As Labour takes over from the Tories, its ‘solutions’ to the crisis within the NHS are without credibility. There is to be no significant increase in funding beyond what the Institute for Fiscal Studies has described as ‘trivial’, and no plans to address the problem of the social care sector. Instead there are plans for further privatisation as the supposed solution to record waiting lists.
Current waiting list figures for appointments and elective procedures stand at 7.6 million. In 2023, with figures from only 48 of 140 NHS hospital trusts, nearly 100,000 elderly people waited more than 12 hours on trolleys in A&E before being admitted to a ward, 25 times more than in 2019. The consequence of these delays is an estimated 268 excess deaths each week. Child health figures are appalling, with a continuous rise in infant mortality in England. By five years of age, a fifth of children in England are overweight and a quarter have tooth decay. Child vaccination rates across Britain have fallen below WHO target levels. Nearly one million children were referred to mental health services in 2022/23, and over a quarter of them were waiting for support in March 2024.
Labour’s election manifesto outlined £2bn worth of investment in the NHS to cut waiting times with 40,000 more appointments per week, a doubling of the number of CT and MRI scanners, a new rescue plan for dentistry with 700,000 more urgent dental appointments, and 8,500 more mental health staff. It promised £1.1bn for staff to provide two million more operations and appointments at weekends and evenings: but this would be payment for staff working extra hours at time-and-a-half rates. With the NHS England budget at £155bn, these amounts are pitiful, especially when compared to the £11.6bn NHS maintenance and repairs backlog.
Incoming Labour Health and Social Care Secretary Wes Streeting declared that he was ‘stunned by NHS failings’ and he has ordered surgeon Lord Ara Darzi to lead an investigation to report back by September 2024. Being ‘stunned’ was empty political theatre: everyone knows that there are huge service and staff shortages in the NHS across the board with over 125,500 vacancies in hospital and community services in England:
The Royal College of Nursing’s current figures show 43,617 empty nursing posts in England alone, equivalent to 12% of posts without a full-time registered nurse.
- In 2023, 52,148 new nurses joined the Nursing and Midwifery Council register, of whom 21,766 were from outside the EU – but 26,755 also left. The net gain of over 25,000 was possible only by drawing in nurses trained overseas. Applications in England to study nursing fell by 16% compared to 2022.
- In the last 15 years, the number of community and district nurses has fallen by nearly 50%, learning disability nurse numbers fell by 45% and health visitors by 30%.
17,000 mental health staff (12%) left the NHS in 2022. - The NHS is short of 11,000 doctors. 30% of doctors currently working in Britain are considering leaving in the next year to work abroad. The General Medical Council said that as many as 96,000 doctors could move abroad in the coming years.
- One in five GP practices has closed or merged in the last ten years and the equivalent of 1,800 full-time, fully-trained GPs have been lost in the last eight years.
Of equal importance are the 152,000 vacancies in adult social care, with over 10% vacancy rates for care workers, registered nurses, occupational therapists and social workers. A quarter of NHS inpatients are suffering from dementia and their needs are complex; discharging them requires social support that often is not available. Labour talks about setting up a ‘National Care Service’ – but the King’s Fund said that ‘The Labour manifesto largely dodges the issue of social care reform’ and that what it says is ‘best described as a plan to come up with a plan.’ Overall, 1.6 million elderly people are not getting the social care they need.
Throughout his time as Shadow Health Secretary, Streeting told us that he would use private facilities to solve the NHS crisis. The government has now employed a former Labour Health Secretary with major private interests, Alan Milburn, to advise on NHS ‘reform’. He has said the long-term sick must be forced to look for jobs to cut welfare costs and reduce Britain’s reliance on immigration. He has earned over £8m from health care consultancy, chairs PricewaterhouseCooper’s ‘health industries oversight’ board while advising private equity group Bridgepoint Capital, which owns Care UK, one of the largest care home chains in England as well as several health care companies. Yet the notion that private services can help reduce waiting lists as the government wants is pie in the sky: without a properly functioning social care system, it is impossible to safely discharge people once they are ready, and if hospitals can’t discharge people, they can’t admit anyone and so waiting times in A&E will continue to rise. Furthermore, the capacity of private hospitals is tiny compared to that of the NHS, they do not provide emergency care, and any increase in their use will merely draw in NHS staff who will in effect moonlight and reduce the time they spend working for the NHS. There is no separate pool of staff sitting around in the private sector of any size: Labour is just trying to pull the wool over eyes to promote the interests of its private health care friends. It is the working class who will suffer the consequences.
Hannah Caller
FIGHT RACISM! FIGHT IMPERIALISM! 301 August/September 2024
