Hospitals are stretched to the limit, but the Tories have stepped up their plans to dismantle the NHS. The Care Quality Commission (CQC), the organisation responsible for regulating health care, last week announced that there should be widespread reduction of hospital beds.
In his first speech since becoming chairman, former Tory MP David Prior said the CQC would play a “huge role” in debates over hospital closures.
Prior said “community care” should replace stays on in-patient wards.
Everyone would welcome the chance for more patients to be treated at home if that’s the best way for them to be cared for. But Prior knows that the funding to make this a real alternative will not materialise.
He wants to cut hospital services despite the number of people visiting A&E doubling in the past decade.
In London there is already a dire shortage of beds.
The Royal London Hospital recently completed a £1 billion redevelopment.
It was set to be the jewel in the crown of the Private Finance Initiative (PFI) scheme, showing the efficiency of private investment in healthcare. The reality is somewhat different.
“There’s always been pressure on beds. And that remains the case despite the new hospital,” said Tina, a nurse who works at the Royal London. “There’s a whole floor they won’t open up because they won’t pay to staff it.”
Tina went on to describe a hospital struggling to cope with the demand for beds.
Winter pressure wards are meant only to help deal with an overspill of patients from a particular harsh winter season, or an epidemic. But Tina said they remain open all year round in the Royal London because “there are just not enough beds to meet the day to day requirements.”
That means there is little or no extra capacity in event of an emergency.
And the constant need to free up space is taking its toll on the staff.
“Nurses can have three meetings before lunch about making sure beds are available. It’s ridiculous,” said Tina.
“It’s quite stressful to make these beds happen. We have to work incredibly hard.”
The CQC has pinpointed 45 hospitals, 20 percent of the overall number in Britain, as earmarked for changes.
A&Es in the Lewisham, Islington and Ealing areas of London have already been threatened with closure.
The CQC announcements came as a report carried out by a consultancy group called for the closure of the two more of the capital’s A&E.
The Better Services, Better Value report said that the emergency departments at St Helier and Epsom in South West London should go.
Claire, a paramedic who works in London, told Socialist Worker about how widespread closures to beds affect ambulance staff.
Crews can wait for anything up to an hour with patients before hospital staff are able to admit them.
“Recently, I had a diabetic whose blood sugar was so low it was off the scale and we had to wait with him in the corridor,” said Claire. “So there’s us and loads of other ambulance crews just waiting there.”
And cuts don’t just mean waiting around in corridors with seriously ill people. Ambulance staff will have to pick up the slack if A&Es close.
“If there’s no emergency department in two neighbouring London boroughs, you could be transporting a patient 15 miles.”
It will take ambulances longer to get to patients and longer to get to hospital.
The London Ambulance Service aims for 75 percent of ambulances to get to callers within eight minutes. Last month it reached 76 percent.
Closures will make this worse.
Claire also revealed how, as the end of the financial year approached, managers desperately tried to persuade ambulance crews to do overtime to ensure they meet targets.
“We’re pissed off,” she said. “If the NHS can afford to pay us triple time, why don’t they employ more staff in hospitals and in ambulances?”
But Prior doesn’t share Claire’s concerns. He says the reason some hospitals fail is because there isn’t a “market” to regulate health care.
Prior wants more competition between hospitals, and to allow private firms into the market.
He thinks this will prevent another scandal like that in Mid Staffs.
Yet the Francis report into Mid Staffs concluded that the problem was bosses putting finance before patient care—and that having too few qualified staff can lead to disaster.
But wards with only one nurse for eight patients are now a regular occurrence around Britain, according to the Nursing Times.
“The NHS revolves around money now,” said Tina. “It’s bloody depressing.” But alongside plummeting morale among health workers, there is also a growing anger.
Kambiz Boomla, an east London GP and activist in the Keep Our NHS Public campaign, outlined the importance of uniting the fightback across London.
He said, “It’s important to see the link between the cuts and privatisation. People should not say, ‘Save my hospital, make the cuts elsewhere’.”
Kambiz insisted that waiting for a future Labour government isn’t an option either. “It’s unlikely they would repeal the Health and Social Care Act that has done so much damage,” he said.
The Tories are plunging the knife into the NHS. We need to act now, and organise the fight back together.
Bosses are the real health bed blockers
The government says that the crisis in hospitals is due to people taking up beds when they should be being cared for at home.
The right wing media calls these patients “bed blockers”. They are mainly older people with chronic conditions.
The Tories say they can save money by moving to care in the community. This would integrate the NHS with social care and release the strain on hospital departments.
However there have been £2.7 billion of cuts to adult social care services since the Tories came to office.
The figure was revealed in a survey by the Association of Directors of Adult Social Services.
Councils plan to make a further £800 million in cuts this year alone.
The NHS should be funding better care at home.
But the Tory proposals will see community staff working in 15 minute windows in people’s homes without the time to provide proper care to patients.
Migrants are not to blame for pressure on the NHS
The Tories are keen to blame the stretched NHS on migrants.
They say that “health tourism”—sick people travelling to Britain to “abuse” the free health service—is a key reason why hospitals are failing.
Yet far from migrants taking advantage of the NHS, many already find they cannot access healthcare.
A law was passed in 2004 that prevents migrants from receiving certain types of care, including treatment for HIV/Aids, and problems associated with pregnancy.
Hospitals started to employ overseas visitors officers who invoiced people for medical care received.
Desperately ill people who could not afford treatment were forced to seek help from charities. There were also cases of women saving up so they could afford to give birth in hospital.
New Tory plans to charge migrants for NHS treatments will apparently include making some types of care completely out of bounds.
But this form of rationing is not restricted to those who have only recently arrived in Britain.
The Tories are using migrants as the thin edge of a wedge. Ultimately, they want everyone to have to pay for treatment and for the poorest people to be denied care.
Opposing these openly racist plans must be part of our fightback against the attacks on the NHS.