11 Valued Matter: Anthropological Insights ... 281In comparing Mexico and the UK, it would be an over-simplification
to suggest that what is at stake here is an integrated healthcare system,
supported by the welfare state and dependent on a deceased-donor model
of organ procurement producing a different set of values upon which
access to treatments hinge. The nature of welfare at play here is far from
stable. It is one increasingly vulnerable to encroaching market forces, a
concern which draws the Mexican situation critically back into view.
To explain, 2 years after the 2008 international banking crises, the
UK Coalition Government embarked on an ambitious programme of
austerity-led reform. The centrepiece was the Health and Social Care
Act, 2012, designed to make substantial changes to the National Health
Service and pave the way for far greater private sector involvement in
the delivery of health care. Operating under the mantle of a “patient-
choice” agenda, the plan was for the private sector to absorb what were
deemed the limitations of a bulky and inefficient bureaucracy. The gov-
ernment vowed to make £22bn of savings, stripping back the NHS
budget to a less than adequate £8bn per year (Beatty and Fothergill
2016 ). Accompanying the drastic cut-back to health services was a plan
to localise power and funding to General Practitioner Commissioning
Groups, effectively giving them control over 80% of frontline services
(NHS White Paper 2010 ). Inevitably, this has raised profound con-
cerns among healthcare professionals, among others, as to whether the
interests of patients are best served by these new arrangements. Among
many other forms of specialist care, organ transplantation is just one
example of a domain where GPs may not have appropriate decision-
making skills. The commodification process which follows the Health
and Social Care Act has already seen the replacement of services critical
to transplant medicine (e.g. nationally supported blood services) cut in
the face of advancing private healthcare provision (Guardian Editorial
2013 ). This process, many believe, is leading to the subordination of
service quality to profitability (Leys and Harriss-White 2012 ) and is a
process which will continue to gather momentum, unless political bar-
riers are put in place. This, if we are to take the work of Karl Polayni
seriously, is unlikely. What he refers to as a “‘double movement” in his-
tory is one where the realisation that state controls are needed to curb
commodification, occur without parallel identifications of mechanisms
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