- National union-led mass demo now!
- Strike action can save our health service
Roger Davey, Chair, Wiltshire and Avon Unison Health (personal capacity)
In April the government’s Health and Social Care Act comes into force, and with it, the potential destruction of the NHS.
It is the culmination of a series of reforms by successive governments – Tory, Labour and now the Con-Dems – that aimed to introduce a privatised system of healthcare, where the market allocates resources, and illness becomes a source of huge profits for ruthless multinational companies.
In essence, the Act will end the government’s duty to provide comprehensive free healthcare for all, and will also mean the NHS is free from parliamentary control.
Instead, GP-led Clinical Commissioning Groups (CCGs) will control finance, have the freedom to decide who they treat, who provides the treatment, and what is free at the point of delivery.
CCGs will increasingly seek to take on healthy individuals whose needs are minimal, rather than the more vulnerable who would require numerous referrals and expensive care.
We are likely to end up in a situation where CCGs pick and choose who they want as patients, in a system that bears little resemblance to the NHS established in 1948.
With NHS finance being drastically cut, CCGs will increasingly look to restrict the provision of free care, with patients having to take out private medical insurance in order to access treatment.
Personal Care Budgets
With the advent of Personal Care Budgets (PCBs), individuals could transfer all their funds into the hands of a private insurance company. Many CCGs would be left with fewer patients and therefore face bankruptcy.
CCGs will be compelled to purchase care within a competitive health market, where major private health companies will seek to undercut the NHS in order to win the more lucrative contracts.
The only NHS organisations remaining will be Foundation Trusts that can give private treatment to 49% of patients and are also vulnerable to takeovers and mergers.
In short, what we are seeing is the end of the NHS, and the establishment of a US-style system, where provision of care is provided by the private sector, with one level for the wealthy, and a basic substandard one for the rest of us.
Alongside privatisation, unprecedented financial cutbacks will see wards, services, and even hospitals close.
But these attacks can be stopped. The Unison health workers’ union should launch a massive national campaign, utilising the huge potential power of the trade unions and working class communities.
Changing the wording of CCG constitutions, or a few meaningless concessions from the government, will not fundamentally alter the drive towards privatisation.
We must demand not just the complete abolition of the Act but the end of all cuts and privatisation in the NHS.
The first step in a struggle that has the potential to defeat austerity itself, should be a national demonstration followed by industrial action to defend every part of the health service from the threat of both privatisation and financial cutbacks.
