By Steve McKenzie, Unite Community member
The NHS is currently facing the biggest crisis in its 76 year history. Huge swathes of the service have been handed over to private healthcare providers, who operate primarily, if not exclusively for profit, rather than clinical need. In addition to this, billions of pounds, which should be being spent on front-line services, are being spent on excessive debt servicing, as a result of the Private Finance Initiative and other poorly financed capital expenditure projects.
Money that should be used to employ more doctors nurses and other healthcare workers, and to pay them properly, is instead being handed over to the finance industry, building conglomerates and private healthcare shareholders. Interest payments and profiteering are playing a major part in bleeding the NHS dry.
Our health service is chronically underfunded, huge amounts of the money that does go in, is being siphoned out, for absolutely nothing in return. Large parts of the NHS are already in the hands of private healthcare providers and as a consequence of the financial problems all of this creates, levels of service to the public have deteriorated dramatically in recent years.
The direct causes of the decline in services are clear:
* There are at least 135,000 staff vacancies in the NHS, with thousands more leaving every year. There are simply not enough doctors, nurses and other health workers to meet patient demand.
* There is a chronic shortage of beds in hospitals up and down the country.
* There are too few surgeons to carry out the number of operations needed.
As a consequence of these shortfalls:
* There are over 7 million on the waiting list for surgery.
* Some patients are left waiting for an ambulance when they need one.
* Some patients are waiting hours in A&E, often in pain, to see a doctor.
* There is systematic deskilling, as fully qualified doctors are replaced with less well trained physician-associates.
Due to a combination of all of these factors, there are hundreds, if not thousands of unnecessary deaths happening each year. This is in addition to the millions of people on waiting lists being left in pain and discomfort.
Successive Tory governments have deliberately and systematically run down the NHS, underfunded it, and handed services over to the private healthcare sector. There is a conscious policy to drive people in pain or in desperate need of treatment, into the private sector. It is a creeping Americanisation of national health care.
Despite Keir Starmer, Labour will win the next election, and form the next government. But if the Labour leadership had an ounce of socialist fibre, they would make the NHS central to their election campaign and it would guarantee a landslide.
It is such a demanding issue that it has led to a Tory MP jumping ship to Labour, and there must be a lot more Tory MPs feeling the heat about how bad the service has become. But it is not enough for Labour just to say that they can do it better, what Labour would needs to do, is to promise a complete rebuilding of the NHS:
* All services need to be brought back in-house, and private contractors and the profit motive, should be driven out.
*Legislation that facilitated the privatisation of many NHS services, (the National Health Service and Community Care Act of 1990 and other Acts), need to be repealed.
*NHS debt needs to cancelled including, and especially, PFI debt.
* There needs to be adequate funding to fill the vacancies, pay decent wages, improve ambulance, A&E, and other services.
The health and social care act of 2012 removed responsibility for the health of citizens from the secretary of state. This is a responsability that needs to be reinstated. The health and care act of 2022 that split up the health service needs to be repealed.
It is a disgrace that the Labour leadership, far from following the tradition of Nye Bevan, the founder of the NHS, are determined to use the private sector to ‘cut waiting lists’. That will simply mean more NHS money is going into private shareholders bank accounts, ignoring the fact that every procedure and operation in the private sector is using staff trained by the NHS and, in the case of surgeons, ‘seconded’ from NHS work.
The rhetoric of the likes of Keir Starmer and Wes Streeting, that they support the principle of a health service “free to all at the point of need” ignores the fact that the private sector is a leech on the NHS. While they are preparing to have money syphoned off the NHS for the private sector, there are no plans announced to improve services. In fact, the diversion of funds into private pockets will worsen the problems of low pay and the thousands of unfilled vacancies.
What is equally dangerous is the mantra coming from right-wing Labour MPs about “reforming” the NHS. As we know from past experience, too often this has meant a cover for more privatision.
Genuine socialists still in the Labour party need to raise their heads above the parapet to defend NHS, if necessary against further privatisation under Wes Streeting’s guiding hand. Pressure needs to be applied through affiliated health service unions (Unison, the GMB and Unite), and affiliated groups like the Socialist Health Association. Unison, GMB and Unite must be made to drop their ‘partnership’ approach and adopt a campaigning stance in defence of the principles of the NHS.
The role of non affiliated unions, (who have been far more effective recently), like the British Medical Association and the Royal College of Nursing must never be underestimated.
Full support of doctors nurses and other health workers in dispute is essential. Getting along to picket lines and activities organising to put pressure on MP’s is essential.
National and local health professionals, and patients groups like Keep Our NHS Public and Reclaim the NHS play an invaluable role, and all socialists should all play a role in supporting their national and local campaigns. Distributing leaflets and collecting signatures for petitions to defend the NHS is the sort of basic activity we all need to be involved in.
All of us have a responsibility to put maximum pressure on our trade unions and above all a Labour government to ensure that it behaves like a Labour government committed to rebuilding the NHS.
Socialists still in the Labour party undoubtedly have a role to play. Resolutions at general management committees and policy adopted at national conference are of vital importance.
Every one of us has a role to play. Raising the issue in our union branches, letters to MP’s, joining demonstrations in support of the NHS and supporting health workers on picket lines.
