On Saturday (15th June) I attended a Labour-hosted meeting in Gloucester, ‘Wither the NHS’. There were several speakers but I feel I must write about what the Socialist Health Association appears to stand for now. The SHA Director, Martin Rathfelder, made the point that the NHS is already full of private provision by asking those who were present to put their hand up if they had contact with someone working for a private company recently within the health service, explaining that GPs and pharmacists etc all work privately and even mentioning hospital food. I was surprised he didn’t mention the fact that the NHS doesn’t make paper towels!
This is rather disingenuous; most GPs have been contracted only to the NHS, not competing for patients and with the long-term welfare of the patient at heart. The patient expects to see the same GP for many years, not the 3-5 years of a privatised outsourcing. This is not even comparable to a company that has no interest in joined-up care or long-term welfare of people. GPs are not in the business of destabilising the ecosystem of the NHS or its ability to cross-subsidise. It sounded as though the SHA’s Director was trying to justify the Health & Social Care Act, particularly the s75 privatisation regulations. Are the SHA really pro the fragmentation of the NHS?
Martin pointed out that there was a survey that apparently said that 60% of the population were indifferent about who provides their care, in order to illustrate that it is not so important who provides our health care. He did not reference it but I can reference surveys that say that the public for the most part want their services run by the NHS, not just paid for by taxation. In Gloucestershire, remember, a huge public response to outsourcing of community services recently resulted in 96% of respondents preferring the publicly-owned option to even the phony ‘co-operative’ model my colleagues and our patients were offered.
I am concerned that attendees the meeting may fear the SHA no longer thinks it important that money put in to health provision should remain in health provision. That diverting it to line the pockets of share-holders is fine, as is paying for expenses that the public sector does not have to pay for (such as VAT). I really do hope the SHA believes that NHS properties should not be moved into PropCo to be rented back again at further expense.
I was relieved to hear Gabriel Scally put the purchaser/provider split argument down early on – I have seen an SHA article that suggests the split should remain, and that there is no proof it costs the amount quoted. Yet research commissioned by the DoH under the last government, estimated the split to cost 14% of the NHS budget. This internal market mechanism is the one major factor that allows the fragmentation of services – especially for the most vulnerable people with long-term conditions or mental health needs.
I felt, from the Director’s comments, that the SHA thinks health services do not need to be publicly-owned or provided – an argument we have seen made on the SHA site before, for example in an article suggesting that transparency was considered more important. Yes, of course transparency is important, but even if all health providers were private companies being more open and transparent than the NHS (which I doubt, privatisation thrives on secrecy) it won’t make health provision any better if they are being open but practising staff culls, cost-cutting, downgrading at the risk of safety and de-recognition of unions.
I have long admired the SHA and it has an incredible past in promoting, publicly and within the Labour Party, a need for a fair, socialist health system in this country, but I am deeply saddened by this apparent departure from its roots. I really did expect more of a challenge to the Conservative/Liberal attack on our health service.