Health care isn’t a privilege, it is a fundamental human right
Transcript of the speech by Dr Kailash Chand OBE at Class Conference 2014:
Ladies and gentlemen, thank you for your invitation to speak here with you today about a matter of the utmost importance – our NHS.
These are serious times. David Cameron “the child of Thatcher” in Downing Street is in the process of achieving what has eluded all the other Tory Governments since Bevan created the country’s most cherished institution, the NHS in 1948. The privatisation of our NHS.
Winston Churchill lost the battle to kill the NHS at birth. Thatcher was prevented by cooler heads from creating an insurance-based system. John Major attempted to suffocate the NHS by bringing in, the internal market. It is David Cameron, however, who is fulfilling the dream of the ‘Tory right’ with help from Nick Clegg to kill the NHS.
The neglect of the NHS was a principal contributor to the downfall of the last Conservative Government and it was a major issue in helping New Labour mobilise mass political support for a landslide general election victory in 1997. Labour’s election manifesto in that year warned that only Labour could “save the NHS”. And they did, a decade of New Labour in government did result in the largest ever sustained increase in healthcare spending in the history of the NHS.
£1 trillion of investment.
100 new major hospitals.
250 NHS Walk in Centres
And 300,000 new staff.
Labour slashed waiting lists and solved the Tory A&E Crisis. Labour should always be proud of its NHS Record.
It must also be recognised, however, in 1999 ‘New Labour’ marked the start of a transition of the NHS from a public sector provider to include the private sector under the disguise of choice and competition. New Labour’s reforms of the NHS proved to be highly unpopular both within and outside the mainstream Labour Party. Foundation Hospitals, PFI and the beginning of outsourcing stain our NHS record, and we have only ourselves to blame.
Professor Anthony King described Tony Blair’s administration as the “first ever Labour government to be openly, even ostentatiously pro-business”.
Thus, New Labour’s leadership had been “converted” from tolerating private enterprise to actively promoting it – a significant political U-turn.
Unfortunately, the last Labour Government laid the groundwork for everything that the Tory-led coalition is now doing to the NHS. Market structures, foundation trusts, GP consortia and the introduction of private corporations into commissioning were all products of an ill-conceived Labour vision of “public service reforms”.
David Cameron aided and abetted by Nick Clegg, has paved the way to turn the NHS over to a plethora of private companies which either commission or provide services, or both. The NHS is being softened up for privatisation which, all along, was the real purpose of the NHS act 2012. Last year seven out of 10 NHS contracts have gone to the private sector.
Who gave this Prime Minister permission to put our NHS up for sale, something which Margaret Thatcher never dared to do? The NHS in 2014 is demoralised, degraded and confused.
8,000 Hospital Beds have been axed.
8,000 Specialist Nurses have been cut
1/4 of a million of NHS staff now exist on zero hours contracts.
1/3 of NHS Walk In Centres have been either closed or downgraded.
62 Maternity or A&E Wards have been axed.
Our A&E waiting times are at their worst for 10 years, and there are now more than 3 million on waiting lists for operations. What’s even more serious is that more than £16bn of NHS Contracts have been offered to the Private Sector. 1.61 million Admissions to private hospitals in the United Kingdom each year are now funded by the NHS. That is 420,000 patients a year. The health service is now the private sector’s second biggest customer. Scandalously, the figures show private hospitals are not even doing their jobs properly. In addition to paying them to care for patients in the first place, the NHS then has to spend thousands of pounds picking up the pieces when things go wrong. A staggering 6,000 patients were admitted to NHS hospitals for complications that occurred while a private patient in 20112-13, an overwhelming 2,600 of them transferred as emergencies. This is not only a disgraceful waste of money, it is disgraceful treatment of the sick and injured.
Things can’t go on like this. It’s time for the labour movement to raise the alarm again, about what is happening to the NHS and build a campaign for change.
We all know that the British public want the NHS to survive as they know it. The only way forward is for Labour to stick to its 1997 manifesto pledge: “Our fundamental purpose is simple but hugely important: to restore the NHS as a public service working co-operatively for patients, not a commercial business driven by competition.”
Ed Miliband’s pledge to repeal the NHS act is a step in the right direction. But Labour must pledge that it believes hospitals and community health services should be publicly owned, publicly run and publicly accountable. We need to integrate all services to work co-operatively to keep people out of hospital. It doesn’t need a market, just leadership (as is the case in Scotland).
What is required is a policy review to abolish the purchase-provider split and to reintegrate health services. Such an initiative will save on transaction costs, marketing, billing and invoicing. At the same time, it will also ensure that patients are not treated as commodities, and forced to shop around for care.
We should get rid of the foundation trust status and the independent monitor. This will allow reintegration of the health service and bring it back into direct parliamentary accountability, stop the culture of secrecy, corporatism, bullying and commercial confidentiality that surrounds every transaction.
There is a great need to end the “money follows patients” system of resourcing and bring back needs-based planning for geographic populations.
The NHS should terminate commercial contracting for NHS services and abandon proposals to offer GP services to commercial companies.
We must restore the principle of fairness through national terms and conditions of service for doctors and all NHS staff. It is imperative that we restore trust between the profession, patients and politicians. Above all, we must allow professional standards to thrive since these are the basis of public and patient trust.
The founding principles and values of the NHS have stood the test of time. Labour’s health team, headed by Andy Burnham, should formulate the policies to fight for those ideals – for comprehensiveness, universality, access based on need and not on ability to pay, for a service that is free at the point of use, for mutuality in which the public accepts that priority should be given to those most in need. Keep markets for profit out of health care delivery. Any adulteration of these principles threatens to cause fragmentation of the NHS with the certainty that never again will such a health service be created. Protecting and pledging to save the NHS from private vultures could be the winning strategy for the 2015 general election. Health care is not a privilege or charity, it is a fundamental human right. And we must fight to preserve it.