Crisis in the NHS

The NHS and social care provision are in crisis, the latest monthly Labour Party all members meeting heard on Tuesday, February 28. The speakers attempted to explain what is happening to healthcare in England and why this current crisis has arisen.

David Burgess, firstly demonstrated that the NHS is suffering very low funding growth under this and the past Tory governments compared to Labour and pre-Thatcher administrations. He also showed that UK funding per patient is far less than the European average. David went on to provide an impressive analysis of Tory Party thinking on the NHS. He quoted from a 2005 pamphlet written by Jeremy Hunt, Michael Gove and Douglas Carswell (among others) which refers to the NHS as a “centrally run, state monopoly” and advocates that patients should be funded to choose for themselves between competing providers; another report from the 1980s written by Oliver Letwin and John Redwood looked to move the NHS out of direct control of government as a precursor to privatisation. David showed how the Coalition’s 2012 Health and Social Care Act essentially fulfils these policy objectives by making NHS England the controlling authority and demanding that services are selected from a market.

Richard Mithen talked about the local agenda and outlined the extraordinary extent of Virgin Healthcare’s dominance of Surrey health services, which many members were surprised by. Virgin currently run

  • Community Nurses
  • Community Matrons
  • Community Hospitals
  • Respiratory Services
  • Heart Failure Nurse
  • Diabetes Services
  • Parkinson's Nurse
  • Tissue Viability Nurse
  • Community Occupational Therapy
  • Community Physiotherapy
  • Community Phlebotomy
  • Community X-Ray Sites
  • Podiatry
  • Lymphoedema Services
  • Minor Injury Unit

For Richard the question is not so much, how can we prevent privatisation, but have we already lost the battle? It was also noted that Virgin Health was run by the husband of our local MP, Anne Milton, at the time that they won the original contract in 2011. Richard addressed the topic of Sustainability and Transformation Plans (STPs), explaining that their sole purpose is to cut costs but avoid any politicians taking responsibility for those cuts. His view, and that of many health professionals, is that the plans will not be remotely workable.

The NHS is in the process of making £22billion of ‘efficiency savings’ while services around them fall into crisis for a variety of reasons. This has led to a market view of health care provision, so hospitals are looking to provide profitable services and are less likely to want to offer the full range that might be expected from a district general hospital."

Brian Creese gave some brief details about another of the current Tory crises, social care. Unlike the hospitals, social care did not come into government control in 1948 and has always been with local authorities. This distinction has created increasing inequalities; while most health care (major and minor) is free at the point of use. Social care is heavily rationed and means tested. This leads to situations where people with dementia have to pay for their own care while people with cancer don’t. Both cases involve significant care needs but they get very different levels of assistance from the state.

There is widespread agreement that both budgets and provision of social care and the NHS now need to be joined together and ring fenced. This will be more efficient, but does not avoid the hard fact that spending on these sectors is likely to rise from the current 9.6% to 12% over the next ten years, so government has to find a way of paying for these services. The answer is not private insurance.

The widely-quoted deficit in social care spending of £4.6billion is derived from funding cuts, greater need and inflation. This figure is widely accepted by a range of professional bodies including the Association of Directors of Adult Social Services and the Kings Fund. The government’s ‘solution’ of a 3% precept on council tax will raise at most £900 million, less than a quarter of that needed. However, it will raise most money in wealthy areas where the social care needs are less. Add to this the plans for councils to retain business rates, which again will favour the wealthy areas, and we see that Tory policies will produce even greater inequality in the funding of social care.  

All agreed that the Labour Party must do all it can to prevent ever greater privatisation of health care services, change the system of social care funding to direct taxation and make sure that the NHS and Social Care systems work together to provide decent health and social care for all the population regardless of age and wealth.

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