private healthcare

NHS at 65, Lewisham & the DLR – 2013

NHS at 65, Lewisham & the DLR: Friday 5th July 2013 was the 65th anniversary of the founding of our National Health Service and I photographed three events connected with this, two in Westminster and one opposite Lewisham Hospital where campaigners were fighting to keep services. And on the way back from Lewisham I took some pictures though the window of the DLR train, mainly as we went past Deptford Creek.

The National Health Action Party was a publicity stunt and single issue parties such as this are never likely to make much widespread impact on British politics. But given the strength of the recent Labour rebellion over Starmer’s attack on the disabled I wonder if a new left of centre political party might result in a radical change in our political system, with possibly a significant number of Labour MPs deserting the sinking ship in favour of a party which represents traditional Labour values. We could then have two different parties fighting out the next election.

NHS 65: GMB – Westminster

The GMB trade union came with three vintage ambulances to protest outside Parliament where trade unionists in vintage ambulance uniforms posed with MPs including Dennis Skinner and Sadiq Khan warning that the NHS is at risk.

I’m afraid I’ve forgotten who the other MPs were, but you can see a couple more in the pictures on My London Diary I took as the photographer for the GMB posed and photographed them. I have a personal antipathy to posing people, though I might occasionally deliberately attract their attention and even very occasionally ask them to keep still or look at me. But generally I see my role as recording what is happening rather than directing it. And here what was happening was that people were being photographed.

Later I went with them (and the ambulances) as they took 65th Birthday cards for the NHS, with the message inside “Do Not Pension Off Our NHS’ to the Ministry of Health, then still in Richmond House on Whitehall.

More at NHS 65: GMB.

NHS 65: Lewisham Hospital

In the memorial garden opposite the Save Lewisham Hospital Campaign were holding a lunchtime party to celebrate the 65th Birthday of the NHS, and as a part of their campaign to keep this busy, successful and much needed hospital open.

The plans for its closure were not related to the hospital’s performance in any way but because the health authority needed to make drastic cuts to meet the disastrous PFI debts of a neighbouring hospital.

There had been a massive community campaign to save vital NHS services at the hospital, backed by “Patients, NHS staff, Lewisham Council, MPs, schools, pensioners, families, businesses, faith groups, charities, unions, students and health campaigners” – the whole community including the Millwall Football Club.

Later at the end of July 2013 the High Court ruled in favour of the Judicial Reviews by the Save Lewisham Hospital Campaign and Lewisham Council and quashed the Government’s closure plans. And ten years later in July 2023 on the 75th anniversary of the founding of the NHS a newly engraved community bench was unveiled to celebrate the victory. I’m sorry I wasn’t present to record that occasion.

More at NHS 65: Lewisham Hospital.

DLR Views – Deptford-Canary Wharf

I decided to travel back from Lewisham into central London by taking the DLR to Canary Wharf where I could change to the Jubilee Line because I could try to take some pictures from the train, particularly on the section where the viaduct goes alongside and over Deptford Creek.

There are many problems in taking pictures from trains. Finding a reasonably clean window is the first, and avoiding reflections another. It was easier back in the 1970s when there were windows you could pull down and lean out! And now apparently AI can remove reflections, though I’ve yet to try it.

DLR Views

NHS 65: Rally & Camarathon – Westminster

On the 65th Birthday of the NHS, Dr Clive Peedell began a 65 mile ultramarathon to David Cameron’s Witney constituency to bury the NHS coffin and launch the National Health Action Party plan by doctors and health professionals to revive the NHS.

Dr Clive Peedell posed in a Cameron mask with the coffin and wreath and had come with a small group of supporters, including one wearing a mask of his coalition partner Nick Clegg. Campaigners accuse both of deliberately running down our NHS, with more and more NHS services being delivered by private healthcare companies.

After posing in front of the Ministry of Health, the campaigners crossed Whitehall to stand in front of the gates of Downing St before processing behind the coffin to Parliament for more pictures, ending with some street theatre involving severed hands and speeches by several distnguished health professions including the Chair of the Royal College of GPs in Old Palace Yard.

I left before Dr Peedell and two others set off on his long run – though I’m sure others would be carrying the wreath and coffin. The event had clearly been set up to attract the media, but received little publicity.

On My London Diary you can read a long statement by Dr Peedell about how the “2012 Health and Social Care Act, will result in the NHS being increasingly dismantled and privatised” with the Labour Party whose “previous pro-market, pro-privatisation reforms, actually set the platform for the current changes” had failed to sufficiently oppose. Health professionals had “formed the National Health Action Party to raise awareness and inform the public about what is happening to their NHS” and had today “set out our own 10 point plan to reinstate, protect and improve the NHS“.

Much more on My London Diary at NHS 65: Rally & Camarathon.

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Save Our NHS – 4th March 2017

Save Our NHS – The NHS was under attack by the Conservatives before it was established in 1948 and has come under repeated attacks since by governments of both major parties particularly since the 1990s.

Providing universal healthcare costs and the current financial year (2023/24) figure of £160.4 billion is around one seventh of total government spending of around £1,200 billion. So it isn’t surprising that governments should wish to see that the money is being spent wisely. But that isn’t was most changes in government health policy have been about.

Even with that large sum, the UK is still getting healthcare on the cheap. According to Statista the spending per person is less than in the US, Switzerland, Germany, Norway, Netherlands, Austria, Belgium, Australia, France, Sweden, Luxembourg, Canada, Denmark, New Zealand, Ireland and Finland and roughly the same as in Iceland and Japan.

It’s perhaps not surprising given this that we often hear reports which compare the results of NHS care critically with those in other countries. But those reports on the BBC and in the papers seldom if ever mention the poorer funding the NHS receives than many of those with better health outcomes.

The US spend per person is considerably higher than all other countries and roughly two and a quarter times that in the UK. But many of the NHS reforms made this century have been based on making our health system more like the American model, which would be a disaster. But it would mean a great opportunity for private healthcare companies, particularly some of those US companies, to make huge profits at our expense.

A surprising number of our MPs have had some financial interest in healthcare either through shareholdings or by sponsorships. The Daily Mirror in 2014 published a list of 70 MPs with links to private healthcare firms which included almost every leading Tory and some from other parties. As well as then Prime Minister David Cameron, they included Former Health Secretary Andrew Lansley, responsible for the disastrous Health and Social Care Act 2012, Health Secretary Jeremy Hunt, former Health Minister Simon Burns, the Work and Pensions Secretary Iain Duncan-Smith, William Hague, Philip Hammond, Sajid Javid, Oliver Letwin, Chancellor George Osborne, Priti Patel, Jacob Rees-Mogg and many other leading Tories, along with Lib-Dems then in the coalition government Vince Cable, Nick Clegg and Simon Hughes.

It’s these people who have introduced policies which have led to large areas of NHS services being provided by private companies, though still retaining the NHS logo and still providing services free to the public. But generally these are the kind of simple, straightforward services and the more complex areas are still left to the NHS.

There is still huge public support for the NHS, despite its problems some of which have been created possibly deliberately by government reforms to erode that support, though more clearly in a drive to make more of its services available to be taken over by private companies.

On Saturday March 4th 2017, thousands came to Tavistock Square, outside the BMA headquarters to march to Parliament Square in protest against the cuts and privatisation of the NHS which they said was at breaking point.

In particular they were protesting the Sustainability and Transformation Plans for hospital closures and cuts in services which had already caused many premature deaths. Doctors and other healthcare workers clearly saw these as a part of a rapid stealthy privatisation with medical services increasingly being run for private profit rather than public benefit.

In 2017 the STPs mutated into Sustainability and Transformation Partnerships and in 2018 these were told to transform themselves into Integrated Care Systems which have now replaced Clinical Commisioning Groups. These plan, buy, and provide health and care services in there areas and are subject to inspection under 70 performance metrics and can be put into ‘special measures’.

According to the Wikipedia article “A report from the Nuffield Trust in December 2021 found that there was very little evidence that integration policies across the UK – including pooling budgets and creating new integrated boards and committees – had dramatically improved patient experience, quality of services or supported the delivery of more care outside of hospitals.” But clearly they had diverted a considerable amount of expertise, time, energy and money away from the real business of the health service – and funding towards private companies.

Estimates for the number on the march varied even more wildly than usual, but it was clearly a large march. My guess was perhaps 30,000 but it could well have been twice that if not the 250,000 the organisers claimed. All the pictures in this post come from the march and the rally before the start, and I was too tired by the time it reached Westminster to photography the rally in Parliament Square.

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Save Our NHS March, London, 2017

Save Our NHS March, London, 2017. On 4th March many thousands marched through London from Tavistock Square where the BMA have their headquarters to a rally in Parliament Square in protest against the cuts and privatisation of the NHS.

The Conservative Party were against the formation of the NHS from the start, and voted against both the Second and Third readings of the National Health Service Bill in the House of Commons in 1946.

The formation of a public state heath service had been advocated by Beatrice Webb as early as 1909, and the idea of a free, comprehensive and universal health provision had been gaining public support over the years, becoming official Labour policy under George Lansbury in 1934. By 1942 even the British Medical Association had proposed having regional councils running hospitals with consultants as paid staff, although they opposed the 1946 bill as they though doctors would lose money under the NHS.

But it was the 1942 report by William Beveridge, Social Insurance and Allied Services, that put the NHS firmly on the political agenda, with even Tory Prime Minister Winston Churchill suggesting in 1943 it would be a part of the rebuilding of Britain after the war, and both Liberals and Conservatives supporting consultations with doctors and others that resulted in a 1944 White Paper, ‘A National Health Service’.

When Labour’s Health Minister Aneurin Bevan put his National Health Service Bill to parliament in 1946, there was general agreement on the idea of a comprehensive health service, but the Tories were opposed to doctors becoming full-time employees and thus being unable to continue in hugely lucrative private practice. And the BMA shared their position, continuing their opposition after the Act was passed and eventually were able to force Bevan to amend the act and remove the introduction of a salaried service for GPs.

So, although it was a great day when the NHS came into being on 5th July 1948, and was from the start a little hamstrung by commercial interests – in this case of individual doctors. Dentistry has never been properly integrated into the system, and many find it impossible to get NHS dental treatment as relatively few dentists are prepared to work at the rates offered by the NHS. Even for those who are able to get registered as NHS patients, their are fees which for those not qualifying for exemption can be prohibitive despite being subsidised by the NHS.

*The march sets of with John McDonnell, Mark Serwotka and others holding the main banner*

It was a Labour government that proposed the idea of prescription charges in a 1949 Act, prompting the resignation of Aneurin Bevan from the Labour government, but it was a Conservative Government that introduced them in 1952. They were abolished under Labour by Harold Wilson in 1965 but he brought them back in 1968 though with significant exemptions based on age, income and medical conditions. Wales, Nothern Ireland and Scotland have now abolished charges, but in England each item now costs £9.35.

Since the 1990s many politicians, particularly Tories but also some of the leading figures in the New Labour government and on the right of the party have backed changing from the current universal system to a personal insurance-based system, and there has also been a huge increase in those taking out private insurance, with now around 4 million having this, mainly through the companies they work for.

Healthcare is now a massive industry in the UK, enabling the wealthy to avoid delays in receiving treatment in the underfunded NHS. The NHS also massively funds the private system, with some private healthcare providers receiving as much as 80% of their income for providing services to NHS patients. Some NHS hospitals also get in on the act by offering private care.

Many of the more routine services provided by the NHS have now been outsourced to private providers and over the years various changes in the way the NHS works have meant more and more has to be made available for tender by outside bodies. In some cases the level of services provided has been extremely poor – when I was in one hospital the outsourced cleaners had insufficient time to clean the floor under the beds, and accidentally putting down my hand I found a dirty dressing and a used needle from a previous occupant. Probably such outsourcing was a significant cause of various hospital-acquired infections.

But much private medicine is of a high standard – using the same surgeons and consultants others expensively trained by the NHS who work both for the NHS and private hospitals. The best private hospitals will have more equipment and more up-to-date equipment than the NHS hospitals that have suffered from years of cuts, and will also provide better conditions for their patients, with private rooms and more.

Having a two-tier system which is rapidly growing means that politicians, themselves wealthy and overwhelmingly representing the interests of the better off, and the more vocal wealthier groups in society, as well of course as the well-paid lobbyists for private health, are less likely to provide the NHS with the funding it needs to provide modern healthcare.

Many believe that our NHS is under threat, slowly and step by step being sold off to private healthcare companies, many based in the US, and that before long the NHS will be a name only, a branding used by private companies (as in many areas it already is.) The country is slowly being prepared for a complete move to an insurance based system, which will be brought in by politicians – Labour or Conservative- still chanting the mantra ‘The NHS is safe in our hands‘.

More at Save our NHS March.