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Sunday, 14 May 2017

Save Our NHS

After leaving university in 1988, I worked for a year for the NHS in the finance department of Leicester Royal Infirmary. Back then the financial pressures on the NHS seemed acute, however that was nothing compared to the situation today. Our NHS is being sucked dry by PFI debt, hammered by underfunding and bit by bit privatised by stealth.


However before we get too carried away with current doom and gloom, it would be sobering to have a few choice facts about life before the NHS was created by the post-war Clement Attlee government.

- Before the NHS, the only system in place was that created by Lloyd-George's National Insurance Act 1911. Premiums were high because they were charged at a flat rate, the Lord and the labourer paid the same.
- The uninsured were only treated in hospital if they had TB (Tuberculosis). Everyone else could sling their hook.
- One in twenty children died before their first birthday.
- Thousands of people died in England every year from treatable diseases such as pneumonia, polio and meningitis.
- Those who could not afford 'to call the Doctor out' had to resort to home remedies such as bread poultices and blackberry vinegar. Or alternatively they could kick the bucket.

This was the reality of 1930s Britain.

Fortunately we now have the NHS, the largest employer in the UK, providing jobs for 1.7 million people. It treats over 3 million people per week in England alone and the NHS budget for 2012-2013 was £109 billion.
However the very scope of the NHS is what makes it attractive to those who want to buy into its services to run them for a profit.


Government politicians love to say that they are spending record amounts on the NHS. In raw terms this may be true. But what they never tell you is that these increases are more than wiped out by the rising cost of drugs and increasing demand due to the rising UK population. Spending per patient is going down while the big drug companies are allowed to charge extortionate rates for their products.
In the 1990s the John Major and New Labour governments came up with the worst idea ever inflicted on UK public services. PFI Deals (Public Finance Initiative). Put simply they got private firms to build new hospitals and then leased the buildings from them at extortionate rates of interest. Here are some astounding statistics:

- The NHS has PFI debt of £80 billion for hospitals which only cost £11.5 billion to build.
- The total PFI debt for all UK public services is £300 billion for projects worth only £55 billion.

The stupidity behind this whole idea beggars belief and yet these rip-off deals keep going on with student accommodation being the latest racket. Meanwhile our so-called 'failing hospitals' are deemed financial failures because they are saddled with years of debt.

The result is endless reorganisations, cuts and outsourcing of services to private firms who bid for contracts at the cheapest rate, often at the expense of quality of service. Some further statistics:

- Between 2005-2009, New Labour blew £780 million on 70 reorganisations in 4 years.
- The current Conservative government has spent £17.6 million on management consultants briefed to draw up plans to cut £22 million from the NHS budget by 2020.
- In January 2017 there were 18,000 trolley waits due to not enough beds.
- Extra funding does not all go to the NHS. In winter 2016-17 £2 million went to private providers eg Richard Branson's Virgin Healthcare.
- Private firms now carry out 17% of hip replacements, treat 10% of all trauma patients and 6% of all gall bladder removals.

Private providers bid for services by offering to run them on the cheap, undercutting the NHS. The Tory government have changed the law in order to insist that the private sector has to be given equal access to bid for services and the imposed cuts create a situation where cheapest wins. Cheapest also often means low paid staff, job losses and a bog-standard or inadequate service for the public.

- In 2013 a Freedom of Information request found that 52 NHS staff had been paid £2 million in gagging orders to stop them speaking out about what was happening to quality of provision.


In 2011 Hinchingbrooke Hospital in Cambridgeshire became the second UK hospital to be given to a private company, called Circle,  to run for supposedly 'failing'. Failing that is in the context of being saddled with £40 million PFI related debt thanks to Mr Blair and being situated in a county with a huge rising population. As a result:

- Circle's debt reduction plan included £311 million worth of job cuts and streamlining A&E services leading to increasingly long waiting times before being seen
- In October 2013 the Childrens' Ward failed to meet national standards of care.
- In 2014 the Care Quality Commission found severe issues with patient care including people lying for hours in their own faeces.
- Circle pulled out in 2015 claiming that the hospital was not financially viable , meaning in other words that even with all of its 'efficiency savings' the lack of funding and crippling PFI debts were too much.

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