‘We must challenge the influence of private healthcare companies if we want to tackle health inequalities’

UNISON Regional Secretary Patricia McKeown launches a special edition of VIEW, the independent social affairs magazine, on the state of the health and social care system.
As private healthcare companies operating in Northern Ireland make increased profits, the health service’s largest trade union UNISON argues that their role is worsening health inequalities, entrenching a two-tier system, and draining capacity from already under-pressure public services.
UNISON Regional Secretary Patricia McKeown is guest editor of a special health edition of VIEW magazine and has brought together articles from public health experts, frontline workers, patient advocates, and journalists. Collectively, they document how long waits, shrinking public provision, and underfunding are steering patients toward private providers while those who cannot pay are left behind.
£300m+ of public money to private providers in 5 years
UNISON is also highlighting the dramatic rise in public spending on NHS-funded private care with more than £302 million paid to private providers between April 2020 and April 2025 by Health and Social Care Trusts, even as waiting lists remained among the worst in the UK.
While outsourcing to the private sector is a major feature of the Executive’s efforts to reduce waiting times in Northern Ireland, VIEW magazine contributors argue that private providers are “cherry-picking” lower-risk, healthier, and often wealthier, patients for profitable procedures, while complications and readmissions return to the NHS, further reducing public capacity. The Scottish government has, as a result, reversed this trend and refocused on building capacity in NHS services.
UNISON NI: choose public solutions over private quick fixes
The message from UNISON is clear: healthcare workers are calling for an end to short-term private workarounds that divert scarce funding and staff and for a decisive shift to rebuild public capacity.
Regional Secretary Patricia McKeown questions the lack of transparency around health service decision making and calls for strong political leadership to fix the public health system:
“Vested interests that see healthcare as an opportunity for profit have a different agenda. One of the big questions for us is which agenda is winning out and who is really taking the decisions? We will continue to oppose privatisation and profiteering with all the means at our disposal. So too should the people we elect.
Many opportunities to get it right have been missed and bad decisions have been imposed on us, mostly because of Stormont’s failure to agree, stay in government and work collectively.
As a union, we have consistently demonstrated that we know how to establish and work in meaningful partnerships to deliver quality healthcare and justice for the workers. It’s time for our government to do the same.”

The full issue of VIEW magazine is available online at: https://shorturl.at/6MJPz