Crisis in the NHS

nhsIt is a reflexion of the ordinary people’s attachment to the National Health Service that the People’s Assembly, Labour Party, KONP, the TUC and a hatful of other organisations keep calling on us to demonstrate to ‘save the NHS’. There are even Tories calling on us to save the much-loved health service that we grew up with and which was loosely based on the Soviet health system when first established. Although it was only ever a poor replica of that once great Soviet system, the NHS was a breath of fresh air to the British working class and, along with much improved state schools and almost adequate unemployment and sickness benefits and various laws protecting some workplace rights, it was enough to lure the British working class away from any thought of fighting for socialism.

Over the years both Labour and Tory governments (and the recent Tory/Lib-Dem coalition one) have heaped praise on this now national institution while continuing to undermine it and opening it up to more and more private exploitation. This has been achieved through Private, Public Incentive schemes, Private Finance Initiatives, foundation status hospitals, the open privatisation of cleaning services within hospitals, forcing departments to compete for ever shrinking sums of money, cutting staffing levels to the bone, packing health management boards with greedy people and allowing them to milk the system, forcing through the compulsory tendering out of most of the services our hospitals perform, making GPs run their own budgets and then keep changing the rules to force them to cut or farm out their fringe services etc., etc., with the aim eventually of doing away with this much-loved institution.

The chairwoman of the Commons health select committee, Tory MP, Sarah Wollaston, has built a reputation of being tough in defence of the NHS, and, as an ex GP, she will cross swords with the Prime Minister, NHS England, the BMA and other GPs when she thinks it necessary. For a Conservative member of parliament, her views are a breath of fresh air in the face of repeated government attempts to mutilate the NHS.

In an interview in the Times on 14 January 2017, she said of our health service “The system is underfunded … The cracks are really in evidence. The pressures on staff are now relentless” adding in regard to the A&E crisis that “Casualty is like the canary in the mine, it’s a mark of the whole system.” In this sense she recognises that A&Es are at breaking point across the country but sees the main problem not as continued underfunding of the NHS, and certainly not one of privatisation or hospital/A&E closures, rather, she says “the NHS will never cope unless the government improves social care.” Continuing “The key issue with A&E is not numbers — there are actually more [beds free] in the summer — but in the winter more people need admitting and fewer are being discharged.” While acknowledging what she sees as the ‘good intentions’ of the government in allowing local authorities to raise council tax to help to cover the shortfall in their budgets for social care, she insists that this is no real solution. For Dr Wollaston there is only one solution to the crumbling social care in the regions, i.e., “It needs new money up front . . . The councils with the highest proportion of people they have to support are the councils who are least able to raise it through council tax.” Warning of a near future with care blackspots in parts of the country because providers cannot afford to maintain a service with the money they receive from the local authority, she adds “These packages are now underfunded. More and more people can’t get care at all in some rural areas.” In a very un-Tory-like message she says that consideration must be given to raising national insurance by 1% to help generate the necessary ‘new money’ along with a social care levy for over 40s, although slipping back to more familiar Tory territory, she also recommends the means-testing of the benefits paid to older people, such as the winter fuel allowance, as another way of raising these funds. Along with this she believes that a cross party group of MPs should be set up to look at further ways of raising funding to keep social services afloat and to thus give instant relief to the NHS. This group can then make a public report because “the public need to have the facts laid out for them in a calm way without the brouhaha of politics.”

Sarah Wollaston, within the confines of capitalism, is seeing the problem within the health service, but unfortunately she is only looking for answers within those same confines when she says; “I genuinely don’t think that we will be able to deliver the kind of NHS and social care that people expect on our current levels of spending… we mustn’t shy away from having difficult conversations with the public about the scale of the problem and what it means if we do nothing… it will mean a lot more of what we have seen in the last week but happening throughout the year and even worse. It will mean people start to see real changes in terms of rationing across the NHS.”

Vast amounts of money put into the ‘NHS’, new or old, will do nothing, however

• while they are being used to buy hugely over-priced drugs from the giant trans-national private producers.

• if money is thrown into the PFI black holes of super-rents that can never be ended until the 40 odd year contracts are finished and the individual hospital is dropping to pieces.

• while hospital and service managements are stuffed with self-seeking robbers and con-artists filling their deep, deep pockets.

• while treatments and services are put out to tender for the enrichment of private companies whose raison d’ être is how much of the public money given to running our health service for us all can they take and keep!

The private health companies are the jackals and vultures picking over the body of the NHS whilst the parliament industry performs public farces for our entertainment with the same old tired lines spoken by one gang or another depending who is in office this week!

In Nottinghamshire, almost 75 per cent of NHS hip and knee operations are being carried out in private hospitals, with a very large majority of these ops paid for by the NHS – this is according to the analysis of National Joint Registry figures supplied to the NHS by Candesic, a private healthcare consultancy which will have made a very high charge for the service. Nottinghamshire is not unique in this matter: every region in Britain will have similar figures and it isn’t just private hospitals where private treatment is carried on: many of these companies use NHS premises and equipment while charging the NHS for the service. And many of the staff walking the wards are supplied at high cost by private companies who rent nurses and doctors to purposely under-staffed NHS hospitals!

All of these parasitic private companies have seen their profits shoot through the roof as a result of the increasingly chronic chaos that has become feature of our health service. No petition or march, local or national, will change this if we are not also building a movement that will mobilise the people to offer successful resistance to the continuing encroachments of the capitalist sharks into our NHS. In the final analysis, we need to build a revolutionary party of the proletariat to lead the fight of the working class for its own social emancipation and to get rid of the capitalist system which forces us to perpetually indulge in these guerrilla struggles.