Last summer Stroud celebrated the 70th birthday of the NHS, but that balmy, joyful day already seems a long time ago. Winter is with us, and it’s forecast that if and when any really cold weather arrives, pressures on A&Es, hospital bed-space, the ambulance service, paramedics and GP surgeries will be more severe than ever.
Why is this the case? Hasn’t the Chancellor of the Exchequer just promised an extra £20 billion to be pumped into the NHS in the autumn budget? Surely that should ensure the smooth running of the service.
The devil is in the detail. That £20 billion is to be spread over five years, and it doesn’t take into account the deficits many health authorities are already running. Health experts have made clear that the government’s pledge was “far from sufficient” to stabilise the NHS against rising demand. They say extra funding is needed for vital areas such as public health, staff training and capital investment for long-term planning.
Increased spending has been announced in a new government five year plan for the NHS – which is light on substance, but appears to advocate ever more reliance private providers within the NHS internal market. It is estimated that the increase amounts to be a little less than half the minimum sum needed to maintain services at their current depleted level. Likewise very modest rises in social care fail to address the dire shortages in that sector.
Shockingly, the NHS infrastructure budget has actually been cut; more is to be spent fixing potholes in roads than hospitals. Shadow health secretary Jonathan Ashworth said: “The rapidly rising backlog of repairs facing the NHS means crumbling hospitals and out of date equipment. This is now putting patients’ safety at risk.”
We have an ageing population, and due to the pressures of our ever more unequal society increasing numbers of people are suffering from both physical and mental problems, but do these factors alone account for the ever rising costs of our NHS? And will these increasing costs make it inevitable that at some point our health service becomes unsustainable, and will have to be run, for profit, by the private sector? Will our health care, free at the point of delivery, be consigned to history?
It’s no great secret that a large portion of the NHS is already run by private companies. Much public infrastructure, such as hospital and schools, plus the services that keep then running, were and are continuing to be provided by Private Finance Initiatives – the brainchild of Conservative think-tanks during the Thatcher era, but implemented from the 1990s onwards. These schemes have being paying the investing companies as much as six times their initial outlay. This drain on NHS budgets is crippling.
Additionally, the 2012 Health and Social Care Act opened the door to Health Authorities commissioning outside clinical groups to practise under the NHS banner, all in the name of the “internal market” and “healthy completion”.
So when we look at today’s NHS we see infrastructure provided at crippling cost by the private sector, private clinical groups, privatised ambulance and paramedic services, private catering and maintenance services, expensive agency nurses being brought in due to staff shortages… and even the booking and referral services are privately run.
It all makes for a highly disjointed system, and one that is haemorrhaging public money into the private sector in a completely unacceptable way. Is the government aware of all this? Assuredly. Is it concerned? Absolutely not. Conservative think tanks since the 1970s have been advocating a privatised NHS, and while faces and administrations have changed over the intervening years the objective has not. The Central Policy Review Board and Nicholas Ridley – architects of so much of Margaret Thatcher’s mischief – may be history, but their legacy is continued through groups such as The Initiative for Free Trade, which recommends that in the aftermath of Brexit, American healthcare companies should be allowed to compete with the NHS to run our hospitals. And our dear cousins over the pond happen to have the most expensive, inefficient and unequal health service in the developed world.
A future Labour government will give the NHS the funding it actually needs, and the proposed Reinstatement Bill will make sure that it – and all the associated services that have been disastrously outsourced – return to public control. In the long term the savings, and benefits to its staff, practitioners and the public, will be massive.
Our NHS has been an incredible, glorious achievement. We must pull out all the stops to prevent the Tories from trashing it.