NHS Footprints plan is latest step to privatisation By Dave Stockton
The crisis of NHS funding is reaching a turning point. According to John Lister “In many areas the threat of cuts and closures could soon be a reality.” He points out that after conducting a survey of 155 acute trust finance reports this shows that “25 have deficits over £25m – and the average deficit is almost £15m. Acute trusts deficits totaled £2.3bn by December.”
The junior doctors’ strikes and campaign against the slashing of trainee nurses’ bursaries have highlighted the dreadful conditions experienced not only by doctors but by all workers across the NHS.
Trusts are also, as a result, also missing treatment targets for A&E patients, cancer patients, those on waiting lists, and most seriously, failing mental health patients, because these, and drug rehabilitation services, are perceived as “unpopular” and easier to cut.
Of course these failings of the NHS are publicised in the Tory tabloids, with the news of the “overspending” to make the case for more privatisation and the move from a universal service free at the point of use to one based on insurance. Another measure aimed at undermining “universal provision” is to make workers or visitors from abroad pay back the costs of medical treatment. This might involve all patients having to prove entitlement.
Despite the Tory-Lib Dem and the present governments' claims to ring fence the NHS against cuts, the two governments have not increased spending in real terms since 2010.
In January the Thatcherite hardliner, Health Secretary Jeremy Hunt, insisted the Trust managers must clear their deficits before they can get any of his £1.8 billion ‘transformation fund’ for 2016-17. In fact half of all acute trusts have deficits above £10 million.
The latest method for imposing cuts to crave up England’s NHS into 44 local “footprint” areas, each mandated to draw up 1-year and 5-year “Sustainability and Transformation Plans” (STPs). There will be no consultation with local people and community organisations. Each “Footprint” will be required to work as an isolated "local health economy".
Clinical Commissioning Groups (CCGs), created by Andrew Lansley’s 2012 Health and Social Care Act in will still be required to put services out to tender – i.e . to spend NHS funds on providing attractive profit margins to the privateers.
The plan talks blithely of this requiring “reconfiguration”, which will mean a return to closures of A&E units and even entire hospitals.
Clearly it is a vital task to mobilise in every local area, not just existing health campaigners or health workers unions, but all trade unions and all the local Labour Parties, to undertake a massive exposure of Hunt’s wrecking plan and halt it in its tracks. Likewise the Labour Party National Executive must publicise and expose this latest demolition job and the Parliamentary Party needs to use the House of Commons to rally forces.
Labour’s two voices
All opinion polls show that the NHS is still appreciated in deed loved by a huge majority of the population and figures at the very top of their concerns when it comes to elections. Defending and indeed restaoring the NHS is a vote winner for Labour.
Yet Labour still speaks out of the right as well as the left side of its mouth on this issue, leading to distrust and suspicion from local health campaigners and many of the hundreds of thousands of new members and supporters who rallied to Jeremy Corbyn last year. This means that the Greens, Plaid Cymru and the SNP were able to steal a march on Labour in proposing a NHS Reinstatement Bill last year and this.
The continued ambivalence is symbolised by a meeting representatives of the pro-NHS campaigns had with Shadow Chancellor John McDonnell and Shadow Health Secretary Heidi Alexander on 13 April, where they pressed again for a comprehensive NHS Reinstatement Bill.
According to a report: “Heidi Alexander said she had not been on a picket line and did not plan to be. She thought that a large number of people would not expect to see the Shadow Secretary of Health on a picket line.” This is a disgrace and she should be obliged to apologise to the junior doctors and pledge to support any further actions or else resign.
The problem facing Labour is that the process of privatisation was started by the New Labour government in 2003. Gordon Brown’s 1997 budget did provide an immediate injection of £1.2bn into the NHS, with real-terms spending rising year on year thereafter.
Yet New Labour, as a result of its strategic orientation towards the prosperous middle classes (“Middle England”), and a fear of increasing taxation for the better off , adopted the Private Finance Initiative, (PFI) to massage its public spending figures.
In 2009 Labour introduced the rule that “any qualified provider” could tender for NHS contracts, allowing patients to be referred to a private hospital or clinic rather than a local district hospital. It is this poisonous legacy that accounts for Labour’s half-heartedness during the campaigns against the Tory measures. This was made worse by the fact that Unison the biggest health service union mounted no serious national campaign of protests and action to kill the Bill.
Now with the Footprints proposal we need to put this right. We need local and national bodies to launch huge public protests and direct action to stop the wreckers . We need Labour MPs to use Parliament to issue calls to action and expose the Tories.
And we need the Labour Party at its Conferennce to adopt a Plan for a fully restored and deprivatised NHS. To be effective, this will not only stop the privateers milking the NHS but recover the billions already plundered. It also means a comprehensive nationalisation without compensation of the entire private healthcare industry including Big Pharma.