Posts Tagged ‘private profit’

Save Our NHS – 4th March 2017

Monday, March 4th, 2024

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.

Save Our NHS

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.

Save Our NHS

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.

Save Our NHS

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.

Save Our NHS

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

Friday, March 4th, 2022

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.


Grenfell 4 Years On – Still No Justice

Monday, June 14th, 2021

Like many I woke up on the morning of 14th June 2017 to the news of a terrible fire that had engulfed a tower block in North Kensington with horrific stories of the death of so many trapped in the building, particularly on its upper floors. It had begun early in the morning after I had gone to bed and switched off my computer and phone, so I hadn’t got the text from an agency asking if I could go there. Clearly by the time I woke up to the morning news the area was swamped by the media and I decided not to add to the pressure on the survivors and the local residents who were traumatised by what they had seen and heard.

I was shocked by the news, but not surprised. It came after years when the government – particularly the coalition, but others too – had been attacking health and safety measures as ‘red tape’ and making cuts to the fire service, particularly in London, that I’d reported on. And after years of attacks by local and national governments on social housing. Though I was shocked to find that the London Fire Service, thanks to cuts made by the London Mayor Boris Johnson, now longer had an appliance to deal with fires in such high-rise buildings and had to call on the neighbouring suburban Surrey Fire Services for one.

I then knew enough about the design of such towers to understand that this fire should not have been possible. If design and building regulations had been followed it should have been confined to the flat were it started and quickly burned out. Instead the videos clearly showed its rapid spread up the outside of the buildings.

It took only a few weeks for the basic facts behind the fire to be discovered, with Architects for Social Housing in particular producing a straightforward account of the many faults, The Truth about Grenfell Tower on July 21st. Their report not only identified the various faults in the type of cladding and in particular its incorrect installation, but also of the lack of proper oversight in large schemes such as this and the culpability of local councillors and officers.

An unnamed senior architect stated at the end of a lengthy comment to ASH,

‘Since PFI was introduced by Thatcher we have a legacy of hundreds, if not thousands, of sub-standard buildings – schools, hospitals, police stations, etc – that the taxpayer is still paying extortionate rents for under the terms of the 30-year lease-back deal that is PFI. This is her legacy of cosy relationships between local authorities, quangos and their chummy contractors. It is a culture of de-regulation, of private profit before public good. Thomas Dan Smith, the Leader of Newcastle City Council from 1960 to 1965, went to gaol in 1974 for dodgy dealings with local authorities in property development, albeit from a different motivation; but what the public must demand and get now over the Grenfell Tower fire are criminal convictions, and soon.’

https://architectsforsocialhousing.co.uk/2017/07/21/the-truth-about-grenfell-tower-a-report-by-architects-for-social-housing/

What should have followed in the next few months was the criminal trial of those responsible, after which there could perhaps have been a public inquiry in particular looking at the lessons to be learnt and the changes in laws required. Instead we got the usual empty rhetoric from politicians and and public inquiry that was set up in September 2017 but only began taking evidence in June 2018. Much of its first phase was concerned with trying to transfer responsibility from the faults of the building and those responsible for it onto the London Fire Brigade, who had acted heroically on the night and managed to rescue many, and in particular to demonises LFB’s Dany Cotton, who shortly afterwards took early retirement.

This report by retired judge Sir Martin Moore-Bick, selected by Theresa May to lead the enquiry should and hopefully will be seen as an incredible indictment of our public inquiry system, which seems to exist to push issues into the very long grass and allow the guilty to escape any real judgement allowing them to spend millions on barristers to muddy the waters and save their skins. The firefighters and the survivors don’t have that protection.

The enquiry continues with some startling testimonies from those responsible for the defective refurbishment and councillors and officers as well as from residents. So far these broadly repeat and support the conclusions of the July 2017 ASH report – but it has taken almost 4 years longer. It’s hard to read some of the testimonies and not think that person should be in jail. But the chances of any justice for Grenfell still seem remote.

In the days after the fire I went on several protests and four days later made my way to see for myself and, like others pay my respects to the dead. The pictures with this article are from that visit. Since I’ve returned for some of the monthly silent walks and other protests in the area, though these have been suspended for Covid.


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