To campaign effectively on the NHS we need to know why the current crisis is happening. We need to know what our politicians have been doing to the legislation that governs our NHS to be able to know what to fight against. So this page will aim to get anyone interested up to speed on exactly what has been happening.
Back in the days of Margaret Thatcher, a decision was taken to begin applying market place economics to our NHS. The neo-liberal economic agenda began, based upon a belief that free trade made good economic sense. The intervention of government in many of our public services, including the NHS was reduced and the private sector granted freedom from any controls imposed by the state, regardless of how much social damage this caused.
Neo-liberalism has affected many aspects of our lives, from healthcare, education and social care to the maintenance of our roads and transport systems. But the NHS had been set up as a publicly owned, funded and provided service as evidence shows that this really is the most efficient method of providing the nation with healthcare.
At first we started allowing the private sector to run non-clinical services such as cleaning and portering into our hospitals. Under Tony Blair NHS Trusts were set up and Foundation Trusts were given responsibility for balancing their own books. John Major started using Private Finance Initiatives to fund the building of new hospitals or building of new wards in hospitals. Apparently this allowed the private sector to carry the risk of investments made into our NHS. This was greatly expanded under Gordon Brown when the crumbling public sector infrastructure was rebuilt using PFI deals without creating a massive whole in the treasury’s purse.
New Labour opened the door to privatisation, but under David Cameron’s government the NHS was railroaded towards full scale privatisation, and the Lib Dems did little to halt these plans.
After pledging in his 2010 manifesto to not make any top-down re-0rganisations of the NHS that get in the way of patient care, once safely inside No 10 Cameron set about the biggest topdown reorganisation that the NHS had ever seen.
The Health and Social Care Act 2012, was shrouded by overly complex language and plenty of it obfuscating exactly what was happening to our beloved healthcare system that was envied across the world. The Royal Colleges were silenced using a carrot and stick technique, our media did their best to tell the public nothing about what was being planned. Nick Clegg signed a letter with Shirley Williams to tell all Lib-Dem MPs that their worries about particular issues with the Bill were unfounded. These days we may call this letter fake-news or post-truth but in 2012 we still called it a lie. It did however achieve its aim of getting the support of all but one Lib-Dem MP behind the Bill and so it was made an Act of Parliament.
The Health and Social Care Act meant individual NHS services were one by one put out to tender with any ‘qualified provider’ entitled to bid to run the service. No clarification was made on what exactly a ‘qualified provider’ means.
Our Secretary of State for Health, currently Jeremy Hunt, became responsible for only promoting universal healthcare for all. The original clause in all previous NHS Acts of parliament that gave the Secretary of State for Health a duty to provide and secure universal healthcare was removed. Healthcare provision is now determined by market forces not by need. If this leads to anyone finding their healthcare needs are not met, our Secretary of State for Health cannot be accused of failure.
Despite claims that this Act would streamline the NHS and reduce bureaucracy it has in fact achieved the exact opposite.
NHS England was an agency created by the Act with overall responsibility for the NHS, headed by Simon Stevens. Watch the video at the end of this page to find out more about him.
So now we have a deeply fragmented NHS, with one department often not knowing what another is doing. The numbers of students training to be doctors, nurses and other healthcare professionals were reduced by 20% in 2010. So now our NHS is starting to see growing staff shortages across all services and many of the staff we do have are suffering from years of pay restraint as we expect them to do the work load of a full staff team.
Many hospitals have lost core services and reduced the numbers of beds on existing services. The private sector has cherry picked the most profitable services and left the NHS to run the rest.
Decisions are no longer made on what would give the best health outcomes but what makes the best financial sense. Our trusts are all getting further and further into debt and staff are often frightened to be seen as politically active by their employer. While our government seeks to get us blaming immigration!
Our government is seeking to use stealth tactics to slowly change our NHS into a single payer system with no state run providers of healthcare. But a quick look at America should show us all we need to know to campaign against this. The Americans spend twice as much per capita on their healthcare which is half as efficient as our system. When people say that we can’t afford our NHS we should always remind them that we can’t afford not to have our NHS.
The overall cost of implementing the Health and Social Care Act has been estimated at around £3bn, but now we are looking at putting in place Sustainability and Transformation Plans. These plans damage our democracy, and damage our healthcare service. Many feel that once put in place the end of the NHS as we know it will be upon us.
One further challenge will be when our government begins making new trade deals post-Brexit. Again these have the potential to reduce our democracy further and damage our healthservice once more.
Here is a video shown at the Eastbourne People’s Assembly about the politics behind this NHS crisis.