Health outcomes

Judith Niechcial writes about the privatisation of the NHS

At Yearly Meeting it was difficult to choose between the various events held during lunch breaks. I am so glad to have attended the session run by a retired GP, Sylvia Melville, from Banbury & Evesham Area Meeting, on the effects of government policy on the National Health Service (NHS).

It may be that many Friends are fully aware of all that is going on, but for me the session was both an eye-opener and a wake-up call. The NHS in England is being dismantled, but you hear very little about this from the media. We hear about the junior doctors’ strike and hospital deficits, but not about the sinister underlying process.

In 1990 Kenneth Clarke introduced an internal market into the NHS. It had three aspects: delegation of budgets to individual GP practices, replacing health authorities with NHS Trusts and creating the ‘purchaser/provider split’. New Labour took this process further by, in 2003, introducing market-oriented NHS Foundation Trusts and their regulator ‘Monitor’, and developing the Private Finance Initiative (PFI), which is currently bankrupting hospitals.

At the Britain Yearly Meeting event Sylvia showed a short, informative and hard-hitting video she has made that summarises the dire effects of Andrew Lansley’s 2012 Health and Social Care Act. This Act abandoned publicly accountable Primary Care Trusts and Strategic Health Authorities and replaced them with Clinical Commissioning Groups (CCGs) nominally made up of local GPs but, in practice, staffed by administrators.

The Act also promoted the internal commissioning system whereby every service has to be put out to tender. Private companies can ‘cherry pick’ services they wish to provide (for example, in my local area a private company has taken over the Urgent Care Centres, still deceitfully using the NHS logo). Public health has been taken out of the NHS and is now shared between local and central government. (Also in my area fifty per cent of the council’s public health staff are set to lose their jobs under the 2016/17 budget, following a reduction in the public health grant from the Department of Health.)

NHS Foundation Trusts are no longer obliged to provide particular aspects of health care, and there are complex requirements relating to the provision of essential services.

Private providers have, of course, to make a profit, which they do by reducing staffing and salaries. If they fail it seems that they can wash their hands of the service and have no further responsibility to patients. They also employ staff that have been trained at public expense, and they have no incentive to provide for further professional development.

I learned that, alarmingly, the previous job held by the head of NHS England, Simon Stevens, was as CEO of the largest private health company in America, where there is an insurance-based system that excludes people in poverty, and where health outcomes are among the worst in the Western world.

The NHS Reinstatement Bill, which aims to reverse this insidious privatisation, was tabled in the Commons by Caroline Lucas of the Green Party, and was supported by Labour, Liberal Democrats, Scottish National Party, Plaid Cymru members and the British Medical Association. It had its second reading on 11 March 2016, when it was filibustered out of existence.

Thankfully, there are organisations campaigning against this creeping privatisation.

Advices & queries exhort us to remember our responsibilities as citizens for the conduct of national affairs. Part of this responsibility is informing ourselves about important issues. By writing this piece, I am trying not to ‘shrink from the time and effort [my] involvement may demand’.

Further information: http://nhsbill2015.org, www.keepournhspublic.com

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