Today’s guest blog comes from Allyson Pollock, Professor of International Health Policy at the University of Edinburgh and author of NHS Plc. She is a leading authority on the privatisation of public services and writes for us today on why students and young people should rise up and take action against the NHS reforms.
Students across the UK should be concerned about the Government’s Health and Social Care Bill published on 19th January 2011. If passed it will forever be known as the Bill that abolished the NHS and students need only look at the system that operates in the US for a glimpse of their future. The US has the most expensive system in the world and the most unjust in the western world. It is a system where over treatment and under treatment is rife and where around 60 million uninsured people and an equal number of underinsured are denied care and that is exactly what government legislators and advisers are using as the model for the health care of the future. If this happens there will be no NHS left for you all to work in, just large corporations where shareholders come before professional autonomy and patient-doctor relationship. This is not scaremongering , just compare the websites and campaigns springing up in support of the NHS with the websites in the US where the corporate health care systems are seen as vicious, ruthless and greedy and where patients and staff are almost powerless. In the US those lobbying to protect the system are the health care corporations and the pharmaceutical industry.
If the Bill is enacted up to 100 billion pounds annually of taxpayers money is likely to be handed over to large for profit corporations, which will run and operate our NHS services for profit. Public administration, public provision and public accountability has been the hallmark of the NHS along with the goal of striving for comprehensive care, free at the point of delivery and delivered on the basis of need. Over the last two decades this has been eroded as we describe in our book NHS plc; governments have put commercial interests before public health and sought to introduce markets, when all the evidence shows they should not. But this Bill, described by the BMJ as Dr Lansley’s Monster is just that, which is why the BMA, RCN, NHS Confederation, numerous other royal colleges and think tanks, medical students, nurses and doctors are furiously opposing the changes. The conflict between shareholders demands and patients’ needs will be ever evident to patients and public in day to day practice and services provided.
The Bill in essence scraps the mechanisms and structures of the NHS which enabled some measure of fairness in the system and replaces it with new corporate bodies which are to be given an extraordinary number of powers and freedoms to form companies and bring in investors, levy user charges and redefine what is NHS care. GPs in the GP commissioning consortium are neither trained nor skilled in planning and providing health services for the whole population, their duty is to care for the patient. They know this, but have no choice now but to allow their practices to join consortium or find themselves taken over by the private sector. But they also know the new consortiums will over time be run by shareholders for profit and in time so will all the services. GP practices are already having to compete for commercial contracts, soon these contracts will specify what services they can and cant provide and determine which patients they can accept.
The government is determined to open up the NHS to the market place and very soon the 100 billion pounds of taxpayers funds will be lining the pockets of new equity investors and the shareholder returns of American and British health care corporations, just as they do with PFI, pensions etc. It is pure market ideology and without a shred of evidence. On the contrary, all the evidence shows that if you create a US healthcare system that is what you will get and the result will be denial of care and exorbitant costs for the tax payer and the patient as private sector providers hold the government to ransom.
All the evidence shows that health care for all cannot be run as a market. Markets create winners and losers and in health care the losers are always the old, the poor, the vulnerable sick and disabled, they carry too much risk for investors and shareholders.
Under the proposals laid out in the Health and Social Care Bill 2011 the Sec of state is in effect abolishing his Duty to provide and secure comprehensive services for the whole population and the mechanisms which enabled that to happen. The new consortium will have no duty to provide and secure comprehensive care as they no longer have responsibility to all patients and residents in a defined area, instead local authorities may end up becoming providers of last resort when patients are denied or cannot get care. And as for the new GP consortiums and providers they are to be granted extraordinary new powers, the power to deny care, to close NHS services and to introduce charges, top up fees and sell private health insurance. NHS trusts are to be abolished and the private sector providers which will replace them are to be given extraordinary new rights. The right to fair and equal treatment will no longer be for patients but for the investors who will use competition policy and trade law to demand a right of entry and a right to ensure that their services can continue to operate profitably.
Our generation had the best of the NHS. We had the best of the welfare state including free education, free health care and above all freedom from fear of health care bills. Now it is up to your generation to fight for what we are in danger of destroying. The BMA are considering taking a legal challenge against the government, you should add your voices. Ultimately the battle for the NHS is a political battle and unless you make your voices heard then the NHS will be lost. Not one citizen in England can afford to lose their NHS; the scale of the public health casualties will be too great if the Bill is passed. The abolition of the NHS should not be our legacy to your generation for how can you care properly in the knowledge that so many will go uncared for. Its your NHS but only for so long as you care enough to fight for it.
Got your attention? Why not get involved in taking action against the NHS reforms for yourself over at our ‘Do Something’ page. If you’d like to write a blog for us please get in touch with us saying what you’d like to write about and when you can have it to us by.
You can read more about Allyson Pollock’s book NHS Plc at http://www.allyson-pollock.com/books.html.