The news that NHS waiting times have reached their highest ever level is a damning indictment of the Tories. Some 80,000 people waited four hours for a bed last month. One in ten people with suspected cancer hadn’t been seen within two weeks.
And there are 43,000 vacant nurse posts across the NHS.
The Tories have spent a decade hammering the health service. But now there’s a general election looming, they are trying to claim they’ll invest in patient care.
To actually improve services England’s NHS budget would have to increase by at least 4 percent a year. Yet the Tories’ pledge of £20.5 billion by 2023-24 amounts to just 3.4 percent. That won’t even undo the damage they have done (see below). And no one can trust their promises.
Paul is a health worker at charity Addacation, which runs an outsourced rehabilitation service that used to be part of the NHS. He told Socialist Worker that Tory cuts and privatisation mean “staff are breaking down in tears, going off ill on stress or leaving the job”.
“I used to have a caseload of 40 clients who you would have time to see more frequently,” he said. “I now have 70 to 80 clients—and that’s after they said there should be a ‘ceiling’ of 65 a few years ago.
“You don’t have any more time in the day and that means you can’t do your job as well as you would like to.”
Health services aren’t just about administering medicine—and Tory cuts have undermined workers’ ability to look after patients’ overall wellbeing. Paul explained, “On Monday one of the clients overdosed and was taken into accident and emergency.
“You would normally go and see them to have a proper conversation, but there was no time to do it. I ended up finishing work late at 6.30pm and then I popped into the hospital at 7.30pm to see the client on my own time.”
It’s no wonder that the NHS is in such a mess. Since the Tories came into government in 2010, annual NHS spending increases have been the lowest in the service’s history.
Under David Cameron annual spending increases were 1.4 percent—compared to 6 percent in the 2000s. It’s even lower than the 2.7 percent that former Tory prime minister Margaret Thatcher oversaw when she drove the NHS to breaking point in the 1980s. The NHS needs more money to meet the health needs of an ageing population.
And when the Tories have given with one hand, they have taken away with the other.
They previously promised £8 billion but only in exchange for NHS bosses forcing through £20 billion “efficiency savings”—cuts—by 2020-21.
That’s why many NHS workers have welcomed the Labour Party’s “rescue package” of £26 billion. Paul said health workers wanted “a change in government” because “it’s just got to be better than the lot that’s currently in”.
Labour’s plan would see annual spending increases to 3.9 percent. This would include 24,000 more nurses, 5,000 GP training places and free prescriptions. There would be £5 billion for improving buildings and over £2 billion for mental health services.
That would be a much-needed boost—but bigger annual increases will be needed to actually improve services.
Labour also needs to go further on privatisation. Jeremy Corbyn has talked of “renationalising” the NHS. But so far party policy has only promised to make the NHS the “preferred bidder” for contracts, over private companies and charities.
In 2010 it was revealed that up to 14 percent of NHS spending went to administering the internal market.
Paul said, “The internal market and commissioning should go—money is wasted in this process. Whether it’s companies or charities on NHS trusts that bid for services, they will spend thousands of pounds trying to get it.
“It should be going to the service and the patient.”
To save the NHS, we need to kick out the Tories—and all the privatisers.
From the benefit freeze to the bedroom tax, the Tories have made slashing benefits a cornerstone of their austerity programme.
These measures, alongside the two-child limit for tax credits and other benefits and the rollout of Universal Credit (UC), have pushed more people into poverty.
Around 14.3 million people in Britain are in poverty, according to the Social Metrics Commission.
And 7 percent of the population is in deep poverty—where their income is at least 50 percent below the official breadline.
UC has fuelled food bank use and rent arrears.
Gemma told Socialist Worker that UC means “many families go without food for long weeks at a time”.
“We went through this ourselves,” she added.
And she blasted the “long winded application process” that her and her husband went through to claim the benefit.
“Every month is a struggle,” she said. “If you challenge them they will sanction you for no reason.”
In areas where UC was implemented first, food bank usage shot up as claimants are forced to wait at least five weeks for the first payment.
The food bank charity Trussell Trust reported that 70 percent of food parcel recipients said they needed the support because their benefits were insufficient, changed or delayed.
Emma Revie, Trussell Trust chief executive, said, “Our benefits system is supposed to protect us all from being swept into poverty.
“But currently thousands of women, men and children are not receiving sufficient protection from destitution.”
Shirley is one of those forced to rely on food banks because of UC.
“I was thrown into an unknown world,” she said. “I didn’t have any money for three months while waiting for Universal Credit.
“I couldn’t pay my rent and I had to work out whether to eat in the morning or the afternoon because I didn’t have enough money for the basics.”
Gemma argued that “the UC system needs to be scrapped in its entirety” and said the Department for Work and Pensions should be investigated over its treatment of claimants.
“They have no sympathy towards claimants, and they certainly do not encourage you to get back into work,” she said. “They treat all claimants like scum.”
Universal Credit needs to be stopped and scrapped–along with the Tories’ wider vicious benefits regime.
Years of privatisation and cuts have left local government across England on its knees. And the future looks even bleaker.
One in three councils say that within five years they will struggle to provide statutory services in child protection and adult social care.
Ameen Hadi, treasurer of the Unison union branch in Salford City, spoke to Socialist Worker in a personal capacity.
He said cuts at Labour-run Salford City Council had slashed their workforce and budget by around half.
“A lot of the services that would have supported people in communities have just disappeared,” he explained. “More and more, what is left is what the council is legally required to provide.
“The whole culture is about hitting targets and isn’t necessarily about helping people.”
Central government cuts have led to a 17 percent fall in council spending on public services since 2009/10, according to the Institute for Fiscal Studies (IFS).
Councils are increasingly forced to rely on local taxation to make ends meet—with the costs passed to ordinary people.
Since 2015, council tax has shot up on average by 15 percent per person.
Council tax arrears is the most common form of debt reported to the Citizens’ Advice charity—and if residents miss one month’s payments they can be chased for the full year’s amount.
This drives people further into debt and poverty.
And the system is skewed against the poorest. One critical source of funding from central government is the New Homes Bonus (NHB).
But the NHB is paid at a higher rate to areas with higher council tax bands—so those in poorer areas lose out.
Councils in areas of high levels of deprivation have historically relied on grants from central government. They have suffered the most from Tory cuts.
Ameen added that the funding formula has changed, giving Salford residents a smaller slice of the pie.
“Because we’re in an area of high deprivation, we used to get more money allocated per pupil, or per resident,” he said.
“They’ve got rid of that now—so it’s not just that we need more money spent.
“We need a fairer division too.”
Councils in the most deprived areas have slashed their net spending by 31 percent. In the least deprived areas, the figure is 16 percent.
Ameen described “big battles” where service users and workers have fought to retain vital services such as day centres and transport for people with disabilities.
Even when services such as leisure centres have survived cuts, privatisation and high prices often keep out poorer residents.
Spending on adult social care services has dropped by an average of 7 percent per person in England.
And spending on social care for the over 65s age group is down by 18 percent. Yet the older population has grown by over 20 percent.
Savage council cuts, often made by Labour-run councils, has sparked strikes to defend vital services.
In Birmingham, home care workers staged long-running strikes against the Labour council.
Some see the solution as councils using their powers to raise taxes locally. Local authorities can increase council tax by 4 percent a year and also adjust business rates.
However the IFS has warned, “Revenues from these two taxes will not keep pace with rising demands and costs.”
It said an extra £1.6 billion of funding will be needed within five years to “meet projected adult social care costs and stop the revenue for other services falling further”.
Raising council tax won’t stop attacks on public services.
It’s just another mechanism to make ordinary people pay for the crisis.
Fighting for decent public services will mean kicking out the Tories and demanding a Labour government implements the huge levels of investments needed.