The profit virus kills the NHS

Workers' Fight workplace bulletin editorials
11 November 2015

As winter approaches, alarm bells are ringing throughout the NHS - so much so, that some NHS establishment figures have decided to go public.

Writing in the Guardian, on 8 November, Christopher Smallwood, an economist who chairs St George's University Hospitals NHS Trust in South London (where the Channel 4 series "24 hours in A&E" is filmed), gave this warning: "The NHS is heading for a real smash, and practically everyone running a hospital knows it. Hospitals are at 100% capacity at the moment and the onset of winter could be a nightmare."

Yet the cause of the problem is well-known and long-standing: under-funding. Despite Osborne's hypocritical pledge to "ringfence" the health budget, "the past five years have seen the smallest increase in health spending over any parliament since the second world war - 0.8% a year", says Smallwood. And this, when, at the same time, operating costs were increasing by more than 5 times as much!

A disaster in the making

As a result, NHS hospitals have built up massive deficits. "Two years ago", writes Smallwood, "a quarter of hospitals recorded deficits. Last year, this rose to half...and 90% expect to be in deficit by the end of this year."

This has dire consequences, because to try to re-balance their books, hospitals have to cut every bit of spending to the bare minimum - or less. So, adds Smallwood, "...vacancies are left unfilled,

staff-patient ratios are relaxed, and hospitals cut their capital programmes, which means fewer operating theatres and MRI scanners... Waiting times for cancer treatment and in A&E departments, are now missed routinely, as is the maximum wait for diagnostic tests... The queues will go on lengthening.

And this comes on top of the destruction of NHS resources: 500 GP surgeries, 51 walk-in centres and 66 A&E departments and maternity wards were closed over the 5 years up to last April!

At the time, over 140 doctors published an open letter in the press, to protest against the deterioration of the situation, denouncing intolerable conditions, such as the fact that "patients have been left queueing in ambulances and NHS trusts have resorted to erecting tents in hospital car parks to deal with unmet need."

More recently, the government's attempt to impose a new contract on junior doctors has caused a storm. It would force them to work even longer hours (they may already be working up to 90 hours certain weeks) while earning less. They are now having a strike ballot - something very unusual for them, but which probably gives an accurate measure of their justified anger!

Cuts, or bounty for the profiteers?

Of course, together with the over-worked NHS staff, the first victims of Osborne's policy are the patients themselves. This year, the numbers of people in need of treatment on the NHS waiting lists went over 3m - a 6-year high! And no improvement can be expected in this respect as long as the government follows its present policy.

This policy is based on a report produced by NHS head, Simon Stevens, which acknowledged that, by 2020, the NHS would need £30bn more each year. However, Stevens' trick was to combine an £8bn/yr budget increase (by 2020, that is, which means that once inflation is deducted it will be reduced to nothing) and £22bn/yr worth of "efficiencies", meaning cuts in jobs and healthcare provisions.

Never mind that the main problem for the NHS today is precisely that it has too few people to do the work and that it cannot offer enough treatments for those who need them.

But, while both patients and NHS workers are affected by this policy, not everyone is losing out. Today, a whole private "health industry" is blossoming, which is mostly funded by the NHS budget and would never have seen the light, if it had not been for the artificial under-funding and cuts imposed on NHS hospitals. The sub-contracting of NHS work to private operators, which was first introduced by Blair, has been generalised since, under the pretext that NHS hospitals couldn't do this work - since they didn't have the funds!

Never mind that this sleight of hand is actually extremely costly, since the NHS budget has to pay for the private shareholders' dividends!

Ultimately, in the NHS as well as everywhere else, Osborne's cuts are designed to allow the capitalist class to milk public funds at the expense of the working class as a whole!