UK Uncut: Stop the traffic to stop the NHS being run over

Tim Holmes explains why you should join UK Uncut on Westminster Bridge on Sunday to fight the coalition’s disastrous health and social care bill.

Westminster Bridge in better times

By Tim Holmes

On Sunday, Westminster Bridge will witness a spectacular mass occupation. This event, organised by UK Uncut, will seek to block the government’s health and social care bill, due to face a lords vote on Tuesday. In the run-up to the vote, activists have been contacting the key Lib Dem and Crossbench lords to encourage them to oppose the bill.

Those taking part have good reason to be angry. It is difficult to think of a more flagrantly anti-democratic stitch-up than Andrew Lansley’s proposals for the NHS. They were in neither the Conservative nor the Liberal Democrat manifesto, and appeared nowhere in the coalition agreement.

Quite the reverse, in fact: explicit promises were made against such “top-down reorganisations”.

As one senior Tory told Sky, “it wasn’t in our manifesto, so we’ve got no mandate for it”. There is simply no evidence of any public desire or support for these proposals.

Nor is it clear why the dire need for this kind of “revolutionary” change arises. Public satisfaction with the NHS has never been higher; studies have repeatedly demonstrated its outstandingly efficient and effective public health provision. The government’s suggestions to the contrary have been shown to be both cherry-picked and utterly misrepresentative.

Its claims of “evidence-based” policy too have been exposed as selective and mendacious. The government had supportive GPs  specifically selected to present to the public in a desperate attempt to convey an – utterly misleading – impression of consent among the medical community. And its feted “listening exercise” – a response to the outcry against the reforms from the medical establishment and the public – proved little more than a sham, with the government privately refusing to budge on its core proposals and simply re-labelling previously organised outreach events.

In fact, the government appears to be responding to the priorities of a rather different constituency.

The Tories have been bankrolled to the tune of hundreds of thousands of pounds by private health interests. Senior Tories and their advisers who helped draft the legislation have strong links with the same interests. So too do the corporate-funded front-groups and think tanks who have lobbied hard and helped forge the health and social care bill, successfully securing “a tsunami of reorganisation” offering “massive opportunities for private health companies”.

Almost regardless of the bill’s content, there has seldom been a worse point to pursue another costly “re-disorganisation”. The government has imposed an astonishing £20bn of “efficiency savings” on the NHS – a level never previously achieved by any health service, anywhere in the world, at any time, and roughly double the private sector’s efficiency gains in the decade up to 2007.

In reality, this means devastating cuts, with massive lay-offs of frontline staff already taking place. Both of these, too, we were promised never to see take place. Into this mix the coalition will be “tossing a hand grenade” at the existing NHS management structure.

Many of the staff consequently jumping ship are likely simply to be re-hired, possibly by private firms, in a massive and dizzyingly rapid overhaul of the NHS’s management. The roll-out of this more fragmented system across England is likely to be incredibly expensive – with costs that could easily run out of control. Many experts have predicted catastrophic results.

But the contents of the Bill are just as devastating. It is widely acknowledged that these reforms will effectively abolish the NHS in England. They also represent a rapid and radical stepping-up of the steady privatisation overseen by previous Governments. And their consequences are likely to be grim.

To begin with, the Bill removes the responsibility of the secretary of state for health to provide a comprehensive health service in England – a central principle of the NHS. Democratic accountability will effectively disappear, and no such requirement is imposed on the new management structures. As the FT has noted, “national standards for care are to be abolished”.

All hospitals will be turned into money-making foundation trusts, organised much like private businesses. Scarce resources will necessarily be allocated on the basis of profit, not need.

Unless they are specifically protected, highly-valued but costly departments, such as A&E or maternity wards, may simply be closed, many hospitals ending up as little more than “glorified health centres”. That’s if they survive at all – many will simply go to the wall, leaving patients without the appointments, operations and services they expected and need.

Foundation trusts can generate revenue by treating private patients – and the cap currently limiting the number of private patients they can treat will be lifted. The result will be a two-tier system, with paying customers fast-tracked to the front of a growing queue of ordinary NHS patients. “As the private healthcare providers flourish”, predicts one commercial pharmacist, “the NHS will become a last resort”.

The Health service will be cracked open, allowing private companies to step in – with some already planning to take over hospitals.

With sharp constraints on the NHS budget in place, this can only force incumbents into atrophy or collapse. Profit-motivated companies are likely to cherry-pick the operations they provide, offering cheap, easy treatments, and leaving the public to pick up the tab for the rest. By competing to undercut each other, they could drive down standards across the board.

New consortia will see medical practitioners commissioning services for patients. But the system will be riddled with conflicts of interest.

GPs will be both buyers and suppliers. Worse, they will always have one eye on costs – particularly in the absence of economies of scale – and will be under pressure not to provide costlier treatments and referrals. They will even be able to impose charges, choose what to charge for, and pocket the “savings” made as income. The results for the relationship of trust between doctors and patients could be fatal.

Overworked and overwhelmed medical practitioners, lacking experience and expertise in commissioning, are likely either to divert scarce time and effort into management; to (pointlessly) re-hire management staff, while the public eats an estimated £1bn in redundancy costs; or to bring in private businesses (with preparations already underway) who can then siphon off the “savings” they make.

Providers will be required to avoid “anti-competitive” practices – enforced through the ever-looming threat of legal action, naturally to the benefit of those companies with the deepest pockets. But this will fragment the system even further, potentially punishing doctors for recommending trusted specialists, sharing expertise, developing relationships, or co-ordinating their activities in the “complex care pathways” required to treat long-term conditions.

As such fragmentation becomes the norm, trainees’ ability to gain a sufficient breadth of knowledge and experience will be in jeopardy.

As BMA council member Ian Banks recently put it:

“If someone is trying to strangle you, there is only so long that you can say: ‘Would you mind using only one hand, or would you mind using a breath freshener?’ At some point you are going to have to give them the old Glasgow kiss. These are not reasonable people; we must not allow them to destroy our NHS.”

This week will be perhaps the public’s last chance to fend off our assailant before England’s NHS passes into history. In joining UK Uncut’s action on Sunday, we might just be able to prevent the unthinkable from taking place.

See also:

Second reading of NHS bill offers a second chance to kill itAlex Hern, October 6th 2011

Northern Ireland health workers strike over budget cutsEd Jacobs, October 6th 2011

Wales to see increase in health spending as Lansley accused of dismantling NHSEd Jacobs, October 5th 2011

Can Lansley be trusted with the NHS? 400 more experts say NOShamik Das, October 4th 2011

Lib Dem MP tells Lords: How the NHS bill needs to be changedAndrew George MP, September 21st 2011

Lib Dem activists face reality about their MPs’ NHS visionTrevor Cheeseman, September 20th 2011

The two faces of NHS reformTamasin Cave, September 7th 2011

46 Responses to “UK Uncut: Stop the traffic to stop the NHS being run over”

  1. Dr NoShock

    1 blog post with EVERY reason plus evidence for joining @UKuncut's action on #NHS this Sunday, by @leftfootfwd http://ht.ly/6QFlg

  2. Ian Parker

    1 blog post with EVERY reason plus evidence for joining @UKuncut's action on #NHS this Sunday, by @leftfootfwd http://ht.ly/6QFeb

  3. Keith Parkins

    Read @UKuncut’s call to action on the NHS at @leftfootfwd: http://t.co/pFwVtEGx By @timbird84

  4. Pat Maguire

    Read @UKuncut’s call to action on the NHS at @leftfootfwd: http://t.co/pFwVtEGx By @timbird84

  5. Sian

    Great round-up of reasons to support @UKuncut's call to action on NHS this Sunday, by @timbird84 @leftfootfwd http://t.co/av0aE8if

  6. Martin McIvor

    Read @UKuncut’s call to action on the NHS at @leftfootfwd: http://t.co/pFwVtEGx By @timbird84

  7. PermanentCultureNow

    Try to make it to this if you can, we cannot let the NHS be privatised. http://t.co/QQiGO7eE

  8. Jamie Valentine

    RT @leftfootfwd: UK Uncut: Stop the traffic to stop the NHS being run over http://t.co/XjLi12uO

  9. Block the Bridge, Block the Bill! « The Red Eye Portal

    […] This Sunday, thousands of protesters organised by UK uncut, including everyone from Labour MPs to union members, health service officials, doctors, and the angry public, will join together to block traffic on Westminster Bridge in a symbolic and powerful effort to show the Governement just how angry we are. I cannot think why the whole country wont turn up, there are free coaches to london, so if you are still umming and ahhing, get on it. This is very important to the future of our nations health. Everyone should be there, no matter what their political leaning. We are all subject to illness, to bad luck. Imagine if the cost of a simple operation left you unable to pay the rent? Doctors in York are already telling patients that they must go private for small ops- and this is just the beginning. See details of the event on the UK uncut website http://www.ukuncut.org.uk/ Another excellent article with alot of information about the bill and why this protest is so important is left foot forward http://www.leftfootforward.org/2011/10/tim-holmes-uk-uncut-stop-the-traffic-to-stop-the-nhs-being-ru… […]

  10. chris star

    Stop the traffic
    To stop the NHS being run over..
    http://j.mp/qNlvQy
    #ukuncut #saveourNHS #NHS

  11. TheCreativeCrip

    Read @UKuncut’s call to action on the NHS at @leftfootfwd: http://t.co/pFwVtEGx By @timbird84

  12. visit info

    UK Uncut: Stop the traffic to stop the NHS being run over | Left Foot … http://t.co/LtYiM895

  13. Ebony Dawn Marsh

    Read @UKuncut’s call to action on the NHS at @leftfootfwd: http://t.co/pFwVtEGx By @timbird84

  14. Clare Richards

    Don't wait until it's too late #SaveOurNHS Read this and consider joining #Blockthebridge 1pm Sunday http://t.co/8OEU1gqF @UKuncut

  15. Tianna Rounds

    Don't wait until it's too late #SaveOurNHS Read this and consider joining #Blockthebridge 1pm Sunday http://t.co/8OEU1gqF @UKuncut

  16. roundclapton

    Great round-up of reasons to support @UKuncut's call to action on NHS this Sunday, by @timbird84 @leftfootfwd http://t.co/av0aE8if

  17. David Norton

    We are the 99% we must join forces. Take our inspiration from the Arab Spring, to the Occupation of Wall Street, all left groups from the passive to the black bloc, please come together, save our NHS our bloody country.

  18. Charlie Holden

    RT @leftfootfwd: UK Uncut: Stop the traffic to stop the NHS being run over http://t.co/W7dbwpgj #savetheNHS

  19. Tim Worstall

    So, what’s the best health care system in the world?

    Hmm, WHO and so on regularly say that it’s the French one.

    That’s the health care system that has a system of government financing and multiple competing providers of the actual health care. You know, a mix of government owned and run, charitable, mutual, not for profit and for profit health care providers all jostling to treat the patients and thus get paid.

    The aim of the reforms to the NHS is to have a “health care system that has a system of government financing and multiple competing providers of the actual health care. You know, a mix of government owned and run, charitable, mutual, not for profit and for profit health care providers all jostling to treat the patients and thus get paid.”

    So, the reason you don’t want the English health care system to have the same structure as the best health care system in the world is what?

  20. Shamik Das

    Why you should be at #blockthebridge today: http://t.co/pFwVtEGx By @timbird84 of @UKuncut

  21. Julie Tomlin

    Read this: The threat to the NHS and #blockthebridge explained – by @timbird84 of @UKuncut http://t.co/FCkJ8Jwh (v @leftfootfwd)

  22. Debbie

    Read this: The threat to the NHS and #blockthebridge explained – by @timbird84 of @UKuncut http://t.co/FCkJ8Jwh (v @leftfootfwd)

  23. Judith Howell

    Why you should be at #blockthebridge today: http://t.co/pFwVtEGx By @timbird84 of @UKuncut

  24. Pucci D

    Why you should be at #blockthebridge today: http://t.co/pFwVtEGx By @timbird84 of @UKuncut

  25. w.m o'mara

    RT @leftfootfwd: UK Uncut: Stop the traffic to stop the NHS being run over http://t.co/QUbJw7Kb
    #NHS Extremely important day….

  26. Betwixt and Between

    Why you should be at #blockthebridge today: http://t.co/pFwVtEGx By @timbird84 of @UKuncut

  27. SierraKhan

    Why you should be at #blockthebridge today: http://t.co/pFwVtEGx By @timbird84 of @UKuncut

  28. PlanetPOV.com

    Read @UKuncut’s call to action on the NHS at @leftfootfwd: http://t.co/pFwVtEGx By @timbird84

  29. Martin McIvor

    Why you should be at #blockthebridge today: http://t.co/pFwVtEGx By @timbird84 of @UKuncut

  30. Wales4theNHS

    My summary of the reasons you should join @UKUncut on Westminster Bridge on Sunday, & fight to save England's NHS: http://t.co/So46gtBG

  31. Tim H

    Tim Worstall:

    (1) Would be very interested in seeing a proper, detailed, credible and peer-reviewed comparison of the French system and the contents of the Health and Social Care Bill. Most expert testimony I’ve seen suggests this takes us closer to the disastrous American model.

    (2) I invite you to look at the citations I listed above about the NHS’s effectiveness. They provide figures from the Commonwealth Fund and Health Affairs placing the NHS top for a range of key outcomes.

    (3) Would love to see references for “WHO and so on”. Cheers.

  32. Lord Owen: NHS is under threat like never before | Left Foot Forward

    […] also: • UK Uncut: Stop the traffic to stop the NHS being run over – Tim Holmes, October 7th […]

  33. The “occupy” protests come to the City this Saturday | Left Foot Forward

    […] Uncut, which organised the “Block the Bridge, Block the Bill” protests against the government’s health reforms last Sunday, are supporting the protests; […]

  34. In touch?! Backbench Tories grumble over “inadequate” £65,738 salary | Left Foot Forward

    […] So perhaps it’s for the best that one MP has had to stop going to clubs with their fellows; having to use the same facilities as the 95 per cent of workers (pdf) who earn less than £61,000 may instil the sort of compassion which is clearly lacking in the members who vote against children, against women, against the disabled and against the NHS. […]

  35. Pucci D

    .@UKuncut present your one stop guide to why you shouldn't trust Cameron with the NHS: http://t.co/d0zQsno4
    #PMQs

  36. Nemesis Republic

    .@UKuncut present your one stop guide to why you shouldn't trust Cameron with the NHS: http://t.co/d0zQsno4
    #PMQs

  37. CAROLE JONES

    .@UKuncut present your one stop guide to why you shouldn't trust Cameron with the NHS: http://t.co/d0zQsno4
    #PMQs

  38. do I know you ?

    .@UKuncut present your one stop guide to why you shouldn't trust Cameron with the NHS: http://t.co/d0zQsno4
    #PMQs

  39. Glenys Thornton

    .@UKuncut present your one stop guide to why you shouldn't trust Cameron with the NHS: http://t.co/d0zQsno4
    #PMQs

  40. Catherine Sharpe

    .@UKuncut present your one stop guide to why you shouldn't trust Cameron with the NHS: http://t.co/d0zQsno4
    #PMQs

  41. malcolm

    .@UKuncut present your one stop guide to why you shouldn't trust Cameron with the NHS: http://t.co/d0zQsno4
    #PMQs

  42. Anti-Cuts Alliance

    .@UKuncut present your one stop guide to why you shouldn't trust Cameron with the NHS: http://t.co/d0zQsno4
    #PMQs

  43. Shanti Lall

    .@UKuncut present your one stop guide to why you shouldn't trust Cameron with the NHS: http://t.co/d0zQsno4
    #PMQs

  44. Rowland Paul Hill

    .@UKuncut present your one stop guide to why you shouldn't trust Cameron with the NHS: http://t.co/Me7mEiU4
    Well he is a Tory!

  45. Sign my petition to drop 'Lansley's monster' | Left Foot Forward

    […] UK Uncut: Stop the traffic to stop the NHS being run over – Tim Holmes, October 7th […]

  46. Johnny Saxophone

    I know I keep saying it but the Torys ARE ACCEPTING BRIBES! WTF http://t.co/lO6uQHCJ http://t.co/DefGr8u9 #nhs #nhsprivatisation

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