Conservatism and the NHS

When the CON/DEM coalition came to power the NHS was in a fairly good condition. The previous Labour government had increased it’s funding by an average of 5.6% per year, waiting times for surgery were as low as they have ever been.

Jeremy Hunt the current health secretary co-authored a book in 2005 with Michael Gove Douglas Carswell and Greg Clark.  It was called ‘Direct Democracy, An Agenda for a New Model Party’, in this book they state “Our ambition is in effect denationalising healthcare in Britain”.  They also refer to the NHS as ‘a 60 year old mistake’ and ‘a fundamentally broken machine’.  Would you trust this man with the welfare of the NHS?

Margaret Thatcher used to have some strong opinions on the NHS but at least you knew where you stood. Her opinions may have been controversial but they were never hidden. She said exactly what she meant.

Compare this with what is going on today. We now have a Conservative prime minister who has stated that it is not their intention to privatise the health service. He has stated that the Health Service is ‘safe’ in Tory hands. There were posters with a picture of David Cameron with the caption “I’ll cut the deficit, not the NHS” and he has even used his disabled son as evidence of his understanding of the value of the NHS.

But the truth of the matter is very different from the spin. The NHS is in the process of being dismantled quietly and insidiously. I know this to be a fact because I work in the NHS and I have seen this process in operation.

This government has put the NHS through the most disastrous re-organisation in its history whilst at the same time cutting it’s funding and privatising large portions of services.

Privatisation

The Conservatives must have hoped that nobody would realise that ‘Outsourcing’ actually means ‘Privatisation’, they must have a very low opinion of the average I.Q. of the general public.

The past few years has seen an unprecedented transfer of NHS services towards the private sector. It is happening in the name of the Tory dogma of ‘Outsourcing’ or ‘Opening services up to competition’, these seemingly innocuous phrases hide a lot of changes which are happening behind the scenes, with as little publicity as the government can manage.

Of course services which have been ‘Opened up to competition’ almost never go back to the NHS because once the service as it existed within the NHS has been dismantled the people and expertise are gone, the equipment has been sold or transferred to other departments, the rooms have either been used for other services or have been rented out to the private company who are now providing the service.

It is very difficult once a service has been privatised to re-instate that service within the NHS and this almost never happens.

The politicians are very patient, many small steps in their desired direction, each one so small as to be imperceptible to the general public can achieve their objective. It works like a ratchet. It is only necessary to ensure that there are no steps in the opposite direction, never going backwards.

Under the new rules all contracts over a certain value must be put out to tender. The existing NHS services are no longer given ‘preferred’ supplier status.

Companies bidding for NHS contracts tend to bid unrealistically low in order to win the contract. They know that once they have won the contract and the ‘in house’ NHS service has been disbanded it would take much more money to re-instate it and in practice this almost never happens. Also they realise that the only competition is now from other private companies.  So once the contract is won and the NHS competition has gone, the next time the contract comes up for renewal the private company tender for the contract will be much more than it was to win the contract in the first place.

The re-Organisation

Andrew Lansley, was the health secretary behind the re-organisation, which came into force in 2013. The changes abolished large numbers of NHS organisations, including all 151 primary care trusts (which provided services such as hospitals, dentists and opticians) and the 10 regional strategic health authorities.

A recent report by ‘The Kings Fund‘ an independent think tank which deals with health related matters said that the changes had been “disastrous” and “distracted” from patient care. The report said that: “A set of policies designed to streamline and simplify the organisation of the NHS ended up having the opposite effect.”

New bodies called clinical commissioning groups were set up to replace the primary care trusts.

These changes may not have been immediately apparent to patients in GP surgeries, but they were described by NHS leaders as “so big you could see them from space”.

The report went on to say that the government’s re-organisation had wasted three years, failed patients and caused financial distress. It adds that the new system is “bewildering in its complexity” and has left a “strategic vacuum” in some areas.

Indeed the changes have brought about a huge deficit in the NHS finances which will have to be dealt with by whatever government emerges after 7th May. But politicians of all shades would rather that this is not mentioned during the election campaign.

Dr Mark Porter, the head of the British Medical Association (BMA) said that the changes were “opposed by patients, the public and NHS staff, but politicians pushed through the changes regardless”.

He added: “This report highlights the damage that has been done to the health service and the major shortcomings of the Act, which distracted attention from rising pressure on services and cost billions to introduce.

“The damage done to the NHS has been profound and intense, but what is needed now is an honest and frank debate over how we can put right what has gone wrong without the need for another unnecessary and costly top-down reorganisation.”


I do not trust the Tories to look after the NHS, I think that if the country is stupid enough to elect a Conservative government on May 7th then the back door privatisation will continue and by the end of the next parliament the NHS will be in a much poorer state than it is today.

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