Lord Robert Winston is not a dreamer – he is a doer. He is also a man who knows a thing or two about human behaviour as well as the NHS.
In the first Labour Party broadcast for the forthcoming local elections he explains he would not normally dream of doing an election broadcast, but states himself so angry about “the way the National Health Service is going”, that he feels the need to stand up and tell us why he feels Labour are the party to protect the NHS which is so dear to his heart.
And so he does…
Labour has firmly placed David Cameron’s betrayal of his own “the NHS is safe in my hands” pledge front and centre; they have placed the campaign to save our NHS and the urgent need to prevent the NHS from being dismantled at the heart of the forthcoming local election campaign.
Shadow health secretary Andy Burnham and Labour deputy chair Tom Watson each reminded us that before the general election, the Tory leader visited hospitals up and down the country promising not to close services, however instead he rammed the Health and Social Care Act through Parliament against the majority informed view, also allowing Andrew Lansley to make changes ahead of constitutional approval.
The health secretary’s actions were described by Burnham as unprecedented – and have been roundly condemned by Prof Angel and the Transitional Risk Register Tribunal.
A key challenge is to help the electorate understand the main elements of the threat to the NHS and its root causes in the face of a complex set of changes contained in the Act – also combined with the lack of a decent information stream through much of the mainstream media.
Hot on the heels of the Risk Register Tribunal ruling (pdf) which is so damning of Lansley and his mayhem of a bill, the message Team Burnham have produced is very clear.
Six broken promises are cited; indeed, if properly explained on the doorstep, these should be ridiculously easy hits:
Broken promise no. 1: “No more top down re-organisation”
He also took absolutely no notice of the huge majority of health professionals who continue to be deeply concerned about the future of the NHS as a direct result of the most complex changes in the history of the service – legislation which is three and a half times as long as the Act which set up the NHS in the first place.
Broken promise no. 2: “We will protect front line services”
The betrayal of the pledge to protect front line services has already seen:
• 4,096 nurses ‘let go’ (with probably another 2,000 in the pipeline according to the Royal College of Nursing – including qualified nurses and healthcare assistants);
• Occupational therapists having to apply for their own jobs with fewer posts to go round (check out Camden);
• District nurse teams diminished (check out Lewisham);
• Private providers such as Virgin and Serco already taking over community services in Surrey and Suffolk – along with the Circle hospital take-over of Hinchingbrook.
These are all based upon business arguments which diminish front line staff numbers: £169 million has already been spent on staff redundancies – some of whom have already been taken back again into similar posts in replacement organisations. The figure is due to rise to £852 million.
Broken promise no. 3: “We will protect A&E and maternity services”
Cameron had promised a ‘bare knuckle fight’ with Gordon Brown to protect A&E and maternity services; given his prowess on the badminton pitch versus Gordon’s handy forehand, the outcome would not have been pretty.
As Cameron knows, A&E and maternity services are front line essential provision which immediately endanger life when they are reduced or disappeared. Just think of the Belfast patient who died untended in a cupboard because his local A&E was stretched to 40% beyond capacity after it was asked to absorb the demand from another local hospital.
Likewise the mothers who have died in agony on labour wards with their wombs torn apart due to a severe shortage of midwives – both on duty and off.
Cathy Warwick, general secretary of the Royal College of Midwives, has warned:
“Parts of England are facing a dangerous shortage of midwives.”
A Conservative Party spokesman recently said that the pledge – to increase the number of midwives by 3,000 – “would not be met”.
Broken promise no. 4: “We will protect local hospitals”
It is now clear the Cameron defender knuckles are firmly tucked under his armpits – such that Nick de Bois, MP for Enfield and former arch proponent of all things related to Tory Party health policy, stated in the Commons how “utterly let down” his local community feel about the loss of Chase Farm.
He has since been less than vociferous about the benefits of the Lansley approach. Other facilities listed in the 29 (pdf) which would be protected by Cameron-rampant have also started to hear the clanging closure knell.
Broken promise no. 5: “We will safeguard waiting times”
Unlike the waiting times Lansley has concocted in an attempt to present this as a promise kept, the official figures show waiting times are starting to suffer.
In January 2012, 25,823 patients waited longer than 18 weeks for treatment – a 25% increase since May 2010.
Shortly after taking office, Lansley downgraded the standard that the NHS should see 98% of A&E patients within four hours, to 95% – but even this target was missed for 13 of the past 15 weeks.
The number of cancelled urgent operations has increased by 42% between the year February 2011 to 2012.
Examples of frustration also include statements from within the NHS itself: by February 2012, 47 Commissioners and 30 Trusts had missed the standard that 90% of admitted patients should be treated within 18 weeks.
As deputy NHS chief executive David Flory said:
“It is unacceptable for performance to fall below the expected standards.”
Broken promise no. 6: “There will be a reduction in bureaucracy as a result of the Act”
Finally, last but not least, broken promise 6 wherein Lansley constantly trumpets a reduction in bureaucracy as a fundamental benefit of the Act – however the reorganisation moves the number of statutory organisations from 163 to 521.How’s that for a magic number to demonstrate the inverse law of shrinking transition?!
With all this in view, Labour campaigners are being tasked with showing the party is committed to securing the core principles of the founding parents of the NHS. Labour Mayors, leaders and councillors are being asked to ‘get out there and limit the damage’, and far from maximising on damage for political gain, work constructively to support the NHS and the health of their local population.
Andy Burnham calls local campaigners “the last point of defence” against “random rationing, restricted treatments and the risk of introducing co-payments”.
Given that many in the Westminster village are still very foggy about the detail surrounding this onslaught, the challenge for local parties to engage effectively on the doorstep on key points must be for the political to be personalised.
Burnham calls the bill’s passing into law “the genie out of the bottle moment”, with the Act already ripping through services. Far from the impact being years ahead, patients are already starting to feel the difference – just ask a few.
What privatisation of the NHS actually means urgently needs to be quantified for doorstep repartee. Integration, collaboration and preservation are the Labour watchwords which need to be translated into real life examples in each locality – and set against real examples of what is already happening as a result of Tory fragmentation and the railroading in of an opportunistic private sector.
A point of reference for those who live in London can be found in the Standard:
“A string of accident and emergency units are set to close in an NHS shake-up that will see some major London hospital severely downgraded in status.”
But what would Labour do instead do I hear you cry? Cuts, yes – but more gradually – and one can be absolutely certain they would not have spent £3 billion on a top down change designed to dismantle the NHS and leave patients out in the bitter cold.
Whilst the lack of clear Labour policy is definitely going to present a problem, there is a horrible irony in listening to Cameron stating he would avoid top down changes which aim for change but instead bring chaos – just take out the avoid and what have we got? A £3billion alphabetti spaghetti to accompany £750 million in cuts – not forgetting of course the additional £500 million which Osborne snatched away under cover of the darkness of his budget.
Add in the government flying in the face of the legal ruling with respect to the Transitional Risk Register to hide their attack on the NHS, which translated, shows the coalition is effectively flouting the law to allow the smash and grab of privatisation to prioritise personal profit over patient care, then the doorstep teams are almost spoiled for choice for tasty topics for NHS discussion which will explain exactly what a vote for Cameron and Lansley actually means in practice.