NHS contracts: would you trust this company with your personal data?

The government recently announced it would invest £3.4bn in a technological development programme to be spent on transformation in the NHS over three years from 2025-2028. The plan is for a nationwide data system using software that will allow individual health service trusts and the 42 integrated care systems to connect digitally and share data, improve care and cut waiting times, for instance by having real-time data on hospital bed number, waiting list sizes, staff rotas etc. Whilst in principle such a programme would be fine if it were in public hands, it has been passed to US company Palantir through a £330m five-year contract to set up and operate a Federated Data Platform. Palantir will have access to and security control of sensitive private medical records.

 

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Childhood in Britain: blighted by capitalism

Amid the escalating capitalist crisis, it is working-class children who suffer the most. Their childhoods are being blighted by persistent poverty, hunger, homelessness and ill health – which now includes rising levels of poor mental health. The Joseph Rowntree Foundation currently calculates that nearly a third of all children (4.3 million) are living in relative poverty in Britain, one of the richest countries in the world. Demographic groups experiencing disproportionately high poverty rates include larger working-class families. In 2021/22, 43% of children in families with three or more children were living in poverty. These figures signify a distressing reality whereby numerous children are deprived of the secure and joyful childhoods they deserve. Children forced to live in poverty suffer adverse effects on their health, well-being, and education. They bear the burden of government policies such as the 2013 overall benefit cap, and the cruel two-child limit on family benefits imposed in 2017.

 

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Healthcare under attack! Stand up! Fight back!

The health of the working class has been deteriorating for more than a decade. A study by the Institute of Health Equity at University College London has found that more than a million people lived shorter lives in Britain between 2011 and 2019 (start of the pandemic) than they would have done had they lived in the wealthiest areas. Almost 150,000 of these deaths were attributed to post-2010 austerity measures which have contributed to falling life expectancy and rising health inequalities in Britain. Poorer people are more likely to spend at least a quarter of their lives in ill-health, while 2.6 million people are currently not able to work due to long-term sickness. Between 2022 and 2023, the number of children living in food poverty almost doubled; now over one million children in Britain experience destitution because they cannot be kept adequately fed, clothed, clean or warm and four million children face food insecurity.

Energy poverty is more prevalent; the End Fuel Poverty Coalition says that last winter Britain saw nearly 5,000 excess deaths caused by cold homes. Nearly one in four British households in social housing experienced energy poverty, creating psychological stress, exacerbating long term conditions, increasing respiratory illnesses and aggravating the impact of sickle cell disease.

 

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Covid-19 cover-up

Covid-19 memorial wall

Over 230,000 people in the UK have died from Covid-19 disease. Almost half the deaths – 100,000 - occurred by January 2021, less than a year into the pandemic. The Covid Inquiry currently underway in London is supposed to be exposing how this disaster could have been allowed to happen, and to hold those responsible to account. Yet the politicians who are its key witnesses have been allowed to breeze their way through the inquiry with no serious challenge over the statements they made or actions they took, or failed to take, during the first year of the pandemic. Instead they have been allowed to lie, to equivocate, to feign ignorance or loss of memory and basically to absolve themselves of all blame. Former Prime Minister Boris Johnson was not challenged for claiming that WhatsApp messages from his old phone covering the period 31 January to June 2020 were: ‘not retrievable’. Current Prime Minister Rishi Sunak - then Chancellor of the Exchequer – drew a similar blank over crucial WhatsApp messages from the period, saying that he ‘did not have access’ to them because he had changed his phone several times and failed to back them up. Appearing before the inqury on 12 December 2023, Sunak ‘could not precisely recall’ important evidence a total of 24 times – much of its relating to his disastrous ‘Eat out to help out’ scheme in August 2020, which – as could have been predicted – seeded a second wave of the virus, prompting a second lockdown. This collective amnesia and blank record of messages comes despite a hard-fought legal ruling in July 2023 to compel those in government at the time to hand over the relevant two years’ worth of Signal and Whatsapp messages to the inquiry. Instead, those who presided over Britain’s Covid disaster chose to delete evidence of their arrogance, their negligence and their crimes. We must never forget that while Covid-19 ravaged disproportionately the working class, in particular the old, the sick and those minority ethnic communities, these self-serving ruling class buffoons sneered and party, willing, in Johnson’s notorious words, to ‘let the bodies pile high’.

 

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NHS a ‘nuclear’ option for service

In November 2023, the government rejected a request from NHS England for a £1bn bailout to cover the effect of industrial action. It said that hospital and primary care leaders should instead reduce activity targets for routine care and focus on those who have waited longest for treatment, and those who need urgent or cancer care.

 

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Britain’s Covid Inquiry

The British ruling class has always seen the Covid-19 pandemic in class terms. It was always primarily concerned with protecting its class interests and hence was only concerned about how the pandemic might affect its wealth, privileges, power and position in society. The Covid-19 inquiry into the pandemic started in June 2022. Its second set of public hearings, Core UK decision-making and political governance, started on 31 August 2023. It has confirmed that the British ruling elite had, and continues to have, nothing but contempt for the lives and health of the working class. Since 2021 and the peak of the pandemic, the government has allowed the virus to spread through the population, has lied that it is now seasonal and ‘mild’, and has dismantled all but a handful of measures to detect, let alone contain it. Millions, including children, are being denied access to vaccinations.

 

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NHS – stripped to the bone

5 July this year marked the 75th anniversary of the foundation of the NHS. At the time the ruling class was concerned to ensure social stability with low wages at home while it looted the colonial empire to restore its economic position post-war. The NHS was a vital component of a settlement it reached with the working class offering the majority a more tolerable life while maintaining the system of capitalist exploitation. Decades of deepening crisis since the 1970s however have now pushed large sections of the working class into poverty or near-poverty, while NHS services have been progressively torn to shreds.

 

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Rich country, poor health – capitalism is the problem

London ambulance at Abbey Road

There are fewer health care workers per head of population now in Britain than in almost every comparable country in the OECD, and with the continual reduction of state welfare, life expectancy has plateaued since 2009. The NHS is short of almost 154,000 staff, with retention let alone recruitment increasingly difficult. An internal document linked to the workforce plan being developed by NHS England says that with no action, the staffing shortfall could reach 571,000 by 2036, warning that in the next 15 years the NHS in England may have 28,000 fewer GPs and 44,000 fewer community nurses, and a substantial shortage of paramedics.

 

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Social care: making money from misery

Large sums of money are being continually squeezed from the care home sector in Britain, with services such as Avery Healthcare and HC-One, Britain’s largest care provider, found in terrible condition, rated one-star for hygiene. Avery Healthcare cashed in on earnings of £8.9m in 2021, with John Stowbridge, the CEO, securing £567,000 in 2020. James Tugendhat, HC-One’s CEO, pocketed £592,000 in 2021. HC-One, despite its net losses of £83m in 2022, paid out £1.8m in dividends to its shareholders in that year. The average resident is paying around £41,000 annually with many being assisted by the state. Care is owned by multiple asset management companies such as Safanad and Court Cavendish, whose sole goal is to milk the cash cow that is the care business. Further commodification of care means disaster for those in need.

 

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NHS from crisis to crisis

The working class faces more austerity, more poverty, more mental health crises and more challenges to its health and wellbeing in every age and stage of life. Meanwhile in the NHS more people wait for appointments and treatment, for admission and discharge. They are cared for by too few staff struggling to give the care they are trained to give, feeling more disheartened and demoralised under the increasing pressure. The NHS has over 120,000 vacancies. The workforce plan awaiting Treasury approval is looking at a 15-year time span and therefore will have no immediate effect. About 40% of the NHS workforce is older than 50 years, and incentives to return after retirement are poor.

Britain has just 2.5 beds and 2.9 doctors per 1,000 population compared to the European averages of 4.7 and 3.7; fewer than eight nurses per 1,000 population compared to France with 11, Germany with 12, Switzerland, 18. There are 2.8 doctors per 1,000 population compared to the EU average of 3.4, and Britain spends 18% less per person than the EU14 average.

 

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Right-wing Covid-19 falsification

Hand holding blood sample and Covid-19 pathogen graphic

The Covid-19 pandemic has officially caused the deaths of almost seven million people so far, but this is likely a gross underestimate. Some studies have estimated from excess deaths data that the true death toll is around 21 million people. Other studies have consistently shown that even a non-hospitalised, ‘mild’ Covid-19 infection is associated with increased risks of heart attacks, blood clots and strokes. The rate is reduced by vaccination, but not to zero. Life expectancy has fallen in every continent. Covid-19 killed 267,000 people in the US, and 39,000 in the UK in 2022, the very year the imperialists insist that the pandemic ended.

 

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Social Care - poverty pay for the many, profits for a few

The revelation that Runwood Homes, the sixth largest for-profit care home provider, had paid its CEO Gordon Sanders £21m over a five year period, despite inspectors finding numerous breaches of staffing and safety regulations in its homes, epitomises the crisis in social care. Runwood, which specialises in dementia care, had a turnover of £154m in 2021. Yet one in three of its 60 homes have been found to breach health and safety standards, with insufficient staffing, awful food, and residents subjected to brutal restraints. This is a system which can make fortunes for a few out of overworked staff on poverty pay, where standards are appalling and regulation next to non-existent.

 

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Growing health inequalities for children

Children play football on a street in Scotland

The Deaton Review of Inequalities published by the Institute for Fiscal Studies in November 2022  found growing life expectancy differences and variation in mortality rate between areas within Britain, between the countries that make up Britain, and between Britain and other wealthy countries. Closing the gaps has slowed and the greater the austerity, the worse the health outcomes for the poorest and most vulnerable. One of their conclusions is that to improve population health, there needs to be a focus on the health and well-being of children, for the children themselves and to weakening the inter-generational transmission of deprivation.

 

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Lethal legacy of Covid-19 pandemic

Covid-19

In 2022, Britain still recorded thousands more deaths (‘excess’ deaths) than would be expected from data for previous years, even after adjusting for an ageing population. This was despite Covid-19 deaths being relatively low compared to earlier in the pandemic.  In the week to 4 November 2022, fewer than half the excess deaths (about 700) involved Covid-19, meaning that other factors are involved. While medical experts continue to investigate the underlying causes, the British government’s refusal to consistently implement basic public health measures, in favour of ‘living with Covid’, is at the heart of this continuing tragedy. The working class is paying the price for the capitalist government putting profits ahead of public health, with the result that long-term harm has been done to people’s health.

 

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No let-up in the NHS crisis

Street mural reads 'National Hero Service'

In July 2022, only four out of 10 patients were able to leave hospital when fit to do so as they awaited a care package. Extreme workforce shortages in the adult social care sector make timely discharge impossible. 99% of healthcare leaders surveyed in July 2022 agreed that there was a social care workforce crisis in their area. It means hospital wards are full, people who need admission to a ward are stuck in A&E, ambulances are queuing outside because A&E is full, and people at home are waiting hours for an ambulance. Britain has fewer beds, fewer clinical staff and doctors per head of population than almost all of the comparator health systems in the 38 countries of the OECD. In particular:

 

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Defend the NHS, fight for socialism

NHS staff march for fair pay (photo: RCN)

Reports of the state of collapse of the NHS have become routine, indeed daily, fare over the past few months. Soaring waiting lists; ever-increasing ambulance and A&E wait times; the appalling state of mental health services, especially those for children; the impact of utterly inadequate social care services on the NHS; the lies that are routinely told about levels of NHS funding, of new funding, of extra funding beyond new funding, of targeted funding in addition to the extra funding, and the constantly recycled deceit that there are 40 new hospitals in the pipeline for completion by 2030, a number expanded more recently to an equally fictitious 48. A new book, NHS under siege, sets out what has happened over the last 12 years to bring about this state of affairs. 

 

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The legacy of Covid-19

The British government’s more than two-year refusal to consistently implement basic public health measures against Covid-19, as well as its 2022 policy of ‘living with Covid,’ continues to result in deaths, disability and an unfolding disaster in the NHS, as the long-term effects of coronavirus disease make themselves felt. Covid-19 deaths now exceed 206,000 people in the UK. With the fourth wave of the disease this year now underway, and the number of people admitted to hospital who test positive for Covid-19 now rising in every English region, this figure will increase. The working class, disabled people and ethnic minorities are paying the price for the Tory and Labour parties putting capitalist profits ahead of public health.

 

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NHS staffing crisis

Demand for care in the NHS continues to outstrip capacity, worsened by the Covid-19 pandemic. There are record number of people waiting for treatment: in July the figure was 6.84 million, with 2.67 million people waiting over 18 weeks and 377,689 waiting over a year. This is 365 times the pre-pandemic figure. The median waiting time for treatment is now 13 weeks. While the waiting list is a visible backlog, there is also a rising hidden backlog of those cancelled, deferred or not yet come forward. The 93% target for people to be seen by a specialist consultant within two weeks of an urgent GP referral for suspected cancer has not been met since May 2020, and the number receiving treatment within two months of screening is still well below standard. The number of people waiting over 12 hours to be admitted onto a ward from A&E is 77 times the pre-pandemic level. From February 2020 to November 2021 there was an 87% increase in the number of people unable to get a hospital appointment after referral from their GP. A survey commissioned by the charity Engage Britain showed that one in ten adults in Britain have turned to private sector health care in the last year, the vast majority because they faced long delays or could simply not access treatment on the NHS.

 

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Covid-19 in Britain, an absolute disaster

Britain is experiencing its third wave of Covid-19 infections in six months, with an estimated one in 17 people, over 3.8 million in Britain and the north of Ireland, infected by 18 July. That’s almost 6% of the population. Protective public health measures have been completely abandoned in favour of ‘living with Covid’. According to the World Health Organisation (WHO) allowing such a high level of virus transmission is ‘playing with fire’.

 

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Capitalism is bad for your health

Every day the media publishes stories illustrating the crisis in the NHS. Waiting times for emergency ambulances, waits in those ambulances outside A&E, waits in A&E for treatment, waits for a hospital bed, waits for a care package to be available for safe discharge, waits for mental health treatment. Former Chancellor Rishi Sunak talks of putting the NHS on a ‘war footing’ to deal with the backlog of 6.6 million people awaiting an operation as he campaigns to replace Boris Johnson as prime minister; his opponent Liz Truss talks about excessive management costs. But everyone knows that since 2010 the NHS has had its funding slashed even if the Tory government and the media say otherwise; that staffing levels as a consequence are dangerously low, and that furthermore there are no serious plans to recruit and train the tens of thousands of nurses, doctors and paramedics needed to make up the shortfall. It is evident that capitalism cannot afford a health system which meets the needs of the working class. HANNAH CALLER and ROBERT CLOUGH report.

 

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Covid-19 in Britain: living in denial

Regent street, London

The vital importance of a public health system to protect the public from mass infection during an epidemic or pandemic, ensuring high rates of vaccination, testing and contact tracing, and isolating or quarantining infected people has been evident over the past two years of Covid-19. The recent outbreaks of the viral disease monkeypox and almost 500 cases of fulminant hepatitis of unknown origin in children should remind us of this fact. But the decision of the newly-formed UK Health Security Agency (UKHSA) to cut 40% of its jobs and suspend routine Covid-19 testing in hospitals shows the contempt which the Tory government holds for such preventative measures.

 

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Bonded labour in the NHS

NHS

An Observer investigation published in March 2022 uncovered the widespread practice of charging overseas nurses who are working for NHS trusts and private care homes thousands of pounds if they wish to change job or return home early. In some cases, nurses who are tied to their roles for up to five years can face charges in excess of £10,000 even if forced to leave their jobs because of bullying or family emergencies. 

 

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Broken NHS

Save our NHS

There is no end to the crisis facing the NHS. Instead, on every indicator, the crisis worsens every week. The number of doctors continues to fall, as do the numbers of nurses. Bonded labour is required to replace some of the lost staff (see box p2). Waiting lists are soaring, with little idea as to when they will peak. Wait times in an ambulance outside A&E, wait times for admission from A&E onto a ward all are at record levels. It is quicker to get a pizza delivery than get an ambulance for a cardiac arrest. Yet we still have the charade where the government proclaims that it is putting more and more money into the service – but out of sight takes the money away. 

 

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NHS Recovery Plan piling lies upon lies

Placards slogans oppose NHS privatisation (photo: Jim Osley)

Whenever government ministers open their mouths to say something about the NHS, what comes out are lies. The commitment to recruit 5,000 extra GPs? A lie. The promise of 40 new hospitals? A lie. The claim now that the NHS will perform 30% more operations a year under the Covid-19 recovery plan? The latest lie: it is manifestly not possible to achieve this sort of increase. The facilities do not exist in sufficient numbers, and crucially nor do the staff. HANNAH CALLER reports.

 

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Bring Covid-19 under control!

Liverpool FRFI protesters demand PPE not profit

Covid-19 cases and hospitalisations are once again on the rise in Britain, less than a month after the government began the process of ending all public health measures (pejoratively termed ‘restrictions’) to control the spread of the SARS-CoV-2 coronavirus. It is at this stage unknown whether this is being driven by the 30% more transmissible subvariant of Omicron BA.2. The UK recorded over 226,000 new cases on 21 March 2022. In that week there were over 600,000 cases, a rise of 37% over the previous week. The Office for National Statistics (ONS) estimates that 4.26 million people, or 1 in 15 people, were infected in the week ending 19 March. In England and Wales 6.4% of the population, or 1 in 16, were infected and in Scotland it was 9% of the population, or 1 in 11. CHARLES CHINWEIZU reports.

 

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NHS: a broken service

NHS workers protest for a pay rise, 2021 (photo: Tim Dennell | CC BY-NC 2.0)

As we go to press the depth of the NHS crisis is becoming ever more apparent. Waiting lists continuing to grow, inadequate and deteriorating staffing levels, a demoralised and exhausted workforce, half of NHS staff reporting illness from work-related stress, 24 hospitals declaring critical incidents in January, and more nurses leaving than joining, all signify a system which is broken. Going into the pandemic, Britain had fewer doctors and hospital beds per capita than most comparable economies. Ten years of real-term funding cuts are the cause; the Covid-19 pandemic revealed how bad the situation had become. The final straw was the complete contempt the Tory government showed for the NHS when it refused to implement serious public health measures to control the spread of the Omicron variant: at times nearly 20,000 Covid-19 patients occupied beds which should have been available for those needing urgent cancer treatment or other procedures. It was in truth an experiment in ‘living with the virus’ – but thousands died of Covid-19, and an unknown number more from other conditions because they could not receive the necessary care in time. 

 

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Dying with Omicron

The National Covid Memorial Wall

On 27 January 2022, the British government ended its ‘Plan B’ Covid-19 public health measures at a time when there was still an average of 100,000 positive tests per day. From 24 March, people infected with the SARS-CoV-2 coronavirus will no longer be required by law to self-isolate. With no legal requirement to isolate, most people will see no point in getting tested. This will allow the virus that causes Covid-19 to spread unchecked through the population. The government has chosen to take this criminally reckless course because of its absolute determination to keep the economy open whatever the human cost. The government now claims Covid-19 is ‘endemic’ and the pandemic is essentially over. Other ‘endemic’ diseases include malaria, tuberculosis and HIV/AIDS. Together, these diseases killed almost three million people across the world in 2021. CHARLES CHINWEIZU reports.

 

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Reframing neoliberal views on the pandemic: a critique of The Grayzone

Anti-lockdown protest in Vancouver (photo: GoToVan | CC BY 2.0)

Since so-called ‘Freedom Day’ on 19 July 2021 when the Tory government ended public health measures to control the spread of coronavirus, more than 25,000 people have died of Covid-19 across Britain. Millions have been infected with the virus, hundreds of thousands are now suffering from the effects of Long Covid. The NHS has virtually collapsed under the pressure of treating tens of thousands of patients while trying to address a backlog of at least six million patients awaiting treatment. Yet the government is determined to end the few public health measures that exist under its ‘Plan B’ by the end of January, and tell us we now need to ‘learn to live with the virus.’ Throughout the surge of infections caused by Omicron and the thousands of resulting deaths, the government set its face against new measures, and was adamant it would not implement a fourth lockdown.

 

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NHS running on empty

Mural in West Belfast in support of the NHS and frontline workers

In Britain, the pandemic health disaster is worsened by the NHS crisis, with insufficient staffing in all areas of health care and a frightening increase in deaths in ambulances, GP surgeries and A&E departments, while waiting times get longer.

 

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Covid-19 response: a path to social murder

FRFI protest for public health

Since the British government announced that all Covid-19 restrictions would be scrapped from ‘Freedom Day’ on 19 July and told us to ‘live with the virus’, there have been over 15,000 deaths and more than 4.3 million new infections. The death rate remains at 800-1,000 people per week, with 1,000 hospitalisations daily, and these levels are set to rise again. Scientists have warned there could be 8,000 more deaths by Christmas if steps are not taken to control transmission. But this does not matter to the capitalists whose priority is keeping the economy open and profitable – something on which all sections of the ruling class and their political representatives both Labour and Tory agree. Together with the mass media they have normalised a regime of social murder. CHARLES CHINWEIZU reports.

 

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Covid-19 winter plan is class war

The national covid memorial wall

The government’s ‘Autumn and Winter Plan’ for the pandemic continues its policy of social murder. The Plan is for tens of thousands of working class people to die in the months to come. The government does not intend to eliminate the virus but wants us to buy into the myth that it can be managed through a vaccination-only strategy. This will not prevent millions of predominantly working-class people from getting infected. Between ‘Freedom Day’ on 19 July 2021, and mid-September there were over 1.7 million new infections and over 5,500 deaths in the UK. As we go to press, almost 1,000 people are dying each week, with 1,000 people being hospitalised daily. The government’s priority remains protecting the interests of the ruling class and the profits of big business.

 

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