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Our NHS is ill. Its health is worsening. Like someone with cancer, symptoms appear in different parts of its body although it just gets by day to day.
Last year's deficit was £820 million. In just the first three months of this financial year it was £930 million.
"The NHS simply can no longer afford operationally and financially to operate in the way it has been", warned David Bennett, head of Monitor, responsible for overseeing NHS Foundation Trusts.
That means rationing health care with lengthening waiting lists; stopping some treatments altogether; concentrating services into regional centres; and more privatisation. Finally, charges will be put on GP visits and hospital treatment, making private health insurance a necessity (for those who can afford it).
That's all great news for corporations aiming to suck profits out of the NHS budget. It's grim for patients and healthcare workers.
The cost of hiring temporary staff to cover shortages has escalated. The Department of Health published plans in 2013 to cut the £2.4 billion bill by 25%. Instead it has grown by 25%!
A few very highly paid medical consultants make headlines but agency nurses, midwives, physiotherapists and many others are regularly hired to fill staffing gaps.
Half the 20,000 student nurses completing their training in 2006 could not get NHS jobs due to cuts. Workloads increased, with bullying management under pressure to meet impossible targets, so sickness absence has gone up.
After a 10% cut in real pay and worsening conditions, more staff leave. Many can earn more as agency, with fewer hours and less pressure.
For 30 years Tory and Labour governments claimed 'a competitive market' was the only way to run the NHS instead of 'outdated central planning'. The staffing crisis is one result. Trusts compete to get trained staff who are in limited supply.
"We will have to clamp down on some of these staffing agencies who are frankly ripping off the NHS," claims NHS chief executive, Simon Stevens. But Stevens is one of the architects of this crisis, first as Tony Blair's health adviser, then as a director of US giant corporation, United Health.
Hiring agency staff hits headlines. Hiring management consultants gets less publicity. Trusts spending on them doubled between 2010 and 2014 to £640 million - enough to pay for three medium-sized hospitals or 20,000 nurses.
The largest management consultants have close links with the Department of Health. In 2013 USA company McKinsey invited David Prior - then chair of the Care Quality Commission, which regulates all NHS hospitals - to discuss "building a national health insurer" and "private health insurance growth opportunities... the new frontier."
They put him up in luxury US hotels at a cost of $3,000. He thanked them afterwards. "I much enjoyed it. It does create the space to think and for ideas to settle... But the biggest message is the scale of likely change - 50% of hospital beds could close."
Lord Prior is now Tory minister responsible for NHS productivity. His replacement at the Care Quality Commission, Michael Mire, is a former McKinsey partner.
In 2014-15 private companies won £3.5 billion of new clinical contracts - up 500% on the previous year. Profit making firms have taken more than 60% of all contracts since 2010.
13 'super-contracts' worth over £100 million each were awarded last year, more than the previous four years added together. Private companies won six. Five were won by consortia of NHS and non-NHS organisations. Only two were won by NHS organisations alone.
'Prime Provider' contracts allow sub-contractors to carry out the work. Virgin Care won a £280 million contract to coordinate care for long-term illness and care of the elderly in East Staffordshire. The companies actually carrying out the work are chosen by Virgin without any further public scrutiny, leading to care workers on zero-hour contracts and the minimum wage.
A voluntary agreement with the pharmaceutical industry in 2013 should have capped NHS spending on branded medicines for two years. But the cost of medicines prescribed by hospitals in England increased by 15% to £5.8 billion in 2013-14.
Partly this is due to new expensive drugs. But older branded drugs are suddenly escalating in price. Turing Pharmaceutical increased the price of a Daraprim tablet (used in the treatment of cancer and HIV) from £8.79 to £488! The medicine was identified 62 years ago. Other less extreme cases are unpublicised.
Labour leader Jeremy Corbyn has rightly said: "It's our NHS. Let's not just protect it from being further destroyed but let's take it back and ensure it's completely publicly run and publicly accountable. Healthcare is a human right, not a privilege."
The new shadow health secretary, Heidi Alexander, has been less forthright. She told the BBC she was open to a "very, very limited role" for private provision, if it improved the efficiency of services.
There can be no compromise with profit-seeking big business. Its priorities are shareholders' dividends, not patient care.
Corbyn must stick to his guns. That needs a programme to cut out the capitalist cancer of 'the competitive market', renationalising all privatised services, ending the rip-off Private Finance Initiative and nationalising the pharmaceutical and medical supply industries (and appealing to workers internationally to nationalise their health and pharmaceutical industries too).
The NHS logo might still fly from hospital roofs but a genuinely integrated national health service barely continues to survive.
My family are witnessing this at first hand. An 84 year old extremely sick relative has been told that she needs to be sent back to a hospital she was brought from, because the brand new Private Finance Initiative build she's currently in doesn't have a bed for her beyond the next 72 hours.
The trouble is, neither does the other hospital, which is at this moment completely full, yet if it fails to locate one within the next three days, it will be heavily fined by the government.
Dedicated staff quietly agree that there is no medical benefit to her being transported 40 miles up the road, yet say they are powerless to contest this insane rule that pits hospital against hospital.
Millionaire health minister Jeremy Hunt, like his New Labour Party counterparts before him, boasts that the creation of an NHS internal market benefits patients and provides them with choice.
One more Tory lie, one more reason to fight like never before to protect our cherished NHS.
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Article dated 14 October 2015
The Socialist, weekly newspaper of the Socialist Party
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