By next year, compared to 1997, NHS spending will have tripled, reaching £94 billion. There are 20,000 more consultants and GPs, 70,000 more nurses, 118 new hospitals, 188 new GP practices. Statistics look good: in 1997, almost 300,000 people were waiting over six months for operations compared with only 199 people in March 2006, the government claimed. In 2003, 75% of people in A&E were seen within four hours and in 2006 98.5%.
However, figures can be massaged, regional and other variations can be hidden and money is not the only solution. 90% of treatments happen in the community, but resources for community services have been cut while money is ploughed into hospitals.
Since 1997, repetitive reorganisation has been the theme, with the initial dismantling of general practice fundholding; setting up of primary care groups, which then became primary care trusts; these then merged to halve the number; while regional health authorities became strategic health authorities and having created 28 such authorities, they were then merged into ten. Some hospitals have become Foundation Trusts and Independent Treatment Centres have been introduced. Private companies are beginning to take over GP practices. The Private Finance Initiative, where the private sector builds the hospital and leases it back to the NHS in return for rent, has been expanded under Labour but with mounting financial concerns that are currently being suppressed.
Competition has been introduced where people and services previously cooperated. Despite reorganisations and the increase in money, there are currently debt, closures and removal of services with hospitals threatened with closure or loss of Accident and Emergency and maternity services. Jobs are being frozen or cut. The promise about choices for pregnant women, for which no extra funding is allocated, is estimated to need 3,000 more midwives but only 1,000 will qualify in 2009. The Connecting for Health IT system cannot deliver and the cost has run into billions. Student nurses are qualifying with no prospect of a job. Chaos reigns in the appointment of doctors.
Private Finance Initiative
In March 2006, the Department of Health tried to stop the publication of work from Manchester University showing the cost of building the first 12 hospitals under PFI. Allyson Pollock, professor at Edinburgh University, has recently shown that the figures quoted by the government to justify PFIs are flawed. Since 1999, there has been ample evidence that the expansion of PFI has led to a contraction in services, with, for example, 30% fewer beds in the PFI hospitals. Recent research by Jean Shaoul of Manchester University shows that the first 12 hospitals built under PFI were paying 8% interest compared to 4.75% for public finance…adding up to an extra £60 million per year for each 30-year contract. The additional cost of private finance, taken overall for the 155 schemes worth £9 billion, comes to £480 million per year. Most hospitals built under PFI are paying back on average 20% more than expected when the deal was signed, with some paying up to 50-70% more. Hospitals have gone bankrupt.
Big business is what underlies the last ten years of Labour in the health sector. A large percentage of Labour’s increase in NHS spending is going to fund PFI. And as he stepped into the leadership position, Gordon Brown announced an expansion of PFI schemes worth tens of billions of pounds.
Hannah Caller
