On a Paris hospital wall: poster graffiti warning: When everything is privatised, we will be deprived of everything. | Author’s image.
Like the detainee gouging repeated marks on their cell wall, I started making one little downstroke on a page in my notebook for each time the voice on the line intoned: “Thank you for waiting. Your call is important to us and will be answered by the next available agent.” The moments between were filled with computer-composed muzak so mind-numbing that my admiration for the obstinate inmate who keeps their sanity sufficiently to remember, day after day, to scratch that wall, began to equal that for the scientists who have developed our Covid-19 vaccines.
There were five full rows across the page by the time I decided that one hour of waiting was enough to prove that the organisation running the test system for those who come in to Wales from abroad did not rate my call as important. The packet containing my sample had been put in the relevant Royal Mail post box during the afternoon of 15 June. The email announcing the result finally came at 2.06am on the 20th. That lateness cost me three days of freedom.
From the point of view of the private company that holds this particular contract, my liberty was less important than the bottom line in its accounts. The steady hollowing out of the NHS – still “free at the point of entry” but with its services increasingly provided by profit-taking private subcontractors – is pushing it closer to the French model. There, private and public moneys mix more openly, all to the growing advantage of the private.
Doctolib and HOPPS
The only way of easily progressing on from your French GP to the examinations and treatments they prescribe is via the spreading tentacles of Doctolib. A web-based booking service, this company has moved from being a start-up of the kind so beloved of President Macron to a fully established powerhouse eying up the potential of world markets, all in less than a decade.
It has done this with the aid of public money and sponsorship and by exploiting simple digital technology to fill a gap in the way the French national health service operates. It makes life easier for patients and professionals alike. Helping patients navigate the fragmented system was a no-brainer. Everything Doctolib does could and should have been done by a properly organised public service, fully funded to help everyone toward better health.
This year it has been the principle means of individuals themselves arranging to get their Covid vaccinations. The annual flu jab is arranged by the public health service – every older person is sent their prescription. No such sensible idea on the vaccines.
During the run up to the French regional and departmental votes across the last week of June, all electors were meant to have received leaflets from the different candidates. Part of this work was contracted out to a delivery company, Adrexo. Many got nothing. This was not just a matter of one lone individual kicking their heels during an extra three days of isolation, it was a direct attack on the democratic rights of French citizens.
As I was hanging onto the phone line hoping for my result, Interior Minister Gérald Darmanin apologised for Adrexo’s “particularly bad” work. Covid restrictions had already drastically limited public activity and face-to-face discussion. Those subcontracted by Darmanin’s ministry consigned to the dustbin, sometimes literally, this last part of the campaigning.
Adrexo is owned by HOPPS, a French conglomerate that aims, according to its own write-up, for “the creation of new industrial models, disrupting established markets and challenging historic monopoly situations … To be a HOPPer is to live every day with the pleasure of discovery, entrepreneurship, with the taste of the new.” It is “above all a human adventure”.
Engels had a saying that has long intrigued me: Freedom is the recognition of necessity. I came across it while a young student and when freedom in life seemed to require rejecting constraints rather than accepting them. Like many a philosophical aphorism that is useful in guiding action instead of filling time with idle contemplation, it explores an essential contradiction of human life.
If we want to enjoy liberty, we need to shoulder the work, the effort, the responsibilities that help make freedom a reality in our lives rather than PR hyperbole on a corporate website. Meaningful freedom is something we collectively create as a shared, fundamental practice of human social relations. We cannot be free without the help of others.
HOPPS claims it “creates human relationships” and so “takes part in constructing the future of the world in which we all live”. This, even as it gnaws at the heart of those public services that are the only ultimate protection for harassed staff and needy clients against being made the vulnerable prisoners of a system where figures on a bottom line weigh more than all the marks on cell walls counting down the days to the moment when the door flies open and freedom comes.