Main parties have no alternative strategy

A London mental health NHS worker

Despite an underfunding crisis – against the backcloth of government austerity – a recent Kings Fund report shows the National Health Service (NHS) bearing up well and high patient satisfaction rates.

But this situation is not sustainable. The fact that the NHS appears to be performing well is because nurses and other staff are doing even more without any increase in resources.

There are layers of administration workers who are being asked to take on two jobs as staff and posts are axed to save money.

A Royal College of Nursing report showed that untrained health care assistants are being left in charge of wards and are being asked to carry out procedures that they are not trained to perform. This only comes to light when accidents occur and patients die. Sickness and absence levels are on the rise as staff reach breaking point.

Multiple A&E closures are leading to increased waiting times and hospitals are now regularly breaching waiting time targets.

Patients are left on trolleys in corridors as the casualty departments that have survived closure become increasingly over-crowded.

Costly restructures – which act as a cover for staff cuts and reducing services – are also draining the NHS budget. Staff and patients are quickly learning that ‘service redesign’ leads to confusion and reduced services, with higher thresholds for accepting patients.

Billions of pounds in ‘efficiency savings’ are being stripped out of the NHS every year. There is now a £30 billion funding black hole.

None of the three main political parties offer a strategy that is capable of rescuing the NHS. Their extra funding pledges of £2 to £3 billion won’t make up for the savage spending cuts since the coalition government came to power.

Private vultures

In spite of the funding cuts the private sector continues to do well. The NHS is increasingly used as a cash cow by private companies, with expensive Private Finance Initiatives costing the NHS £60 billion over time.

Figures from the Nuffield Trust indicate that the overall NHS drug budget has increased by 10% in 2014-2015, while spending on staffing has only increased by 0.15%.

Excellent care requires a holistic approach, resting on highly skilled staff working together.

Drugs alone won’t work. However, patients are consistently offered medicines more than any other therapy or treatment.

In mental health services, day centres are being shut because a private provider has won the bid and wants to introduce a ‘new model’ which ‘signposts patients to services’ rather than offering services directly.

Mental health service users die 15-20 years earlier than the rest of the population, so there is a drive to ensure that we offer basic physical health care and advice on smoking cessation, weight loss, diabetes monitoring, etc. This is a demand from the top, but without the training or additional resources needed.

People can be left on waiting lists for psychiatric services for months before they even get a first assessment and are batted back to the GPs as overstretched community teams struggle to cope with the complex caseloads we already hold.

Increasingly, the NHS is measured on how trusts perform financially rather than on the availability of care and how that care is delivered.

If patients are to continue to remain satisfied with the NHS, the profit motive that is seeping into the heart of care must be robustly challenged by the trade union movement and wider community.