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All materials published and promoted by L Smith, PO Box 1109, London N4 2UU
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In 1997 Blair denounced Margaret Thatcher’s internal market in the health service, and warned we had “Ten days to save the NHS”. Yet nine years later the NHS faces a massive new round of cuts in beds, jobs and patient care as his “modernisation” package takes effect. NHS managers are determined to balance the books of NHS Trusts – despite the scale of the shortfall, estimated at £800m in 2005-6. Many Trusts and Primary Care Trusts (PCTs) facing further, bigger financial problems in 2006-7.
It is increasingly clear that the aim is to shut some existing hospitals in order to create not just an internal market but a free market in health care in which the NHS is only one among many providers.
New Labour wants the NHS to be little more than a centralised fund that commissions and pays for patient care. This involves a dwindling number of NHS hospitals alongside a growing reliance on Foundation Trusts and various private sector providers, which are set to cream off a growing share of the budget and trained staff.
NHS hospitals remain the only providers of accident and emergency services and of services for patients with complex and chronic conditions, which the private sector sees as unprofitable. As they lose waiting list patients to the private sector many local
hospitals will struggle to survive financially. The government has admitted it is prepared to see NHS hospitals closed as a consequence.
New Labour argues that the NHS budget, at £76 billion, is now more than double the 1996-97 figure. Billions of this, however, are funnelled into contracts with private health providers. Ministers want at least 10 percent of elective operations to be carried out by the private sector this year, rising to 15 percent by 2008. There are
plans to hive off the services provided by PCTs, with large-scale private sector contracts for MRI scanning, X-rays and diagnostic services. Ministers are planning to ensure that at least 15 percent of GP practices are taken over by private companies by 2008. New Labour is set to multiply tenfold the level of private sector clinical
care it inherited from the Tories.
The introduction of Foundation Trusts was a “reform” virtually nobody wanted. Already it has started to go wrong with major hospitals forced to axe beds and services to balance the books.
Foundation Trusts were the first to test out a new “payment by results” system designed to increase competition and maximise numbers of NHS patients treated by private hospitals. From April 2006 hospitals are supposed to be paid not on the basis of block
contracts, but only for the work they do, receiving a standard, fixed price payment per item of treatment delivered. Ministers admit that this system could force the closure of “failing” NHS Trusts.
The payment by results system will cause the biggest problems for new hospitals funded under the Private Finance Initiative (PFI), which are saddled with high, fixed overhead costs, while lacking spare beds and capacity to take on additional patients. A classic
example of this is the Queen Elizabeth Hospital in Woolwich, which has been declared technically bankrupt due to its rigid PFI contract. The only way it can try to save money is by cutting clinical care and closing beds.
Across the country the spiralling cost of the next round of PFI schemes has brought a review and a fresh round of cutbacks as NHS chiefs try to reduce bed numbers and the size of new buildings to more affordable levels, while the PFI profit stream to
shareholders is guaranteed.
Long-term care for the elderly has been largely privatised, with the closure of NHS geriatric beds and an increasing reliance upon privately run nursing homes and services. Home care has met a similar fate, with more than 70 percent of services now delivered
by private companies. Many services, such as chiropody, which were once available on the NHS for older people have now been withdrawn from the menu of NHS care, forcing people to pay privately or go without.
Respect believes that there is no place in the NHS for the private sector, which has been shown to inflate costs, drive down standards, increase bureaucracy and administration, and “cherry pick” the most lucrative services, leaving gaps in care or forcing the collapse of public service provision. The only way to ensure a comprehensive
and equitable service accessible to all is through a publicly financed, publicly provided and publicly controlled and planned service.
RESPECT CALLS FOR:
> A fully funded, publicly owned NHS, delivering care free at the point of use.
> Opposition to PFI schemes: all privatised services to be brought back into the NHS. No further closure of local hospitals or specialist units.
> Bring all agencies administering care services into public ownership under NHS or local government control.
> Abolition of charges for prescriptions, chiropody, dentistry, eye and hearing services.
> Expanded psychiatric health services.
> Improved training opportunities for doctors, nursing and related services.
> Regulation of the drug companies, which make massive profits out of the NHS.
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