HOSPITALS ACROSS London will close, accident and emergency departments will be lost, and thousands of beds will go. So says NHS London, the strategic health planning authority for the capital. The British Medical Association warns of £5 billion cuts in London’s health services in a report called “London’s NHS on the Brink”. What is posed is a wholesale ransacking of the NHS by private companies, accompanied by dramatic cuts.
Paula Mitchell
David Cameron’s advertising hoardings claim: “I’ll cut the deficit, not the NHS”. All the main parties would have us believe that the ‘savage cuts’ they all propose will not touch essential frontline services such as the NHS and schools.
This is a lie. All the big business parties promise to ‘deal with’ the historically high government deficit, £178 billion this year, and they are determined to do this by making working-class people pay.
For the rich to be let off the hook, frontline services will have to be savaged. Even the head of the Audit Commission, the spending watchdog, has declared the idea that the NHS and schools can be protected as “insane”.
Initially it could be that there are not actual cuts in the NHS as such, but a freeze on spending. This amounts to a cut, because health costs steadily increase.
Some would say that the NHS is a bottomless pit and there simply isn’t enough money to keep pouring in. This is a difficult argument to sustain when the bankers are taking home £60 billion in bonuses in the same city that faces £5 billion NHS cuts!
And there is a simple reason why health costs are high – profit.
Private interests
It has always been the case that huge sums of money are sucked out of the NHS by the pharmaceutical companies.
For some years now, health costs have also increased due to the profits leeched by building and supply companies through Private Finance Initiative (PFI) and other privatisation projects. PFI was the Tories’ brainchild but was carried on with a vengeance by New Labour.
To take the cost of construction of new buildings out of the government’s public borrowing figures and give money-making opportunities to their big business friends, contracts are awarded to private companies to do the work. The NHS then pays the company for use of the building or services over a period of years.
Once the contract is entered into, it is difficult to break without incurring large penalties. But it means that the cost to the NHS escalates beyond all proportion. According to the British Medical Association in London, works costing £2.65 billion will ultimately lead to total payments of £16.7 billion.
Costs are also escalating because of the profits grabbed by private service providers. Currently around £7 billion of NHS money a year is spent in the private sector, with, for example, contracts given to private firms to provide cataract operations (paying for a certain number of procedures whether or not they actually carry them out).
But this privatisation could dramatically increase. From 2007, private companies have been invited to tender for primary care in the NHS, which accounts for 80% of the NHS budget. These issues have already been the focus of local campaigns.
In Tower Hamlets, for example, patients, health care workers and members of the public have protested at GPs surgeries being handed over to multinational private company Atos Origin. In Camden, American firm United Health runs three GP practices, and another company called Care UK has been offered a health centre.
Warning given
BEHIND THE devastating changes proposed for London’s NHS is the Darzi framework for London. Two years ago when this report was first launched, we warned: “The re-organisation of London’s health service is really about saving money and opening the door to private health companies to buy up a cost-effective and very profitable London health service” (The Socialist, 21-27 February 2008).
London district general hospitals will be downgraded to local hospitals and polyclinics, losing A&Es and other services. Services will be concentrated into a handful of ‘specialist’ hospitals, so-called ‘centres of excellence’, across the city. This process has already happened in South East London, for example, where Queen Mary Hospital in Sidcup has been downgraded to a local hospital, and A&E and maternity departments have been closed.
We all want excellence in our services. But not when this ‘excellence’ is hiding huge cuts and privatisation!
Polyclinics, already spreading across the capital, mean that local GPs’ surgeries are merged into ‘super-surgeries’ offering a number of services that hospitals offered previously.
There is a tendering process to decide who will run these poly-clinics. Health bosses in Camden planned to close down four local practices in Bloomsbury and secretly courted a private company, Branson’s Virgin Healthcare, to run a polyclinic at University College London Hospital.
A few years ago campaigns sprang up all over the country when the government suddenly demanded that NHS Trusts had to balance their books. Many had run big deficits for years, made much worse by spiralling PFI contracts, and balancing the books meant big cuts.
Most of these campaigns have died down, and health bosses probably think they can push through these latest proposed changes behind our backs.
But as the article on King George’s hospital in Ilford (see right) shows, once the concrete reality of NHS cuts becomes apparent, campaigns in local areas have to be renewed. Once again we demand that there is a co-ordinated trade union response, linking up local campaigns, to defend our national health service.
The Socialist Party demands:
- Bring all health services into public ownership and rebuild the NHS as a publicly funded service free at the point of need.
- Remove the trusts, abolish the internal market, cancel the debts. Representatives of NHS workers, trade unions and health service users as well as the government should make decisions about how the NHS is run and what its priorities are.
- Abandon the Private Finance Initiative (PFI). No more profiteering by construction companies and banks. All new hospitals to be built with public funding using direct labour and not for private profit.
- Nationalise the pharmaceutical industry and medical supply industry under working-class control and management to end the massive amount these parasites drain from the NHS. Integrate these services into a democratically controlled NHS.
- Cleaning, catering and other services should not be run for profit.
- A minimum wage of at least £8 an hour and a 35-hour week for all health workers.
- A socialist programme to eliminate poverty and inequality – the biggest killers and causes of ill-health.
