Link to this page: http://www.socialistparty.org.uk/issue/389/4402
Big business plunges NHS into crisis
LABOUR'S ELECTION manifesto declares that "Whenever NHS patients need new capacity for their health care, we will ensure that it is provided from whatever source."
So their plans are clearly for more privatisation and more involvement of the private sector in providing care for NHS patients.
Socialist Party members involved in the NHS all over England and Wales explain the consequences of these policies and how to fight them.
THERE IS an unprecedented crisis in the NHS trusts in the West Yorkshire area. Patients are suffering as hospitals close wards, cut staff and make bed closures, in an attempt to balance massive budget deficits.
Jackie Grunsell, NHS worker
In the Leeds NHS trust £16 million-worth of cuts proposed by April this year, have so far led to several ward closures in the local hospitals. Staff recruitment has been frozen, with a block on overtime and a ban on buying-in agency nursing.
Around 150 vacancies arise at the trust each month, which will now not be filled. Nurses report that cover on the wards is at dangerously low levels. There are now no job placements for nurses currently finishing their training at Leeds university.
This is at a time when their skills are badly needed at hospitals across the city. The loss of beds has led to care in the community being stretched to breaking point.
The funding crisis has speeded up the decision to close a small, well-loved hospital to inpatient care, with the loss of 174 beds. It seems likely the land will be sold for housing development. The fate of a local cancer care hospital also hangs in the balance.
Despite Trust bosses' claims that cuts won't affect frontline services, it is clear to everyone this is already happening. Pressure from staff and the community is building and has managed to stop proposed theatre closures so far.
Just down the road in Bradford a similar situation has arisen. The Royal Infirmary there was celebrating gaining Foundation status in April last year, meaning it could supposedly control its own budget independent of central government. A few months later the trust was plunging into debt, which now exceeds £11 million.
Monitor (the hospitals regulator) forced the trust to commission a report into the crisis and how it could be alleviated. Monitor appointed a New York company who appeared to understand little about the workings of the NHS and proceeded to charge £160,000 for the report.
Far from easing the effects of the crisis, they appear to have made things worse. They have certainly not prevented the bed cuts and another 230 job losses are now expected. There is a freeze on staff recruitment despite shortages.
The hospital has stopped providing 'unnecessary' snacks for patients between standard meal-times. They have stopped using security guards to patrol the car park at night, leading to a female doctor being attacked as she left work. There are shortages of clean linen and basic equipment, with staff working under extreme pressure.
Despite the desperate situation, the government have effectively washed their hands of Bradford. Health secretary John Reid has said he will not intervene as the 'independent status' of the trust means they can't be helped.
THE WORST affected by debt in West Yorkshire is the Mid Yorkshire trust, comprising Wakefield and Pontefract hospitals.
They are making up to £34 million 'cost efficiency' savings over the next 16 months. In order to obtain the privately financed new hospitals development deal, the trust is aiming to get rid of at least 100 beds.
There have been suggestions that the burns unit and possibly the spinal unit could close with the loss of vital services to the whole region. However, trust bosses are playing things very close to their chests, claiming they can't disclose the full extent of the planned cuts due to commercial confidentiality.
It looks likely that the Pontefract hospital will close to most inpatients who will be forced to move to the Wakefield site.
So how on earth has the situation got so bad in West Yorkshire? There is no doubt government under-funding, combined with local mismanagement, is to blame. Attempts by trusts to move towards Foundation status or obtain Private Finance deals have added to the financial burden at the expense of patient care.
The New Labour government is making the public pay for less services, to line the pockets of private profiteers. Meanwhile health workers are expected to treat more patients, quicker, with less beds!
We demand these hospital trusts open the books so the public can see where their money is really being spent. There should be no 'commercial confidentiality' cover-up of the finances and no profiteering from health care.
New hospital developments must be fully publicly funded and controlled and properly staffed. The government bailed out Railtrack, a private company, to the tune of billions when it fell into crisis.
It should immediately do the same for the NHS, cancelling debts owed by these hospitals. Foundation hospitals should be fully integrated back into the health service. We call for democratisation in the NHS which should be run by workers and the community for their benefit, not that of the fat cats.
Private Finance Initiative (PFI)
Laughing all the way to the bank
THE PRIVATE Finance Initiative (PFI) was originally thought up by the Tories to please their pals in the construction industry but it has now been enthusiastically embraced by New Labour.
Under the scheme, banks, construction and other companies raise money to build hospitals and other public facilities. This costs anything between 1% and 4% more than the costs of public borrowing.
The hospitals are then leased back by the public sector over 30 years or more. But after all this time and all this payment of public money, the PFI hospitals will still be owned by the private companies, not the NHS.
The advantage to the government is that big business are given a nice little earner whilst the whole costs don't show up as a public debt.
The disadvantages are that the NHS has to pay for decades for buildings it will never own and which are designed to suit big business, not the changing health needs of the population.
The NHS has to pay for these schemes out of current revenues, so the new buildings are smaller so that beds and staff numbers can be reduced.
Each PFI hospital scheme therefore comes with its own targets for treatment and bed occupancy rates which are nothing to do with the current or forseeable health needs of the population. PFI hospitals are therefore more expensive, smaller and have to be used more intensively to meet the targets dictated by the private sector.
The private companies involved in these schemes make handsome profits without bearing much risk. In a report produced for UNISON last year, it was found some shareholder profits are 61% higher than that agreed in the PFI contract. And that when PFI schemes run into trouble, they are bailed out from the public purse, whilst the directors and shareholder laugh all the way to the bank.
Trade unions fight back
THE THREAT of action over pay by workers at the Norfolk and Norwich University hospital has forced one of the biggest companies running privatised NHS services back to the negotiating table.
A concerned NHS worker
UNISON members employed by Serco threatened to strike on 30-31 March. Serco then offered a derisory £5.00 per hour, backdated to October 2004, and £5.20 from April 2005. Members have rejected this and UNISON have recruited 100 new members in the space of 48 hours.
The Norfolk and Norwich University hospital was one of the Blair government's PFI forerunners. The building and site are owned by Serco and leased by the hospital. All maintenance, porters, cleaners and catering staff are employed by Serco.
Serco began as a 'facilities management' company, more than 30 years ago, when it was awarded a contract to run the missile warning system at RAF Fylingdales in Yorkshire!
Serco employs about 20,000 staff throughout 30 countries. They specialise in taking on public services. Keeping costs down inevitably involves making workers reapply for their jobs, cutting staffing levels, or employing workers on short-term temporary contracts, not to mention trying to get away with paying their workers the very lowest of wages.
Working for the NHS I have seen a progressive deterioration of the quality service that was once offered. Staff morale is being eroded by the quangos and middle management employed, often on extortionate salaries, to saturate the NHS with unnecessary bureaucracy and 'initiatives'.
Staff and workers can make a difference, as is evident from the threatened strike action by workers not prepared to accept the measly offers made by their employers.
The NHS was set up for the benefit of people of this country, regardless of status. Let this government or the Tories have free reign and you can kiss the NHS goodbye and welcome a two-tier health service - those who can afford treatment and those that cannot.
Messages of support to: Harry Seddon, Branch Secretary, UNISON, The Norfolk and Norwich University Hospital NHS Trust, Colney Lane, Norwich, NR4 7UW or harry.seddon@ nnuh.nhs.uk
Costs rocket for Birmingham hospital
THE FRONT-PAGE story in the Birmingham Evening Mail on 17 March was about the trebling of the cost of the proposed 'super-hospital' for South Birmingham.
Clive Walder, Birmingham
This is replacing the existing Queen Elizabeth and Selly Oak hospitals at a cost of £1.75 billion.
For all this money, the city will get an extra 39 beds, despite projections of a doubling of the over-85 population in the medium term. The only thing super about this is the profits that the company building the hospital will get.
Super-bug because of super-pressure
THE NATIONAL Audit Office estimates that about 5,000 people die every year as a result of hospital-acquired infections like the so-called superbug MRSA. They say the figure could be a lot higher though, because hospitals don't collect data on all these infections.
MRSA hit the headlines again recently after it caused the death of a new-born baby in an Ipswich hospital. After an investigation, consultant microbiologist Dr Philip Jones said: "I think the pressures on the hospital, because it is running at such a high bed occupancy, are making it very difficult for us to do everything possible to limit MRSA... With the hospital being as full as it is, what we can not always do is segregate patients who have MRSA from other patients."
So it is not just the privatisation of cleaning services, with the resultant cuts in staff numbers, training, pay and working conditions that has contributed to the rise in these infections. The way that hospitals are forced to run now is making it harder for staff to control infection.
A senior infection control nurse at Ipswich Hospital explained: "When the turnover in the ward is very high, when you are striving to get people through the system, then these time issues become very strained...People have to have the time to do things properly and sometimes we don't always have that time."
The intensification of the pressure on hospitals to meet targets, without the resources to do this properly, is putting people's lives at risk. New hospitals built under the Private Finance Initiative (PFI) invariably have fewer beds than the hospitals they are built to replace. This puts more pressure on fewer resources - and leads to practices like beds in maternity wards being used for people undergoing emergency surgery - putting very sick people in close contact with new-born babies.
No case for treatment centres
ONE OF the most damaging effects of dragging the market into the NHS is that hospitals are forced to compete with each other for patients. And it is clear that New Labour intend to use more private facilities to treat NHS patients. At the moment, 4-5% of operations are carried out in the private sector. Health secretary John Reid has revealed this is planned to rise to 15%.
But in addition, NHS and private 'treatment centres' have put existing hospitals at risk of closure. 30 treatment centres and two mobile units exist at the moment to provide 'fast-track' treatment like hip and knee replacement and cataract operations. A further 17 NHS-run centres are due to open in 2005 and 34 private-sector units are also planned.
The British Medical Association warned the government that treatment centres would lead to ward and operating theatre closures and job losses. This is now being borne out by the threat of the closure of Charing Cross hospital in London. The hospital is faced with a £100 million bill to upgrade its buildings but has debts of £37 million because of losing 'trade' to treatment centres.
Three years ago Charing Cross bought a private hospital for £14 million so it could carry out thousands of hip and knee operations. But it has had to close one ward and only 40 of its 116 beds are being used.
These debts and the fact that the hospital is on a prime Thames-side site has led the highest-paid trust executive in the country - Derek Smith on £210,000 a year - to propose closing Charing Cross to rebuild the nearby Hammersmith hospital.
All this was supposed to have been kept quiet until after the general election.
Socialists standing to defend the NHS
MICK GRIFFITHS, the secretary of the UNISON branch which covers the Mid Yorkshire trust, is the Socialist Party's candidate for Wakefield in the general election.
"We've been campaigning for the last ten years against the privatisation of Wakefield and Pontefract hospitals. 35,000 people have signed a petition against the Private Finance Initiative (PFI) scheme.
The proposed deal will mean over one hundred beds being cut - but a lot of the details are secret, with the company claiming commercial confidentiality. We're aiming to expose the wheeling and dealing through the union and with a political campaign during the general election.
They are already shutting down wards and closing beds as preparation for the PFI - people are afraid they are going to lose their job if they protest. There is already over a £50 million deficit that the Trust are trying to claim will be wiped out by the new hospital but we know that it will cost us more money in the long run for less services."
ROB WILLIAMS is the Socialist Party's candidate in Swansea West.
"We've been the main party campaigning against the health crisis in Wales.
Swansea has the biggest waiting list in Wales and Wales has got the longest waiting lists in Britain. So it's important for us to campaign for decent health facilities and against the privatisation and cuts which are undermining the health service. We've campaigned over the past two years about the maternity unit in Neath and Port Talbot hospital and the downgrading of casualty at Singleton in Swansea."
GRAEME JONES is standing in Bristol North West, campaigning against hospital cuts and closures in the city.
"It's a scandal that MPs feather their nests while chopping our services.
We need ordinary people in Parliament, living on a workers' wage.
That's why I'm standing. Please support me."
A SOCIALIST policy for the NHS would mean the immediate end to all privatisation and a reversal of all the privatisation already introduced.
The NHS should be democratically run with the full involvement of NHS workers and users.
It should be fully integrated - between hospitals, primary care, community care, social services, dentistry etc.
A socialist government would redirect money currently spent on war and occupation into the health service.
The nationalisation of the pharmaceutical and other companies currently making super-profits out of the health service would release billions.
At the same time, measures to increase living standards - like a decent income for everyone, including pensioners, good quality housing, a shorter working week and free sport and leisure facilities for all would massively improve people's health. At the moment low-paid workers are almost three times as likely to suffer chronic ill health as highly-paid managers.
- No more privatisation.
- Reverse all privatisation in the NHS. Rebuild it under democratic control and free at the point of use.
- Nationalise the pharmaceutical industry and the medical supply industry and integrate them into the NHS.
- A minimum wage of £8 per hour and a 35-hour week for all health service workers.
- Abandon PFI. Fund new hospital building programmes through central government, using direct labour.
- Massively increase spending on health care as part of a socialist planned economy.
In The Socialist 21 April 2005: