Is the NHS safe in Conservative hands?

It seems to me that the Conservatives are trying to break the NHS by driving it into debt and reducing the workforce whilst privatising it gradually by the back door with as little publicity as possible.

Of course they don’t want to be seen to be destroying the health service because that would be politically unpopular.  But it is difficult to break the NHS without people realising what you’re doing.

The first thing they did was to decimate community health care and council services.  The people served by these services didn’t go away or stop requiring treatment therefore the burden of treating these people was dumped on the NHS causing already overstretched services to be swamped and budgets to become overspent.

Now Mr Hunt is trying to impose a contract on the junior doctors which will designate weekends as normal working days.  The modest pay increase included in the new contract will be more than offset by the reduction in overtime payments under the new contract, so it’s actually a pay cut.

But for the junior doctors it is not about pay, it is about the drive to fully staffed operation of NHS hospitals seven days a week with no extra staff and no extra funding.  And Mr Hunt says that he isn’t trying to make doctors work longer hours, errr ….  something doesn’t seem to add up there.

The drive to implement a seven day NHS is based on flawed statistics which misrepresent the real situation.  The NHS already works seven days a week.  Routine clinics and services are only run during the week but all the departments and services which are needed are staffed during the weekend.

The much quoted statistic about you being more likely to die if admitted at the weekend than if admitted during the week is deliberately misleading.  Many people are admitted during the week for a variety of reasons, most of which are the result of routine hospital visits.  However the routine services are not run at weekends so if you are admitted at the weekend it is more likely to be the result of an emergency.

People who are admitted as the result of an emergency visit are likely to have more serious problems than those admitted as a result of a routine visit and I would suggest that this is more likely to be the cause of the difference in outcome rather than any deficiency in the care at the weekend.

So why are the Conservatives and in particular Mr Hunt trying to break the NHS?

Is there perhaps some hidden agenda at work here?

Well in 2005 Jeremy Hunt co-authored a book, ‘Direct Democracy: An Agenda for a New Model Party‘.  If we look at the chapter on health we see that the author said on page 78 – “Our ambition should be to break down the barriers between private and public provision, in effect denationalising the provision of health care in Britain”.

I have read a copy of the book although I cannot post any more than a brief excerpt here due to copyright concerns.  It used to be widely available on the web but is disappearing fast as copies available on websites are mysteriously vanishing.  However it is still available in some places.

This book which was co-authored by Jeremy Hunt advocates the de-nationalisation of the NHS and the introduction of an American style insurance scheme were patients pay into their individual pots and decide how to spend it.  This gives grave cause for concern given that Jeremy Hunt is now in charge of the NHS.

Having a seven day NHS is not possible without adequate resources and staff, but if the real reason you’re doing it is in order to break the NHS so you can introduce privatisation as a remedy then it makes perfect sense!

 

Brexit, what a stupid decision!

“Ever feel like you’ve been cheated?”

John Lydon

As far as I can tell the referendum started out as an internal spat in the upper echelons of the Conservative Party.

Why did the country collectively make such a monumentally stupid decision in the EU referendum?

And now that we have made such a stupid decision, the people who were encouraging us to vote to leave and making such grand promises, 350 million pound per week to spend on the NHS, control over our own borders, control on immigration, etc, etc, these people are just turning away and dropping out.  Even David Cameron has resigned.

The leaders from the leave campaign are all leaving, they don’t want to take responsibility for the mess they have created, they don’t want anything to do with the aftermath because they know that the lies they told us will be exposed as lies.

“Well actually we won’t have 350 million a week to spend on anything, it was a fictitious figure.”

“Well actually we won’t be able to control immigration after all sorry, bit of an over-exaggeration there.”

I think one of the problems was that both sides were running such negative campaigns. Both were claiming disastrous things would happen if you don’t vote the way we want you to vote. The Remain campaign should have focused more on the positive aspects of EU membership and what we were getting for our money.

Things like the Advanced Manufacturing park in Sheffield, that was funded with EU money.  Would it have been funded without EU money?  Well it might have been but only if it was in London!  and therein lies the problem.  There is a metropolitan elite in London which marginalises the rest of the country, if it’s outside London it dosen’t matter.

There are a lot of people outside London who feel marginalised, there are many people who wanted to show the London elite that they can’t ride roughshod over the rest of the country, they wanted to make a difference.

The EU vote wasn’t just a vote to leave the EU it was a big two fingers up at austerity and immigration and at the cozy clique of public school toffs who are running things.  And yes they made their voice heard but what a mess they have created in the process.  Leaving the EU won’t significantly reduce immigration, not if we want to remain part of the single market and if we do leave the single market then we are screwed financially.  Leaving the EU won’t mean an end to austerity, it will actually generate a lot more austerity, you thought you had it bad brother, you ain’t seen nothing yet!

The 350 million pounds a week was a fictitious figure, yes as a top line figure we gave 350 million pounds a week but we were getting most of that back in a rebate so the actual figure was much smaller, and on top of the rebate we also got money for projects like the Sheffield Advanced Manufacturing Park, grants for scientific research, subsidies for farmers, etc, etc.

So if you were expecting an increase in funding for the NHS after this vote then think again, the money isn’t there, it never was.  Funding will probably be cut drastically when the value of the pound falls through the floor and we suffer the worst recession in living memory, but at least we got our county back yippee!

Political Manipulation

I feel disenfranchised at this election, I live in a ‘Safe’ Labour constituency. Whatever candidate the Labour party put up, however bad, will get in with an overwhelming majority.

Rupert Murdoch’s vote counts a lot more than mine and he doesn’t even have a vote in this country.

The Sun newspaper is controlled by Rupert Murdoch and its editorial content will broadly reflect his views. If it does not the the puppetmaster gets a new puppet rather quickly.

In Scotland the Sun is telling people to vote SNP but in the rest of the UK the Sun is telling people to vote Tory.

This is because the puppetmaster knows that the Conservatives have no chance of getting many seats in Scotland and he doesn’t want those votes to go to Labour.

I don’t particularly like Labour since they dumped their socialist principles and turned into ‘New Labour’ but given a choice between a Labour government and a Tory government I think a Labour government is less bad.

If we get another Conservative government then over the next five years they will eviscerate the NHS, they will continue to erode (or circumvent) workers rights and to erode tenants rights.

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.

Some thoughts on NHS pay

These times of austerity have been austere indeed for people working in the NHS, unlike members of parliament who awarded themselves a 10 % pay increase NHS pay has been frozen for the past three years, this means that since 2010 pay has actually fallen by 10% once you take inflation into account. The NHS administrators wanted to continue the pay freeze but they have been overruled by the government. The government felt on the one hand it couldn’t afford to give staff a pay rise, while on the other realising it couldn’t afford not to.

So this year there has been a pay rise of a sort but it is only 1% and it is a ‘pay uplift’ rather than a pay rise. What’s the difference you ask? Well a pay uplift is not consolidated so at the end of twelve months the pay goes back to what it was before the pay uplift (conveniently just after the next election).

All NHS staff will get at least a 1% pay uplift. Just over half the staff receive incremental pay rises each year – determined by their length of service and performance. For those who are still receiving increments because they are not yet at the top of their pay band there will be no pay uplift at all they will only get their incremental increase, those whose incremental increase is less than 1% will have their pay rise made up to 1%.

The government has been quick to portray incremental pay increases as being ‘automatic pay increases’. They also point out that people in the private sector do not get ‘automatic pay increases’.

This is a deliberate and cynical misrepresentation of the facts.

Let me explain.

For any job there is a ‘going rate’ for that job, a rate one could reasonably expect to receive if one were employed doing that job.

Arrangements in the private sector vary a great deal but generally you could expect to be employed on that going rate at the start of your employment.

For NHS employees there is also a going rate for the job but an NHS employee does not get put onto that rate at the start of their employment, instead they would be employed on a much lower rate and then get annual increments determined by their performance each year until they reach the top of their pay band (which is the going rate for the job), at that point they receive no more increments. Incremental pay is meant to reward the growing competence and skills that come with experience.

This was originally done save money on the pay budget but now it has become convenient to the government to portray it as being ‘automatic pay rises’. This government is showing complete contempt for NHS staff.

The ‘pay uplift’ trick will be applied in 2015-16, when the ‘pay uplift’ will also be 1%. But these two 1% uplifts will not add up to 2% because when the 2014-15 uplift runs out our pay goes back to the level it was before, the new uplift just maintains it at this meagre level for another year.

The pay deal which has been imposed will cost the NHS over £1bn each year.

The bean counters in the NHS are warning that we can’t afford this. To help cope with rising demands, the NHS has been asked to save the equivalent of 4% a year (£4bn to £5bn in cash terms) and pay accounts for 40% of the overall budget.

This is not the only threat to the NHS, this pernicious conservative government are busy privatising the NHS behind the scenes and they have introduced a new trade agreement with the United States of America which will allow American private healthcare companies to bid for NHS contracts. It also allows American private healthcare companies to sue the NHS for anti-competitive practises (i.e. being subsidised by the government).

This Conservative government might say that the NHS is safe in their hands but their words ring very hollow when one examines the facts.

The unpublicised limits on A&E

There is a problem in the Accident and Emergency departments in Britain and this is a problem which has been glossed over in the press.  I was absolutely amazed that the press have not picked up on this more than they have now that the information is in the public domain.

The problem is that each Accident and Emergency department has a limit to the number of patients it can admit before it suffers financial penalties.  If a patient is admitted and if they are within their quota then the cost of that patients treatment in the hospital will be funded.  If they go over their quota and admit a patient then the hospital only gets 30% of the cost of treatment for that patient.

There are also government rules on re-admission, there is a limit on how soon someone can be admitted to hospital after having been previously admitted to hospital.  If they are admitted within this time then the assumption is that their previous treatment was inadequate and the subsequent treatment is not funded.  But there are many patients with chronic and serious health problems who would have recurring problems whatever the quality of their treatment.

Think about this.  It is not as if the hospitals are empty and the doctors are admitting patients needlessly just to make money for their hospital.  Hospitals are usually full (over full in many cases), admitting someone who attends an A&E department is a serious matter, the patient is only admitted if they have a serious clinical need.

With this quota system it places an additional strain on doctors working in A&E when they have to take into account weather the hospital can afford to admit the patient.  The decision weather to admit a patient or not should be entirely a medical decision not a financial one.

I am not saying that there have been cases where a patient has been sent home when they should have been admitted to hospital purely because the A&E department was over it’s limit or if the patient had been admitted previously within the time limit.  But one could imagine a scenario where this might well happen.

How would you feel if that patient was one of your relatives?  How would you feel if that patient was you?

Back door privatisation of the NHS

Margaret Thatcher died recently.   She was exceptional in many ways, I for one took exception to her.   But whatever your opinions of her were, at least you knew where you stood.   Her opinions were controversial at times 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.   But the truth of the matter is very different from the spin.   The NHS is in the process of being dismantled quietly and insidiously.

The past few years has seen an unprecedented transfer of services towards the private sector.   It is happening in the name of the Tory dogma of ‘Opening services up to competition’, this seemingly innocuous phrase hides 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 have moved elsewhere, the equipment has been sold or recycled, 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 current CON/DEM 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.

It may take many years to achieve their goal, but the Conservatives will keep moving relentlessly towards it privatising the NHS bit by bit until a hospital is just a building within which private companies provide various services and the NHS will exist in name only.

That will be a sad day indeed.