Who will defend the NHS?

The Labour Party has long presented itself as the principal defender of the NHS. Yet in one fell swoop, the Conservative Party outflanked it with an apparently unconditional guarantee that in government they would meet the 2019/20 £8bn funding gap identified in the December 2014 Stevens review: The NHS Five Year Forward View. Labour was left looking flat-footed: it has pointedly refused to meet the gap, pledging instead an extra £2.5bn to fund training and employment for an extra 8,000 GPs, 20,000 nurses, 5,000 care workers and 3,000 midwives. Even this, however, is conditional on receiving matching income, in particular from the so-called Mansion Tax to be imposed on homes worth more than £2m, and a levy on tobacco companies to guarantee a week’s turnaround time for cancer tests and results. The reality is that the NHS is not safe in Labour’s hands: its pledges during the election campaign to end privatisations are just lies.

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Health Matters - Capitalism is bad for your health

At the end of March the NHS deficit stood at £1bn; on current projections by the end of March 2016 it will be £2.5bn. The NHS is in financial meltdown, and despite a poll showing that 46% of the electorate regards the NHS as the issue that will decide which way they vote at the general election, all we get from the major bourgeois parties is smoke and mirrors.

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Health matters - Fight to save the NHS

As we approach a General Election, the depth and extent of the crisis in the NHS is evident. In an unprecedented step, hospitals responsible for 75% of care across the country have rejected a proposal to cut the tariff (a standard amount for each type of treatment) by 1.9%. They have stated that they cannot manage a fifth round of cuts without either endangering patient safety or reducing the number of operations they perform. The majority of foundation trust hospitals are in financial deficit; 80% of all hospitals will be by the end of March. They will also face a transfer of £1.9bn to social care from April and further cuts of £290m in specialist care and £220m for some A&E services. There are insufficient numbers of nurses, GPs and A&E doctors. General practice as whole is almost broken with few trainee doctors wanting to become GPs; waiting times for appointments are running into days and sometimes weeks. Mental health service provision is a disaster area. Hospitals around the country are declaring major incidents because they are unable to cope with the number of people coming into their A&E departments and then requiring admission. Meanwhile the proportion of GDP being spent on health services is falling as a result of austerity. HANNAH CALLER and ROBERT CLOUGH report.

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Nothing is irreversible – act now to save the NHS

The NHS faces meltdown. The third week in November revealed the extent of the crisis: a 5% rise in attendances at A&E departments across the country compared to the same period in 2013 led to units as far apart as Cambridgeshire, Scunthorpe, Middlesbrough, Wigan, the Wirral and King’s Lynn urging patients to stay away. The situation has been made worse by cuts in social services which have meant patients cannot be discharged safely, reducing the number of available beds. The reason is quite simple: there is not enough money. Five years of flat-line funding has left it facing a £30bn budgetary shortfall by 2020. With their commitment to austerity, none of the parliamentary parties have the slightest intention of plugging the gap. In the meantime, stories of bad care and deteriorating quality are cynically used by the media to claim that a nationalised service cannot work.

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NHS - End privatisation and save our surgeries

Fight Racism! Fight Imperialism! 240 August/September 2014

The NHS budget has a £2bn shortfall for 2015-2016 and still there is the target of £30bn efficiency savings by 2020. In England between 2012-13 and 2013-14 the number of trusts in deficit rose from 45 to 66 and a £383m surplus in 2012-13 became a £100m deficit in 2013-14, despite emergency funding. This included £500m in summer 2013 to help prepare for the winter pressures, followed by another £150m in November. In June this year, a further £400m was provided to reduce the pressure on A&E and allow 100,000 extra operations in July and August when it emerged that waiting times for many operations, such as hernia repairs, cataract removal, tonsil and adenoid surgery, hip and knee replacements, are rising sharply. It is estimated that following three years of standstill funding, the NHS needs £15bn for the five years from April 2015 to avoid collapse.

While the media plays its part in prophesying doom and gloom, helping to soften the public up for more privatisation of services deemed to be failing, the reality is that conditions are reaching a tipping point. In April, the number of people waiting more than 18 weeks for an operation reached a six-year high of three million, with patients waiting up to 30 weeks in some places. In May, the cancer treatment target was missed for the first time since 2009 and the number of people unable to be discharged through lack of social services support reached the highest level yet. The number of people unable to get a diagnostic test, such as MRI or CT scan within the six weeks set out in the NHS constitution, has doubled in the year from 1% to 2.2%. In June 2014 figures showed the number of GPs has fallen since 2010 when the ConDem coalition took over, and the A&E four-hour waiting time target was missed nationally for the 49th consecutive week.

Terrifying privatisation

Private companies are steadily increasing their share of the £9.75bn annual budget for NHS community health services, up from 12 to 18% of the market, from £1bn in 2010-11 to £1.77bn in 2012-13. At a time when overall funding for mental health services has fallen by 2.5%, private companies have increased their provision by 12% over two years (£1.05bn to £1.17bn).

Cancer care is now next on the privatisation list, with the NHS looking at the biggest outsourcing of services worth £1.2bn. In Staffordshire, many private health care companies have expressed interest in securing the £689m ten-year contract for provision of cancer care for a population of 767,000 served by four Clinical Commissioning Groups (CCGs – responsible for distributing £66bn of the NHS’s £110bn budget). The same four CCGs are also seeking to outsource a separate £535m contract for end-of-life care. Macmillan Cancer Support is advising the four CCGs. These contracts add up to £1.22bn, over twice the previous record of £500m of Richard Branson’s Virgin Care to provide various community health services in Surrey. Virgin Care is currently a bidder along with Care UK for a contract worth £800m to provide older people’s services for Cambridgeshire and Peterborough CCG. The Staffordshire cancer services contract will require private companies not just to provide the service but after the first two years to assume the responsibility for designing the whole system.

GP services under threat

A study funded by the National Institute for Health Research showed that one in four people (26.5%) presenting to A&E did so as they could not get a GP appointment quickly enough – 5.8 million in all. A College of Emergency Medicine study says that anyway only 15% of A&E attendees could have been appropriately treated at a GP surgery. General practice share of NHS funding has fallen from 11% to 8.4% in recent years. Many surgeries cannot cope with the demands.

From April this year, budget cuts have begun to affect some GP practices with the phasing out of the Minimum Practice Income Guarantee (MPIG) over the next seven years. The government has decided to give less weight to deprivation and more to age. MPIG was introduced in 2004 to ensure that practices in socio-economically deprived areas with a big turnover of patients were adequately funded. Tower Hamlets in east London, one of the most deprived areas in England, will lose out to more affluent areas with a greater number of elderly people, even though in Tower Hamlets there are more people with serious long-term conditions at a younger age. An example is the highly-regarded Jubilee Practice which will lose nearly £1m over the next seven years. With MPIG being phased out, services will be cut and the surgery may have to close. There are 98 practices in England in this situation, many in London, five in Tower Hamlets alone.

As an additional threat to GP practices, in July, health secretary Jeremy Hunt announced plans to place GP practices in special measures if they are deemed to be failing their patients, just as he did with 17 hospital trusts in 2013. Proposals to ‘name and shame’ practices which are seen to miss cancer diagnoses are no more than a vindictive punishment which far from resolving existing problems may create additional ones with GPs referring unnecessarily to avoid stigmatisation.

In the run-up to the general election next year, Labour politicians will twist and turn to avoid any clear commitment to fund a decent health service. While they talk of repealing the Health and Social Care Act, they will not make any commitment to nationalise privatised services, let alone PFI contracts. The NHS will be as unsafe in their hands as it was when they were in government.

Join your local NHS campaigns, fight against closures and privatisation.

Hannah Caller

More Articles ...

  1. Fighting to save Whittington NHS Hospital /FRFI! 239 Jun/Jul 2014
  2. Mental health: services ground down/ FRFI! 239 Jun/Jul 2014
  3. Health Service: remorselessly deepening crisis /FRFI! 239 Jun/Jul 2014
  4. Big Pharma rip-off /FRFI! 239 Jun/Jul 2014
  5. NHS?fragmented, privatised and on the brink/ FRFI 238 Apr/May 2014
  6. Mental health problems equal discrimination and poverty / FRFI 236 Dec 2013/Jan 2014
  7. Lewisham Hospital victory for campaigners/FRFI 235 Oct/Nov 2013
  8. Health matters/FRFI 234 Aug/Sep 2013
  9. We want our NHS back
  10. NHS emergency services face collapse/ FRFI 233 Jun/Jul 2013
  11. Health matters: Cuts kill people /FRFI 231 Feb/Mar 2013
  12. Lewisham Hospital and the PFI parasites – Feb 2013
  13. Lewisham Hospital and the PFI parasites – Feb 2013
  14. NHS emergency - Save Lewisham hospital/FRFI 230 Dec 2012/Jan 2013
  15. ConDem health reforms - The end of the NHS in England /FRFI 229 Oct/Nov 2012
  16. Banks get bailed out, hospitals go to the wall / 228 Aug/Sep 2012
  17. Health privatisation gathers pace
  18. Health and Social Care Bill - The taste of things to come /FRFI 226 April/May 2012
  19. NHS sinks deeper into crisis / FRFI 225 Feb/Mar 2012
  20. Health care secondary to profits/ FRFI 224 December 2011/January 2012
  21. Stop the NHS sell-off / FRFI 223 Oct / Nov 2011
  22. The Plot Against the NHS - Review - Sep 2011
  23. The end of free universal health care? / FRFI 222 Aug/Sep 2011
  24. Profiteering and Abuse in Care – Demand Decent Services as a Right! - 10 Jun 2011
  25. NHS – open for business, closed for treatment / FRFI 221 June/July 2011