The affordable cost of our healthcare

Workers' Fight workplace bulletin editorials
31 March 2014

The process of dismantling the NHS by closing down facilities and allowing more and more private sharks to feed off its budget, is not exactly new. It began under past Tory governments, in the 1980s. Then Labour governments took it even further under Blair and Brown. And, since 2010, despite their pledge to "ring-fence" healthcare, the ConDem coalition has been running down the NHS even more than their predecessors.

But so far at least, no government has ever dared to put into question the principle that the health service should be free at the point of use. Or, at least, they haven't done it openly. Because, in practice, they have already invented many ways of giving patients no choice but to pay for their care - especially when they need treatment urgently and cannot wait for months for a hospital appointment.

Less and less free care?

But this may be about to change. At the end of March, a think-tank called "Reform" which specialises in advising government on how to run public services, produced a report on the future of the NHS entitled "Solving the NHS care and cash crisis". Put in a nutshell, its main (familiar) argument is that the NHS is becoming "unaffordable" due to an ageing population - and that, therefore, its costs must be cut drastically. In addition, this report argues that new sources of NHS funding need to be found urgently.

What caught media headlines was the proposed introduction of a £10/month "membership fee" for all adults who use the NHS, which would be collected by local authorities, together with the council tax. But, in fact, this is not the only proposal contained in this report. Another, is to increase alcohol and tobacco duties and introduce special taxes on all products deemed "unhealthy" - like fizzy drinks, sweets, etc...

What is common to these proposals is that they are deeply unfair, since they amount to charging a flat health tax, independent of people's income - including for those who earn less than the income tax lower threshold. It is reminiscent of the poll tax. And while these additional taxes would be a burden on the poor section of the population, which already has enough difficulty making ends meet, they would be negligible for the well-off!

But there is even worse in this report: in particular, the proposal to charge hospital patients a "hotel fee". A figure of £20 per night has been suggested. As if in-patient treatment is a luxury that the sick can do without! "Healthcare, free at the point of use"?

Health care is not "unaffordable"

Following the publication of this report, ministers were quick to deny that they had any immediate plans to implement it. Of course. Especially since they are busy trying to rally voters in the run-up to the coming elections!

But the head of "Reform", Andrew Haldenby, just "happens" to have made his career in the Tory party. So it's not for nothing that much of his report is devoted to proposals which expand on the ConDems' new Care Bill - in particular the "commercial diversification" of hospitals in order to raise revenue, the systematic tendering out of services to private companies and the full powers to be conferred on administrators, allowing them to close down hospital facilities against doctors' advice.

But Labour isn't any better when it comes to NHS policy. The author of Reform's report, Norman Warner, happens to be a Labour peer and a former health minister under Blair!

Even more telling is that the new head of the NHS, appointed by Cameron, is Simon Stevens, who was NHS advisor to Blair until 2004! He then left to join the US private health giant, United Health. He is thus well-qualified to implement the latest "reforms", ie., the next phase of commercialisation of the NHS!

The truth is that the main parties agree on the running down of the NHS. They all bow to the capitalists' wishes: first, to cut "public expenditure" on the NHS, and second, to divert a larger and larger amount of what's left, into private pockets.

And this is the reason that the NHS is at risk. The main problem is not lack of "efficiency", as politicians claim, but a lack of permanent staff and facilities. Nor is it "unaffordability". If the NHS weighs so heavily on the state budget, this is primarily because it is a captive market for the giant pharmaceutical companies who suck their profits out of it. In addition, it is paying for the profits of all the private contractors and healthcare companies which have mushroomed over the past 2 decades, thanks to backdoor privatisation.

If the health profiteers were taken out of the picture, by the state taking over the whole "industry", without compensation to shareholders whose pockets are already full of state money, there would no longer be any question of "affordability"!