Why cake and candles won’t save our NHS. A critique of NHS birthday celebrations.
Last Saturday was celebrated by many as the 66th Birthday of the NHS. Introduced in 1948 the National Health Service made health services affordable for many, particularly women and children, for the first time.
However, it is two years since the coalition government introduced the Health and Social Care Act (2012). Which changed the NHS in England to such a point it would be unrecognisable to those who introduced the NHS in 1948.
The original NHS did two particularly revolutionary things. Firstly, it collectivised the health risk of the nation. Health care costs are often beyond the means of the individual. But not everyone gets sick. The NHS was the first system in the world which put need before ability to pay. Paid for through general taxation, everyone would contribute and everyone would be able to receive the benefits.
Secondly, it removed the profit motive from care. Because all hospital employees would be state employees, nobody in the NHS chain would be required to make a profit. This meant they could focus on the care of the patient and the hospital would not need to take money out of the service to satisfy an owner or shareholders.
In 2012, the coalition government succeed in reversing both these revolutionary principles which founded the NHS. The attacks on the principles which found the NHS have been going on for a long time. Ever since Thatcher’s conservative government the conservative party have sought to under fund the NHS, making it impossible for it to provide the services required by the nation. This led to increased waiting times and a poor quality service. The Labour Party reversed this shortfall in funding, but at the cost of massive PFI debts, and brought in the private sector to help quickly deal with the problem of incredibly long waiting times.
The Coalition have finished the job started by these successive governments and in England have removed these two founding principles from the NHS. (Health is a devolved issue and this has largely, though not completely, protected the NHS in Scotland and Wales. Northern Ireland has a combined health and social care service)
In England, NHS Foundation Trust Hospitals can now take up to 49% of their business from private patients, leading to the potential for a two tier health system. As seen at University College Hospital were £7750 will see you jump to the front of the queue for an elective caesarian section in their new plush private wing, the ‘Fitzrovia Suite’. The principle of collective risk and collective payment has been shattered. A premium services is now available within our state run hospitals for those with the ability to pay.
Alongside this, the coalition reforms put private providers at the heart of the new system. Clinical Commissioning Groups now tout for the lowest bidder to run NHS services. Between April and December 2013 70% of these went to private companies. That’s taxpayer cash being given to private companies to pay their shareholders. The profit motive has been forced back into the heart of our healthcare system. With it comes corruption, collusion and an end to the idea of putting the patient first.
This does not describe the NHS that Nye Bevan created. It does not describe the NHS that I want to work in. I want to sing the praises of our National Health Service and shout from the roof tops about how fantastic it is. Unfortunately the health service that until recently was the best in the world is gone. Or if not gone yet it is disappearing and we are now too late to stop it.
The National Health Service which is left is a logo and no more. As if they had left the British Rail logo on the railways in the 90’s. Left by the coalition because they did not have the decency to tell the public what they were doing to the NHS. I’m not surprised. If they had been honest about their intentions they would not have been elected.
The NHS doesn’t exist in England any more, cake and candles wont bring it back. A well thought out political, industrial and community campaign just might. That has to start with being honest with the public. Until we put back in place the principles that made the NHS worth celebrating, there will be no birthday celebrations from me.