NHS on the brink of extinction

First published in Tribune  Saturday, October 19th, 2013

In his speech to this year’s Labour conference, Shadow Health Secretary Andy Burnham confirmed that if the party wins the 2015 general election, he will introduce legislation to repeal the Health Act 2012 in the following Queen’s Speech. He did concede that a repeal bill would keep some of the act’s clauses – for example, retaining those of them that created “new entities” such as health and wellbeing boards. His proposed bill would also amend the role of clinical commissioning groups (CCGs), so they would be focused on designing services “clinician to clinician”, rather than commissioning them.

Burnham’s speech was music to the ears of all who love and value the National Health Service.

Andy Burnham
Andy Burnham at the head of the Save the NHS Demonstration

The coalition’s NHS reforms have been a disaster on all the fronts. The deeply damaging effects of the changes have been to distract and fragment an NHS already facing severe financial pressures. The reforms have ignored the central problem for health systems – how to merge social care for fast-ageing populations with the traditional diagnose-and-treat approach – to achieve the Government’s real desired outcomes.

While Andy Burnham’s “whole care person” approach addresses the core issue, the Conservative-led Government has spent more than two years pushing through changes to the NHS in England on reluctant doctors and vulnerable patients. Yet these changes have done nothing to meet the real challenges we face.

The reforms were supposed to transfer control of the NHS’s £100 billion to the family doctors, or GPs, on the front line. Bizarrely, as hospitals have begun to fail and treatment waiting times rise, Prime Minister David Cameron and Health Secretary Jeremy Hunt now choose to blame those very same doctors for all the ills of the NHS.

In past 21 months, £10.7 billion worth of our NHS has been put up for sale, while 35,000 NHS staff have been axed, including 5,600 nurses. Half of our 600 ambulance stations are earmarked for closure. One-third of NHS walk-in centres have been closed and 10 per cent of accident and emergency units have been shut. The A&E departments are performing at a 10-year low. The morale of the NHS family is at rock bottom. Their pay has now been frozen for two years under the coalition, and they have also been forced to accept a major downgrading of their pension benefits. Freezing and squeezing pay is heaping financial misery on more than a million NHS workers. At the same time, the NHS is going through a massive reorganisation, with staff having to deal with job cuts, rationing and ever-increasing patient numbers.

What kind of message does all this send to health workers about the value this Government places on their work? And what incentive is there for young people to join the NHS when those who currently work in it are so undervalued?

A failing NHS will only help to boost private healthcare insurance for those who can afford it, signalling the death knell for a universal healthcare service, free at the point of use.

There has been a noticeable change in the Government’s attitude to the NHS. It has become openly critical of the service while giving a nod to the right-wing media to launch an unprecedented attack on it. They have seized on the problems at Mid-Staffordshire and 14 other failing trusts to make a general attack on the whole of the NHS in order to justify their plans to reorganise and privatise the service. Government policies are designed to open up health to corporate parasites. The introduction of “any qualified provider” means that private companies must be allowed to bid to provide a range of health services.

In Greater Manchester, for instance, NHS commissioners have drawn up a list of 24 approved providers for diagnostic services. Of these, more than half are from private companies. This will have a significant impact on NHS trusts in the region. Trusts need the funding from routine diagnostic work to subsidise more complex procedures and emergency services.

The Health and Social Care Act 2012 clearly fulfils all the commonly accepted criteria for healthcare privatisation, and that is why the coalition has imposed it on the nation despite near-universal opposition.

To date, we have seen £1.4 billion wasted on redundancy payments, £7.8 billion on agency and consultancy firms, and £500 million extra in negligence. That’s more than £8 billion that could have been used for patient care.

Private sector providers want to de-professionalise and down-skill the practice of medicine in this country, so as to make staff more interchangeable, easier to fire, more biddable and, above all, cheaper. Private sector providers want to replace doctors with nurses and nurses with healthcare assistants. They especially like to replace skilled staff with computer algorithms, which do not have any employment rights. We have seen where such a “cost-saving” and “innovative” strategy leads in the case of the mortgage market, with money lent for consumption to people who cannot repay it, while small firms are starved of essential funds to weather hard times and expand their business when opportunities arise.

The NHS is one of the most cost-effective, highest quality and most equitable healthcare services in the world. Nevertheless, it now stands on the brink of extinction.

If you talk to people from countries which have mainly private sector healthcare systems – as we soon will have, too, if the present Government is allowed to complete its reforms – you will find that they regard the NHS as a jewel beyond price: safe, high-quality care available to all, no matter how poor. This is the most civilised accomplishment for which the Labour Party is responsible.

There is even a nationwide activist movement in the United States devoted to trying to introduce an NHS-style model over there. And yet the British Government led by David Cameron and Nick Clegg is itching to convert our NHS from a public service to a set of business opportunities for US-based transnational insurance and health provider corporations. The Health and Social Care Bill is an irrelevance to the real troubles facing the NHS in England.

The terrible state of the healthcare system in the US, even if Barack Obama’s reforms come into play, reinforces the point that the privatisation of state-funded healthcare delivery is not something that is welcome in England – except by big business and those paid to expedite its entry to the NHS.

Ed Miliband should give a firm commitment that, whomever he choose as Secretary of State for Health in 2015, and even if Labour has to enter a coalition agreement after the next general election, Andy Burnham’s pledge to reverse the NHS Bill will be carried out.