15th January 2017
The National Health Service (NHS) in the UK is probably the last remaining vestige of the social democratic ambitions of the post war 1945 Labour government. A health service free for all at the point of use; comprehensive education; council housing; nationalisation of the key strategic industries and utilities; national insurance and pensions; and full employment as a stated political objective. These were the collective principles, of support for working class people, which were the touchstones of political debate from 1945 – 1979, when the ruling class decided enough was enough and the Thatcher government began the dismantling process.
The destruction of that legacy has not always been easy or straightforward. The heroic defence of jobs and communities, which was the impetus behind the Miners’ Strike 1984/85, is the most outstanding example of trying to stem the tide. Protests against the proliferation of nuclear weapons and the tragic waste of resources on Trident nuclear submarines; demonstrations against the poll tax; inner city disturbances triggered by heavy handed policing but often the consequence of austerity and poverty; student protests against tuition fees; trade union action to defend jobs, wages and working conditions; all erupt at different times and require the ruling class to firefight in order to sustain their position.
By degrees though working class votes have been cunningly bought off. Share buying under the guise of ‘people’s capitalism’ was one trick. Home ownership through the sale of council housing was another. Comprehensive schooling has been gradually eroded, to be replaced incrementally by the insidious academy system. The legal restrictions placed upon trade unions have tied them in knots. The demonisation of trade union activity by the unholy trinity of the Daily Mail, Daily Telegraph and Daily Express, aided by TV news media has poisoned the public perception of trade unions.
Local government, which for many years could play some role in mitigating the worst excesses of the Tories in power, is being restricted increasingly to the delivery of statutory services, with little scope for local innovation or diversity. While the Tories have enforced a programme of austerity upon the victims of the 2008 banking crash, the perpetrators are given tax handouts. The anti-people politics of UKIP are given unjustified levels of airtime while Jeremy Corbyn, as the official Leader of the Opposition, still struggles to get a hearing on the BBC.
So, in a week when the Chief Executive of the British Red Cross has described the situation in the NHS as a “humanitarian crisis”, and Jeremy Corbyn has declared it a “national scandal” there is clearly an issue to be addressed. Corbyn has been quite clear, stating that,
“The health service is at breaking point. But this crisis is not due to an outbreak of disease. It is a crisis made in Downing Street by this government – a crisis we warned them about.”
NHS Chief Executive, Simon Stevens, this week claimed that the Prime Minister was “stretching it” to suggest that the NHS had received the money required to sustain service levels until 2020.
Stevens told the Public Affairs Select Committee last week that over the next three years NHS funding will be “highly constrained” and that by 2018 spending per person in real terms “will go down.”
While this has provoked the inevitable denials from Downing St, Stephen Dorrell, former Tory Health Secretary and currently the chairman of the NHS Confederation, backed Stevens, saying
“He is obviously a Cameron appointee, he has widespread respect. We should be looking at the evidence of what is happening. Simon is not saying ‘it is all impossible’. What he is saying is that if we don’t invest particularly in social care but in a range of public services, and if the health service ends up as the only place where the light is on, then it won’t meet the demands being placed upon it.”
It is widely acknowledged that there is a growing crisis in Accident and Emergency units.
Health service chiefs have acknowledged that in some parts of the country A&E departments are now “very reliant on locums”, with most of the trusts needing around 10 to 12 “middle grade” doctors, but only having two or three. Such medics are junior doctors, who have finished basic training but are still learning specialist skills and have yet to qualify as a consultant.
In November a report by the Commons health select committee warned that A&E departments need at least 8,000 doctors, 50 per cent more than the 5,300 currently employed, to keep pace with the rise in emergency admissions in the last five years.
It is increasingly recognised that the logjam in the NHS is as a result, not only of insufficient funding, but of pressures in social care, which is under strain due to cuts in local government finances.
The population of the UK enjoys increasing life expectancy. However, living longer is not necessarily the same as living in good health. Privatisation has introduced the profit motive into care for the elderly, a disgraceful state of affairs and one that Jeremy Corbyn has said he will address. The lack of social care provision means people cannot be supported in their homes. Therefore more people have to stay in hospital for longer, slowing down the system.
Care providers are balking at having to pay staff the recently introduced living wage, wanting to pass the additional costs on to local authorities. Local authorities are stretched to breaking point and cannot afford the unfunded additional costs. Recruitment into social work as a profession is at crisis levels. Care provision is closing because private sector providers, being pushed to improve wages, are now squealing that they cannot make a profit.
The Royal College of Physicians and the Royal College of Nursing are both saying that the NHS is now experiencing its worst ever winter crisis.
Jeremy Corbyn has accused Prime Minister, Theresa May, of being “in denial” about the state of the NHS. That is putting it mildly. Due to the dedication of its staff the NHS might squeeze through this winter but crisis management is no way to run the nation’s health provision.
The Health Service needs to be saved, rebuilt and restored to its rightful pride of place, as one of the truly great achievements of the Labour movement in the UK. Only Labour have a realistic chance to do that, the alternative does not bear consideration.