Labour has announced its most vicious attack yet on the NHS in a policy document published by the department of health last week. There is a clear intention to dismantle the NHS as we presently know it.
Remarkably the changes do not require parliamentary approval and are already being implemented.
Under cover of buzz words like “choice”, the plan is to smash the NHS into profitable fragments to be hived off into the private sector.
The plans are in direct conflict with even the minimal promises of last year’s Warwick agreement between trade union leaders and New Labour.
Most of us think of the NHS as hospitals — but the bulk of healthcare is primary care. This means community services delivered by GPs, district nurses, physiotherapists and many other health workers.
The government plan is to completely remove the provision of patient care from existing NHS organisations, and hand it over instead to a mishmash of private sector companies, voluntary agencies and foundation trusts.
By the end of 2008, the NHS primary care trusts will look after patients only as a last resort, where no other providers exist. Where there are no alternative providers, the NHS will have the job of developing them.
Reacting to the plan, Howard Catton, the Royal College of Nursing’s head of policy, said, “It takes us from a position where 25 to 30 percent of nurses are employed in the private or independent sector to one where it could eventually be 70 percent.”
In a separate exercise, primary care trusts have to cut management and administrative costs by 15 percent, and strategic health authorities have to deliver a “significant reduction” in costs.
Labour likes to pretend that white collar workers are unnecessary bureaucracy.
But the NHS needs its medical secretaries and receptionists just as it needs doctors and nurses. These cuts will mean significant job losses within a year. And even after that, the administrative side of running the NHS can be handed over to “external agencies” and “consortia”.
Alongside the attack on community services, every hospital trust will become a foundation trust by 2008. Ambulance trusts will be forced to become foundation trusts too.
This will be accompanied by a move towards other non-NHS healthcare providers.
The dismantling of primary care will be mirrored by the fragmentation and privatisation of hospital and ambulance services.
All of this is about removing any meaningful public control or planning of health care. When the Tories introduced the market into the NHS, patients died. Now Labour is going much further than the Tories ever dared.
The plans are a disaster for every NHS worker and every user of the NHS.
They fatally undermine the ability to plan health services and hurl care into the uncertain realm of competition and private interests.
The government claims the aim is an NHS that is “fit for purpose” — but it will only be “fit for profit”.
The NHS trade unions face a stark choice. To defend our members, and to defend our NHS, we have to take on the government and win. If we don’t fight now, the NHS will be smashed to pieces.