THE BIG push is on to destroy the national network of A&Es that millions of people depend on, and to convert at least 100 to a version of ‘urgent care centres’.
This project of NHS boss Keogh is even being advertised proudly as creating a ‘two-tier NHS’, a Premier division and the rest, the second best.
A feature of the change will be the encouragement that is to be given to ambulance and all paramedic staff to treat patients on the spot, or to take them to GPs or any ‘community option’ that will keep patients from ‘clogging up’ Accident and Emergency Departments.
At least 100 A&E departments, under the new Keogh Plan, will only provide much reduced levels of service, meaning that many patients who cannot be treated on the spot, or dumped onto the community, will have to travel much longer distances to receive the care that they need. That some will die in transit is obvious, but then that’s progress isn’t it?
Officials are stressing that this new two-tier system of A&E departments is the only way to keep the NHS free at the point of use, despite the fact that NHS budgets have already been cut by billions of pounds.
Under this ‘new NHS order’ only 70 A&Es will be designated as ‘major emergency centres’ which treat serious conditions and injuries.
The other aspect of the Keogh plan is that serious efforts are to be made to keep away the 40% of current A&E users, whom the Coalition and its supporters in the NHS say should not be admitted to any A&E in the first place. They are to be treated by paramedics, or even pharmacists, or just told to go away under this higher form of healthcare.
All this is happening just weeks before the start of the winter, when flu and other epidemics are predicted to create a crisis for millions of people and the NHS. The solution is after all simple, we now learn: just turn them all away.
Sir Bruce Keogh, the NHS medical director, considers that the state is under siege by patients who don’t need NHS A&E care at all!
He singles out the ‘intense, growing and unsustainable pressure’ from an ageing population and the high numbers who turn to casualty departments because they are allowed to.
A spokesman for NHS England said of Sir Bruce: ‘He is not proposing any downgrading but believes after this process, the overall number of emergency care centres will remain broadly the same.’
Sir Bruce ‘believes’ that the huge cut in proper A&Es that he is proposing will be the last big cut.
However the public are not mugs. He is hardly going to say that even bigger cuts will follow! The public knows that his ‘belief’ is no guarantee, and could well amount to providing the credulous with ‘fool’s gold’, and be the smokescreen behind which even bigger and even more savage cuts and changes, including payment for treatment, are being prepared.
As it is, his NHS proposals include ripping up GP contracts. There is to be seven-day around the clock access to family doctors for routine health problems, with GP telephone appointments and treatment, and with pharmacists given more responsibility for diagnosing and treating.
This seven-day around-the-clock working for GPs, with the same or lesser numbers of qualified doctors, is to be supplemented by extended training for paramedics on how to keep more patients out of hospital, making special use of the ‘new evidence’ that is said to prove that up to half of 999 calls could be managed at the scene where the call is made.
Under the plans, the controversial 111 phoneline, the same phone line that has repeatedly collapsed, is to play the central role in managing demand for urgent care, with people who have little medical experience making life or death decisions.
Already assurances are being given that call centres will have more medical staff on hand, and staff will be able to access electronic patient records so that advice is ‘better tailored’.
Sir Bruce says that these changes are ‘the only way to create a sustainable solution — and ensure future generations can have peace of mind that, when the unexpected happens, the NHS will still provide a rapid, high quality and responsive service free at the point of need.’
The reality is that the UK ruling class has decided that the NHS and the Welfare State has to go, so that capitalism, which can no longer afford them, can survive.
Capitalism is dying. There is only one solution to the crisis that its death agony is creating.
That solution is the skilled surgery of a socialist revolution to bury it and replace the bourgeois order with a workers government and socialism. This is the only way forward.
