A recent “correction” in The Guardian makes it the first mainstream newspaper to confirm what many activists, bloggers and most of all, health workers have known for months: the so-called “needless deaths” statistics pedalled by the media are a crude scare tactic designed to shore up public support for “reform” – the Tory term for privatisation.
For the last few months, the right-wing media and BBC have been quoting a figure of 13,000 “needless deaths” (Daily Telegraph 14th July 2013) at the 14 NHS Trusts investigated by the Keogh Report into mortality rates.
The Keogh report looked at whether a higher than expected death rate at 14 Trusts from 2005-12 was the result of poor care.
But as an article by leading statistician Dr David Spiegalhalter in the British Medical Journal makes clear, the Report says that it is not possible to work out the number of avoidable deaths from either of the two mortality indexes currently used.
As the Keogh Report states:
It is in my view misleading and a potential misuse of the figures to extrapolate from them a conclusion that any particular number, or range of numbers of deaths were caused or contributed to by inadequate care.
Why?
Both the SHMI (Summary Hospital-Level Mortality Index) and the HSMR (Hospital Standardised Mortality Ratio) are standardised to recent national averages.
As Spiegelhalter points out:
…so we would expect at any time that around half of all trusts would have ‘higher than expected’ mortality, just by chance variation around an average.
He then gives the example of the SHMI rate for January-December 2013 which showed 56 per cent of all Trusts had higher than expected mortality rates.
This makes it clear that the claim that there have been 13,000 preventable deaths is at best a blatant misrepresentation, and at worst a cynical lie.
And what about Mid-Staffs?
The Trust at the centre of this most artificial of media-scares is regularly branded with the responsibility for between 400 and 1,200 more deaths than would have been expected between 2005 and 2009.
Yet there is no published data to show this.
As this detailed article makes clear, the world of NHS mortality statistics is a murky place where fact is not easily distinguished from deception.
Statisticians and journalists have done vital work exposing the distortion of statistics by the Tory propaganda machine. But with the collusion of the biggest media monopolies, it’s easy for the Tories – and the multinational profit-making ‘health industry’ which funds them – to simply set the agenda and impose the narrative they want us to hear.
Statistics can be made to work to prove anyone’s point. But a government which tries to terrorise its population by implying hospitals are leaving people to die needlessly is a government that has contempt for those it rules. A government of millionaires who don’t rely on the NHS cannot be trusted to defend it.
But it should come as no surprise.
The Liberal Democrats and Tories receive huge amounts of funding from private healthcare companies – many of which, like Virgin Health, are now buying up NHS services to run for profit.
The millionaire’s media owned by the likes of Rupert Murdoch is less interested in accurate reporting than enforcing terms of debate which are favourable to its owners.
Murdoch, after all, doesn’t just own unprofitable newspapers – his real money comes from investment in swathes of private firms, the circling vultures looking to cherry pick the most profitable parts of our public services.
It’s clear we can’t trust those who stand to profit from NHS privatisation to tell us the truth.
It’s true that there are many problems with our hospitals. But are these problems the fault of a workforce which is underpaid, understaffed, demonised and harassed by endless ‘reforms’ which satisfy government bean-counters instead of the needs of staff and patients?
No, the fault must be laid at the door of successive governments which have constantly looked to break up the NHS – the repeated outsourcing, Private-Finance Initiative (PFI) schemes and reorganisations which have undermined the benefits of a centrally planned system, designed to meet the needs of the people not line the pockets of bureaucrats, managers and shareholders.
Privatisation of professional in-house cleaning services was one of the major factors behind the MRSI outbreaks. Private contractors simply shifted to employing untrained workers, many below the minimum wage, many having to work two or more jobs. The decline in quality was predictable as it was preventable.
As with PFI, which has locked Hospital Trusts into absurd contracts where they pay several times the real cost for new buildings and facilities. The idea is that the government arranges to pay the money back over several decades – meaning it can claim that it is keeping borrowing low in the present.
The result is that NHS Trusts go bankrupt as they are sucked dry by the parasites of finance capital. The Tories claim private providers will run our hospitals more efficiently.
Given that these providers are in fact multinational cartels – the same ones responsible for bankrupting our Trusts to begin with – competing to run services cheaper than their rivals, the idea that this ‘market’ will result in better care is ludicrous.
After all, you can’t simply go to another A&E if the one near you is poorly rated. Can expectant parents really chose to have their baby delivered in an elite London hospital if they live in Doncaster?
Control of our health service by a government which is constantly pressured by big business to relax barriers to market penetration (and bigger profits) is never going to be perfect.
But we defend it because it’s better than the alternative – when the profiteers get complete control of our health service, it will be broken up beyond all recognition. Whether we pay up front, or through higher contributions as government subsidies to private providers soar, it will still be the working class that pays and the billionaies who profit.
An economy run on the principle of individual competition for profit can never tolerate the operation of an independent service which subordinates the principle of profit to the principle of human need.
That’s why the struggle to defend the NHS points to the struggle for socialism – a world where those who create and recreate our society decide how to distribute the results of what they produce.
The democratic control of the economy by those who produce the wealth and services our society functions on is the basis for an economy which provides for the needs of the millions – not the greed of the millionaires.
By KD Tait
