Socialist Worker

The fight for the NHS is far from over

by Jackie Turner, GP in London
Issue No. 2295

The hugely unpopular Health and Social Care Bill is a deeply regressive piece of legislation. It will unleash one of the biggest social injustices ever visited on NHS users and workers.

If enacted it will fundamentally change the NHS from a tax funded service to an insurance-based system as we see in US. These changes will not become apparent immediately. But the direction of travel is obvious.

New Labour was already pushing ahead with privatisation. But health secretary Andrew Lansley’s reforms give the private sector unprecedented access to the NHS—and they expect to make a tidy profit.

The government would have us believe that the bill is all about patient choice and em­powering GPs to purchase the best care. But this could have been achieved without legislation.

GPs have already begun to set up Clinical Commissioning Groups (CCGs) to buy health care for their patients. But at a time when the NHS has to make £20 billion “efficiency savings”, GPs will find that they have to ration care.

CCGs will find it very difficult to balance their budgets. Economies of scale will force them into larger and larger groups and to lose their locality focus.

Many CCGs are being advised on their “operational development” by firms such as McKinseys, which is positioning itself to swoop in and take over.

After this it will not be clinicians who decide what care is available on the NHS—it will be big business. And firms, of course, will only provide what is profitable. Health insurance companies will offer policies to fill in the gaps.

The bill will increase the cap that a foundation trust hospital can earn from private patients from 3 percent to a whopping 49 percent.

These hospitals are run as businesses. If they can’t balance their books they will prioritise private patients—sending NHS patients to the back of the queue.

Despite what David Cameron and Lansley say, most doctors are outraged at such a naked attack. Most of those who are implementing the reforms do so out of a desire to protect their patients and to fend off the private sector.

Whatever happens, the fight is far from over. As the reforms take root there will be more scandals. We will see repetitions of the Southern Cross care homes’ bankruptcies and closures.

We will also see more campaigns to save hospitals as they are merged and closed. Socialists need to be at the heart of the movement to save the NHS. The Health and Social Care Bill should be Cameron’s poll tax.

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