An interview with George Monbiot.
‘Neoliberalism is the dominant ideology of our times. It tells us we should strip away anything that interferes with the discovery of a natural order. It believes that wealthy people deserve to be wealthy and poor people deserve to be poor and that there is a ‘natural hierarchy’ of human beings.
‘It also believes that anything such as taxation, regulation, trade unions, public services, protest and in some cases democracy itself interfere with the discovery of that natural order. So these should by one means or another be minimised or shut down completely. You end up with a world in which decision are made at an economic level rather than a political level, which means that the power of money rules supreme.
Why this is so harmful
What neoliberalism does is grant almost unlimited power to corporations and the people who run them. It has created a global class of oligarchs, some of whom seem to be more powerful than democratically elected governments. It disempowers the rest of us. It undermines the enabling state, public services, effective regulation, and the power of people, and puts us on the road to plutocracy instead (the rule of money and those who possess it).
‘We need to name it and bring it into the light. When something has a name and it has a definition and when people recognise what it is, that is the first step towards challenging that thing. But if it can operate namelessly and below the radar it’s very difficult to challenge. That’s step number one. Step number two is explaining the problems with it and why it is causing so much social harm. Step number 3 is creating a viable, attractive alternative to it which people would vote for and invest in, in various ways, and see as an effective way of running society better than neoliberalism does.
Neoliberalism and economic inequalities
‘I think what we’ve seen is a significant rise in inequality, particularly in wealth inequality. What that leads to in turn is a great political inequality, because those with tremendous economic power can easily translate it into political power, as we’ve seen with Donald Trump, Elon Musk, Jeff Bezos, Larry Emerson and so many other multi-billionaires, and that pushes democracy to the sidelines. Neoliberalism has greatly enhanced and accelerated that process.
Neoliberalism and health equality
‘Neoliberalism is extremely damaging to health equality and public health as a whole. We see in extreme neoliberal societies, and the USA is the exemplar, how while very rich people might have access to better and better health, poorer people have worse and worse healthcare. We see in some cases even reductions in life expectancy and a whole load of diseases associated with anomie, despair and alienation, which neoliberalism also is a very powerful breeder of.
Deservedness (‘the undeserving sick’) and health inequalities
‘That’s a very powerful strand in neoliberalism. It certainly becomes particularly powerful when in the cause of cutting state budgets, which is an important neoliberal tenet, governments then try to exclude people from disability benefits, and they maintain that a lot of people who are actually very sick are not very sick and they are malingerers.
Effects on the NHS
‘We’ve seen governments who have clearly wanted to privatise the NHS. I think it’s pretty clear that that was the Tory ambition. When we saw Andrew Lansley’s reforms they could scarcely have been better designed to destroy the NHS as an effective entity. Of course they couldn’t take it all away because it’s an extremely popular institution and they would have found themselves voted out of office. But it’s been death by a thousand cuts: outsourcing here, privatisation there, underfunding everywhere.
‘A really important element, which is often neglected, of the difficulties facing the NHS is the huge legacy of the Private Finance Initiative (PFI): a classic neoliberal attack on the NHS, where in the guise of providing more money and more services it was actually handing over large chunks of the NHS to the private sector on terms which were designed to minimise private sector risk while maximising private sector gain. What you ended up with was the state taking on the risk and the private sector taking on the profits, and this huge legacy of costs being dumped on the NHS as a result, which many hospital trusts continue to struggle with.
‘NHS dentistry has almost died, and that’s by design. That’s absolutely catastrophic. NHS dentistry is like the laboratory for what they would like to do to the NHS as a whole if they could get away with it. From the point of view of pushing people into the private sector, the private sector is doing very well out of it; but from the point of view of patients it’s been an absolute catastrophe. There are the cases of people trying to make their own fillings and sticking them in with superglue, pulling out their own teeth, or just going without any dentistry at all and living in constant pain. It’s effectively back to the days of before there was an NHS where dentistry is concerned and we see the results of that.
Hope for restoring and protecting the NHS
‘The NHS is in a very difficult situation at the moment. A lot of people feel let down by it, which isn’t the fault of the NHS at all let alone of its remarkable and dedicate staff but just the result of massive underfunding and of loading other aspects of the failed state like social care (13% of NHS beds are occupied by people who should instead be in social care). The NHS is just a sort of dumping ground for anything the state doesn’t want to do anywhere else. That combination has had a massive impact on NHS services, on ambulance times, on waiting times in A&E, on the waiting lists for treatment.
‘The amazing thing is that despite all that people still recognise it’s not the fault of the NHS, and there’s still enthusiasm for the NHS. I strongly suspect that large numbers of people would be prepared to pay more tax if they could only see a more robust health service as a result.
‘If it were not for doctors, nurses and everyone else putting in the extra yards the whole system would have fallen apart. It’s a system which relies on goodwill to an extraordinary extent because it’s so under-resourced.
‘We need a strongly unionised workforce which is going to stand up for itself, and use all the tools of protest and effective political dissent to try to protect the NHS, to protect their own jobs but also the service in which they’re so heavily invested but we can’t just rely on doctors to do this for us as a population. We should be doing everything we can to defend and improve the NHS.
‘The King’s Fund suggests that over the Tory years there was a £200 billion NHS deficit: the gap between what should have been spent to maintain a modern, effective service which incorporates new technology and can work effectively which a growing, ageing population. So any extra funding that the government now gives making up current account shortfalls is still falling far short of the capital losses which have taken place over the preceding 14 years. It does seem to be that we need a much bigger funding settlement than the one we currently have.
(George Monbiot writes regularly in the Guardian and has lead a career as an international investigative journalist (including working for the BBC) as well as campaigning in the UK on road building and conservation. He has published several books on the current state of democracy, and more recently has spoken out at length on the damaging effects of neoliberalism.)
[This is an abridged version of the full interview, conducted by Alan Taman, available in the October-December 2025 newsletter]