By Phil Welldrake and Andy Ford.
The Conservatives Health and Care Bill offers the prospect of yet another huge shake-up of the NHS. Primarily it is aimed at capping spending on the NHS, even in the face of an ageing population, advancing medical technology and medicine, chronic staff shortages and a systemic crisis in social care.
The Bill breaks the NHS up into a number of Integrated Care Systems (ICS), which appear to be based on the American Healthcare Management Organisations (HMO). HMOs exist to protect the profits of insurance companies by capping the total expenditure of each hospital or health provider. In the American health system, care is not provided on the basis of clinical need, but on the basis of what the patient or their insurer can afford.
Phil Welldrake writes: As a member of Greater Manchester and national Keep Our NHS Public (KONP), and as a Unite member campaigning to protect the Reproductive Medicine Service at St Mary’s Hospital Manchester, I am writing to alert as many people as possible to both to the impending dangers to the NHS in England, and to the threat posed to the future terms and conditions of all health workers in England.
Vital that labour movement is mobilised against these ‘thiefdoms’
The Bill passed its Second Reading and will now enter its scrutiny and amendments stage on parliament’s return on the 6thSeptember. Subject to the degree of opposition, it is likely not to reach its final reading until late November 2021. It is vital that during this stage we are able to mobilise the labour movement and the public to oppose this bill. I have attached some detailed independent analysis of this legalisation
This Bill and the legislative proposals within it confirm an intention to break the NHS up into 42 semi-autonomous ‘thiefdoms’ that are democratically unaccountable and with a heavy influence from the private sector in funding decisions and the allocation of public funds. And if that is not bad enough, the legislation no longer gives a statutory duty to provide a comprehensive range of health care to citizens and undermines the professional status of NHS staff. Added to which, it is likely to create regional pay systems and to destroy the national terms and conditions that have existed in the NHS since 1948.
BMA also oppose the bill.
Please take the time to read this analysis of the Health and Care Bill and its impact on patient care and staff terms and conditions, by Greg Dropkin Liverpool KONP. The BMA are also opposing the Bill and their view can be read here. And Open Democracy, in a powerful article, highlights how the Bill will affect the working of the NHS and its impact on patient care and staff pay and terms and conditions . This final item is an article from John Lister, editor of “Health Campaigns Together” highlighting the lack of transparency and democratic accountability in the working of the NHS under the new Bills proposals.
If these proposals are passed without substantial amendment it would effectively mean the end of the NHS has we have known it, and it will have a permanent detrimental impact on the health care of patients and the future terms and conditions upon which NHS staff are employed. The management structures in this Bill lack any democratic accountability and establish mechanisms by which representatives of private companies can be appointed to seats on key decision making boards, thereby giving them control and influence in the future running of the NHS .
It will effectively be the end of an NHS in England as a public provider of comprehensive health care, based on clinical need and free at the point of delivery. The passage of this bill, and particularly its proposed changes to assessment and discharge policies from the NHS to social care, will also have a devastating impact on social care at a time when it is on the verge of collapse and there are no clear government proposals to address future social care issues.
The labour movement could do far more about it
The Bill is opposed by the Labour Party and other opposition parties in England, and also by the British Medical Association. However, despite the catastrophic impact this Health and Care Bill could have on the NHS, the trade unions and the Labour Movement could do far more about it, even as this Bill passed its second reading.
In order to have any chance of at least securing amendments to the worst aspects of this bill, the support of the major health care unions will be of vital importance. I hope that upon reading the material attached to this article you will be able to raise issues within your union branches and CLPs to mobilise support and to encourage your national unions to oppose this Bill. KONP have produced leaflets aimed at hospital staff members alerting them to the risks posed to their terms of employment and professional status.
There is a narrow window of opportunity
KONP can provide a speaker to attend your branch meeting to highlight our concerns regarding the future implications of these proposed health care reforms. Between the September 6 and possibly early November through to mid-December, there is a narrow window of opportunity to make amendments to this Bill to mitigate its damaging impact on future health care in England. But if we are do so, we need to start planning and campaigning now!
Phil Welldrake is a member of Unite union and Keep Our NHS Public in Manchester, and Andy Ford is chair of the NW Health Committee of Unite.
