By Ajanta Silva
Standing reality on its head, UK Prime Minister David Cameron declared that “the NHS [National Health Service] is safe because of us…” at the Conservative Party conference last month.
What Cameron failed to mention was that the previous Conservative/Liberal-Democrat coalition, which he led, carried forward the plans of the previous Labour Party government and, over the last five years, imposed £20 billion “efficiency savings” from the NHS’s £108 billion annual budget.
The 2010-2015 parliamentary term recorded the lowest ever real term funding for the NHS in its entire history, despite claims that health spending was going to be “ring-fenced.” The 0.85 percent rise in spending each year was a quarter of the average since the NHS was created after the Second World War.
The situation is set to deteriorate dramatically in this month’s national spending review, which includes the NHS. According to the John Appleby, chief economist at the Kings Fund health sector think tank, NHS finances will be “squeezed as never before”.
“It is clear from both the historical record and international comparisons that health spending in the United Kingdom could hardly be considered profligate—yet it is now set to reduce further as a share of our expanding national wealth.”
On the one hand the government trumpets that NHS spending in England will increase by £8 billion by 2020/21, while on the other Health Secretary Jeremy Hunt is demanding that £22 billion in further “efficiency savings” are found.
There is a huge deficit in the latest statistics—a massive £930 million in the first three months of the year, surpassing the whole of last year’s £822 million overspend. Appleby points out that this was due “neither to a lack of reform nor a reluctance to reduce waste and improve productivity.”
Chris Hopson, Chief executive of NHS Providers, declared, “These results are not a surprise. Providers have been flagging their rapidly deteriorating financial position for more than two years now.
“NHS trusts and foundation trusts are doing everything they possibly can to avoid financial deficits, but they are experiencing a triple whammy: rapidly rising patient demand, an extra £2 billion unfunded staff cost they have been required to add, and the deepest and longest funding squeeze in NHS history, despite the NHS ring fence,” Hopson said.
The chair of the governing body of the British Medical Association, Dr Ian Wilson, added, “The NHS is facing a funding crisis the likes of which we have never seen, and despite politicians’ promises, current funding is barely enough for the health service to stand still.
“With winter just around the corner, which will undoubtedly increase pressures on services and staff, it is also deeply worrying that trust finance directors continue to raise concerns over staff morale. The government must wake up and take action.”
This has been the bankrupt plea of the professional organisation for doctors for years. The government, of course, is fully conscious and is taking action—pressing on with its austerity measures and privatisation programme regardless.
When reports on the deficit started to emerge, both Hunt and Chancellor George Osborne tried to shift the blame onto the £1 billion a year cost of agency staff employed by hospitals as if that was the root cause of the deficit. In reality, hospitals are compelled to use agencies to maintain safe staffing levels because of recruitment freezes and the slashing of front line jobs.
Other reports have been published since Cameron’s speech, which further expose his claim that the NHS is safe with the Tories.
The total number of patients on hospital waiting lists in May 2015 stood at 3.4 million, the highest since 2008. Trolley waits (waiting more than four hours for a hospital bed after attending an Accident & Emergency centre) have increased dramatically to around 20,000 in August, 25 percent higher than the same month last year.
There has been a massive increase in patients who languish for weeks in hospitals despite being medically fit for discharge. Around 5,000 patients were in this position at the end of August, most often because of cuts to community care services provided by local councils.
The hardships facing mental patients are just as bad. Detentions under the Mental Health Act have risen by almost 4,000 (eight percent) in NHS hospitals in the past year. The mental health charity Mind said the figures suggested, “People are not getting help for their mental health problems early enough, meaning they become more unwell and more likely to reach crisis point” and end up in hospital.
The financial crisis and decline in patient care is the product of funding cuts and the drive to privatisation by successive governments. The 1997-2010 Labour government introduced or laid the groundwork for most of the policies now being imposed.
Private Finance Initiatives (PFIs) were introduced in 1992 by the Conservative government, but vastly expanded after the Labour Party under Tony Blair came to power. Some 101 of the 135 hospitals they built were financed in this way. They have become a massive burden on NHS finances, with an estimated £79 billion having to be repaid for the £11 billion borrowed for their construction.
The Blair government also created NHS Foundation Trusts as independent business entities, allowing hospitals to earn up to four percent of their income from treating private patients. The coalition’s 2012 Health and Social Care Act, which put in place the framework for wholesale privatisation of the NHS, raised the cap to 49 percent. Cash from private patients has increased to £526 million this year, accelerating the development of a two-tier health service.
No one should be in any doubt that the crisis that has been created over the last period will be used to complete the demolition of NHS as a public service. Whatever public façade the ruling class and their representatives in parliament put on when talking about the NHS, they despise it as one of the most fundamental of all the hard won social gains of the working class.