
it was just a little piece
of paper on my inbox,

01:09:07.896 --> 01:09:09.584
I just happened to pick it up next

01:09:09.584 --> 01:09:12.240
and it just happened to come to me--

01:09:12.240 --> 01:09:16.297
and they had called from
a hospital in California.

01:09:16.297 --> 01:09:20.502
A patient from Nevada and
been on a transplant list.

01:09:20.502 --> 01:09:21.300
- [Pilger] Heart transplant?

01:09:21.300 --> 01:09:23.950
- Heart transplant. They had a heart--

01:09:23.950 --> 01:09:26.425
a heart became available, a match,

01:09:26.425 --> 01:09:28.199
and the surgeon was ready to operate.

01:09:29.311 --> 01:09:33.397
So I called, and I thought
this was just a formality,

01:09:33.397 --> 01:09:35.142
because there's-- nobody would do

01:09:35.142 --> 01:09:38.096
a medically unnecessary heart transplant.

01:09:38.096 --> 01:09:40.801
You couldn't get through
the transplant process.

01:09:40.801 --> 01:09:43.582
So I talked to him, he
explained the situation:

01:09:43.582 --> 01:09:45.586
they had a heart
available, they called him,

01:09:45.586 --> 01:09:47.670
they got him, you know, to this hospital.

01:09:49.000 --> 01:09:52.280
So I approved it, stamped
my little "Approve" on it,

01:09:52.280 --> 01:09:54.601
and then just everything went to hell,

01:09:55.522 --> 01:09:58.361
because that was a half a
million dollar transplant.

01:09:58.361 --> 01:09:59.780
So then all these people start rushing in.

01:09:59.780 --> 01:10:01.736
"We've got to figure out a way to deny it.

01:10:01.736 --> 01:10:02.711
"We can't pay for it.

01:10:02.711 --> 01:10:04.022
"You've gotta call the doctor back."

01:10:04.825 --> 01:10:07.807
I'm a physician, I know
what the consequences

01:10:07.807 --> 01:10:10.898
are going to be to this man
who doesn't get his heart.

01:10:12.343 --> 01:10:15.316
You know, he's going to
continue to deteriorate.

01:10:15.316 --> 01:10:18.184
And his congestive heart
failure could last two days,

01:10:18.184 --> 01:10:22.979
two years, but he's been
consigned to cardiac hell.

01:10:23.046 --> 01:10:25.866
I mean, he's going to slowly deteriorate.

01:10:25.866 --> 01:10:30.156
And whether he died two days
later or two years later,

01:10:30.966 --> 01:10:35.761
you know, I participated in
consigning this man to death.

01:10:35.936 --> 01:10:37.614
I mean, I signed his death warrant.

01:10:39.110 --> 01:10:42.217
I would try to do the best
thing I could do as a physician

01:10:42.217 --> 01:10:45.996
but I was always coming up
against this huge machine.

01:10:45.996 --> 01:10:49.161
It was just grinding away to keep patients

01:10:49.161 --> 01:10:52.546
from getting what they needed,
because that cost money.

01:10:52.546 --> 01:10:55.586
I mean, the whole purpose
was to make money.

01:10:55.586 --> 01:11:00.343
That's the risk for all
these other attempts

01:11:00.343 --> 01:11:03.096
at privatizing portions
of something like the NHS,

01:11:03.096 --> 01:11:07.891
is when you begin to
hand over the benefits,

01:11:09.042 --> 01:11:13.338
the funds, to these private
companies to manage.

01:11:13.338 --> 01:11:15.103
I mean their goal is
going to be to make money,

01:11:15.103 --> 01:11:18.779
not to provide better care or
more care or appropriate care.

01:11:20.908 --> 01:11:23.785
[ominous ambient tones]

01:11:26.096 --> 01:11:29.175
- [Pilger] This is the
town of Wise, Virginia,

01:11:29.175 --> 01:11:31.879
in the mountain country of Appalachia,

01:11:31.879 --> 01:11:34.596
where some of the poorest Americans live.

01:11:35.946 --> 01:11:39.087
The coal mines once gave people here

01:11:39.087 --> 01:11:41.220
a precarious life.

01:11:41.220 --> 01:11:44.829
Today many are unemployed and unwell.

01:11:58.358 --> 01:12:02.482
Every summer, an extraordinary
event comes to Wise,

01:12:02.482 --> 01:12:04.698
offering free healthcare

01:12:04.698 --> 01:12:08.448
of a kind unknown in the United States.

01:12:08.448 --> 01:12:12.373
This is Remote Area Medical, known as RAM.

01:12:18.066 --> 01:12:19.870
- It's a wonderful community
that comes together

01:12:19.870 --> 01:12:21.749
and actually looks out for each other.

01:12:21.749 --> 01:12:25.087
They come in, we greet them in the morning

01:12:25.087 --> 01:12:28.098
starting at five, six
o'clock in the morning.

01:12:28.098 --> 01:12:29.211
Come through and we register them.

01:12:29.211 --> 01:12:31.637
We don't ask them identifying questions.

01:12:31.637 --> 01:12:33.805
You know, we don't care
if they have insurance,

01:12:33.805 --> 01:12:36.145
we don't care their income, demographics.

01:12:36.145 --> 01:12:38.390
We just ask 'em, "Where does it hurt,

01:12:38.390 --> 01:12:39.861
"and how can we help you?"

01:12:47.145 --> 01:12:51.182
- [Pilger] RAM is like a
pop-up war-time field hospital

01:12:51.182 --> 01:12:54.127
run entirely by volunteers

01:12:54.127 --> 01:12:57.016
and set up in an agricultural showground.

01:12:57.944 --> 01:13:00.833
It's as if the NHS has come to town.

01:13:01.810 --> 01:13:04.688
[indistinct chatter]

01:13:25.065 --> 01:13:28.604
People wait for days
for the clinics to open,

01:13:28.604 --> 01:13:30.448
sleeping in their cars.

01:13:31.289 --> 01:13:34.898
Most of them have no other
hope of medical care.

01:13:37.533 --> 01:13:39.010
You're gonna stay in the car tonight?

01:13:39.010 --> 01:13:40.832
- Yup.
- Yeah, so what are--

01:13:40.832 --> 01:13:42.290
who are you seeing tomorrow?

01:13:42.290 --> 01:13:43.249
- Dental tomorrow.

01:13:43.249 --> 01:13:45.387
- [Pilger] You've got some urgent problem?

01:13:45.387 --> 01:13:46.768
- I actually chipped a tooth a week ago.

01:13:46.768 --> 01:13:48.897
And he's got a filling,
she's just got a cleaning

01:13:48.897 --> 01:13:50.796
'cause the school does free
stuff for middle schools.

01:13:50.796 --> 01:13:53.002
- [Pilger] Yeah, are they asleep in there?

01:13:53.002 --> 01:13:55.611
- He's out. It's actually
peaceful here at night.

01:13:55.611 --> 01:13:57.385
- [Pilger] It is peaceful, isn't it?

01:13:58.823 --> 01:14:00.943
- We're supposed to meet
up with the plastic surgeon

01:14:00.943 --> 01:14:03.993
that did her removal of
her little bump on her head

01:14:03.993 --> 01:14:06.908
last year, and so he can see a follow-up

01:14:06.908 --> 01:14:08.184
of what it looks like this year, so.

01:14:08.184 --> 01:14:10.792
He can see how it turned out, so.

01:14:10.792 --> 01:14:12.595
- [Pilger] Okay, what
would that have cost you

01:14:12.595 --> 01:14:14.916
to have that done?
- Probably several thousand,

01:14:14.916 --> 01:14:16.700
especially to get somebody like him,

01:14:16.700 --> 01:14:19.798
because he's actually a really well-known

01:14:19.798 --> 01:14:21.323
plastic surgeon from Charlotte.

01:14:21.323 --> 01:14:24.425
So to get him would probably
be several thousand dollars.

01:14:24.425 --> 01:14:25.552
- [Pilger] Several thousand dollars?

01:14:25.552 --> 01:14:26.760
- Yes.

01:14:26.760 --> 01:14:28.381
- [Pilger] Whereas here you go for free.

01:14:28.381 --> 01:14:29.180
- Mm-hmm.

01:14:32.256 --> 01:14:34.327
- My sister is actually utilizing this

01:14:34.327 --> 01:14:36.836
because she has no health insurance.

01:14:36.836 --> 01:14:37.795
And she's a veteran,

01:14:37.795 --> 01:14:40.954
still fighting to get benefits for that.

01:14:40.954 --> 01:14:43.611
And so we brought her
here to get dental work

01:14:43.611 --> 01:14:46.114
because she can't afford health insurance.

01:14:46.114 --> 01:14:49.183
- Can't tell you happy I
am to be here right now,

01:14:49.183 --> 01:14:50.957
because I have some abscessed teeth

01:14:50.957 --> 01:14:53.623
that I've been dealing with
for the last couple years.

01:14:53.623 --> 01:14:55.273
- [Pilger] So you're gonna
have your teeth looked at?

01:14:55.273 --> 01:14:56.759
- And I have Crohn's disease.

01:14:56.759 --> 01:14:58.035
- [Pilger] And you have Crohn's disease?

01:14:58.035 --> 01:14:59.799
- I have Crohn's. I have a
lot of medical issues, too.

01:14:59.799 --> 01:15:01.516
And I haven't-- I've
been off my medication

01:15:01.516 --> 01:15:03.837
because I can't afford it
without health insurance.

01:15:03.837 --> 01:15:06.095
- [Pilger] What does your medication cost?

01:15:06.095 --> 01:15:08.363
- Let's see, the last time I
had it was about six years ago.

01:15:08.363 --> 01:15:12.353
And just for two bottles, they
were $490-something a piece.

01:15:12.353 --> 01:15:14.923
- [Pilger] Oh, and how
long would that last you?

01:15:14.923 --> 01:15:17.177
- That would last me a month.

01:15:17.177 --> 01:15:21.282
And that's only part of my
meds. My cholesterol's high.

01:15:21.282 --> 01:15:25.856
- I'm a million, about $1,500,000 in debt

01:15:25.856 --> 01:15:28.278
for medical bills.

01:15:28.278 --> 01:15:29.673
I've been sued.

01:15:29.673 --> 01:15:33.749
My credit is destroyed from medical bills.

01:15:33.749 --> 01:15:34.548
- [Pilger] Right.

01:15:34.548 --> 01:15:39.264
- And so I can't even buy one
room, my credit is so bad.

01:15:39.264 --> 01:15:42.012
And I've been sued and
I just don't pay 'em.

01:15:42.012 --> 01:15:42.985
I can't.

01:15:42.985 --> 01:15:43.800
- [Pilger] Yeah.

01:15:45.414 --> 01:15:46.505
- But this is wonderful,

01:15:46.505 --> 01:15:49.070
'cause Appalachia really
needs these kind of clinics.

01:15:49.070 --> 01:15:51.187
And I didn't know about
'em till three years ago.

01:15:52.422 --> 01:15:53.314
Well tonight we're just gonna

01:15:53.314 --> 01:15:55.004
sit in the car all night and wait.

01:15:59.931 --> 01:16:03.038
- [Pilger] So you're
sleeping here tonight, yeah?

01:16:03.038 --> 01:16:05.474
And you've got your ticket for tomorrow?

01:16:05.474 --> 01:16:06.481
- Yup.

01:16:06.481 --> 01:16:08.208
- [Pilger] Tell me why you're here.

01:16:09.157 --> 01:16:11.596
- Glasses and dental.

01:16:11.596 --> 01:16:14.137
- [Pilger] So you're getting
a full health check-up?

01:16:15.046 --> 01:16:16.861
Why do you feel you need that?

01:16:17.980 --> 01:16:20.809
- Well, diabetes runs
rampant in my family,

01:16:22.253 --> 01:16:24.185
so with this service it
gives the opportunity

01:16:24.185 --> 01:16:26.305
to stay one step ahead of it.

01:16:26.305 --> 01:16:27.679
- [Pilger] Yeah, yeah.

01:16:30.687 --> 01:16:33.430
What are you mostly concerned about?

01:16:33.430 --> 01:16:36.701
- Neck, back, seven bulging disc,

01:16:36.701 --> 01:16:38.139
permanent pinched nerve in my back,

01:16:38.139 --> 01:16:40.796
and there's nothing they
can do surgical-wise

01:16:40.796 --> 01:16:42.656
to make it better.

01:16:42.656 --> 01:16:45.469
So I miss out there helping people, but--

01:16:46.713 --> 01:16:47.902
- [Pilger] You have a lot of pain then?

01:16:47.902 --> 01:16:49.849
- Yeah, a lot of pain, yeah.

01:16:49.849 --> 01:16:52.429
- [Pilger] And who will you see tomorrow?

01:16:52.429 --> 01:16:54.251
- I'll be seeing the neurosurgeons

01:16:54.251 --> 01:16:56.946
and those people in the medical,

01:16:56.946 --> 01:17:01.741
and then over to vision
to get my vision done

01:17:01.837 --> 01:17:04.107
'cause I've got glaucoma on my left eye.

01:17:07.735 --> 01:17:10.018
- [Pilger] What would
that cost you to see--

01:17:10.018 --> 01:17:12.693
to get that kind of treatment outside?

01:17:12.693 --> 01:17:16.664
- Outside you're looking at,
just for the surgical part,

01:17:16.664 --> 01:17:20.241
about $1,000 each visit.
Somewheres around there.

01:17:20.241 --> 01:17:23.895
So this is like one of the
best things here, in my eyes,

01:17:23.895 --> 01:17:25.254
that they do every year.

01:17:25.254 --> 01:17:27.712
- [Pilger] It's only this
free health care here

01:17:27.712 --> 01:17:30.762
that offers you some kind of solution.

01:17:30.762 --> 01:17:33.179
- Yeah, it does, it helps a lot.

01:17:33.179 --> 01:17:37.398
Not just me-- my wife,
everyone else that's here,

01:17:37.398 --> 01:17:38.782
that's camping out tonight.

01:17:39.623 --> 01:17:41.426
- [Pilger] I wish you well for tomorrow

01:17:41.426 --> 01:17:43.172
and that everything goes...
- Y'all too. Thank you.

01:17:43.172 --> 01:17:45.713
- [Pilger] ...really to
plan for you and your wife.

01:17:45.713 --> 01:17:46.512
- Thank you.

01:17:52.388 --> 01:17:56.828
- [Pilger] It's 6:00 AM and
the sun is just coming up.

01:17:56.828 --> 01:17:58.347
Everyone has a number.

01:17:59.293 --> 01:18:03.036
- Anybody with a numbered
admission ticket below 40.

01:18:05.865 --> 01:18:10.660
41, 42, 43, 44, 45.

01:18:12.490 --> 01:18:15.635
We're offering mammograms, PAP smears.

01:18:15.635 --> 01:18:20.430
We're taking chest X-rays.
We're doing EKGs inside.

01:18:20.670 --> 01:18:22.569
- [Pilger] Can I ask you why you're here?

01:18:22.569 --> 01:18:26.798
- I work at a gas station,
and for me to get insurance

01:18:26.798 --> 01:18:29.858
for me and my husband is over $200.

01:18:29.858 --> 01:18:31.277
That's just for vision and dental.

01:18:31.277 --> 01:18:34.938
I can't afford that making
$8 a hour, you just can't.

01:18:36.063 --> 01:18:37.684
- [Pilger] Would you like to see a free

01:18:37.684 --> 01:18:40.331
public health service right
throughout the United States?

01:18:40.331 --> 01:18:42.690
- I really would, I thought
Trump was gonna get it done

01:18:42.690 --> 01:18:45.116
but I guess that flopped a little.

01:18:45.116 --> 01:18:48.631
To have to go out of another
state to get health care,

01:18:48.631 --> 01:18:50.037
health services, is crazy.

01:18:50.037 --> 01:18:51.708
- Did you sleep in the car last night?

01:18:51.708 --> 01:18:52.810
- No, honey, actually--

01:18:52.810 --> 01:18:54.054
- We got here at about,

01:18:54.054 --> 01:18:56.145
what, 3:00, 4:00 in the morning?

01:18:56.145 --> 01:18:58.399
And it took us a couple
of hours drive, so...

01:18:58.399 --> 01:19:02.122
- And I worked until 1:30 this morning.

01:19:12.669 --> 01:19:17.465
- [Pilger] RAM was founded in
1985 by the late Stan Brock,

01:19:17.877 --> 01:19:22.097
a Londoner who believed
passionately in the right of people

01:19:22.097 --> 01:19:26.204
to healthcare regardless
of their ability to pay.

01:19:27.592 --> 01:19:32.150
- Stan was the world's
expert on free healthcare.

01:19:33.116 --> 01:19:34.452
It had to be free.

01:19:35.418 --> 01:19:37.566
It had to be real care, high quality.

01:19:37.566 --> 01:19:39.062
He didn't want us to tell somebody

01:19:39.062 --> 01:19:42.016
to go find a doctor or a dentist.

01:19:42.016 --> 01:19:46.063
Stan was the guy who
could inspire the workers,

01:19:46.063 --> 01:19:48.183
he could inspire the volunteers.

01:19:49.161 --> 01:19:51.015
And his words were simple:

01:19:51.015 --> 01:19:53.156
we, me, you.

01:19:54.284 --> 01:19:56.967
And that is why you folks
are gathered here today.

01:19:57.840 --> 01:20:02.581
And in Stan's honor, we will
never forget the mission.

01:20:14.000 --> 01:20:17.750
This is one of the most
economically deprived

01:20:17.750 --> 01:20:21.835
parts of America.

01:20:21.835 --> 01:20:24.415
The coal industry boomed in years past

01:20:24.415 --> 01:20:25.924
and has mostly declined.

01:20:26.841 --> 01:20:30.083
We have some counties out
here that have no dentist,

01:20:30.083 --> 01:20:34.188
and there are lots of specialties
that we don't have at all

01:20:34.188 --> 01:20:36.003
that cities take for granted.

01:20:37.909 --> 01:20:39.932
- The nurse practitioner
at the Health Wagon

01:20:39.932 --> 01:20:43.452
wanted me to come because I
have chest pains sometimes

01:20:43.452 --> 01:20:47.737
and my blood pressure
is, like, uncontrollable.

01:20:47.737 --> 01:20:49.379
- Okay, can you describe your chest pain,

01:20:49.379 --> 01:20:50.786
what kind of a pain you get?

01:20:50.786 --> 01:20:52.342
- Well, sometimes it hurts,

01:20:52.342 --> 01:20:55.052
like a dull hurt down my arm.

01:20:55.052 --> 01:20:57.560
But this morning it's just
been, like, sharp twinges.

01:20:57.560 --> 01:20:59.545
- Do you smoke?
- Yes.

01:20:59.545 --> 01:21:03.765
- We're a belt of disease.
We're a belt of lung disease,

01:21:03.765 --> 01:21:05.395
I'm a pulmonologist.

01:21:05.395 --> 01:21:09.212
So we're a belt of asthma, COPD, smoking.

01:21:09.212 --> 01:21:11.590
We're a belt of lung cancer.

01:21:11.590 --> 01:21:13.873
We're a belt of heart disease, stroke.

01:21:13.873 --> 01:21:18.668
We're a belt of obesity and
we're a belt of opioid use

01:21:19.071 --> 01:21:21.500
tied into mental health issues.

01:21:23.128 --> 01:21:26.465
- [Pilger] So when they
come to you what, typically,

01:21:26.465 --> 01:21:27.561
do they come with?

01:21:28.565 --> 01:21:31.155
- They're short of breath,
they have a cough,

01:21:31.155 --> 01:21:32.795
they have exercise limitation,

01:21:32.795 --> 01:21:34.550
they're having difficulty working.

01:21:34.550 --> 01:21:38.002
And we can do a chest
X-ray on the mobile unit,

01:21:38.002 --> 01:21:41.052
we can do a breathing test
of pulmonary function.

01:21:41.052 --> 01:21:45.262
- [Pilger] Are you able
to catch disease in time?

01:21:45.262 --> 01:21:48.427
- We did find three
lung cancers in one day

01:21:48.427 --> 01:21:52.781
here at this event, and so
we do find serious disease

01:21:52.781 --> 01:21:55.735
with chest X-ray and our other screenings.

01:21:55.735 --> 01:21:58.104
But the most common thing
we find is, of course,

01:21:58.104 --> 01:22:00.751
the common diseases,
discovering high blood pressure,

01:22:00.751 --> 01:22:02.256
discovering diabetes.

01:22:02.256 --> 01:22:04.609
We discover things that
they have no idea about.

01:22:06.313 --> 01:22:09.046
A lot of the patients know
hey don't feel very well,

01:22:09.046 --> 01:22:11.003
but they don't know why.

01:22:11.003 --> 01:22:13.892
They're trying to cope, trying to exist.

01:22:14.935 --> 01:22:18.061
Diabetes is a disease
that people tend to deny.

01:22:18.061 --> 01:22:20.162
They don't even like the word "diabetes."

01:22:20.162 --> 01:22:23.010
In the mountains they'll
say, "Got a little sugar."

01:22:23.010 --> 01:22:25.638
They won't say the word "diabetes."

01:22:25.638 --> 01:22:27.623
And they're trying to cope

01:22:27.623 --> 01:22:31.654
by putting off till tomorrow
what they can't afford today.

01:22:35.430 --> 01:22:36.993
- [Pilger] It's a bit of a
lifesaver here, isn't it?

01:22:36.993 --> 01:22:40.813
- Yeah, this is a great
program. Fantastic program.

01:22:43.337 --> 01:22:45.356
- [Pilger] What do the
people who live around here

01:22:45.356 --> 01:22:49.165
who don't have the medical facilities do?

01:22:49.165 --> 01:22:50.685
- They do without.

01:22:50.685 --> 01:22:51.762
- [Pilger] They do without.

01:22:51.762 --> 01:22:55.646
- They have no teeth, or partial teeth.

01:22:55.646 --> 01:22:59.329
They have no diabetic treatment,

01:22:59.329 --> 01:23:01.832
no high blood pressure treatment.

01:23:01.832 --> 01:23:05.940
So if they come here they
at least get some medicine.

01:23:10.502 --> 01:23:12.381
- [Pilger] Typically, what
are you dealing with here?

01:23:12.381 --> 01:23:13.465
What are you treating?

01:23:13.465 --> 01:23:15.498
- We've seen several patients this morning

01:23:15.498 --> 01:23:18.254
that have received more
than ten extractions.

01:23:19.382 --> 01:23:20.840
- [Pilger] The reason
these people are here

01:23:20.840 --> 01:23:23.487
because they can't afford
to go to the dentist.

01:23:23.487 --> 01:23:24.667
- They can't afford to go to the dentist

01:23:24.667 --> 01:23:27.314
or they have insurance that
really isn't working for them.

01:23:27.314 --> 01:23:29.903
Some of these people who work
in these small communities,

01:23:29.903 --> 01:23:33.087
their insurance may only be
acceptable in a regional area.

01:23:33.087 --> 01:23:35.772
Go outside that region,
the insurance isn't accepted.

01:23:36.808 --> 01:23:40.050
- [Pilger] It just sounds like chaos.

01:23:40.050 --> 01:23:41.891
- It is, it's chaos and
it's a vicious cycle.

01:23:41.891 --> 01:23:44.269
And that's why things like
these are so important.

01:23:44.269 --> 01:23:47.444
- [Pilger] Stan Brock was
quoted yesterday about,

01:23:47.444 --> 01:23:51.194
famous quote of, "All
healthcare should be free."

01:23:51.194 --> 01:23:54.493
- Right, I don't deny that,
I don't disagree with that.

01:23:54.493 --> 01:23:56.823
And if people are suffering,

01:23:56.823 --> 01:24:00.343
it doesn't make much sense
to me as a human being.

01:24:00.343 --> 01:24:01.753
- [Pilger] When and how
is there going to be

01:24:01.753 --> 01:24:03.978
free healthcare in the United States?

01:24:03.978 --> 01:24:05.016
- Not in my lifetime.

01:24:05.992 --> 01:24:08.859
- And our pharmaceuticals
are unbelievably expensive,

01:24:08.859 --> 01:24:11.449
the highest cost for drugs in the world.

01:24:11.449 --> 01:24:13.319
In other countries I can get medicine--

01:24:13.319 --> 01:24:17.356
I can go to India and
buy medicine for pennies

01:24:17.356 --> 01:24:19.102
and give it out to patients.

01:24:19.102 --> 01:24:22.928
But here, when I as a charitable doctor

01:24:22.928 --> 01:24:25.997
go to get one asthma
inhaler for one patient,

01:24:25.997 --> 01:24:30.792
that's $400 for one month's
supply for an asthma patient

01:24:31.023 --> 01:24:33.900
when 6% of our population has asthma.

01:24:33.900 --> 01:24:36.013
It's like an incredible rip-off.

01:24:54.102 --> 01:24:56.819
[truck engine idling]

01:24:58.480 --> 01:25:03.096
- And then they were gone,
wrapped up in a few hours.

01:25:04.215 --> 01:25:08.118
The lesson for us on the
other side of the Atlantic

01:25:08.118 --> 01:25:09.464
could not be clearer.

01:25:10.554 --> 01:25:15.349
Could the NHS be reduced to
charity that comes and goes

01:25:15.733 --> 01:25:18.767
like this extraordinary event in Virginia?

01:25:31.029 --> 01:25:33.666
[ominous booming tone]

01:25:49.482 --> 01:25:51.803
This is the city of London,

01:25:51.803 --> 01:25:55.629
home to some of the world's
richest money movers,

01:25:55.629 --> 01:26:00.424
gamblers, insurance companies,
hedge funds and banks.

01:26:02.247 --> 01:26:04.778
It was here and in Wall Street

01:26:04.778 --> 01:26:08.902
that the great financial crash of 2008

01:26:08.902 --> 01:26:11.559
was caused by a system of greed,

01:26:11.559 --> 01:26:14.151
mismanagement and corruption,

01:26:14.954 --> 01:26:18.723
most of it rescued by the government.

01:26:18.723 --> 01:26:23.518
And it was here that the
imposition of an extreme ideology

01:26:23.767 --> 01:26:27.146
called austerity was justified.

01:26:28.850 --> 01:26:33.646
Austerity is one of the
propaganda triumphs of the age

01:26:33.895 --> 01:26:37.146
because there's no need for austerity.

01:26:37.146 --> 01:26:38.987
There is a debt owed by banks

01:26:38.987 --> 01:26:41.960
that were bailed out with our money.

01:26:41.960 --> 01:26:44.953
We the people don't owe a penny.

01:26:44.953 --> 01:26:47.149
Then why are we paying for it?

01:26:47.149 --> 01:26:49.853
Why are the poorest picking up the bill

01:26:49.853 --> 01:26:52.692
when some of the biggest
companies in the world

01:26:52.692 --> 01:26:55.291
pay little or no tax?

01:26:55.291 --> 01:26:59.444
Why has mass poverty returned to Britain?

01:26:59.444 --> 01:27:02.925
Why are the very premises
of civilized life,

01:27:02.925 --> 01:27:06.167
of which the National
Health Service is a beacon,

01:27:06.167 --> 01:27:09.715
being run down or put up for sale?

01:27:09.715 --> 01:27:12.467
Why, according to one study,

01:27:12.467 --> 01:27:17.263
is there the greatest rise
in mortality in 50 years?

01:27:19.037 --> 01:27:21.693
The study undertaken by
you and your colleagues

01:27:21.693 --> 01:27:23.710
gave out some really damning evidence:

01:27:24.753 --> 01:27:28.177
that thousands of excess
deaths in England and Wales

01:27:28.177 --> 01:27:31.044
were linked to cuts in the health service.

01:27:31.044 --> 01:27:34.218
In the first seven weeks of 2018,

01:27:34.218 --> 01:27:38.256
an additional person
died every seven minutes.

01:27:38.256 --> 01:27:42.928
- The only thing that fits
is austerity, the cuts--

01:27:42.928 --> 01:27:44.145
cuts to the health service,

01:27:44.145 --> 01:27:46.696
but cuts to social care as well.

01:27:46.696 --> 01:27:49.736
Because as the cuts got deeper and deeper,

01:27:49.736 --> 01:27:52.574
people began to die faster--

01:27:52.574 --> 01:27:56.248
the frail and the elderly first.

01:27:56.248 --> 01:27:57.811
Elderly women who are much more likely

01:27:57.811 --> 01:28:00.803
to be living on their
own than elderly men.

01:28:00.803 --> 01:28:03.719
And we first said this
over four years ago.

01:28:03.719 --> 01:28:05.713
And the cuts continued,

01:28:05.713 --> 01:28:09.962
and then life expectancy
itself began to drop.

01:28:09.962 --> 01:28:14.757
You're talking about 120,000 people so far

01:28:15.965 --> 01:28:19.073
who have died earlier
than they would otherwise.

01:28:19.073 --> 01:28:21.576
For child and infant
mortality we're ranked--

01:28:21.576 --> 01:28:23.868
well, neo-natal deaths,
we're 19th in Europe.

01:28:24.750 --> 01:28:26.726
And that's getting worse.

01:28:26.726 --> 01:28:28.375
One thing that shocks medics,

01:28:28.375 --> 01:28:31.301
our babies used to have a
three times better chance

01:28:31.301 --> 01:28:35.060
of not dying than babies in
Portugal in the '60s and '70s.

01:28:35.060 --> 01:28:36.901
Portugal was always put forward

01:28:36.901 --> 01:28:40.325
as a terrible place to be born.

01:28:40.325 --> 01:28:43.173
Now you're much more likely
to get to your first birthday

01:28:43.173 --> 01:28:46.175
if you're born in Portugal than in the UK.

01:28:46.175 --> 01:28:50.107
- The changes in the health
service have a great deal to do

01:28:50.107 --> 01:28:51.891
with privatization.
- Yeah.

01:28:51.891 --> 01:28:55.977
- The change of the character
of the health service

01:28:55.977 --> 01:28:57.846
has much to do with that.

01:28:57.846 --> 01:28:59.726
And in making this film

01:28:59.726 --> 01:29:02.709
we've found that it's much more prevalent,

01:29:02.709 --> 01:29:04.838
certainly, than I realized.

01:29:04.838 --> 01:29:06.795
What's the impact of that?

01:29:06.795 --> 01:29:08.972
- When you think you're part of something

01:29:10.084 --> 01:29:11.427
which is truly precious to people,

01:29:11.427 --> 01:29:14.640
that's when you work longer
hours that you're not paid for,

01:29:14.640 --> 01:29:16.280
that's when you spend another minute

01:29:16.280 --> 01:29:18.898
with somebody that you wouldn't otherwise.

01:29:18.898 --> 01:29:22.935
Turn it into a business
where they're customers

01:29:22.935 --> 01:29:26.465
and not patients and, you know,

01:29:26.465 --> 01:29:29.255
the same way that most
people treat their jobs,

01:29:29.255 --> 01:29:32.833
it's how you get paid
but it's not a vocation.

01:29:32.833 --> 01:29:34.952
And that's very dangerous with health,

01:29:34.952 --> 01:29:37.589
because you really want the
people looking after your health

01:29:37.589 --> 01:29:41.358
to actually care about you,

01:29:41.358 --> 01:29:44.152
not care about when they're
going to be going off shift.

01:29:51.179 --> 01:29:55.466
- [Pilger] On Clapham Common
in London is Glass Door,

01:29:55.466 --> 01:29:59.954
a voluntary organization
giving refuge and food

01:29:59.954 --> 01:30:00.945
to homeless people.

01:30:06.620 --> 01:30:08.346
For some of the people here,

01:30:09.199 --> 01:30:12.364
their predicament bears
a striking likeness

01:30:12.364 --> 01:30:15.283
to patient dumping in the United States.

01:30:17.159 --> 01:30:20.017
- We're getting a lot
of emergency discharges

01:30:20.017 --> 01:30:23.048
from local hospitals.
We're getting a lot of people

01:30:23.048 --> 01:30:27.843
who have been seen by their
local mental health units

01:30:28.054 --> 01:30:30.068
and been told that although they do

01:30:30.068 --> 01:30:31.583
have a mental health problem,

01:30:31.583 --> 01:30:33.866
they don't meet the threshold for care.

01:30:33.866 --> 01:30:37.616
We've had people who have
arrived literally in scrubs

01:30:38.556 --> 01:30:42.718
and open-toed sandals
from mental health units

01:30:44.262 --> 01:30:46.554
where there's been a
sort of discharge meeting

01:30:46.554 --> 01:30:48.472
at sort of ten o'clock in the morning,

01:30:48.472 --> 01:30:50.707
five o'clock in the afternoon
they're put in a taxi

01:30:50.707 --> 01:30:52.586
and sent down to us.

01:30:52.586 --> 01:30:56.844
Last year we had a man
who had been discharged

01:30:56.844 --> 01:30:59.194
from the local hospital nine days

01:30:59.194 --> 01:31:00.824
after having open heart surgery.

01:31:00.824 --> 01:31:04.661
We have NHS workers who are homeless.

01:31:04.661 --> 01:31:07.145
You know, it's a testament
to their staggering loyalty

01:31:07.145 --> 01:31:09.523
that even though they are sleeping rough,

01:31:09.523 --> 01:31:11.316
they'll get up at seven
o'clock in the morning,

01:31:11.316 --> 01:31:14.069
dust themselves off and go into work.

01:31:14.069 --> 01:31:15.536
- [Pilger] They go and work in the NHS?

01:31:15.536 --> 01:31:17.071
- Yes.
- Having slept rough?

01:31:17.071 --> 01:31:18.739
- Having slept rough, yeah.

01:31:18.739 --> 01:31:22.643
We have careworkers, we
have healthcare assistants,

01:31:22.643 --> 01:31:23.441
people who go--

01:31:23.441 --> 01:31:26.790
The people who go out and do personal care

01:31:26.790 --> 01:31:30.692
for our aging relatives,
our sick individuals,

01:31:31.581 --> 01:31:33.493
have oftentimes been sleeping

01:31:33.493 --> 01:31:35.172
on a church floor the night before.

01:31:38.198 --> 01:31:40.490
- [Pilger] This is St. Stephen's Church

01:31:40.490 --> 01:31:42.428
in the heart of London,

01:31:42.428 --> 01:31:44.886
just behind the Houses of Parliament.

01:31:47.069 --> 01:31:48.204
It's mid-winter.

01:31:50.205 --> 01:31:52.143
And this is David Coombe,

01:31:52.143 --> 01:31:56.161
whose remarkable
organization, Street Souls,

01:31:56.161 --> 01:31:59.182
cares for the victims of austerity

01:32:01.771 --> 01:32:04.438
with hot meals, clothes,

01:32:04.438 --> 01:32:07.318
glasses that people can no longer afford,

01:32:10.278 --> 01:32:13.385
and above all a warm place

01:32:13.385 --> 01:32:15.709
where people can feel human again.

01:32:18.967 --> 01:32:22.679
David, just describe Street
Souls and how it began.

01:32:22.679 --> 01:32:25.153
- What I really wanted to
do was a compassionate act

01:32:25.153 --> 01:32:27.589
involving my two younger
children at the time,

01:32:27.589 --> 01:32:31.348
who I think were six and
eight, maybe, at the time.

01:32:31.348 --> 01:32:35.354
And I said to them, just
before Christmas, I said,

01:32:35.354 --> 01:32:37.649
"We're not going to buy Christmas
presents this year, boys.

01:32:37.649 --> 01:32:40.114
"We're going to buy sleeping
bags for homeless people.

01:32:40.114 --> 01:32:41.514
"We're going to take soup and sandwiches

01:32:41.514 --> 01:32:42.866
"out to the homeless."

01:32:42.866 --> 01:32:44.852
Which of course didn't go down too well,

01:32:44.852 --> 01:32:46.923
as you can imagine with young lads.

01:32:46.923 --> 01:32:50.337
We got a big van full up
with sandwiches and soup

01:32:50.337 --> 01:32:52.102
and literally drove around London,

01:32:52.102 --> 01:32:53.665
and we did this several times.

01:32:53.665 --> 01:32:57.022
- What struck you at first
about the people you met?

01:32:57.022 --> 01:32:58.460
- That they were just like me.

01:32:59.400 --> 01:33:01.117
One thing that was very apparent

01:33:01.117 --> 01:33:03.105
was it's not as portrayed in the media.

01:33:03.105 --> 01:33:05.807
There's not drunk-- everyone's not drunk,

01:33:05.807 --> 01:33:07.466
everyone's not a drug addict.

01:33:07.466 --> 01:33:10.985
In fact, I'd say that
was a minority, you know,

01:33:10.985 --> 01:33:12.827
totally the opposite of what most people

01:33:12.827 --> 01:33:14.038
would probably believe.

01:33:15.982 --> 01:33:17.555
A lot of these people have just had

01:33:17.555 --> 01:33:19.581
misfortunate events in their lives.

01:33:22.494 --> 01:33:27.289
- That direct connection
between political decisions

01:33:27.471 --> 01:33:30.617
and homelessness, that's
something you've seen isn't it?

01:33:30.617 --> 01:33:32.488
- Yeah, very much so.

01:33:32.488 --> 01:33:34.607
You know, in 2010 Westminster City Council

01:33:34.607 --> 01:33:38.232
tried to pass a by-law
within central Westminster

01:33:38.232 --> 01:33:41.377
to make it illegal to sleep
rough and punishable by,

01:33:41.377 --> 01:33:44.677
I think it's a tariff fine of £500 pounds.

01:33:44.677 --> 01:33:45.676
Which is kind of crazy.

01:33:45.676 --> 01:33:47.803
a homeless person's not
going to have £500 pounds.

01:33:47.803 --> 01:33:50.366
But also illegal to feed homeless people.

01:33:53.049 --> 01:33:57.106
- [Pilger] What's the direct
connection between austerity

01:33:57.106 --> 01:33:59.369
and the people that you help here?

01:33:59.369 --> 01:34:02.035
- The lack of aftercare is
something that I've noticed.

01:34:02.035 --> 01:34:03.474
You know, some of the guys we have here

01:34:03.474 --> 01:34:05.267
who've had some quite major operations

01:34:05.267 --> 01:34:07.742
are effectively turfed
back out on the street.

01:34:07.742 --> 01:34:09.688
- [Pilger] Give me an example.

01:34:09.688 --> 01:34:11.667
- Well, I've got a fella who's had

01:34:13.126 --> 01:34:14.503
a couple of knee operations,

01:34:14.503 --> 01:34:17.418
and what he calls home
is a janitor's closet

01:34:17.418 --> 01:34:21.279
of seven foot by four
foot in a block of flats.

01:34:21.279 --> 01:34:24.575
That's where he goes,
that's where he convalesces.

01:34:25.952 --> 01:34:28.735
I have a lovely chap who had,
I'm not sure what surgery,

01:34:28.735 --> 01:34:31.353
but major surgery, so his chest looked

01:34:31.353 --> 01:34:36.148
rather like sort of a
quilt, had to go in a place

01:34:37.251 --> 01:34:39.112
he was given five stories up with no lift,

01:34:39.112 --> 01:34:41.039
immediately having this operation

01:34:41.039 --> 01:34:43.804
where he had 140 stitches or whatever.

01:34:45.173 --> 01:34:46.336
It's just so wrong.

01:34:48.033 --> 01:34:50.843
It's in, out, in, out. It's
free up the beds and, you know.

01:34:54.098 --> 01:34:55.396
You know, the life
expectancy on the street

01:34:55.396 --> 01:34:56.921
is 47 years old.

01:34:56.921 --> 01:34:58.477
- 47?
- 47.

01:35:00.345 --> 01:35:04.008
- It's heart-breaking because
the bar is set so high now

01:35:04.008 --> 01:35:05.744
on who you can admit to hospital

01:35:05.744 --> 01:35:08.909
because there are so few hospital beds.

01:35:08.909 --> 01:35:11.307
You know, it really is a case
that unless you're threatening

01:35:11.307 --> 01:35:14.817
to imminently kill yourself or
you're psychotic to the point

01:35:14.817 --> 01:35:19.334
of just incredibly
disturbed as an individual

01:35:19.334 --> 01:35:23.189
or a threat to other people,
then you're sent home.

01:35:23.189 --> 01:35:24.465
And unless you---

01:35:24.465 --> 01:35:27.514
- [Pilger] What if home is not a home?

01:35:27.514 --> 01:35:29.145
What if it's in the street?

01:35:29.145 --> 01:35:30.804
- Well, it's just heart-breaking.

01:35:30.804 --> 01:35:32.837
I mean, there's been a lot of occasions

01:35:32.837 --> 01:35:35.551
when I've had to send
someone out onto the streets,

01:35:35.551 --> 01:35:38.447
and you just send them out into the night

01:35:38.447 --> 01:35:40.845
and you don't know what's
going to happen to them.

01:35:44.556 --> 01:35:47.514
- [Pilger] John Watts
works with David Coombe

01:35:47.514 --> 01:35:48.582
as a volunteer.

01:35:49.726 --> 01:35:53.006
We're on his regular
run to check on people

01:35:53.006 --> 01:35:57.072
with nowhere to sleep in
near freezing temperatures

01:35:57.072 --> 01:35:58.769
but on the streets.

01:35:58.769 --> 01:36:03.459
- [Watts] We've created a
have and have-not society,

01:36:06.385 --> 01:36:08.913
and we don't like to particularly see

01:36:11.298 --> 01:36:12.419
the ones who have not.

01:36:14.028 --> 01:36:16.605
- [Pilger] David was
saying that life expectancy

01:36:16.605 --> 01:36:20.239
of people on the streets was 47.

01:36:20.239 --> 01:36:21.863
- [Watts] Yeah, yeah.

01:36:21.863 --> 01:36:24.820
- [Pilger] How long has he
been there, do you think?

01:36:26.457 --> 01:36:27.639
- Months.
- Months?

01:36:30.466 --> 01:36:33.237
- [Man] Excuse me, are you volunteer?

01:36:33.237 --> 01:36:34.789
- I'm part of Street Souls.

01:36:34.789 --> 01:36:36.359
- [Woman] Have you got
a spare sleeping bag?

01:36:36.359 --> 01:36:38.250
- [Man] I need to get one,
I've just come out of jail.

01:36:38.250 --> 01:36:39.415
I haven't got one.
- I need a sleeping bag.

01:36:39.415 --> 01:36:42.035
- I've got one sleeping
bag left, all right?

01:36:44.554 --> 01:36:46.494
- [Man] Please, please.

01:36:46.494 --> 01:36:48.451
- I'll be back in two weeks.

01:36:50.548 --> 01:36:52.936
- [Woman] One, you can't use a toilet.

01:36:52.936 --> 01:36:55.276
Two, you can't get housin'.

01:36:55.276 --> 01:36:58.060
Three, we're having a nervous breakdown.

01:36:59.956 --> 01:37:03.584
And...it's not good.

01:37:04.500 --> 01:37:05.611
- No, it's wrong.

01:37:07.782 --> 01:37:09.645
- [Pilger] What happens to their health?

01:37:11.541 --> 01:37:14.054
- It deteriorates rapidly.

01:37:14.054 --> 01:37:18.801
They suffer from all sorts of things,

01:37:20.018 --> 01:37:21.662
and their mental health suffers.

01:37:22.522 --> 01:37:23.747
They don't sleep enough.

01:37:23.747 --> 01:37:26.665
They only get a couple of hours sleep

01:37:26.665 --> 01:37:28.708
because they're either moved on

01:37:28.708 --> 01:37:31.224
or they're nervous about people.

01:37:36.237 --> 01:37:38.922
It's just a downwards spiral, basically.

01:37:38.922 --> 01:37:42.250
- For those who are not
used to being homeless to be

01:37:42.250 --> 01:37:47.045
sleeping on a cold pavement,
that must be a shock.

01:37:47.077 --> 01:37:49.311
- I think it would be a shock for anybody.

01:37:50.147 --> 01:37:52.799
You know, it's bad enough in the summer.

01:37:52.799 --> 01:37:55.159
In this weather and in these temperatures,

01:37:56.990 --> 01:38:01.785
I just find it unbelievable
in the 21st century.

01:38:06.058 --> 01:38:07.497
- [Man] Stop that!

01:38:10.992 --> 01:38:14.733
- [Pilger] Why is this happening in 2019,

01:38:14.733 --> 01:38:16.049
in the middle of London?

01:38:16.895 --> 01:38:18.645
[man ranting and shouting obscenities]

01:38:18.645 --> 01:38:21.523
We stopped filming when the frustration

01:38:21.523 --> 01:38:24.470
of one rough sleeper spills over.

01:38:25.299 --> 01:38:26.328
- [Man] Fuck off!

01:38:26.328 --> 01:38:29.418
- [Pilger] Okay, sorry, okay, sorry.

01:38:46.285 --> 01:38:49.315
For more than six months we phoned,

01:38:49.315 --> 01:38:54.111
texted, emailed and wrote
to government ministers

01:38:54.216 --> 01:38:57.221
and officials who run the
National Health Service.

01:38:58.302 --> 01:39:01.083
The Secretary of State, Matt Hancock.

01:39:01.083 --> 01:39:04.164
The Head of NHS England, Simon Stevens.

01:39:05.293 --> 01:39:08.499
The Chair of NHS England, Lord Prior.

01:39:09.753 --> 01:39:12.278
The Health Minister, Caroline Dinage.

01:39:13.560 --> 01:39:16.171
The former Prime Minister, David Cameron.

01:39:17.108 --> 01:39:20.820
The former Health
Secretary, Alan Millburn,

01:39:20.820 --> 01:39:24.390
and many other officials and politicians.

01:39:25.433 --> 01:39:29.461
No one responsible for
the future of the NHS

01:39:29.461 --> 01:39:31.475
was available to be interviewed

01:39:31.475 --> 01:39:34.403
on the urgent issues raised in this film.

01:39:35.954 --> 01:39:36.935
Silence.

01:39:40.739 --> 01:39:45.218
- If you start out with
a core, a principle,

01:39:45.218 --> 01:39:49.131
of wanting to care for
everybody, you know,

01:39:49.131 --> 01:39:52.394
you've already started
at a foundation of value.

01:39:53.840 --> 01:39:57.561
I mean we've never really
had that here, you know.

01:39:57.561 --> 01:40:01.905
There's never been, you
know, a healthcare system

01:40:01.905 --> 01:40:03.670
that started with ethical values

01:40:03.670 --> 01:40:05.888
and said, "Okay, healthcare is a right,"

01:40:06.854 --> 01:40:08.532
or, you know, certain other values.

01:40:08.532 --> 01:40:11.218
We've never started there and built on it

01:40:11.218 --> 01:40:14.469
so that we have a lens by which we can

01:40:14.469 --> 01:40:16.425
measure everything that's happening.

01:40:16.425 --> 01:40:20.252
You do, you have that.
And if you lose that,

01:40:20.252 --> 01:40:21.690
then you'll never get it back.

01:40:22.803 --> 01:40:26.553
- We gained the freedom
from fear in the past.

01:40:26.553 --> 01:40:29.842
There's an enormous sense
of relief from thinking

01:40:29.842 --> 01:40:32.431
you are no longer going to
be a burden on your family.

01:40:33.304 --> 01:40:35.404
You're no longer-- not just
having to fear for yourself

01:40:35.404 --> 01:40:37.418
and your own pain and suffering,

01:40:37.418 --> 01:40:39.528
but the idea that your
family would either have to

01:40:39.528 --> 01:40:41.753
try and look after you or find the money

01:40:41.753 --> 01:40:43.729
for somebody to treat you.

01:40:43.729 --> 01:40:45.628
And it was one of the most remarkable

01:40:45.628 --> 01:40:47.872
and rapid improvements in living standards

01:40:47.872 --> 01:40:49.550
and quality of life.

01:40:49.550 --> 01:40:52.085
That fear has come back again.

01:40:52.085 --> 01:40:55.912
- It was a political
decision to give us an NHS,

01:40:55.912 --> 01:40:59.268
and we got that in 1948 with the 1946 Act.

01:41:01.292 --> 01:41:05.828
It was a political decision
to take it away in 2012.

01:41:06.890 --> 01:41:08.693
It only needs a political decision

01:41:08.693 --> 01:41:10.841
and the will of the people
and the politicians,

01:41:10.841 --> 01:41:13.958
because the people have not
lost faith with the NHS.

01:41:13.958 --> 01:41:15.476
They want an NHS.

01:41:16.423 --> 01:41:18.513
- I believe they will
reach a tipping point

01:41:18.513 --> 01:41:22.982
of public awareness,
at which time our politicians

01:41:22.982 --> 01:41:26.732
cannot get away with the
deception any longer.

01:41:26.732 --> 01:41:30.012
If enough of the general
public stand up and say,

01:41:30.012 --> 01:41:32.141
"No more of this,"

01:41:32.141 --> 01:41:33.676
if the profession can unite

01:41:33.676 --> 01:41:35.987
and realize the power they have,

01:41:35.987 --> 01:41:37.620
we can stop this very quickly.

01:41:38.433 --> 01:41:41.463
- The government need
to believe in the NHS,

01:41:41.463 --> 01:41:43.135
not mess about with it.

01:41:43.947 --> 01:41:45.810
They need to properly fund it,

01:41:47.927 --> 01:41:50.373
and they need to trust
those that are there

01:41:50.373 --> 01:41:52.655
to get on with their work

01:41:52.655 --> 01:41:54.471
and let them get on with their work.

01:41:55.743 --> 01:41:57.364
- [Pilger] People like you.

01:41:57.364 --> 01:42:00.580
- Yes. To trust us.

01:42:06.641 --> 01:42:11.436
♪ And did those feet in ancient time ♪

01:42:13.114 --> 01:42:17.910
♪ Walk upon England's mountains green ♪

01:42:19.069 --> 01:42:23.864
♪ And was the holy lamb of God ♪

01:42:25.218 --> 01:42:30.014
♪ On England's pleasant pastures seen ♪

01:42:31.803 --> 01:42:36.598
♪ And did the countenance divine ♪

01:42:37.737 --> 01:42:42.532
♪ Shine forth upon our clouded hills ♪

01:42:44.197 --> 01:42:48.992
♪ And was Jerusalem builded here ♪

01:42:51.438 --> 01:42:55.353
♪ Among those dark Satanic mills ♪

01:42:58.225 --> 01:43:01.102
[exhaltant orchestral music]

01:43:07.985 --> 01:43:12.780
♪ And did those feet in ancient time ♪

01:43:14.383 --> 01:43:19.178
♪ Walk upon England's mountains green ♪

01:43:20.356 --> 01:43:25.152
♪ And was the holy lamb of God ♪

01:43:26.638 --> 01:43:31.433
♪ On England's pleasant pastures seen ♪

01:43:33.112 --> 01:43:37.907
♪ And did the countenance divine ♪

01:43:39.176 --> 01:43:43.971
♪ Shine forth upon our clouded hills ♪

01:43:45.637 --> 01:43:50.432
♪ And was Jerusalem builded here ♪

01:43:52.734 --> 01:43:56.649
♪ Among those dark Satanic mills ♪

01:43:59.628 --> 01:44:03.385
[exhaltant orchestral music]

01:44:09.710 --> 01:44:14.505
♪ Bring me my bow of burning gold ♪

01:44:16.710 --> 01:44:21.505
♪ Bring me my arrows of desire ♪

01:44:23.052 --> 01:44:27.847
♪ Bring me my spear, O clouds unfold ♪

01:44:29.262 --> 01:44:34.057
♪ Bring me my chariot of fire ♪

01:44:36.391 --> 01:44:41.186
♪ I will not cease from mental fight ♪

01:44:42.725 --> 01:44:47.520
♪ Nor shall my sword sleep in my hand ♪

01:44:49.173 --> 01:44:53.968
♪ Till we have built Jerusalem ♪

01:44:56.330 --> 01:45:00.725
♪ In England's green and pleasant land ♪