The NHS is teetering on the brink of privatisation. We must stand up for it

 

 

This article first appeared in The Guardian's Comment Is Free section on 11/03/15.

 

In 2012 the secretary of state’s legal duty to provide NHS services was severed and the structures for destroying the NHS were put in place. Today, with the general election around the corner, we are presenting a cross-party bill in parliament to stand up for the NHS we are all so proud of. The NHS that was such a defining part of our identity during the stunning opening of the 2012 London Olympics. The NHS that was ranked as one of the best health services in the world in a 2014 study.

Our much-loved service is in danger. Thousands of jobs have been axed, including more than 4,000 senior nurses. More than 50 of the 230 NHS walk-in centres have been closed and 66 A&E and maternity units have been shut or downgraded. On top of this, the future mandated by the 2012 act is one where all hospitals in England that we think of as NHS hospitals only have to be 51% NHS – and 49% non-NHS. Why would anyone pay if they could get exactly the same on the NHS? This is setting up a queue-jumping service for the better-off.

The private sector is circling – there is, after all, a very tempting prize to be picked off – an annual NHS budget of £120bn. Private health firms already pocket £18m a day – that’s £6bn in the last year – from the NHS budget. More than 170 GP surgeries are run by corporations. Today, if you call 999 it could be a private ambulance crew that comes to treat you. Based on the trends that these figures show, private firms are on course to net £9bn of the NHS contracts that are up for grabs. The direction of travel is plain to see.

The inescapable truth is that the private sector is camping out on the lawn of the NHS, cherry picking. Even Norman Tebbit pointed out the dangers of this, and wondered how young NHS surgeons would learn if the private sector had nicked all the easy stuff. This is a problem that is getting worse, but it is not new. Private hospitals’ share of NHS-funded patients grew rapidly between 2006 and 2011. By 2010-11 private companies performed 17% of hip replacements, 17% of hernia repairs and handled 8% of patients’ first attendances in relation to orthopaedics or trauma, such as a broken limb.

But we know the private sector avoids the chronic long-term, complex conditions and, when it does try and take over, it fails – Hinchingbrooke hospital being the latest example. Last week, Michael Sheen rightly made a blistering NHS speechcalling on anyone with any political power or influence to stand up and to fight for the equality, fairness and compassion that our NHS was founded on. The bill we present today, to reinstate the NHS, is an attempt to do just that. It is the culmination of months of hard work and consultation by campaigners, grassroots keep-our-NHS-public groups and health experts, led by Prof Allyson Pollock and barrister Peter Roderick.

That’s why our bill is guided by the principles of the National Health Service Act 1946, and reinstates the secretary of state’s duty to provide services throughout England. As it stands, without this duty and with the other 2012 changes it is now legal for NHS England to be whittled down to a core service. We are on the precipice. This is because, under the 2012 act, the list of services that foundation trusts must provide after April 2016 will be reduced.

The NHS must be the provider if it is to avoid being reduced to a set of bidding wars that leaves its heart hollowed out

Senior health service managers from the NHS Confederation are already warning we may need “hotel fees” for hospital stays. Unless we act now, services will be restricted, people will go without care or will end up with private health insurance, charges or co-payments. The NHS reinstatement bill would put a stop to this once and for all, while also stopping costly market mechanisms that are frittering away NHS money that could be spent on patient care. Administering the artificial “marketplace” that has been created over the last 25 years is hugely wasteful.

The NHS must be the provider if our health service is to have coherence and avoid being reduced to a set of contracts and bidding wars that leaves its heart hollowed out and resources wasted. In March 2010, just before the last general election, the respected health select committee found that running the NHS as a “market” cost the NHS 14% of its budget a year.

In the pre-market late-80s, the NHS spent only 5% of its budget on administration. On that basis we are wasting 9% of a £120bn budget. That’s more than £10bn down the tubes. The committee concluded its report by saying that “after 20 years of costly failure, the purchaser/provider split may need to be abolished”. They were right then and the case remains ever more urgent today. As we present our bill, today also happens to be NHS Change Day celebrating the solidarity and co-operation in the NHS. Our bill is drafted to enable a grassroots, bottom-up reinstatement of a public NHS, guided by exactly those people sharing ideas and best practice today. Scotland has done it, so why can’t we?

A national service has to be about whole systems, not isolated institutions. In 1946, Bevan and those who fought for and created our NHS did so following six years of toil and unimaginable sacrifice. What the founders of our NHS achieved was radical and far-reaching and they did it in the face of strong opposition. So can we.

The NHS bill 2015 is co-sponsored by Caroline Lucas, MP for Brighton Pavilion (Green), and Andrew George, MP for St Ives (Liberal Democrat).

 

Join The Discussion