The Government and NHS England Direction to “Think the Unthinkable”
on NHS Cuts and Closures Will Be Another Disaster for Society
It was revealed by the Health Service Journal (HSJ) i during the General Election that the government-led NHS England commissioners were planning “unthinkable” measures across 14 areas of England which included closing hospital Accident and Emergency departments, acute services, stopping treatments and systematically extending waiting times. This was kept secret during the election, as was the outcome of the consultations on the Sustainability and Transformation Plans (STPs) which had received massive opposition from health campaigns, councils and health staff in the run-up to the election. However, it was revealed in the Conservative manifesto and Theresa May’s admission that her new government intended to implement the Naylor report which would accompany these closures of vital NHS services with a massive sell-off of NHS property.
In spite of the fact that May’s government has not received a majority in Parliament in the June 8 General Election, it is pressing ahead with its anti-social offensive in health and social care. For example, in South Tyneside, a consultation to downgrade the hospital’s consultant-led maternity and A&E starts on July 5. In addition, instead of addressing the funding crisis that they have created in the NHS, the government and NHS England have instructed fourteen other areas of the country to draw up plans to reduce overspending, including closures of maternity and A&E departments. These areas include: Bristol, South Gloucestershire and North Somerset; Cambridgeshire and Peterborough; Cheshire (Eastern, Vale Royal and South); Cornwall; Devon; Morecambe Bay; Northumbria; North Central London; North Lincolnshire; North West London; South East London; Staffordshire; Surrey and Sussex; Vale of York; and Scarborough and Ryedale. Also, speaking about the STPs, the British Medical Association has warnedii that nearly 23 million people in England – more than 40% of the population – could be affected by proposed cuts to A&E departments.
The cause of these deficits to hospitals and the health services they run have been mainly created by the annual “cost improvement” programmes which are imposed on them by government and their commissioner, NHS England. By 2016 the “deficit” just involving Hospital Trusts was £2.45 billion. Although a substantial sum, it is nothing compared to the whole budget of the NHS, which is in excess of £100 billion. Yet, the government’s imposition of these “deficits” on individual hospitals has led to big cuts in services, and a situation where hospitals are scrabbling for income from private operations, charging for parking and so on, and have left most hospitals very seriously underfunded and with huge debts. The government then imposes, through its organisation “Monitor”, coercion to get hospitals to divest themselves of hospital services and staff using the threat of outside takeover or merger. “Consultations” on NHS closures and downgrading then take place on the back of massive cuts and where the blueprints have been decided in the corridors of power without, or with little involvement of the clinical staff and the people are left with a rapidly reduced and poorer unsustainable and unsafe health service. As a cover the government tries to impose a mass media blame culture on the hospitals for “overspending” and even on the patients for “ageing” and demanding too many services. These are all smoke screens to hide the criminal role of a government hell-bent on taking no responsibility for the people’s welfare, whilst directing the economy to pay the rich in Britain.
The real scandal of these “deficits” is that responsibility lies with the government and the Department of Health to meet all the needs of the NHS budget and provide a modern health service that meets the needs of all and provides comprehensive acute, community mental and social care services accessible to all in their localities. The Francis Report of the Mid Staffordshire NHS Foundation Trust Public Enquiryiii pointed out the devastating effect on safe and sustainable healthcare in one hospital where management focused on “financial issues” cutting nursing staff which led to hundreds of patients being left without food and water and proper care and many dying as a result. It said: “It is clear from the evidence at both inquiries that the Trust was operating in an environment in which its leadership was expected to focus on financial issues, and there is little doubt that this is what it did. Sadly, it paid insufficient attention to the risks in relation to the quality of service delivery this entailed.” In other words, the hospital Directors who are employed to keep the hospital in budget and meet “cost improvement” – cuts that government was imposing on the NHS – led to this disaster of healthcare at the Mid Staffordshire NHS Foundation Trust. This was the environment of government cuts that concentrated everything on issues of finance rather than of patient quality and sufficient staff and wards.
Consider the implications of further extending this environment across our whole health service, not just affecting quality, but now even access to these health services as local A&Es and other acute services close, which is precisely what the government is implementing. Add to that further unsafe and unsustainable funding for hospitals and acute health services that remain. Health services will not become safer if services are moved to a fewer number of acute hospital sites where A&E departments cannot cope. This is not only likely to increase waiting times for more overstretched services, it also means people have to travel further distances from their communities seriously increasing the risks to patients lives. This further impacts already overstretched ambulance services, bus services, car parking, etc., further exhausting the resources of society and impacting on the most vulnerable whose right to life, let alone the right to healthcare, will be threatened.
In an interview in the Independentiv, Janet Davies, Chief Executive of the Royal College of Nursing (RCN), said on the eve of the national day of action this week, that they were organising a summer of lobbying, as a “final warning” to ministers to take action or face its nurses striking for the first time ever against plummeting nurse recruitment, and chronic low pay and high stress pushing people out of the NHS. She said that dire staffing shortages have left the NHS on the brink of another Mid Staffs hospital scandal, putting hundreds of lives at risk. She warned: “They are risking it again. They are aware of the problem, but their solutions are not working.”
The fact is the aftermath of the tragedy of Grenfell Tower and the large number of horrific and avoidable deaths has exposed the whole rotten edifice of the pay the rich system in Britain. The direction of government and NHS England to “Think the Unthinkable” on NHS cuts and closures will be another pending disaster for society imposed by such a system. For health workers and for the working class and people, turning this around requires an organisation that empowers the people and that unites people regardless of political and other views to organise themselves to deprive the ruling circles of their power to deprive the people of what belongs to them by right, that upholds the right to health care and the rights of all. The people’s demand for an anti-austerity agenda and the demand of the ruling circles for private interests to prevail are face-to-face in Britain as never before since the anti-social offensive was unleashed during the Thatcher years and when New Labour became its champion under Tony Blair. This experience must be summed up by the working people, the initiative kept in their own hands as they strive for empowerment. Let us take control of economic affairs and make the claims on value that workers and public service workers produce. Let us build the Workers’ Opposition as the new public authority to shape the direction for society to stop paying the rich and invest in a new social economy that meets the needs of all!