The British National Health Service (NHS) turns 70-years-old this year, on 5 July. Festivities are planned across the country to celebrate perhaps the greatest achievement of the 1945 post-war Labour government. And rightly so. The NHS continues to provide care free at the point of delivery. It is, in essence, the embodiment of a socialist approach to healthcare: free and universal.
Activists from the IMT's British section, Socialist Appeal, will be joining a demo on Saturday in London, as thousands march to defend the NHS. 70 years on from its inception, the NHS isn’t in ripe health. In fact, it is currently on the critical list, in need of life support.
Chronic underfunding, a massive expansion of the private sector into healthcare provision, and a demoralised, underpaid workforce have combined to put the NHS in grave danger.
Without a fundamental change in how the NHS is organised and funded, it will cease to exist, as we know it.
Private companies continue to vie for ever-more lucrative contracts, putting the nation’s health into the hands of profiteers and shysters.
In 2016-17, private care providers were awarded 267 out of 386 clinical contracts, worth a total of £3.1bn. Richard Branson’s Virgin Care is now the largest private company in the NHS, with over 400 contracts worth around £1 billion. Such is Branson’s caring nature that, after losing a recent contract bid, he successfully sued the cash-strapped NHS for £1m!
NHS Trusts ended the last financial year with a deficit more than double that expected, amounting to almost £1bn in the red. Hospitals have been forced to seek further “efficiency savings” just to try and maintain current levels of care provision. This means essentially cutting services to stay afloat.
The knock-on effect impacts upon everyone – patients and staff alike. Trust Executives move staff around at a moment’s notice to plug gaps in services and endlessly restructure services. They also seek to discharge patients from hospital as quickly as possible, often without adequate care provision in the community.
In my own experience as a nurse, I regularly see my colleagues in tears as a result of trying to provide good care with minimal resources; upset at how they have been treated by management. Many of my friends and colleagues, often with years of experience and dedication to the NHS, have left or are planning to leave the service.
This is due to the daily pressures of trying to provide excellent care for sick and vulnerable people, while service managers chivvy and berate us to discharge patients and ‘improve flow’. This is a scenario replicated up and down the country as the NHS creaks at the seams.
But staff have just received a huge pay rise, right? Not so.
The majority of NHS staff are to receive a 6.5 percent pay increase spread over three years, which is below the expected rate of inflation for the same period. In effect, then, we are receiving a pay cut!
13 out of 14 health unions voted to accept the deal, with only the GMB (relatively small in the NHS) urging its members to reject it. Over 80 percent of GMB members rejected the deal and are now in the process of deciding what action to take.
The remaining unions – the largest of which are Unison, Unite and the RCN – all recommended that their members accept the deal as the “best that they could achieve under current circumstances”. This despite the government being in total disarray on every front.
The Tories had been forced onto the back foot by organised health workers, who had successfully demanded an end to the public sector pay freeze. But now the energy and momentum have been squandered. Thousands of union members are furious that union bosses frittered away an opportunity for a real, inflation-busting, no-strings-attached pay deal.
Make the rich pay for this crisis
This month’s NHS funding announcement by the government – cynically timed to coincide with the NHS birthday celebrations and to distract from the Tories’ woes – is an uncosted fantasy. There is talk of a “Brexit windfall”, which even the government’s own ministers have described as “tosh”. Increases in taxation are being mooted as another option alongside possible increases to national insurance.
This all feeds into the narrative that the NHS is unsustainable and unaffordable and that private insurance is ultimately the only way forward. Especially since many private health insurance companies are circling like vultures for the anticipated introduction of Accountable Care Organisations (ACOs): the government's plan to hand over entire regional services to a single (likely private) company.
But of course, nobody mentions the fact that the costs facing the NHS are rising precisely because of the eye-watering profits made by private drug providers and big business healthcare equipment firms. Or the fact that it is the crisis of our privatised social care system that forces hospitals to look after elderly patients, exacerbating the shortage of beds available.
Instead of pay cuts, tax increases, and privatisation, therefore, we should be demanding that we extend the boundaries of the national health service. Get rid of fat-cat managers and consultants! Nationalise big pharma! And bring social care under public control!
People vs profit
The prognosis is not good for the NHS in Tory austerity Britain. At 70 years old, it should be thriving and looking forward to providing free and universal world-class care well into the future. Instead, it is teetering on the brink, driven to virtual destruction by the vermin who put profit before people.
Tony Benn once said:
“It’s about whether our society puts people in a place of dignity and serves them, or whether you just hand over the money to gamblers who don’t create any wealth at all.”
The crisis in the NHS is a symptom of the wider crisis of capitalism. Only through a bold, radical, socialist alternative, where the wealth of society is in the hands of the many, can we achieve a world that does indeed put all people in a place of dignity.