Nothing is more gut-wrenching than watching a close friend dying in front of you. And I mean beyond close: a friend who brought you into the world, helped raise you, and was there whenever you were most desperately in need. So, spare a moment for our National Health Service. Time of death: midnight, 1st April 2013. Cause of death: murder.
That this will strike many as hyperbole is because the assault on the NHS is one of the most scandalously under-reported issues in modern British history. Newsnight actually devoted a piece to scrutinising the privatisation of an institution once described by Tory Chancellor Nigel Lawson as “the nearest thing the English have to a religion”.
Only two years too late, then. Frequently, the attack is presented on the Government’s own terms: as the simple devolution of power to doctors and patients. Cuts of up to £20bn by 2015 are spun as “savings”. And who can disagree with “savings”?
A charitable explanation would be the sheer complexity of the Tory assault. The Health and Social Care Act is more than three times longer than the legislation that established the NHS in the first place. When I asked journalists adamantly opposed to the Tory plans why they had failed to adequately cover this travesty, they sheepishly responded it was too complicated: it went over their heads.
Cynical though it may be, that so many of those running our glorious “free” media are covered by private health insurance should not be ignored either.
From today, strategic health authorities and primary care trusts are formally abolished. Some £60bn of the NHS budget is now in the hands of clinical commissioning groups, supposedly run by GPs. This is a sham, though one which turns local doctors into human shields for the privatisers. In reality, the vast majority of GPs will keep on doing what they do already – looking after patients – while commissioning will be managed by private companies.
It’s worse than that. Under the Government’s Section 75 regulations – even after they were revised after huge political pressure – all NHS services must be put out to competitive tender unless the commissioning groups are satisfied a “single provider” can deliver that service. But as the British Medical Journal has asked, how can they “be sure there is only one possible provider except by undertaking an expensive tender?”
Indeed, were they to refrain from doing so, they would risk a costly legal battle. As over a thousand doctors and nurses warned last month, the regulations will “force virtually every part of the English NHS to be opened up to the private sector”. A free-for-all in the English NHS beckons.
As Dr Lucy Reynolds, a research fellow at the London School of Hygiene and Tropical Medicine, puts it, “the public sector will shrink away, and the private sector will grow”. All NHS hospitals will be forced to become foundation hospitals, laying the ground for them to be pushed into the private sector. That process is happening to my own local hospital, the Whittington Hospital, which is selling £17m worth of assets and faces 230 fewer beds and 570 job losses.
Let’s be clear what it at stake: services, people’s health and even lives. As Professor Terence Stephenson of the Academy of Medical Royal Colleges put it last week, doctors’ warnings had been ignored, and “unnecessary competition [would] destabilise complex, interconnected local health economies, in particular hospitals, potentially having adverse effects on patient services”.
And a warning from a leading member of a profession not known for overstating a case: patients could be “in danger from complications” from a fragmented NHS. Resources will no longer be distributed on the basis of need: the rules of the market now rule supreme. “It’s chaos, really,” says Brian James, until recently chief executive of the Rotherham Foundation Trust. Small and medium-sized hospitals will be “bankrupted by the market and more will be pulled into the big teaching hospitals”.
The great sell-off of our NHS is already well under way. Virgin Care now run more than 100 NHS services across the country, from radiology departments to GP clinics. Last year, they were given a £100m contract to run services in Surrey, and a £130m contract to run key NHS services for young people in Devon. Not that you’d know, of course: services run by the profiteering vultures circling ahead operate under the NHS logo, hiding privatisation from public view.
Just where is the opposition? Labour, the mother of the NHS, is hobbled by its own record. Although it injected desperately needed cash into our health services when last in power, New Labour helped to lay the foundations for this Tory offensive. Former Labour Health Secretary Frank Dobson once condemned government plans to contract out commissioning, “with private companies handing work to private hospitals... If that wouldn’t amount to privatisation, I don’t know what would.”
But that was 2006, and it was Tony Blair in office. The disaster of New Labour’s Private Finance Initiative – the equivalent of buying public services on a credit card – has left hospitals saddled with debts of £79bn. Hospital trusts face bankruptcy as a result.
Labour’s own health spokesperson, Andy Burnham, has commendably pledged to repeal the Tories’ NHS Act. But let’s not forget that the last time they were in opposition, Labour pledged to renationalise the railways: on assuming office, it was deemed politically impossible. That must not happen again, and pressure must be brought on the Labour leadership to reject their own past.
The Tories didn’t have the guts to put their proposals before the electorate. Despite its flaws, the NHS had record levels of public satisfaction before the Tories began systematically dismantling it. You need only look to the US – where their inefficient market-driven system consumes twice as much of GDP as our NHS – to see the superiority of publicly-run healthcare. New Labour’s own privatisation doubled the cost of administration in our NHS.
It was Nye Bevan (pictured above, in 1948) who said “The NHS will last as long as there are folk left with the faith to fight for it”. It is with huge regret that I must say that – however much faith we have – we did not fight to save it. The NHS has been killed, murdered, assassinated by a Tory government. The question now is – do we have enough faith to bring it back to life?