At our recent health conference in Liverpool, I watched a film specially made by Michael Moore (of Sicko fame) about Britain’s National Health Service and the American system. He pointed out that health bills are the biggest source of bankruptcy in the United States. It couldn’t happen here? One look at the current Health and Social Care Bill, shows just how close we are getting to the American model. That bill, being implemented incipiently, along with the £20 billion in “efficiency” savings demanded by the Government and the abolition of targets, is pushing our beloved NHS to the brink. It will be turned into little more than a brand name that can be bought and sold, not a much-valued public health service.
The sheer scale and pace of changes outlined in the bill have lead to widespread anger and concern among patients, staff, charities, doctors, health experts, unions and even some Conservative MPs – so much concern that the Government was forced to announce a “pause”. But many fear that “pause” is a cosmetic one, designed to get the Government past the May elections. Statements from the top that ministers need time to explain their “reforms” only serve to foster suspicion that it’s a publicity gimmick.
People know full well what is happening to their NHS and they don’t like it. Evidence is stacking up of long delays in referrals from GPs to outpatients, apart from emergencies. Many NHS trusts have simply stopped funding for procedures such as IVF treatments, operations for hernias, varicose veins and tonsillectomies – short-term Treasury gains, but long-term pain for patients. Waiting times for hips and knee operations that improve quality of life are rising, just as they did during the last blitz on the NHS by Margaret Thatcher when waiting lists for these operations stretched to 18 months and even two years.
A recent Guardian report looked at how private hospitals “expect business to boom as NHS cuts bite, waiting times lengthen and those patients who can find the money decide to pay for treatment instead”. Official figures show that waiting times are at their longest for three years. Some hospitals have put new restrictions on treatments or put routine operations on hold for months. This situation will not get better.
The NHS becomes a political football, particularly during elections. Any party hoping to gain power needs to demonstrate its NHS-friendly credentials or risk losing votes. Labour has traditionally been seen as the party of the NHS and the last Labour Government invested billions of pounds to make up for years of Tory neglect.
David Cameron unashamedly used his personal experiences of the NHS to convince the public that the Tories had changed. He claimed the “NHS is safe in our hands”, funding would be ring-fenced and the “frontline” would be protected. Just one year later, things look very different. Public confidence in the Government’s handling of the NHS is very shaky. Staff are feeling battered from all sides – facing huge job cuts and attacks on their pensions. The promise that frontline staff would be protected has been quietly swept under the carpet as nurses, doctors and consultants find their jobs included in plans by trusts making cutbacks. It’s as though the importance of the staff-patient ratio in ensuring quality patient care, so painfully demonstrated by the Mid-Staffordshire Foundation Trust, had never been learned. And you don’t get more frontline than London ambulance services, where 900 jobs are to go.
The NHS has always adapted and changed to meet new circumstances, but it cannot provide more care with less money. It is vastly different from the NHS of 60 years ago. It is not the dinosaur portrayed by the Government that needs to be dragged, kicking and screaming, into the 21st century. It is a vibrant and responsive public service, constantly developing new treatments, new surgical equipment and new ways of working in the interests of patients.
Staff have vastly different skills and expertise from 60 years ago. They are continually updating their training to deal with new techniques and technologies. Demand from an ageing population keeps rising, and complex surgery and equipment add to the growing health bill. Drug companies fuel the demand for ever-more costly drug treatments and they make massive profits from the NHS. Change is inevitable and embraced, but the changes in the Government’s Health and Social Care Bill will have devastating consequences.
The £20 billion demanded in so-called efficiency savings, and the likely £3 billion that this latest top-down re-organisation will cost, is leaving the NHS in danger of collapse. Private health companies are already circling like sharks. They can see that the Government’s proposals will damage the NHS irrevocably and they smell profits there for the taking.
Our NHS faces the biggest crisis in its history. The Tory-led coalition wants to go much further than Thatcher ever dared. Its plans are not based on necessity, but on political ideology – roll back the state and allow big business in to make a killing at public expense.
Next week, in many parts of the United Kingdom, the voters will get a chance to deliver a verdict on the record of the coalition. Unison has launched a mass advertising campaign highlighting the 400,000 job cuts hitting the public sector. When vital jobs go, vital services on which people rely go, too. In the NHS, this can be a matter of life and death. Nye Bevan said: “The NHS will last as long as there are folk left with the faith to fight for it.” Unison will fight to preserve it.
Dave Prentis is general secretary of Unison
