Illness has become indulgence; disease has become damnation. An otherwise unassuming date, 20 July 2020, may mark the final battle for our NHS if it’s to truly remain ours… or, remain at all.
For it was on this date that 340 conservative MPs voted down “New Clause 17”; an amendment to the post-Brexit trade deal to protect our NHS from foreign interference. In other words, for Donald Trump to keep his grubby little hands off our national pride and treasure. I call this “the final battle” for the simple reason that the NHS has been fighting for her life for 40 years now. And she’s losing.
You may realise my personification of the NHS, referring to it as she and her. Why? Well, the narrative of the NHS is the narrative of all of us. How many of us were born in an NHS hospital? How many of our lives and our family’s lives has she saved? The NHS is more than a set of buildings or a mere organisation; she is every one of us. A living, breathing establishment made up of 1.5 million dedicated workers, 66.6m patients. She is ours, and we are hers.
There are folk that do not share these sentiments: 340 of them to be exact. Willing to sell out our NHS, along with every single one of us in the process. This is the stain marking Boris Johnson’s Conservative government and its predecessors since the 1980s. The NHS, it turns out, was not safe from the perils of Thatcherism. An ideological crusade to include the NHS, a monolith of Nye Bevan’s socialist ideals, into market economics commenced.
Outsourcing of ancillary services like cleaning, catering and porters was just the start. The Covid-19 crisis proved the fallacy in this “outsourcing”; a euphemism for throwing around responsibility. Contracted cleaners from Lewisham Hospital were forced to walk away at the height of the pandemic, following the shameful and abject failure of the private company to pay their staff for weeks on end, and potentially disrupting clinical activity.
Thatcher laid the groundwork for what was to come: the so-called “internal market”. Shifting the NHS away from collaboration, towards competition. NHS hospital trusts were now subjugated as “providers” whereas GP practices were now “purchasers” of services of hospital trusts. Hospital trusts had a perverse incentive to perform excessive investigations and increase their incoming referrals for the sake of profit. Medicine is about people, marketisation is about profit – they are, and always will be, incompatible.
So, just how much does this internal market cost? Brace yourselves – £10bn: after seeing administrative costs rise from 5 per cent of the total NHS budget pre-1980s to 13.5 per cent. So much for marketisation. The market system promised efficiency and savings; instead, we have dither and expensive wastage. That £10bn was ours, to be spent on us, not vanquished through sheer imbecility.
The war on our beacon of public health continues under the coalition of chaos, and then under the Tories singlehandedly. These years were marred by harrowing privatisation, chronic, deplorable underfunding, failing to meet A&E, cancer treatment and elective surgery waiting times, 100,000 unfilled job vacancies, of these 44,000 nurses and 10,000 doctors, a 17,000 reduction in NHS beds. To name just a few. Behind all these abject failures and political crusades are lives and people in their most vulnerable of states.
Our money is being spent recklessly on an ideological crusade, in a war waged against our NHS and, by extension, us. The onus and anguish should befall on the government to fund our public health system; the responsibility shouldn’t fall on the shoulders of a 100-year-old man. The NHS is not a charity. Donations aren’t required. It is already paid for, by us.
The NHS has endured, albeit in a tired, beaten state. Now the greatest battle is yet to come. The final battle.
“America first!” the American president bombasts. Whilst our best interests go unheard. The president’s bullyboy tactics will, likely, be met with little resistance from our own prime minister. Our NHS will be mercilessly laid at the helm of US pharmaceutical companies who have long complained about the NHS not paying the ransom for their drugs, despite, the UK drugs spending having risen by 22 per cent in recent years. Already rationing drugs, and rejecting life-saving treatments for some, a hike in prices would be a catastrophe. Currently, a health technology assessment, by NICE, details the cost-effectiveness of drugs, making a balanced decision whether to procure the drug. This too is threatened by the US trade deal. By selling the NHS, we’re selling our nation’s soul.
The NHS is every single one of us. It is, no wonder then, that three quarters of the public don’t want the NHS on the table of a US-UK trade deal. More personally, the NHS has cured me, operated on a family member, educated me, funded my education – all amidst a global pandemic. I, for one, refuse to see the NHS being fragmented and destroyed by an insidious US trade deal. I, and I can say with confidence, the wider British public, irrespective of stripe, refuse the monopolisation of medicine. Perhaps the 200 parliamentarians having financial links to private companies involved in healthcare want to reconsider their allegiance: hindsight is always 20-20.
A 100-year-old hero raising £33m, a national Birthday celebration, a weekly cheer, a country covered in thank you rainbows: few things unite a divided kingdom, and the NHS is one of them. Our NHS is not up for sale, we are not up for sale.
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