While the Tory appeal to ‘Get Brexit done’ was critical in securing the votes of swathes of elderly Thatcherite working class homeowners in the north and midlands, it was supported by promises of extra funding for the NHS. The Tories knew that such pledges would not just neutralise Labour commitments but would address the real concerns of a layer which is increasingly dependent on the NHS and which could never afford private care. Eye-catching guarantees of 40 new hospitals, 50,000 extra nurses and £34bn additional funding served to distract attention from a service which has been driven into the ground by ten years of austerity and real-term cuts.
The figures are clear: in England alone the number of hospital beds has fallen by 17,000 since 2010, there is a shortage of 100,000 staff including 10,000 doctors and 40,000 nurses. Performance against targets set more than 15 years ago continue to fall: the A&E waiting time target, requiring 98% of all people arriving in A&E to be seen, treated, discharged, admitted or transferred within four hours was cut to 95% by the Coalition government in 2010. It was last met in July 2015; December 2019 showed the lowest figure ever of 68.6% in hospital-based A&E units. 100,000 people were left waiting at least four hours and some up to 12 or more to be admitted to a bed on an appropriate ward.
Now that ambulance services have stopped paramedics managing A&E queues so they can go back out on urgent calls, hospitals are sending ward nurses to deal with the queues in corridors around the A&E department. Health Secretary Matt Hancock has had the gall to propose that that target should be scrapped as it is no longer ‘clinically appropriate.’
The Tory election pledges are of course illusory. Had NHS spending increased at the rate prior to 2010, the Health and Social Care budget would now be £35bn higher. So the Tories’ promised increase in spending of £34bn over five years will not catch up with today; the figure anyway drops to £20.5bn in real terms after inflation and cost pressures are taken into account. Much of it will have to be used to defray the accumulated hospital debt of £14bn.
The extra nurses promise is also a sleight of hand: the plan is now forecast to take ten years rather than the five-year life of the current parliament. And it will not be 50,000 new staff: 18,000 of the total is to be met through retention of existing nurses; the remaining 32,000 will include many less qualified nursing assistants, and recruits from overseas. However, there are no plans to remove visa, immigration and NHS charges which apply for migrant workers – and these will extend to EU nationals after Brexit. The disastrous fall in trainee student nurse numbers following the withdrawal of the nursing bursary in 2017 will not change significantly since its promised return turned out to be a £5,000 grant which still needs the trainee to shell out £9,000 in annual student fees. A further pledge to recruit 6,000 GPs will include 3,000 trainee doctors spending more time in general practice. In 2015, then Health Secretary Jeremy Hunt promised an extra 5,000 GPs. Since that time, the numbers have actually fallen.
The 40 new hospitals are equally fictional: nothing will materialise before 2024. Six hospitals have been promised £2.7bn, while a further 21 have been merely promised a share of £100m to draw up plans for future financing. Meanwhile over 100 trusts with a backlog of maintenance bills t otalling an estimated £6bn will get no financial help.
The purpose of Tory fictions – apart from securing their re-election – is to distract attention from a service where waiting lists and waiting time are getting longer, many treatments are subject to rationing, migrants are being denied treatment, and a postcode lottery operates for treatment including urgent mental health support, and many staff working in tendered-out services denied a living wage or sick pay. Fight for the NHS!
Hannah Caller
