Brexit, profiteers and the NHS
The American threat
During his recent visit to Britain the US President Donald Trump caused
widespread horror in the bourgeois press when he stated that, in
negotiations for any post-Brexit US-UK trade agreement, everything,
including the NHS, would be on the table. Within a very short time,
however, the President seemed to have backtracked on that remark. Mr
Trump’s apparent U-turn followed a huge and well reported backlash from
trade unions, Conservative leadership candidates and opposition
politicians. Trump in a later interview, referring to the question of the
NHS and his earlier comment, said “I don’t see it [the NHS] being on the
table” adding: “Somebody asked me a question today, and I say,
‘Everything’s up for negotiation’ because everything is, but I don’t see
that being – that’s something that I would not consider part of trade.” The
main media responses following the second statement seem to go from ‘Trump
having been soundly put in his place’ up to ‘he is now telling lies to
appease us and that post-Brexit the US health giants will still want our
NHS’.
We must repeat what we have been saying repeatedly for quite some time now:
“There is very little of the real NHS left!”, so much is now owned or
serviced by the private sector, and US firms are well represented among the
private players that stick an NHS label on themselves in order to rip money
from the ailing NHS cash cow. It seems much more likely that someone has
taken President Trump to one side and pointed out that the US companies are
already here pre-Brexit and that in Britain politicians don’t state the
obvious, especially where healthcare is concerned, for fear of a public
backlash. The British bourgeois way is to keep the door open for the
privateers while referring to the NHS as one publicly owned and accountable
organisation which every bourgeois political party swears to defend, while
claiming all the others want to privatise it.
It is in this light that we must view statements like; “The NHS is not for
sale” issuing forth from the Health Secretary, Matt Hancock, in response to
an earlier utterance from the US Ambassador that the NHS must be open to US
firms post-Brexit, and “The NHS as a publicly run, publicly owned
institution is part of our DNA”, coming from Jeremy Hunt, the Foreign
Secretary (and now contender for the office of Prime Minister), who
previously served as the Health Secretary. These two Tory ministers were,
of course, at the time that these statements were made, rivals for the
leadership of their party and, as both have very obvious and public links
to the NHS, both obviously felt they had to be seen to be defending it. The
Labour Party can play this game equally well. Jon Ashworth, the Shadow
Secretary of State for Health was not to be left out, saying: “Though Trump
may have later reneged on his original comments, no amount of rowing back
should be enough to dismantle the seed of doubt that has now been planted
by the president. I want to send a clear message to Donald Trump: our NHS
absolutely must not be for sale, and with a Labour government it certainly
would not be.”
Mr Ashworth’s little party political broadcast does not stop at pretending
all the private schemes brought in to rob and ruin the NHS under Labour
governments did not happen. Hoisting the mantle of sole NHS protector onto
his party, he continues to attack both Trump and Brexit as the villains in
his dream saga: “…if we have a trade deal with the United States, that
could genuinely mean Trump’s America, with its huge private healthcare
corporations, could get their hands on NHS contracts that I believe would
severely undermine our free at the point of use universal and public NHS. I
don’t remember seeing that on the side of any Brexit bus.” Of course, Mr
Ashworth would have been quite happy doing that very same deal if in power
and especially if it could have been with that nice Mr Obama through the
good offices of the EU, as was originally mooted, but such is the two-faced
reality of bourgeois politics, the ‘Punch and Judy’ show for adults with
imperialism hiding behind the screen, doing all the voices and with its
blood-soaked hands stuck up all the glove-puppets! That won’t appear on the
side of any buses either, will it Mr Ashworth!
Acadia is a Tennessee healthcare firm that paid £1.3 billion on buying the
Priory Group, which, through its contracts in the NHS, relieves the British
taxpayers of around £720 million annually.
Universal Health Services (UHS) is another US firm filling its pockets
indirectly from the Treasury through the NHS. UHS have recently bought up a
lot of psychiatric services in Britain including Danshell which is the
proud owner of a Durham hospital that has featured in a Panorama exposé of
abuse towards patients. The UK operations of UHS are run by ‘Cygnet Health
Care’ (CHC), which, in between public crocodile tears regarding that exposé
of their ‘care’, claimed that it was genuinely “shocked and deeply saddened
by the allegations.” The latest accounts of CHC shows the company receiving
revenues from some 220 NHS purchasing bodies and reveals their profits from
the NHS rising to a staggering £40.4 million. Scores of other American
firms have joined the current feeding frenzy of private companies in
‘so-called’ NHS psychiatric care; and so secretively are many of the ‘care’
units being operated that many patients are being subjected to solitary
confinement, violent restraint, hatch feeding and forced sedation with
little chance of investigation or proof-gathering being afforded to
relatives except by the expensive methods of programme makers like Panorama
who cannot be everywhere. It would be nice to blame solely the financial
speculators and funding grabbers that are the private sector, American or
otherwise, but the truth was, is and remains that without the willing
cooperation of law-makers in Parliament generally and the government of the
day specifically (whichever bourgeois party is the government at any given
time), the abuses of psychiatric patients and the abuse of the public purse
could not take place.
It’s not just the Americans!
The NHS was cracked-open a long time ago to allow private firms the legal
right to bid for the care and treatment contracts alongside any ‘in-house’
bids, and if these privateers should occasionally lose out to an in-house
bid, they often drag the whole thing through the courts costing the NHS
million of pounds until the privateers get their own way.
One British private healthcare company (Circle) has for 11 years been
running the Nottingham NHS Treatment Centre, which provides 240,000
operations and check-ups a year, but Nottingham University Hospitals NHS
trust (NUH) put in a better bid and won the contract. Circle immediately
called its law team and, following a bitter and costly legal battle between
Circle the NHS, the NUH were confirmed as the better bid and they were
handed the £320m contract to run the centre for the next five years.
Circle had run the Nottingham ‘Independent Treatment Centre’ (ISTC) since
it opened in 2008. Which bourgeois party was in government then we have to
ask? Oh yes, it was the Labour Party which, according to Mr Ashworth the
Shadow Health Minister, would not allow, if they were put back into power,
“our NHS” to be for sale!
Circle was one of a large number of private companies that were given
charge of ISTCs around the country to use for the manufacture of fabulous
profits for themselves. Other private companies that won this particular
NHS lottery to enrich themselves from the public funding given to the NHS
included Care UK and Ramsay Health Care both of which are still running
other ISTCs and making a lot of profit from them.
The Nottingham Treatment Centre is in for a rocky handover, however, as the
Rushcliffe NHS clinical commissioning group (CCG), which awarded the
contract to the NUH, envisaged a transition time of seven months to make
sure that the treatments and running of the centre remained smooth during
the takeover by NUH from Circle. That time is now being chopped down to
eight weeks as Circle are trying to cause mayhem in a bid to prove their
claim that NUH cannot run the centre. This nasty tactic by the ousted
private company could spell delays and possibly disaster for the thousands
of people who are waiting for treatment at the Nottingham centre, including
many cancer patients, as it faces possible delays once NUH takes over the
contract on 29 July because it will not be in a position to take on the
full range of services immediately.
Jonathan Ashworth MP, has surfaced again to attack the private sector that
threatens our wonderful NHS, saying he was pleased Circle had lost the
contract and has criticised the firm for using solicitors to try to thwart
the contract decision. “It’s hugely welcome this service is returning to
our public NHS and out of the hands of Circle” he stated, seemingly
forgetting who gave them the contract in the first place – or perhaps
hoping that we will forget! “Patients well remember Circle’s chaotic
handling of the Hitchingbrooke hospital contract” he added in a reference
to another victim of the Circle fund-sucking ‘care’.
It was in 2012 that Circle became the first profit-driven health firm to be
put in total charge of an NHS hospital as it took over the running of
Hinchingbrooke hospital in Cambridgeshire. Just three years later it gave
the contract back to the NHS following ‘financial problems’ stating that it
could not keep up with rising demand. The investigators rated the
hospital’s care during Circle’s time at the helm as inadequate.
The money skimmed off by profiteers is urgently needed elsewhere
Meanwhile the storm hovering over us of the near complete breakdown of the
system of hospital and GP care in Britain, as reported in Lalkar:
March/April 2019 issue, continues to gather. Without staff there can be no
healthcare and, unless doctors and nurses can be found very quickly, what
is left of the NHS will come crashing around our ears, causing a
humanitarian crisis of extreme severity. A report from the Nuffield Trust
shows that the number of GPs per 100,000 people has shrunk from nearly 65
in 2014 to 60 last year. Even if these losses in the number of GPs were
evenly spread it would be causing great problems, but the lowest number of
GPs seems to be concentrated in the poorest (most in need) areas. All these
problems could be solved if the NHS funds were directed to the areas of
need rather than to the enrichment of parasites.
There are 7,148 surgeries operating in England according to the most recent
NHS figures which were released in July 2018. The harsh truth is that some
357 could face closure during the next year and, with each surgery in the
country having on its books an average of 8,279 patients, it means that
almost 3 million people could be left without a doctor if 350 practices did
close next year.
In the year between July 2017 and July 2018 more than 260 GP surgeries
closed their doors in England so, unless the trend can be stopped and
reversed, that projected 350+ surgery closures is not by any means
panic-mongering but a very real prospect.
Incidentally, to the extent that the NHS is still functioning as well as it
manages to do, it is understood by most sensible people and even a fair few
bigots that without immigrant workers (1st, 2nd and 3rd generation) our NHS
cannot exist, and yet there are still people wanting to put greater
restrictions on foreign workers entering the country to work in the NHS.
Until we are prepared to put serious money into training more doctors and
nurses, we cannot hope to see the survival of even the much-reduced level
of healthcare that we currently enjoy much longer.
Incredibly, Richard Murray, the Chief Executive of the King’s Fund, is on
record as saying that without radical action to expand the NHS workforce,
there is “a very real risk that some of the extra funding pledged by the
government will go unspent, waiting lists will continue to grow and
important improvements to services like mental health and general practice
will fail”. Of course, when he says that some funding will go unspent he
means only that it will not be spent on “radical action to expand the NHS
workforce” but will instead be quietly clawed back by the government on the
grounds that the NHS did not have the staff to spend it!
Urgent action needed
We need eradicate all the leeches growing fat from the funding that is
supposed to keep our healthcare going, be they the amazingly bloated levels
of greedy and bureaucratic managements throughout the system, or their even
more parasitic financiers. We need to end the putting of services out to
tender which is giving our money straight to people who give nothing back
and desire only the maximum profit for themselves.
Moreover, we need to end the private production of drugs that give the
pharmaceutical giants the ability to dictate how much the NHS has to pay
above the real financial costs of producing any given medicine. We need
good quality, properly funded, accountable and publicly owned
pharmaceutical enterprises unencumbered by the profit motive but instead
powered by the ideals of public service, able to focus far more on research
to find definitive cures to various ailments, rather than continuing to
rely to such a great extent on lifelong palliatives that generate eternal
profits.
Private enterprise, i.e., the creation of the greatest amount of wealth for
a small group of individuals by performing the least service possible at
the lowest cost to themselves, is not and can never be good for healthcare.
The company Interserve was given a huge seven year contract worth £300
million to provide facilities management for hundreds of NHS buildings
across Leicestershire, yet that contract had to be ended after only three
years following many complaints and reports of patients receiving meals up
to three hours late, uncleaned and bloodstained corridors, and various bins
overflowing, making even a short trip to hospitals or clinics very
hazardous to the health of workers, patients and visitors alike.
Another example would be Coperforma, a patient transport service whose
actual service was so shocking in its unreliability that often patients
were forced to wait for hours to get to urgent care, and getting home
afterwards within two hours of the time you were supposed to was likened to
the chances of winning the National Lottery top prize.
Carillion was another cleaning company with a disastrous record. After
winning a £200 million five-year estates-and-facilities management
contract, they failed to clean any of the hospitals properly to the point
where infectious waste was seen overflowing in a children’s ward.
Meanwhile, in the United States, where a bank account is checked before a
pulse, the pharmaceuticals companies are having great fun at the expense of
the poorest and politically weakest sections. The Israeli drugmaker, Teva
Pharmaceutical Industries, is one of the world’s largest manufacturers of
generic medicines. This rapacious company has already faced criticism in
February 2018 for charging $18,375 for a bottle of 100 pills for a rare
medical condition known as Wilson disease. Another purveyor of overpriced
drugs is Mylan who have also generated outrage for raising the price for a
two-injection EpiPen set to over $600 from $100.
These two companies, along with Pfizer, Novartis and others, stand accused
in the US courts of conspiracy and price fixing. “Rather than enter a
particular generic drug market by competing on price in order to gain
market share,” the complaint states, “competitors in the generic drug
industry would systematically and routinely communicate with one another
directly, divvy up customers to create an artificial equilibrium in the
market, and then maintain and increase anticompetitively high prices,” said
Gurbir S Grewal, the New Jersey Attorney General in a statement relating to
the case. The named companies have, it is claimed by the New Jersey State
Prosecutor, in some cases raised prices together by 1,000%.
The NHS and Brexit
These companies and/or their subsidiaries also operate in Europe and, as
readers of Lalkar and Proletarian know from past articles, Britain’s
toothless health watchdog has in the past allowed these very methods to be
practised by drug companies here. In short, there is little that is done in
America that isn’t also done here to some extent. The point is to remove
all, not just US, private firms from the NHS. But that will not happen
while we live under the dictatorship of the bourgeoisie (bourgeois
democracy if you prefer). Revolution is the long-term fix for the NHS, and
most other real problems, but we will support whatever steps within
capitalism that do not go directly against the long-term interests of the
working class and the goal of revolution and a proletarian dictatorship
that we have. However, there are plans to try to use the NHS as some sort
of reason not to support Brexit and that must be combatted.
One of the reasons that so much is being made of US firms grabbing NHS
contracts at this moment is to try to create a strong anti-Brexit feeling
within the working class. Within the bourgeoisie there is a majority for
staying within the EU, but a serious split exists, with quite a vocal
minority bourgeois pro-Brexit group very much in evidence as well. Within
the petty bourgeoisie, the situation is one of mainly pro-EU Remainers, but
the working class can easily outvote them all and it is here that there
exists a large pro-Brexit group that is growing in numbers and anger.
If we look at the British lobby group, 38 Degrees, whose members and
campaigns usually run along middle class lines, they stayed out of direct
participation in the Brexit – Remain argument but now, in the name of
saving the NHS, of course, they are firmly weighing in on the remain side.
In their latest letter to members and supporters they argue that: “the
‘no-deal’ Brexit some candidates are talking about could mean the NHS as we
know it is sold off to American businesses. Donald Trump has already said
the NHS will be ‘on the table’ in any trade deal after Brexit.” But what is
the no deal Brexit except the absence of a deal? The majority of voters
decided that Britain should leave the EU but this idea that you cannot have
a no-deal Brexit means that the House of Commons and its overwhelming
Remain majority can keep finding ways of not agreeing until everyone
forgets what the question was! This is clearly understood by the 38 Degrees
leaders as they advise that; “If enough of us come together again, we can
show MPs that we are not prepared to tolerate a version of Brexit that
risks our NHS.”
Yet it must be obvious to all but the wilfully blind that, Brexit or no
Brexit, the NHS is being deliberately dismantled piece by piece to the
point that in area after area it risks collapse. To suggest that only a
trade deal with America would be the cause of collapse is to whitewash what
is already happening, pushed forward by the political representatives of
both bourgeois parties that have been in government in the years since the
NHS was founded, with a view to cheating the British public of their most
cherished institution, the NHS.
Advisors to US President Donald Trump are routinely frustrated by the
President’s seemingly limitless ability to play down rising tensions with
Iran. Despite mock imperialist media outrage over alleged Iranian attacks
on oil tankers, and the shooting down of a US drone in mid-June, President
Trump has yet to light the fuse on what would be a cataclysmic intervention
in the Middle East.