By Dara O’Coghaidin, Mental Health worker / 02 September 2013
Established in 1948 to be a free and universal system of healthcare, the NHS reached the pensionable age of 65 in July and is sadly unwell. Patient satisfaction has plummeted from an all-time high of 70 per cent to just 58 per cent in a year as operations get cancelled and waiting queues soar. Seven thousand nurses have been axed since 2010 and eight of London’s A&E departments are slated for closure and downgrading as the coalition government aggressively pursues a £20 billion package of cuts.
Much of this disillusionment was based on the widely quoted figure of 13,000 “needless deaths” in the Keogh Report. This assumption has since been discredited because it is not based on any real comparison with normative rates. However, the effect of this smear campaign and the staff cuts on nurses’ morale is real; according to the RCN, two thirds of nurses have considered leaving the profession this year due to stress.
Privatisation
The NHS is being dismantled and privatised. Last year the government implemented the Health and Social Care Act, which saw Andrew Lansley’s nightmare vision for the dismantlement of the NHS enshrined in law. Through a series measures including the establishment of Clinical Commissioning Groups (CCG), the Act effectively hands huge swathes of the NHS over to the private sector.
From April 2013, 211 CCGs replaced 150 primary care trusts as the commissioners of most NHS services in England. They now control around two-thirds of the NHS budget. The Act forces these organisations to give private companies the chance to compete for contracts, leading to a race to the bottom in quality of service and staff conditions as private companies bid against each other for contracts. As the Bill was being debated and voted on in both houses, more than 200 parliamentarians held financial interests in businesses involved in healthcare. This is what “democracy” looks like!
Lansley’s Act can be seen as the consolidation of the previous government’s steady encroachment of market principles and practices into the provision of healthcare. Back in 2002, Labour’s Alan Milburn championed the Bill that created Foundation Trusts that are run much like private businesses and whose success is judged on “financial viability”. Foundation Trusts can turn 49 per cent of their beds over to profitable private patients and charge for a range of services. Milburn is one of 10 previous health ministers who have taken lucrative consultancies with private healthcare companies.
Hospitals throughout the country are facing bankruptcy. Barts Health Trust in East London, Britain’s biggest NHS Trust, has announced it is losing £2 million a week. The trust is saddled with a ruinous PFI debt of £1 billion costing £115 million a year, i.e. £2 million a week. But instead of cancelling the PFI and taking the buildings back into public ownership, Price Waterhouse Cooper has been parachuted in and proposes to cut up to 1,600 jobs, saving £30 million this year alone, meaning meeting minimum ward staffing levels will become an impossibility.
In just three years £7 billion of new NHS contracts have flooded the private healthcare market. Virgin Care runs more than 100 services across the country, Serco has won a £140 million contract to run community healthcare in Suffolk and Sainsbury’s now owns over 250 pharmacies across the UK. The shameless transfer of cost-effective public services to the profit-hungry private sector represents an accelerating reversal of what the NHS was created to achieve: making healthcare a right, and no longer something that could be bought and sold.
Fightback
As Tory MPs and delegates gather in Manchester on 29 September, tens of thousands of NHS workers, campaigners, trade unionists and service users affected by the cuts will march against the dismantling of the NHS. As union leaders dither over what action to take next, we need to build a movement that transcends its current fragmentation and coordinates local grassroots struggles against cuts to the NHS.
There are positive signs for a successful fight: Lewisham Hospital won a victory against health minister Jeremy Hunt’s plans to close its A&E service as the High Court ruled it was “unlawful”. This followed a concerted campaign by Save Lewisham Hospital – comprised of campaigners, health workers and community groups – to defend their services. Last January 25,000 local residents marched against the plans, following door-to-door leafleting by activists.
However, Lewisham Hospital continues to be threatened with partial closure to bail out the South London Hospital Trust, which has PFI schemes consuming 18% of its income. This shows that we have to be vigilant – but also that local victories cannot be secured until we have won nationally.
Strike action against attacks on jobs, pay and working conditions is also a key feature of the resistance. The strike by Unison members in the Mid-Yorkshire Hospital Trust against ‘down-banding’ pay cuts is one such example. Leeds Pathology staff are also taking strike action against new shift patterns leading to inadequate staffing levels and a large drop in take home pay. Local strikes by health workers, bolstered by public support, could begin to redevelop a militant anti-cuts movement to stop the Tories’ slash and burn of the NHS.
But we need to act now.
