LABOUR’S Health Secretary Alan Johnson announced plans yesterday to allow well-off patients to make so-called ‘co-payments’ for drugs and extra treatments, while still receiving care provided by the National Health Service.
Speaking about the work of the National Institute for Clinical Excellence (NICE) he said it would have ‘greater flexibility, particularly relating to drugs for the terminally ill’, while continuing to ensure that ‘taxpayers get value for money’.
He accepted that ‘the price of drugs is up to the manufacturers’, but said that the government would try to get them cheaper through ‘patient access schemes’.
Johnson said: ‘It is unreasonable that the NHS should fund every new treatment’ irrespective of its efficacy and cost. He added: ‘It would be wrong to take away a patient’s right to NHS care if they purchase drugs privately . . . It will end from immediate effect.’
Johnson’s statement is a major blow to the principles of the NHS. The NHS is a state-provided service, funded out of general taxation, ensuring free, comprehensive, universal and equitable healthcare.
Patients are treated according to medical need and not on their ability to pay.
At the same time, ever since the NHS was set up, there has been a private healthcare sector. Doctors receive fees for treatments, health insurance companies take premiums to fund care and chains of private institutions, like BUPA and Nuffield hospitals, provide treatments for those who have the money to pay for them.
The rich have always had the choice of being able to ‘go private’ and pay for doctors, tests, hotel-style hospital rooms, treatments and the drugs they want to buy.
Under the NHS ‘code of practice’ it has not been possible for those with money to be an NHS patient and ‘go private’ simultaneously, to get extra treatments and drugs not provided by the NHS.
This has prevented a two-tier NHS, with first-class healthcare for the rich and second-class care for the poor.
Johnson’s announcement is a major blow against the NHS as a universal and equitable healthcare system, introducing charges for drugs like in the American-style private system, where the standard and extent of care is determined by the money paid by the patient.
This is the latest step by Prime Minister Gordon Brown’s government, following in the footsteps of his predecessor Tony Blair, to break up and privatise the NHS, a process initiated by the Tory governments of the 1980s and early 1990s.
The Brown government has expanded Private Finance Initiative (PFI) schemes for building hospitals in the NHS, putting NHS funds in the hands of property developers and financial speculators for decades.
The Labour government has adopted this commercialisation of the NHS, through the purchaser-provider split. It is channelling most of the NHS’s funding to government-appointed PCTs, which buy services from NHS hospitals and private corporations.
Within the NHS, the government has imposed Payment by Results (PbR), is turning hospitals into Foundation Trusts, that will operate like private businesses and has even begun to bring in private companies to manage NHS hospitals, for example at Huntingdon’s Hinchinbrooke Hospital.
The trade unions representing NHS staff and the whole trade union movement, whose members and their families are reliant on the NHS, must immediately take action against Brown’s privatisation of the NHS and Johnson’s moves towards charges for NHS care.
The huge financial crisis, which has led to record levels of government debt, means that all these processes will be speeded up as the budget for the NHS is slashed and the commitment to provide free universal and equitable treatment is scrapped.
The fight to defend the NHS demands the mobilisation of the whole trade union movement in mass political strike action to throw out Brown’s bankers’ government and replace it with a workers’ government that will carry out socialist policies.
Only the nationalisation of the pharmaceutical monopolies can end the profiteering out of life-saving drugs and guarantee the supply of affordable drugs for doctors to prescribe within the NHS.
Only a state-owned NHS, managed by representatives of staff and patients, can provide free, comprehensive healthcare for all.