By John Pickard
Just about the only part of the Tories’ coronavirus strategy that even approaches ‘world beating’ seems to be the vaccination programme – and that is only because Boris Johnson has had little to do with it. Unlike the big majority of the Tory anti-Covid measures, which have been handed out in crony-contracts to Tory friends and backers, the vaccine roll-out is being managed by the NHS.
The vaccination planning has not been based on dishing out lucrative contracts to businesses, but to groups of GPs, known as primary care networks (PCNs), each covering up to 50,000 patients. These PCNs have been able to organise effective programmes, often giving jabs up to 12 hours a day, seven days a week. Between them they have established around 1,500 vaccination centres in England alone. They are staffed by 30,000 NHS workers and nearly three times as many volunteers.
Fifteen million vaccinations
It is as a result of having an NHS-based system that fifteen million vaccinations have already been given and although there are still arguments about priorities and glitches, it has been largely a successful operation. It is all the more galling, therefore, that Boris Johnson will try to claim the credit for a programme that he has had little to do with. It is even possible that its success, along with relaxations in the lockdown, will be reflected in support for the Tories in the May elections.
Although the vaccination programme is an exception to the general rule, what the Tories have learned from the pandemic is that they can dish out lucrative contracts to business friends with only token opposition from the current leadership of the Labour Party. That is the rationale behind the new top-down reorganization of the NHS now being proposed by Boris Johnson and Matt Hancock.
When the new plans were revealed, it was at first suggested that Hancock’s proposals were relatively benign. The Guardian, for example, suggested on February 6 that “Boris Johnson is planning a radical overhaul of NHS England, as he reverses controversial privatisation policies introduced by David Cameron”. In fact, far from reversing privatisation of the NHS, these plans will accelerate it.
More streamlined privatisation
The white paper outlining the proposed reorganisation gives the NHS and local authorities “a duty to collaborate with each other” so that there is an integrated system tying together health and social care. Because that is a measure that most health and care professional would support, it is something being flagged up by the Tories to ‘justify’ the changes.
But the real aim is to facilitate swifter and more streamlined privatisation. The proposed changes will put far more power in the hands of the Secretary of State for Health and at the same time to do away with what the Financial Times described as the “rigid procurement rules” put in place by the last major Tory health reforms in 2012. Those so-called ‘Lansley’ reforms, under David Cameron’s premiership, introduced a massive increase in privatisation in the NHS, but there were also procedures put in place to make the tendering process open and seemingly competitive.
It is these tendering procedures that the Tories now want to do away with. Too often, the white paper says, there is “retendering and re-procurement” and the result has been that contracts are still “won repeatedly by the same organisation”. The Tories answer, therefore, is to do away with the procurement process, to make it more “flexible”. What they have learned from the coronavirus pandemic is that a nod and a wink from a Tory MP or minister are far easier than open procurement processes.
New procurement procedure: a nod and a wink
We have seen during the COVID pandemic how contracts have been handed out willy-nilly to Tories’ friends and party donors. Confectionary companies get PPE contracts. Mates of Dominic Cummings get polling contracts. A former neighbour of Matt Hancock’s sends him a WhatsApp message and he gets a multi-million pound contract.
Johnson’s personal friend and the wife of a Tory MP (and a person without any qualifications or experience in public health), Dido Harding, gets to head up test and trace. Lo and behold, test and trace turns out to be no more than a black hole into which public funds are poured, leading directly to private business accounts. And so it goes on. This is the new model for procurement for the whole of the health and care sector for the future.
We should not be at all surprised at the further opening up of the NHS and social care to privatisation. One of the reasons why the NHS has struggled to cope with coronavirus is because the service has been looted for decades, through outsourcing to private companies and by scam PFI contracts.
The Tories are not going to let a new public health crisis go to waste: despite the illogicality of a major health reorganisation being announced in the middle of a pandemic, it is a signal to them that the pandemic has opened up golden business opportunities, so they are eager to cash in even more.
Tories always opposed NHS
The Tory Party, from 1948 to date, have always been in principle opposed the idea of a publicly owned and administered national health service. They voted against its establishment in 1948, but they are stuck with it now. They are therefore making the best of a bad job, by gradually squeezing and undermining the NHS, and turning it bit by bit into a milch-cow for private companies. Left to the Conservative Party, the NHS will become unrecognizable and something more like a US-style health care system.
In today’s House of Commons, dozens of Tory MPs have links to the private health and social care sectors. Matt Hancock, for example, received a donation of £10,000 in his Tory leadership bid from Wol Kolade, the head of the Livingbridge private equity firm that owns Vanguard Healthcare. Jeremy Hunt, who was replaced by Hancock as Health Secretary, received a donation of £20,000 from the owner of Genix Healthcare, a private dental provider.
Tory links to private health
Iain Duncan Smith, another Tory big hitter, gets £20,000 a year as a board member of the Tunstall Health Group. This payment, more than the average UK wage, is for only 30 hours work a year. Former cabinet member Andrew Mitchell, received £30,000 a year (for five days work) as a “senior adviser” to UK Global Health Care Ltd. And so it goes on. Tory interests in both houses of parliament, are littered with references to private social care, pharmaceutical companies and private health care. They are all eager for their friends and paymasters to get bigger slices of the cake.
The Labour Party should be mounting an effective opposition and offering a bold alternative to the looting of the Tories. The 2019 Labour election manifesto was at least radical in its denunciation of Tory mismanagement. “There are 100,000 staff vacancies in NHS England,” it pointed out, “including a shortage of 43,000 nurses. There are 15,000 fewer hospital beds. Every winter, bed occupancy rates exceed dangerous levels. Patients now wait far too long to see their GP, for an ambulance or for treatment. Our immediate task is to repair our health services. Our urgent priority is to end NHS privatisation.” And this state of affairs, was before the pandemic hit.
Unfortunately, these bold words are yet to be repeated or in any way endorsed by the current Labour leadership. Keir Starmer and his whole team are wedded to the failed ideas of Tony Blair’s New Labour project, now re-branded because of its toxicity as ‘New Leadership’. The New Labour brand is toxic precisely because many of the worst privatisation measures introduced since 2010 – like the so-called ‘internal market in the NHS – were introduced by the Blair governments. There are also former Labour MPs, notably in the House of Lords, who also have interests in private health, something the Starmer team will not highlight.
Starmer attached to the ideals of Blairism
It is fundamentally because of their attachment to the ideals of Blairism and New Labour that there has been little leadership or opposition to the Tories from Starmer’s team. Shadow Health Secretary, Jonathan Ashworth, responded to the white paper by tamely noting that “reducing the role of privatisation in the NHS was very important”, while saving his main criticism for the timing of the re-organisation, thereby missing the whole point of white paper.
The Labour leadership might have paid lip-service to the hard work and dedication of NHS and social care staff, but they have signally failed to support calls for decent pay rises for the same staff.
The Labour Party will make no headway against the Tories, either now or in May, unless it adopts bold socialist policies on the issue of the NHS and social care. The NHS has been described as the “nearest thing to a national religion” and understandably so, because it is an institution that is so dear to the hearts of most voters that it could be an election winner in itself.
Socialists in the Labour Party have to fight in the party and in the affiliated trade unions for the adoption of health and social care policies that are signally in the interests of working people. Labour must demand that there is an end to all profiteering from illness, old age, infirmity or disability. Labour should demand:
*The integration of health and social care, as publicly-owned services, managed democratically by local authorities and health authorities.
*The cancellation of all PFI contracts: all hospitals, clinics and facilities to be NHS-owned and managed
*The cancellation of all outsourcing and privatisation contracts, to bring all services back in house
*The nationalisaton of all social care facilities, to be run collaboratively by the NHS and local authorities
*Integration of all private hospitals into the NHS
*The nationalisation of pharmaceutical and all other industries providing goods and services to health and social care.
*A decent pay rise for all NHS and social care staff of at least 15% of current wages, and a crash recruitment programme in all shortage professions, in collaboration with health and social care trade unions
