Dave Murray, Essex Socialist Party
According to Tory health secretary Sajid Javid, the NHS is at a crossroads. If we keep doing what we are doing the costs of the NHS will devour the economy. It’s just too big. This was his message to the Royal College of Physicians on 8 March.
This is based on a factoid – in 2000 health and care spending was 27% of “day-to-day public service spending” and it will rise to 44% by 2024 – which is alarming, but misleading. In the real world, health spending slightly decreased as a percentage of the UK’s economy for a decade up to 2019.
For Javid, the current health and social care bill doesn’t go far or fast enough. Before the NHS can recover any kind of equilibrium at (hopefully) the end of the Covid pandemic, he intends to go for another round of shock therapy.
Javid claims that his reforms will be driven by the ‘3Ps’ – Prevention, Personalisation and Performance – a classic three-word slogan. Realists will find out that the reforms will engage with the slogan in a very twisted way.
‘Prevention’ will mean preventing people from seeing qualified medical practitioners – you’ll have to use the NHS app on your phone as the first point of contact, as well as the medium for screening, consultations, health promotion etc. In a situation where the Joseph Rowntree Trust sees “little prospect of reversing trends… of rising child poverty”, and where one-third of households may live below minimum income standards, there is no prospect of doing serious work on preventing ill health. Such work would have to tackle poverty head on.
‘Personalisation’: remember Javid is not a doctor, he is a banker, and his vision of personalisation is all about the money – patients will get a personalised health budget. They will be free to spend it anywhere in the NHS – or the private sector. What happens when your budget runs out is anyone’s guess. It is designed to corrode our NHS from within.
‘Performance’ is the third ‘P’. This does not mean that the outstanding performance of the NHS workforce will be recognised and rewarded with a decent pay rise. It means a leadership review, led by a man who commanded British forces in Afghanistan. Ask yourself how that went! This speech should be an alarm call for everyone who genuinely shares the vision of a free comprehensive public health service. It’s time to step up the fight to defend our NHS, and for a decent pay rise for NHS workers.
