The Health and Social Care Bill continues its tortuous way through Parliament. During January, the Royal Colleges of General Practice, Nursing and Midwifery came out in open opposition; other Royal Colleges are following suit. Prime Minister Cameron’s claim that NHS staff support the Bill is proving ridiculous. The House of Commons Select Committee on Health, dominated by Coalition MPs, is against it – but on the grounds that it is distracting attention from the need to save £20bn by 2014. However, the need to turn the provision of health services into a source of profit for private capital remains overriding, and despite all this opposition, there is no evidence that the Coalition is going to either abandon or significantly change the Bill. Hannah Caller and Robert Clough report.
Privatisation remains the name of the game despite the lies of the Coalition. Monitor, the regulator of NHS foundation trusts, has issued proposals on licensing hospitals to provide services in the future which focus entirely on their financial solvency. One licence condition ‘would require licensees to maintain an “investment grade” credit rating, either from one of the major credit ratings agencies (Standard & Poor’s, Moody’s and Fitch) or from another agency that we would approve’. There are no proposed licence conditions for quality of care. In October 2011 the Department of Health issued draft guidance which makes it clear that by 2016 support services for Clinical Commissioning Groups (CCGs, responsible for purchasing hospital care) in England will be provided solely by large commercial organisations. The government has now said it will lift the cap on the proportion of income a foundation trust can obtain from private patients from 2% to 49%.
Despite many amendments, the Bill still does not restore the duty of the Secretary of State for Health to provide or secure the provision of health services. This is because its purpose is to abolish the model of tax-financed universal health care on which the NHS is based. It will be up to individual CCGs to decide what services they commission locally, and which hospitals will provide them. Anything outside this will either require individuals to pay top-up fees or take out private health insurance: it will necessarily be a two-tier system, with the poor and working class getting a rotten deal. The self-same companies which run CCGs may also own the hospitals that provide the care or involve themselves in the provision of health insurance. It is a recipe for corruption and fraud on a vast scale.
Just how bad it will get is shown by the PIP breast implant scandal. PIP was a French manufacturer of silicone breast implants, one of the largest in the world and producing 100,000 implants a year, most for export. In 2011 it was revealed both that it was using a non-medical grade silicone in its implants, a mix of agricultural and industrial grades, and that the implants were more likely to rupture than equivalents. Over 40,000 women in Britain had received the implants from private cosmetic surgery companies. Most of these have refused to accept any liability, and some have disappeared altogether. In early January, 60 women demonstrated against The Harley Medical Group and Transform because they have refused to replace the implants for free. Just what will happen when, in the privatised NHS of the future, a company providing hospital care goes bust, closes down or is otherwise no longer viable? What happens if they botch operations, use faulty equipment or fail to provide proper treatment? With the government determined that clinical negligence cases should no longer qualify for legal aid, the poor and working class will once again suffer.
Job losses and service cuts continue to accompany the drive to cut NHS spending by £20bn. On Merseyside 4,000 jobs are to be lost to meet financial targets, and the South London NHS Trust is considering the closure of Bexley hospital to cut a £69m deficit. Nationally, the number of patients waiting more than 18 weeks for treatment has soared by nearly half since the ConDem Coalition came to office. 20,662 inpatients treated in May 2010 had waited more than 18 weeks; in November 2011 the equivalent figure was 29,508. Over the same period the numbers waiting more than a year for inpatient treatment more than tripled from 321 to 1,018. In all nearly a quarter of a million people do not get treated within the 18 weeks guaranteed under the NHS constitution, and 20,000 have to wait more than a year.
In response to the pressures he faced, senior orthopaedic surgeon David Goodier resigned in November 2011 from St Bartholomew’s and The Royal London Hospitals in east London. Five out of 12 orthopaedic surgeons in the department resigned in 2011. In an email leaked to the press, David Goodier said ‘I have been complicit in a poor standard of trauma care and am guilty of negligence by association … I can no longer stand idly by when patients are at best having their human rights breached, and at worst physically harmed by the care they receive.’ He cited a lack of equipment, lack of operating theatre time, too few beds, and insufficient nurses and other staff, and said that what is in fact a crisis is now treated as the norm. It is a story that can be repeated up and down the country and one which will be worse if and when the Health and Social Care Bill becomes law.
Save the NHS!
Fight Racism! Fight Imperialism! 225 February/March 2012
