By Ajanta Silva

In an open letter to the leaders of the three major parties in Britain, the heads of a number of health professional bodies and charities declare that the National Health Service (NHS) is at the breaking point as a result of the “longest and most damaging budget squeeze in its history.”

The letter continues, “The NHS and our social care services are at breaking point and things cannot go on like this. An NHS deficit of £30bn is predicted by 2020—a funding black hole that must be filled.”
The signatories include the heads of the British Medical Association, the Royal Colleges of Nursing, Physicians, General Practitioners, Midwives, Paediatrics and Child Health, Obstetricians and Gynaecologists, Ophthalmologists, and the heads of leading charities.

Highlighting the plight of patients and low morale of staff created as a result of unprecedented attacks on the NHS by the Conservative/Liberal Democrat coalition government, the letter says, “Savings have been made, and despite the best efforts of nurses, doctors and other staff, patients have not been insulated from these cuts. Too many staff feel undervalued and demoralised when all they want is to be able to care for patients.”

Everywhere in the NHS there are “signs of a system buckling under the twin crises of rising demand and flat lining budgets.” The examples, as quoted, include:

• A shortage of GPs means that patients are struggling to get an appointment to see their doctor.
• Pressures on maternity services mean that many women are not getting the high quality care they deserve.
• Major accident and emergency departments in England have failed to meet their waiting times targets for an entire year.
• Thousands of patients are facing longer and even unacceptable waits to find out whether or not they have cancer, because services are under extreme pressure and referral targets are being missed.
• In mental health, patients in need of emergency support are being moved to hospitals hundreds of miles away because there simply are not enough beds in their area.

The letter explains that the crisis engulfing social care services is due to huge cuts in local government funding, shortages of social workers and other staff and dismantling of social support and benefits. After coming to power in 2010, the new government imposed 33 percent “efficiency savings” on local councils up to 2015 and last year announced a further 15 percent cut in 2015-2016. As a result, some 220,000 social care workers are reported to receive less than the national minimum wage and two-thirds of workers providing care in patients’ homes are on zero-hour contracts and have no financial or job security.

The letter points out:

• Families continue to be crippled by the cost of care, and thousands of elderly and vulnerable people are not getting the help they need and deserve just to live their daily lives safely and with dignity.
• People with long-term progressive conditions such as dementia have been cut adrift, reliant on unpaid and unsupported carers to live from day to day.
• There is also a pressing need to invest in children and young people’s physical and mental health, not just as a moral imperative, but also to help prevent problems later in life that may need more intensive and expensive support. Party leaders David Cameron (Conservative), Ed Miliband (Labour) and Nick Clegg (Liberal Democrat) have all vowed not only to ring fence the NHS budget, but to increase it. No one should be fooled by these promises, which are aimed at winning votes in next year’s general election. Since coming to power, the coalition has relentlessly carried out plans already drawn up by the previous Labour government to impose £20 billion in cuts (so called “efficiency savings”) over five years to the NHS’s annual budget.

During its own 13 years in office, the Labour Party stepped up the privatisation process in the NHS with the tacit support of the unions. They introduced more and more Private Finance Initiatives (PFIs) to build hospitals, many of which have been saddled with massive deficits.

In 2012, the current government brought in the Health and Social Care Act, accelerating the dismantling of the NHS and expediting the privatisation process. More than half of the NHS budget has been transferred to Clinical Commissioning Groups (CCGs), which now have to give equal weight to private health providers in tenders for services. Data for 2013, the first year of the Act’s operation, suggests almost 70 percent of contracts for NHS services in England were won by private companies. Last month, a poll revealed that 85 percent of GPs thought the NHS would be privatised within 10 years and 45 percent believed it would occur within five years.
Following the massive opposition that erupted to the closure of heart units, maternity units, Accident and Emergency services (A&E) and hospitals earlier this year, the government inserted Clause 119 into the Care Bill in order to prevent legal challenges to its plans to break up and privatise the NHS.

The funding crisis and daily reports of NHS “failures” had led to a deafening campaign in the media and bourgeois think-tanks calling for the introduction of charges for NHS services. There is little reference to the 2008 financial crisis and the £1 trillion bailout of the banks—more than enough to fund and improve the NHS for decades.
The ruling elite and its representatives in Westminster are determined to change the founding principles of the NHS. Behind the constant refrain that services will be “free at the point of delivery” will stand a privately provided health service system.

The letter by the health and social care professionals appeals for “a comprehensive, fully-costed, long-term spending plan if an NHS true to its founding principles of universal healthcare, provided according to need not ability to pay, is secured for future generations.” However, not only will these appeals to the party leaders go unheard, they will even will be used for reactionary purposes, to speed up the break-up of the NHS, unless the working class intervenes in defence of the NHS under a socialist strategy.