This Saturday, thousands of healthcare staff, trade unionists, and community activists will take to the streets to say: save our NHS! We publish here three letters about the crisis in the NHS, including two first-hand experiences from nurses on the front-line.
Join the demonstration in London this Saturday (3rd February), beginning at midday on Gower Street and marching to Parliament.
The NHS is in crisis – we must fight back
Graeme Hendry, Unison Shop Steward, Rochester & Strood CLP (personal capacity)
“What is Toryism but organised spivvery?”
So said Aneurin Bevan, the day before the NHS came into being on 5th July 1948.
Seventy years later and those words ring truer today then they’ve ever done. As the NHS is increasingly opened up to private enterprise, the health of the nation has become a gambling chip in the madness of the market. The priorities of these parasites lies in profits before service, quality, and standards.
I have worked as a nurse in the NHS for 20 years and what I am witnessing today is the most sustained attack on the NHS in its entire history.
The NHS is being starved of funding. The government claims that healthcare is receiving more cash annually. On the face of it, this is true. But, as always, the devil is in the detail.
Since the NHS was established, funding has traditionally risen on average by 4 per cent a year in real terms. Since the Tories came to power in 2010, however, the rate of funding has slowed to an average of 1.2 per cent a year. This is well below the required level needed to sustain the current levels of service for an ageing population.
According to the King’s Fund, planned health spending for 2018/19 will be at least £4 billion short of what is required. This will lead to an estimated funding gap of £20 billion by 2022 if current funding plans are adhered to. The King’s Fund state that for 2018/19, “[the NHS] will not be able to maintain standards of care and meet rising demands for service.”
The effect this is having on day-to-day services is proving catastrophic. Tens of thousands of people who are awaiting surgery for cataracts, knee, and hip repairs have had their operations cancelled.
In hospitals up and down the country emergency departments are full to capacity. People awaiting urgent treatment are stacked up in corridors on trolleys for hours at a time. Temporary partitions are employed to divide beds and provide a bare modicum of privacy and dignity. Elderly patients approaching the end of life are lying in cubicles in overrun departments, waiting for ward beds that are already occupied. Hospitals are forced to open poorly staffed and equipped ‘makeshift’ wards to cope with the demands. Delays to ambulance response times have led – in at least one high profile case – to an elderly person dying as a result. Community services have been hollowed out.
The effect on healthcare staff is obvious to see. Wards are routinely understaffed. Stressed, overworked doctors and nurses are struggling to cope. They are caring for patients with complex needs, but without the staff numbers to support them, as NHS trusts cut budgets back to the bone in an effort to reduce multi-million pound ‘overspends’.
Nursing staff are leaving the profession in droves. It was reported recently that the number of nurses leaving the NHS in the last year alone would fully staff 20 hospitals. The Tory’s abolition of the training bursary for nursing students last year led, unsurprisingly, to an instant decrease in those applying for nurse training.
Does all this sound familiar? If so, it is because it is the typical strategy of governments looking for an excuse to privatise and create new profitable avenues for their capitalist friends. Run an essential public service into the ground through sustained cuts to funding. Undermine public confidence and support for said service. Then offer to raise it, like a phoenix from the ashes, through private investment.
But extensive research and data demonstrates that privatisation does not improve healthcare services. Instead, it cuts funding, strips assets, and pays dividends to hungry shareholders.
The Health and Social Care Act 2012, enacted by the Tory-Lib Dem coalition, extended marketisation in the NHS. According to the World Health Organisation, it effectively abolished the NHS as a publically-owned body in legislative terms. During 2016-17, 70% of NHS contracts (worth a combined £3.1billion) went to the private sector.
This is to be extended further by the clandestine introduction of Accountable Care Organisations (ACOs). These are the Tory government’s way of circumventing parliament and introducing the largest reconfiguration of NHS service provision in recent years. The result will be an imported US healthcare model, with integrated health and social care services run by a single service provider. ACOs will be put out for tender, with US private healthcare giants poised to bid to run huge swathes of the NHS.
And don’t forget the Sustainability and Transformation Plans (STPs), drawn up by NHS commissioners, NHS providers, and local authorities. These plans are of local cost reductions to services – to the tune of some £22 billion in England. So we have more cuts, rather than desperately needed improvements.
The NHS is in crisis. We must fight back.
So what is to be done?
Co-ordinated action by the labour movement is needed now to send a clear message to the Tory government: hands off our NHS!
This demonstration can only be the start. Any concessions and reforms from the ruling class will only ever be temporary. When the opportunity arises, they will snatch it all back. We cannot settle, therefore, for mealy-mouthed promises of a bit more money and token concessions here and there.
We must demand the reinstatement of the NHS as a fully-funded, publicly-owned and publicly-accountable healthcare system – free from private profiteering and marketisation. This can only be achieved, in the first instance, by a socialist Labour government committed to real, lasting change.
We need a complete rejection of capitalism, together with all its spivvery and profit-driven parasitism. Only the creation of a socialist society, with a rational planned economy under democratic workers’ control, can meet the needs of society at large – both on a national and ultimately a global scale.
We must all stand together and defend the NHS!
The NHS crisis: socialism or barbarism
By Dan Langley, NHS nurse and RCN activist
This winter’s news has been littered with gut-wrenching stories about the crisis in the NHS. The Tories, however, are turning a blind eye to the destruction and suffering they’re causing.
The crisis is deepening every day. Nurses are disappearing. People are needlessly dying at home. Hospitals are being pushed beyond their bed occupancy limits. Thousands of surgeries are being cancelled. Ambulances are queuing for hours. Patients sleep in corridors in pain. Mental health patients are left waiting for days.
All the Tories can respond with is pure disdain. They continue to parrot their line of “nothing to see here”. Previous NHS minister Philip Dunne shamelessly shouted across the commons that “A&E has chairs”.
Even the National Audit Office, which scrutinises public spending for Parliament, has let the cat out of the bag. They describe the financial problems in the NHS as “endemic” and “unsustainable”.
There are problems beyond the historic low levels of funding. Nurses are being forced out of the NHS at an alarming rate. This is due to a toxic concoction of low pay, mental health issues, unsafe staffing, hugely pressurising workloads, and more complex patients as a result of the economic crisis and an aging population.
Just last year alone, 33,000 demoralised nurses – the backbone of the NHS – disappeared. That’s a 20% increase compared to the 2012 rate. Patient safety is now highly jeopardised.
Medical students and nursing students are now being exploited beyond their clinical competence – recruited into the workforce to cover the staffing shortfall. Shockingly, hospital office workers with no clinical expertise are also being drafted into this dangerous position, in a desperate attempt to relieve the pressure.
But again, this extraordinary and desperate situation still doesn’t have an impact on the Tories and their private healthcare friends. These chums include Healthcare America and Richard Branson, whose only motivation is the pursuit of profit.
While hospitals struggle to find the funding for critical care, Virgin – the non-tax paying multinational – has sued the NHS…and won! But not a noise was heard from the Tories, who continue to patronisingly praise NHS staff and lie about funding statistics.
Moreover, private healthcare providers were awarded 267 of the 386 clinical contracts in 2016 (a rate of 70%). This included seven of the most valuable contracts, starving the NHS and the public of much needed revenue streams and accessible care.
Between all these stories, the billionaire class and their media puppets are still finding time to demonise nurses and print farcical articles. For example, Sky News stated that, “Pressure on NHS hospitals in England eased slightly in the last week”. This story was based on a drop in the occupancy level from 95% to 94.9%! But these figures are well above the safe occupancy level of 85%.
Through all this hardship, exhausted NHS workers continue to persevere. They continue to fight back, not only for themselves but for the patients and for the entire NHS system. Meanwhile, the Tories try and drag the working class back to the dark ages.
To take a country with universal healthcare and allow private firms to plunder it can only be described as uncivilised and barbaric. Consultants have penned pleas to the government that fall on deaf ears. Nurses have written letters to the patients about why they can no longer help them. And a recent Labour Party political broadcast was solely dedicated to health workers describing the crisis and echoing the call to rid us – once and for all – of the Tories.
Trade unions have appealed to the Department of Health for funds. But these are not on the horizon any time soon. Twelve unions have asked for emergency funds for the NHS. They have rightly pointed out that austerity is the main cause of this current emergency.
Actions speak louder than words, however. After years of suffering a public sector pay cap, the union leaders have only asked for a 3.9% pay rise for nurses and other healthcare professionals. But this doesn’t even cover what has been lost over the years due to inflation. And there has been little transparency or consultation with members over this demand.
Amongst nurses, the union leaders say we need to be ‘realistic’ about pay. They act as a break on nurses’ anger, avoiding industrial action as if it were the plague. But the time for appeals to the Tories has long passed.
As a frontline NHS worker, I’ve seen the ills of capitalism laid out bare. I’ve witnessed needless suffering, with my patients coming in with worse and worse problems. But we have less and less to offer them, with no resources, no equipment, no beds, no staff.
We need to be able to say that the NHS will be there for you – and future generations – when your health fails. This means putting up a militant, united fight now.
- Re-nationalise the NHS! Bring work back in-house! End PFI! Take back contracts from the capitalist vultures!
- Fight for a real pay rise for staff! Reinstate the bursaries!
- Make the rich pay for this crisis! The only choice is socialism or barbarism.
The Tories are sabotaging our NHS
Khaled Labidi, Cambridge Marxists
The NHS is under direct sabotage from the Tory government. There is a growing suspicion that our health service is being severely underfunded in order to facilitate corporate expansion.
NHS chief executive Simon Stevens’ request for a minimum increase of £4bn in 2018 reflects the ever-increasing demands placed on the NHS. Rising cost of drugs and new technology. Rising hospital admissions. An ageing population. And an increase in chronic conditions.
In the same breath, Stevens commented that the NHS has been underfunded by £20-30bn (compared to countries such as Germany and France) since the dawn of the Tory-led austerity epoch.
The safety of patients will continue to be compromised as a direct result of the health service enduring the longest period of austerity in its history. This is despite the best efforts of NHS staff.
This winter, patients have died prematurely waiting in corridors. An 81-year-old woman died in her house waiting almost four hours for an ambulance. And an increasing number of NHS hospital trusts declared ‘black alert’ – a desperate admission that they have already reached full bed capacity and that patients arriving at A&E must be taken elsewhere.
NHS England, consequently, was forced to take unprecedented measures and postpone all non-urgent surgery (roughly 55,000 operations) until the end of January.
We cannot afford to let these conditions become the normal. Apologies from Jeremy Hunt to patients and praise from the Prime Minister to NHS workers is not enough. It does not mask or in any sense alleviate the life-or-death predicament that people in Britain are facing every winter.
Dr Anthea Mowat, the chair of the British Medical Association representative body, stated that:
“What is happening in our A&Es is symptomatic of pressures across the entire system…Each winter the pressure on the NHS worsens, and politicians are not taking the long-term view needed to ensure the NHS can keep up with rising demand.”
Philip Hammond’s £1.6bn increase in NHS funding for this year – less than half of what Stevens requested – is a clear political manoeuvre. It is designed to threaten the stability of the NHS and strengthen the case for privatisation.
If this assertion does not seem convincing, consider that Jeremy Hunt previously received a £32,920 donation from hedge fund baron Andrew Law, a major investor in healthcare firms.
We have a delirious Tory government with a destructive tendency to ignore healthcare specialists and the needs of our population. The pattern of underfunding our health service is making crises inexorable. The government’s reluctance to properly fund the NHS plays all-too-conveniently into the hands of private corporations to capitalise on.
There is fear that the NHS is corroding from within. NHS contracts won by private enterprises rose to £3.1bn in 2016-17. The outsourcing of some of the most profitable procedures is making the capitalist class even richer.
We need a Corbyn Labour government stop this: a Labour government armed with a socialist programme to stamp out corporations that are profiting from illness; a government that properly funds the NHS by expropriating the rich, parasitic elite.
As Dr Gavaghan eloquently puts it: “Let us refuse to allow this government to take the humanity out of our NHS”. We say: let us fight for socialism.