Next week could mark the end of the National Health Service – is anyone going to do anything about it?
FROM THE CRADLE TO THE GRAVE?
I was taught that to grab the attention of an audience, there were certain devices that could be employed to great effect. Rhetorical questions provoke thought. Asking the reader to consider hypothetical cases stimulates the imagination. Everyone warms to an anecdote. However, I prefer the bold statement. So, here is mine. By this time next week, our National Health Service, free at the point of use, bequeathed to us by the generation that defeated Hitler, could well be under sentence of death.
Its demise seemed inevitable earlier this year, but a stay of execution was achieved in April as the nurses and doctors fought back and said, “no!” Apparently chastened, Andrew Lansley, Secretary of State for Health, and David Cameron, the Prime Minister, declared their intention to “pause, listen and reflect”. Sleeves were rolled up, ties removed and hospitals visited. Ever the ex-PR man, Cameron understands that when the going gets tough, the tough get themselves photographed next to some pretty nurses.
Too soon, the big ‘pause’ is over and the Health and Social Care Bill has been dragged from its sick bed. The first thing to say, is that it’s a big piece of legislation. Alarmingly, suspiciously so. What, we wonder could have been hidden in all of those folds and wrinkles? Something rotten, perhaps?
As summarised by The Guardian and Observer newspapers in recent days, the key proposals make for grim reading. Political accountability is to be abandoned, as Lansley is expected to hand over responsibility of whatever we might like to call the new ‘service’ to a National Commissioning Board, leaving him free to shrug his shoulders and say, “not my fault, guv,” if things go wrong. He’ll then have plenty of time for more important work: namely, the shmoozing of the many foreign health companies that have been earmarked to run, at present count, some twenty English hospitals. A German company, Helios, has already been identified as one such.
The fact that the NHS is to be regarded , unlike, say the police or the armed forces, as a business and not a public service is to be taken for granted as European Business law will be enforced to allow “any willing providers” (a euphemism for the private sector) to run any services they so wish, just so long as they do it cheaply enough. (And how is this ‘cheapness’ achieved? Simply dismiss staff and then re-employ them on lower salaries and reduce the amount and the quality of ‘expensive’ training. Unions, of course, will not be welcome – bad for business.) Competition and profits, or ‘dog eat dog’ if you prefer, will be the prime motivators in how health care is to be provided in Cameron’s Big, Bad Society.
For us in the north of England, the future looks particularly bleak. The National Commissioning Board can distribute money to wherever it likes, not necessarily to where it will be needed. Southwards, probably. The funding will be, in the first instance at least, from taxation. Again, fears of undemocratic non-acountability will be justified as these public moneys will be handed over to autonomous private companies to with as they please; some of it likely ending up as huge bonuses for the new-rich ‘health entrepreneurs’.
Worried about bed space? The Bill allows for ‘capping’ of private beds to be removed. If you require a bed, be prepared to pay for one: especially if the hospital needs to swell its coffers before it has to go cap-in-hand to private equity institutions for an even bigger bail-out. (These institutions are not banks, as such. Think of them as loan shark operations run be very posh people. You could ask Southern Cross, the care home company, about private equity, but they went bust, owing money to private equity institutions…)
It’s only natural when faced with such a blatant assault on something so fundamentally important, so profoundly crucial to the vast majority of us that we shake our heads in disbelief. “They’ll never get away with it,” we reply. After all, it wasn’t mentioned in the manifesto. Anyway, the LibDems will stop it. won’t they? Certainly, Shirley Williams, writing persuasively in The Observer this week, is leading a fight back. But what of Mr. Clegg? According to him, “breaking up the NHS is exactly what we need to do to make it a more responsive service.” This is hardly a point of view that inspires hope for the survival of the NHS as a country-wide public service, even when, in its present form, it is internationally admired for its efficiency and its effectiveness.
Indeed, the suggestion that the NHS will live on only as a brand name and a repository for health insurance (the U.S. model – need I say more?) is also supported by Clegg. Not even to be eventually funded through taxation, NHS will then only be accessable to those who could afford it – and not for those whose poverty forces them to ‘opt out’ of any U.S. style health insurance model. Thanks, Nick.
Others share this view of a future ‘NHS’. Mark Britnell, one-time NHS official, now the boss of a private health consultancy, sees the NHS as a, “state insurance provider, not a deliverer of care.” A “state” provider that would then be sold off? Possibly to the kind of companies who regularly pay the Prime Minister’s colleagues for ‘advice’ and ‘information’ and how have contributed, according to The Observer, a cool ÃÂ£750,000 to the Conservative Party? Draw your own conclusions from this.
All political careers have their defining moments. For Churchill, it was the realisation that Chamberlain was finished and that the destiny of Britain lay in his hands. For Thatcher, it was the Falklands, or so it should have been if it wasn’t for the Poll Tax. And Cameron? What should define his premiership? A flapping, flopping economy presided over by that coldest of cold fish and chief cheerleader for the banks, George Osborne? The looting of English town centres by unhugged hoodies? Victorian levels of social and economic inequality? Let us consider, instead, THE defining moment to have been the week Cameron forgot that his government are not the owners of our public sector, but its caretakers; the week he tried to kill of the NHS, our NHS; the week we all said, NO!”
(My research has come from the The Guardian and Observer newspapers, the BMA website, the Keep Our NHS Public website and the campaign group 38 Degree, who have collected well over 400,000 ‘e-signatures’, and whose suppoters have raised funds to pay lawyers to research the legality and implications of the