NHS England warned yesterday that by 2020-21 the gap between the NHS budget and rising costs could reach £30bn, meaning that when the current programme of £20bn cuts in the NHS by 2014-15 is taken into account, cuts of £50bn are required ‘to save the NHS’.
The organisation’s chief executive, Sir David Nicholson, who supervised the dash for Foundation Trust status at Stafford hospital that led to huge staff cuts and an outcome of thousands of deaths, has had the nerve to ‘warn’ that unless the NHS is reorganised (read shut down and privatised) ‘pressures’ could lead to another Mid-Staffs disaster.
He told BBC Radio 4’s Today programme: ‘We need to make sure that the way in which services are organised is in the best way for patients.’
He unashamedly advocates mass hospital closures, to be replaced by preventative care and ‘improved services’ for people in the community, as part of a drive to make the NHS more efficient and productive.
Nicholson insisted that it was ‘really very urgent’ that decisions were made, and that trying to maintain services in the same number of hospitals ‘is completely unacceptable to us in the NHS’.
One of the organisers of the disaster in Mid-Staffs warned that: ‘If we don’t tackle these issues now and over the next couple of years – the future for many of our organisations is facing those very dangers that Mid-Staffordshire faced during the years it was involved in this terrible tragedy.’
Nicholson is advocating mass hospital closures, and transferring the main emphasis of care into the community, away from hospitals and onto GPs whose contracts are to be ripped up so that they can be forced to try to carry the extra load.
At the centre of this campaign is privatisation, bringing in the private medical industry to purchase contracts that will keep a much-reduced NHS functioning, but no longer supplying the kind of care that is needed.
Nicholson’s solution is to simply close down hospitals so that healthcare can be carried out in the community by a very hard-pressed and privatised primary care set-up.
The BMA has just responded to the House of Commons Public Accounts Committee report into the provision of the Serco-provided out-of-hours service in Cornwall.
Dr Laurence Buckman, Chair of the BMA’s GP committee, said: ‘The PAC report into the failure of out-of-hours care in Cornwall raises serious issues about the operation and transparency of contracts with non-NHS providers throughout the NHS.
‘Despite assurances from government ministers, it is clear in the case of Cornwall there was a complete breakdown in the regulatory framework that was supposed to ensure that patient care would not be compromised when NHS services were taken over by a non-NHS provider. This is underlined by the failure of the local Primary Care Trust (PCT) to hold its contractor to account, despite repeated complaints from local GPs.
‘The BMA has repeatedly warned the government about the risks entailed in opening the NHS up to greater competition. The government must ensure that this disgraceful situation does not happen again…If we do not get a grip on the problems exposed today then we run the risk of seeing the failures in Cornwall becoming routine across the NHS.’
Exactly so!
Then there is the issue of the government creating a private sector bonanza out of the NHS, following the passing of the Health and Social Care Act.
Commercial companies look set to gain 1.5 billion pounds worth of NHS funding from contracts issued within the last three months. This surge follows the government’s new competition rules which came into force in April. Over 100 opportunities have been advertised according to figures compiled by the NHS Support Federation. The latest contract notice is the biggest so far – to run community services in Cambridgeshire and is worth £800 million over five years.
So care is to be carried out by the private sector in the community with hospital care as a last resort. Privatisation and profits are to come first, at the expense of healthcare.
The drive is now full on to bankrupt the NHS and replace it with private medical care, whose primary concern is profits.
Unison’s Christina McAnea has said that there needs to be a debate about the future of the NHS.
No debate is needed. What is required is a struggle by the trade unions to defend the NHS, insisting that since it is a choice between the NHS and the Welfare State or saving bankrupt capitalism from its crisis – it is capitalism that must go.
The BMA and the NHS trade unions must take the lead in organising the defence of the NHS. This mean stopping hospital closures with trade union-backed occupations, and organising a general strike to bring down the coalition and bring in a workers government. This must nationalise the drug industry, end the PFI robbery, and restore all of the NHS cuts. The NHS must be the backbone of a socialist society.
