Forest of Dean & Wye Valley

SELLING OFF THE NHS

In Editorial on February 21, 2011 at 2:13 pm

Britain pioneered the idea of a national health service, free at the point of need, which would be open to all who required treatment in hospitals, doctors’ surgeries and dentists throughout the country.

It was launched in the summer of 1948, as part of the sweeping welfare reforms introduced by the Labour Government to look after the wellbeing of us all, in sickness and in health from the cradle to the grave. It was denounced at the time by many Tories as a “scroungers’ charter”. Many doctors also opposed it. Indeed, eight of them signed a letter to the Sunday Express complaining that it would “undermine the priestly quality which is inherent in medicine”. And so, quite rightly, it did.

But despite a threat by many doctors to boycott the new NHS, it was launched – complete with free prescriptions, and free dental and eye care. Doctors soon fell in line – and so, too, did the Tories. Indeed, by the mid-1950s they were claiming it as their own.

By the time Thatcher came to power, the NHS seemed unassailable. But she did her best to undermine it. She cut funding, she closed hospitals, and encouraged patients to opt out and go private. The cost of the NHS she claimed was escalating “out of control”. Her notion was to reduce the Service to a “safety net” for those who couldn’t afford private treatment. Private insurance schemes boomed, NHS hospitals were closed and waiting lists for treatment soared. In the first eight years of Thatcher’s rule, 250 hospitals were closed whilst only 35 new ones were built – with the loss of 36,000 hospital beds.

When “New” Labour was returned in 1997, new hospitals were built, and funding for the NHS was increased. But Blair continued and indeed extended the iniquitous practice of “private finance initiative” funding for new hospital builds and the “rationalisation” of services and structure carried out by the previous regime.

THE CAMERON THREAT:

Now, under David Cameron, the principles and practices of the NHS face their biggest threat since the birth of the Health Service. His plans were outlined last Autumn in the Clarion (“Don’t let the free market take over the NHS” – our October/November issue). Now they have reached the stage of parliamentary debate.

He is trying to sell it to us with all the fervour of a patent medicine salesman. His main thrust is that his reforms will allow GPs a greater say in controlling budgets and running the service. Of course many doctors don’t want the extra burden of administration on top of their present duties. It wasn’t what they were trained to do – and many of them have a heavy enough workload already. Yet 80 per cent of the healthcare budget will be handed over to GPs, who will be able to form themselves into consortia to decide how their share will be spent.

But that, of course, is merely the sales pitch – the extremely dubious icing on the cake. The main thrust of Cameron’s proposed legislation is about handing over the NHS to the free market.

Hospitals will be “freed” from Whitehall control, and those in the NHS will find themselves in competition with private hospitals to provide care for patients. If they are deemed to be inefficient they may be taken over by the private sector.

What kind of overall planning or co-ordination this allows isn’t made clear from the Bill. “Competition” however will be promoted, and the weakest will be driven to the wall.

From where we’re standing, this is akin to lunacy. The whole idea is driven by right-wing Tory ideology (with a secondary consideration that it will “save money”). Despite what the Government says, it won’t be the GPs in the driving seat – it will be private capital and the drug industry who will increasingly be able to call the shots .

How this will affect the pattern of health care within the Forest is difficult to say at the moment (across the border in Wales, the new legislation won’t apply). All we know at present is that care services in the County will be transferred to a new “social enterprise trust”. Unison, the union representing health workers, make the point that they were not consulted on the new structure, and under the new set up, “staff will no longer be NHS employees,” according to a Unison official. “…it means profit taking priority over the patients’ health”.

The changes will of course have a greater impact on larger hospitals such as those in Gloucester or Bristol.

All this could have an effect on patient care. For those seeking treatment at present their main concerns are that they can be treated as close to home as possible in a clean, friendly, reassuring environment. But what if the nearest hospital is closed down? What if the treatment is no longer available?

There are many who work in healthcare who are, naturally enough, deeply concerned about Cameron’s reforms. They regard them as deeply flawed. As we see it, it marks the end of a National Health Service that most of us grew up with, and came to regard, quite literally, as a lifeline.

Recent opinion polls suggest that the reforms are deeply unpopular with the public and, indeed even amongst doctors and NHS staff. Already campaigns are being formed to save the NHS. The least we can do is give them our support. If we don’t we are in danger of ending up with a semi-Americanised system in which the vision of those who founded the service in 1948 will be lost for good.

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