“I’m not being disingenuous. I really haven’t spoken to anybody who’s in favour of [the Health and Social Care Bill]”, says nurse consultant Andrew Frazer in the Guardian’s “100 NHS Voices” survey.
The Guardian’s interviews of 100 people who work in and around the NHS were heavily skewed in favour of medics, chief executives and other well-healed professionals. However, despite the middle-class bias, it gives a rough picture of where this Bill is at and how it is being understood. There is almost universal condemnation for the plans; their attitude is backed up by the tiny 14% approval rating in the population at large.
The introduction of a conflict of interest by the Bill is a key point. Peter Wilmshurst, consultant cardiologist, comments, “The NHS is the best way to provide healthcare. Where you are getting a fee for a service, patients can’t be sure they are getting the treatment they need rather than the treatment that gives the doctor who delivered it the most money.”
Privatisation was condemned even by those that stood to gain.
Fay Selvan, Chief Executive of a social enterprise, predicts “The private sector will cherry-pick the most profitable services, leaving the NHS without the critical mass to provide the rest.”
Lord James Adebowale, the CEO of Turning Point (charity dealing with mental health, drugs and alcohol problems), thinks the market favouring the big health giants: “There is a real danger that the procurement process will favour the organisations from the for-profit sector who lack any track record in health and social care because they have the capital and the right access.”
Even advocates of the Bill are worried. GP Johnny Marshall is a major player in the National Association of Primary Care – a shady organisation that receives large portion of its funding from private health firms and has been lobbying vociferously for GP commissioning. Marshall thinks the Bill will fail because GPs will refuse to engage and the NHS will resist this level of change. He emphasises how smaller GP consortia will have to outsource commissioning to the private sector.
But the survey also points to a class divide in the NHS which may become significant.
While most of the well-paid professionals are concerned about the mechanics (or lack of mechanics) in the Bill, the more proletarian grades are feeling the pressure of the cuts.
Midwife Janet Fyle describes the pressure in the maternity suite: "When women are pregnant, they have all these ideas about what it’s going to be like. And then you come in and the midwives think: ‘Well today we’re busy, so we’re going to induce you, just get you through the system.’ That cannot be right."
Ambulance dispatcher Richard Chow describes the changes he has seen throughout his career:
“When I first started 14 years ago, a busy day would mean 3,000-3,500 calls. Last year we went over 6,000 in a day...Over five years we have to save £50m and shed 580 jobs.”
Psychiatric nurse Michael Buxton argues “There is a real worry that the NHS will be broken down by stealth into services that you have to pay for. The most valuable thing about the NHS is the idea that everyone’s health is equally important … this is what we stand to lose.”
Buxton is right. Despite the complexities of the Bill, Tories plan to is a simple one: starve the NHS of funds and then release the private sector vultures to feast on the carcass.
But this big picture is missed by the noisy middle-class commentators. Some of the more affluent professionals emphasise the "unbearable demand" made by patients on the health service. It is a view promoted by the professional associations who collaborated with New Labour’s marketisation and PFI waste-creating projects that has sucked £ millions away from frontline care. It is s view that is blind to the fact that NHS is being starved of funds by the cross-party consensus to implement £20 billion cuts.
Like New Labour, these professionals have uncritically accepted of the government’s class war ideology of austerity.
While maintaining unity with the most astute middle-class professionals in the campaign against the Bill, we must also raise our own banners for independent working-class politics.
The founding principle of the NHS was the right to state-of-the-art, comprehensive healthcare free at the point of need. Until recently it was well-understood that this requires a radical redistribution of wealth from the rich to the poor through general taxation.
In 1948, the Labour government kept the wartime top rate income tax rate of 98% in order to create the welfare state. Nowadays the tax burden is felt most sharply by the poorest in our society.
If the NHS is underfunded then this is due to social policies that have returned us to Victorian levels of inequality and the attempts of successive government’s to turn the welfare state into a slush fund for the rich.
We must not only fight the Bill, but also fight to reverse our current economic model of socialism for the rich and replace it with a welfare state that benefits the working-class majority.
Taking on Branson
By Vicki Morris
On Saturday 17 March Health Alarm leafleted against the Health and Social Care Bill outside the Virgin Health Club in the Plaza Shopping Centre on Oxford Street, London.
Our slogan was “Don't let Richard Branson asset-strip the NHS!” Virgin Care (formerly Assura Medical) is one of the private companies moving in to make profits from the NHS. They are currently bidding to run children's health services in Devon. We had a good crowd, in spite of the persistent rain — enough to worry the management: security guards and two police officers kept us off the premises.
The police followed us to the pub where we dried out after the protest, and then trailed us when we moved off to the Hackney Keep Our NHS Public demonstration at the Department of Health.
Occupation against NHS cuts
On 16 March, 20 people occupied the headquarters of the Oxfordshire Primary Care Trust to protest against the government’s plan to scrap the NHS.
One of the occupiers, Larry Saunders, described the bill as “the most destructive bill in a generation” adding that it is not too late to “keep the battle going”.
Larry said that they had received a “sympathetic reception” from staff at the Primary Care Trust.
The police and security staff have been less sympathetic, and have been trying to persuade the occupiers to leave. They have refused to do so because their protest is legitimate and non-violent.