Link to this page: http://www.socialistparty.org.uk/issue/743/15739
NHS: Condition critical. Prescription: mass action to end all cuts and privatisation
Every area of the National Health Service faces crisis as the government financial squeeze threatens thousands of job losses and closures of hospital departments.
Private firms now treat one in five patients with certain conditions.
As campaigns against cuts are launched in local areas, Jon Dale argues that a bold strategy is needed to see off these attacks.
NHS jobs are disappearing - 750 are now threatened in Rotherham. Over 1,000 nursing and other jobs are threatened by the closure of 24 out of 30 NHS Direct call centres.
Increasing commercial competition from private healthcare companies, and takeovers of NHS services by private companies, are leading to fragmentation of healthcare.
Patients will suffer as services are run by businesses, out to make profits for shareholders who don't see other areas ripe for profitable investment.
A recent Kings Fund report says: "It is not going to be a case of shaving a bit off how long patients stay in hospital to save a few pounds.
"Most hospitals have already reduced their agency nurses, put off repairs and immediate things that save money, so what is left?...
"Only the big things like large-scale reorganisations of A&E and maternity services across whole cities, which is clearly much more difficult to do."
Some trusts are already bankrupt or on the verge of bankruptcy. South London NHS Healthcare Trust has been spending over £1 million a week more than its income.
Administrators have been sent in to replace top management and recommended that the trust be broken up and either run by neighbouring trusts or offered to private companies.
Both options would lead to big cuts, including closing at least one hospital. 39 organisations are interested in running parts of the trust, including Circle, Care UK, Serco and Virgin Care.
Circle, recently given a contract to run Hinchingbrooke Hospital, identifies 32 other trusts as "a growth opportunity". These trusts' annual revenue is £8.2 billion.
Sherwood Forest Hospitals NHS Trust is threatened to 'run out' of money by January. Private Finance Initiative (PFI) costs for its £396 million hospital rebuilding project have leapt from an already massive £1.26 billion to £2.05 billion.
The Department of Health (DH) has had to bail out seven trusts such as Barking Havering and Redbridge, which needed £55 million last year to stay afloat.
Peterborough and Stamford needed £41 million. The DH already faces a £1.5 billion bill to bail out trusts with PFI problems - equivalent to £60 million a year.
Some MPs now say what socialists have been arguing for over 15 years! "We are concerned that the financial viability of a number of trusts is being undermined by the fact that they are locked into unaffordable PFI contracts," says the Public Accounts Committee. "It is unclear how the Department will continue to underwrite payments once most of the money moves to the NHS Commissioning Board." This is due to take place next year.
This national crisis demands emergency national action to save the NHS as a national service, available to everyone without charge.
Strong local campaigns in every community threatened by cuts and closures must be built, but must not be left alone to fight for the scraps left on the plate. Arguing for the axe to fall elsewhere will not save the NHS.
Local campaigns should oppose all cuts and privatisation. Where medical advances are used to justify cuts, for example because new techniques avoid hospital stays, campaigners should demand any money saved is used to improve other local parts of the service.
'Patient safety' is also used to justify cuts, eg shortages of specialist doctors and other healthcare professionals leading to their concentration in fewer centres.
This has been the case with the children's heart surgery centres and decisions to close local Accident and Emergency and maternity services.
The safety argument must be taken seriously, but figures comparing one hospital with another do not measure the risks to ill or injured patients from travelling long distances.
Health trade unions should take the lead to organise local campaigns. The National Shop Stewards Network is campaigning to put pressure on the health unions' leadership.
Health workers want to defend the services they provide. They are threatened by job losses, pay cuts and worsening work conditions, seen most clearly in the South West region.
All financial accounts should be open to trade union and community inspection. Let's see where our money is going, without 'commercial confidentiality' arguments being used to justify secret deals.
All trade unions should link local campaigns together into a national campaign to save the NHS. Trade union members and their families (whether NHS workers or not) are threatened.
In the absence of a national lead, health workers may lack confidence to take on the government alone.
The TUC must urgently organise and campaign to build a 24-hour general strike, which many health workers would join, while maintaining emergency services.
Trade unions and health campaigners should call for full renationalisation of all privatised parts of the NHS and all PFIs.
Debts to big corporations and banks should be cancelled, with compensation only in cases of genuine need.
The whole NHS should be democratically run by health workers' and community representatives, instead of appointed, highly-paid directors aiming to hand over more and more to profit-making corporations.
NHS doctors organise new political party
A 24-hour general strike, with more action planned to follow, could split the coalition government apart and lead to a general election.
Then the question would be, who would rebuild the NHS as a national publicly owned service? Ed Miliband was booed at the 20 October TUC demo for saying a Labour government would continue with cuts.
His one real cheer was when he said Labour would "end the privatisation experiment." But why was the previous government that he was in carrying out this "experiment"? Why have some of his former colleagues in that government now got lucrative jobs in the private healthcare industry? Does 'One Nation Labour' include these parasitic companies?
There is no sign that Labour plans to renationalise already privatised parts of the NHS or the PFIs. Labour could have killed off Lansley's Health and Social Care Act by announcing that a future Labour government would renationalise, without compensation, all areas of the NHS taken over by private companies under this Act.
A group of doctors and academics recently announced the formation of a new political party, National Health Action (NHA).
One leader is Dr Richard Taylor, who twice won a seat to parliament as an independent opposing Kidderminster hospital's closure.
NHA say they will "give voters the opportunity to have the patient choice they have never been offered - to reject the dismantling of the NHS." They rightly say: "The Labour Party's record on the NHS is also poor.
"It helped open the door to the exploitation of the health service by commercial providers.
"Privatisation and commercialisation waste vast amounts of public money by diverting into shareholder profits and fees and payments to lawyers, accountants and administrators.
"It will increase costs and transfer risk from the wealthiest in society to the poorest and most vulnerable."
They note "public money has been lavished on supporting the financial sector to the detriment of public services... money could be found to fund and sustain an excellent health service for all, if we had an economy that was not structured to serve the demands and greed of the top 1% wealthy."
NHA plans to stand against prominent coalition MPs but have not ruled out opposing one or two prominent Blairite privatisers.
Hopefully it will coordinate with the Trade Unionist and Socialist Coalition to maximise opposition to destruction of the NHS.
A political alternative to the big business-backed parties would encourage workers and community activists that the fight to save the NHS can win.
Socialists argue that the money for the NHS should come from the wealthiest, but also by rooting out private profit, including nationalisation of the pharmaceutical and medical supplies industries.
The Socialist says:
- No cuts, closures or job losses in the NHS!
- Kick big business out of the NHS. End PFI and cancel the debt
- For a 24-hour general strike to defend the NHS
- For a campaign of opposition centred on the trade unions
- Local campaigns should work with health unions, patients' organisations, GPs opposed to the changes, and the public, to save the NHS
In The Socialist 21 November 2012: