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NHS - obliterated by Con-Dem plans, not 'liberated'
Using the cover of 'saving' money to pay off the budget deficit by reducing 'bureaucracy', the Con-Dem government is effectively proposing the wholesale privatisation of the National Health Service.
Cameron and Clegg aim to finish what Margaret Thatcher started in the 1980s and Labour enthusiastically continued.
These Con-Dem millionaires are seizing this opportunity to loot the NHS and hand over lucrative contracts to their millionaire friends in the City - the same people who brought the world economy crashing to its knees - as well as asking us to pay for their crisis through cuts in our jobs, our wages and our public services.
"Denationalisation" of health care
Andrew Lansley, the new Tory health minister has set out his government's plans to reduce the NHS to dust.
Seumas Milne, writing in the Guardian, summed up the proposals: "From a major public service with a million employees, [the NHS] will have become a central fund with a minimal workforce, commissioning services from a string of private companies in a fully-fledged healthcare market." He reported that Kingsley Manning of the health firm Tribal is looking forward to the "denationalisation of healthcare services in England".
In short, these plans mean the wholesale privatisation of the NHS.
Privatisation not participation
The media focus has been on the role of local GPs, who are currently self-employed, as opposed to being NHS employees, being handed the responsibility for much of the £100 billion health budget, possibly as much as 80%.
Lansley is proposing that consortia of GPs come together to run the health trusts, which will all be foundation trusts, ie privatised.
35,000 doctors could form up to 500 consortia which will then 'buy care' from local hospitals or other providers, including private organisations.
They will hire staff to manage these processes. While some have welcomed this proposal, Unison reports that around half of GPs are opposed. The NHS will become a so-called 'independent' commissioning board which would oversee and be charged with improving health standards.
It would have control of all the budgets.
The many losers and few winners
In June David Cameron warned that the Con-Dem cuts plans would "affect every single person in our country.
And the effects of those decisions will stay with us for years, perhaps decades to come." If these proposals for the NHS are realised the implications for patients, staff and private contractors are enormous.
The US model springs to mind. Because of the absence of a similar model to the NHS 40 million people in the US live and die without access to health services.
As usual the most vulnerable are most likely to suffer in a market-led system. Two-thirds of GPs say they lack the expertise to commission mental health services, according to Rethink, a mental health charity.
In his speech Lansley signed the death warrant for national pay bargaining and agreements: "Pay decisions should be led by health care employers rather than imposed by the government.
In future, all individual employers will have the right, as foundation trusts have now, to determine pay for their own staff." Tens of thousands of workers employed by the PCTs will be anxious that the oncoming wave of privatisation will mean deterioration in pay and conditions and/or job cuts.
On pensions he ominously said: "We ... remain committed to ensuring that pension solutions are found that are fair to the workforce in the health service and fair to the taxpayer".
The boss of Carillion, one of those companies that exists to pick up private outsourcing contracts, is said to have been "excited" at the prospects of the Con-Dems' swingeing cuts.
Such private contractors are now salivating. Bart Johnson, chief executive of Assura Medical, said: "We are enthusiastic about the reforms. Assura Medical already works with groups of GPs across the country providing a whole range of services." In June Assura announced that its group trading profit from continuing operations was up 155.8% to £13.3 million, before these measures kick in.
As is their wont the Tories and their Lib Dem supporters dress up the destruction of crucial and critical public services as developments in democracy.
This massacre is being sold under Lansley's slogan of "nothing about me, without me" to give the impression that patients would be central to future decisions.
But GPs will rely on private companies who are accountable to shareholders alone. The Tories sell this as a way of 'reducing bureaucracy' and they promise to cut spending on management by 45%.
But as Dave Prentis, Unison general secretary, said: "As most GP time is currently spent caring for patients, this means that they may have to resort to using a new tier of private management consultants or commissioning clusters - resulting in increased costs."
In the run up to this year's general election Tory leader David Cameron promised that funding for health would be ring-fenced and that spending would in fact go up at a rate a little above inflation.
The reality of this so-called promise has already been exposed by the RCN nurses' organisation. It has found 9,973 jobs that have been earmarked for redundancy, vacancy freezes, natural wastage, downgrading of job roles, or ending the use of temporary and agency staff.
The government has said that £20 billion of savings is required in the NHS by 2014. Lansley is also speaking with a forked tongue. He labours points about 'independence' and 'freedom from political interference' and 'consultation'.
In reality he and his coalition government of millionaires, who no doubt have the numbers of private Harley Street specialists on quickdial, plan to drive this bloody plan through over a two-year period.
During the general election campaign Labour candidates liked to dress themselves in the cloak of saviours of the NHS.
This was and is pure hypocrisy. Labour's 13-year reign saw the massive expansion of the internal market in the NHS while Private Finance Initiatives sucked up enormous amounts of public money, depositing them in the pockets of private, profiteering contractors.
Lansley's plan is but the next logical step. Privatisation of the NHS began under the Tories in the 1980s but was ramped up by Labour. They established Foundation Trusts, which can act like commercial companies, selling property and services, and borrowing money.
As of March this year the GMB union had identified around 640 current PFIs, with more than 100 new projects in the pipeline (across all public services).
The total cost was estimated at £250 billion over 25-30 years, four times the value of the assets built (£64 billion).
British PFI debt is equivalent to £8,400 per taxpayer.
Allyson Pollock wrote: "Over the last decade Labour encouraged primary care trusts - NHS bodies that planned and purchased care for their local populations - to turn to private-sector management consultants and for-profit healthcare companies to help them develop "commissioning" skills." Labour has so far provided no evidence that they will go beyond sound-bites in defence of the NHS.
Now that the government is talking about handing aspects of the health service to local government we will see how the many Labour-led councils challenge this along with fighting the Con-Dem cuts and defending jobs and services.
Evidence so far in councils such as Neath/Port Talbot and Kirklees is that they are more than willing to hand down cuts to local government workers and service users.
Save our NHS
While all three main parties agree wholeheartedly on the 'need' for private companies in the NHS the majority of public opinion wants the NHS to remain a public service.
An overwhelming 89% of the public agree that "public services should be run by the government or local authorities, rather than by private companies", according to a 2005 YouGov poll.
A mass workers' party that represents that majority view is desperately needed as part of the struggle to save the NHS.
In 2006 hundreds of thousands marched in towns and cities across Britain against cuts and closures of hospitals and health services.
Anti-cuts unions must appeal to health campaigners to participate. The Socialist Party calls for a national trade union-led demonstration against all cuts in jobs and services.
The slogans for this demonstration must include opposition to the destruction of the NHS and 'kick out the profiteers' as well as defence of all jobs, services, pay and conditions.
So far the TUC has not indicated that it will make this urgently-needed call. If it won't then a demo called by a 'coalition of the willing' unions must be supported actively by all those who want to defend the NHS from these prowling Con-Dem wolf-packs.
Ultimately capitalist politicians are saying that we can't afford the welfare state - a publicly funded health service, education system, benefits and pensions.
Yet in Britain alone they made £1.2 trillion available to bail out an economic system whose purpose is to create vast wealth for a handful of privileged individuals.
Meanwhile the majority lives in poverty. Now these politicians, acting on behalf of the obscenely wealthy, come back to the working class to ask for more.
We have to fight these attacks, but we also say that there also has to be an alternative, where all the wealth produced in society and the resources are owned and controlled by the majority and the distribution of resources is democratically planned; in other words a socialist society.
Further material will be produced on the different aspects of the proposals. The Socialist welcomes contributions from those who work in the health service and from patients who will be affected by these changes.