By Alex Rutherford
THE NHS IS facing a historic crisis. After the Tories’ criminal mismanagement of the Covid pandemic, waiting lists have more than doubled, more than 300,000 patients have been waiting more than a year for treatment. These delays lead to worse patient outcomes and unnecessary deaths.
The ever increasing waiting times are a symptom of deep structural issues in the NHS. Although touted by some on the left as a ‘socialist’ project, in truth the NHS is highly capitalistic in its organisation. This has been a crucial element of the NHS from its inception, with private ‘partnerships’ acting as GPs and dentists. And of course Big Pharma was never nationalised.
The tendency towards free market ideology in public services was accelerated by the Thatcher regime’s introduction of the ‘internal market’ which turned hospitals into ‘Trusts’ in competition with each other. Finance officers began to call the shots, overriding clinical staff decisions.
But it was Tony Blair who introduced the Private Finance Initiatives which have led to the profit motive being introduced throughout the health service. This saddled hospitals with huge debts, making the NHS pay the banks’ consorita many times over for new buildings and facilities.
More recently, the Tories’ austerity programme since 2010 has led to a 25% fall in real wages for health workers, causing a staffing crisis. The removal of bursaries for student nurses and prospect of long hours in terrible conditions led to a staffing shortfall.
This was then made worse by Brexit driving away many skilled migrants who filled crucial positions. The coronavirus pandemic was just the straw that broke the camel’s back.
Labour’s plan
What is Labour’s plan to reverse the years of decline? The headline pledges are a reduction of waiting times, through more appointments being made available, as well as increased access to GPs, dentists and mental health staff.
But apart from 8,500 more mental health workers, the intention is not to hire more staff—instead, the existing staff will be asked to work longer hours.
Staff are already pushed to their limit and drastically underpaid, leaving little incentive to take additional shifts. Without significant wage increases to attract and retain more staff, it is hard to see how any of Labour’s pledges will be achievable.
In 2020–21 £11 billion of the NHS budget was spent on contracts with healthcare multinationals, who skimmed a massive profit for the privilege. More privatisation will increase this waste and further break up the NHS.
Starmer’s plan will inevitably fall far short of the stated objectives, not to mention the actual needs of the NHS. The plan does nothing to address the crucial structural issues: funding shortfall, internal market, staffing crisis.
Above all the NHS needs a massive cash injection—£32 billion according to the British Medical Journal—just to stay afloat. Labour must guarantee these funds in full.
We say:
