This was the Week the NHS Died, and No One Cares

28.4.13

Need Not Greed: Save the NHSKeep Our NHS Public"The NHS will last as long as there are folk left with the faith to fight for it"Stop the sell-offNHS not for saleSave Lewisham Hospital public meeting
The panel for the Save Lewisham Hospital public meeting

Save the NHS: A Protest Outside Parliament, and a Public Meeting in Lewisham, a set on Flickr.

On Wednesday April 24, the House of Lords voted by 254 votes to 146 to dismiss a motion, proposed by the Labour peer Lord Hunt of Kings Heath, a shadow health minister, to prevent the passage of regulations relating to Section 75 of the Health and Social Care Act (the Tories’ wretched legislation for NHS reform, passed last year), which was sprung on an unsuspecting public back in February.

The reason I call this the week that the NHS died is because the regulations enforce competition on almost all NHS business, paving the way for private companies to swiftly and effectively dismantle it, cherry-picking services they can easily make profits out of, and cowing the newly appointed Clinical Commissioning Groups (the GPs responsible for 80 percent of the NHS budget), who will be afraid of ruinously expensive legal challenges if they dare to take on the private sector.

It is not strictly true, of course, that no one cares, but I stand by the necessity of such a provocative headline. In fact, a 38 Degrees petition was signed by over 360,000 people, but millions should have been on the streets since the Tories first announced their intentions to destroy the NHS. That, however, has never happened. On the night of the Section 75 motion last week, despite furious lobbying of peers, and some great speeches in support of the NHS (by Lords Hunt and Owen in particular), the last chance to block the legislation was lost.

This was a particular betrayal by the Lib Dem peers, not one of whom voted to save the NHS. As the Daily Mirror explained, “The move to throw out the regulations was backed by 114 Labour peers, 23 crossbenchers, six others and the Bishops of Bath and Wells and Bristol. The Government was supported by 173 Tories, 63 Lib Dems, 15 crossbenchers, the Bishop of Exeter, Ulster Unionist Lord Empey and Labour’s former health minister Lord Warner. Later analysis of division lists showed there were no Government rebels.”

Disgracefully, the Daily Mirror was one of the few media outlets in the UK that even bothered to cover the debate, quoting from Lord Owen (David Owen), an independent crossbench peer who was a foreign secretary in the Labour government in the 1970s, who, as the Mirror put it, warned that “the regulations were part of the erosion of the traditional NHS,” and that they “would leave the NHS unrecognisable within 20 years.”

As he told peers, “Don’t think this is a minor step. If this goes through the National Health Service as we have seen it, as we have believed in it, as we have persuaded the electorate that we support it, will be massively changed. It will take five, 10, 15, maybe 20 years, but unless we pull back from this whole attitude there will be no National Health Service that any of us can recognise.”

He added, “I for one feel tonight one feeling only — overwhelming sadness.”

Lord Hunt told peers that the regulations “could not be in the interests of patients,” as the Mirror put it. “Every day up and down the country a market is unfolding in the NHS,” he said, adding, as the BBC put it (in one of the only other reports in the British media) that the problem is that “they hold open the door to a competitive, marketised service in which I am afraid that … the interests of patients will be not first but last.” The Mirror also described how he “warned of the ‘fragmentation’ of NHS services and said the regulations removed the ‘discretion’ of commissioners to decide when to offer services out to tender.”

As he explained, “I believe we face the prospect of NHS services being placed in the middle of a costly bidding war with private companies, discrete services cherry-picked for profit while the NHS is left to run the more complex and expensive services but with less money.” He added, “How can that possibly be in the best interests of patients? It cannot — I believe we should reject this order.”

In response, health minister Earl Howe tried to claim that the law relating to competitive tendering had not changed “one iota,” and said that the regulations were designed to provide “safeguards,” and Lord Clement-Jones of the Liberal Democrats accused Lord Hunt of promoting “conspiracy theories,” but their protestations are unconvincing. Shamefully, far too many Lords have interests in the very companies that stand to make a financial killing from the privatisation of the NHS, and cannot be trusted. As the investigative journalist Andrew Robertson asked on Open Democracy on Wednesday, “Why, considering their extensive conflicts of interest, are many of these Lords not barred from voting?” The same question should also be asked of MPs.

Despite the apologists for Section 75 trying their best to hoodwink the public, the medical profession and their colleagues, the BMA (the British Medical Association) is one of numerous organisations that are unconvinced. Before the vote, the BMA stated that the regulations need to be replaced with new rules that “unambiguously reflect Government assurances that commissioners will not be forced to use competition when making their commissioning decisions.”

After the vote, Andy Burnham, the shadow health secretary, said, “It is sad that in this, the 65th anniversary year of the NHS, the unelected House has voted to undermine its founding principles and plant the free market at the heart of the NHS. David Cameron promised to put GPs in charge, but has instead forced them to carve open the NHS to full competition. He has put the NHS up for sale — without the permission of the British public. Labour will never give up this fight for the NHS and serves notice tonight on the Prime Minister that we will continue to oppose his NHS privatisation plans on the ground in every community. He cynically used the NHS to get into Downing Street but it becomes clearer by the day that it is simply not safe in his hands.”

Unfortunately, there is, as yet, no guarantee that, even if the Labour Party wins the next election, they will reverse the Tories’ butchering of the NHS, although I fully believe that, ravaged by the Tories — and by senior NHS management — in the years running up to the next election, the NHS will be a huge campaigning issue in 2015 as the cuts begin to bite.

*****

On Thursday, the day after the Lords vote, campaigners in Lewisham delivered an antidote to the bad news from the Lords, with a public meeting in the Great Hall of Goldsmith’s College, in New Cross, put together by the Save Lewisham Hospital campaign. The meeting was packed out, with hundreds of local campaigners turning up to have their say, and to listen to the speakers, Professor Colin Leys, an expert on the NHS and the co-author of The Plot Against the NHS, Dr. John Lister (of Health Emergency), Dr. Louise Irvine, the chair of the Save Lewisham Hospital campaign, Rachel Maskell of Unite, and Pat Smith of the Labour Party, who got a resolution to save the NHS passed at the Labour conference in October, and whose conference speech is here.

Despite health minister Jeremy Hunt approving plans to severely downgrade Lewisham Hospital in January this year, as part of outrageous proposals to bail out a neighbouring NHS trust, two judicial reviews challenging the legality of the decision are underway — one launched by Lewisham Council and the other by the Save Lewisham Hospital campaign. Further actions are also planned — the Hunt for Hunt, a trip to Jeremy Hunt’s Surrey constituency on June 15, and A Lewisham People’s Commission of Enquiry on June 29, chaired by Michael Mansfield QC.

Before that, however, there is a London-wide demonstration in support of the NHS taking place on Saturday May 18, which I hope people will attend. The demonstration begins at 12 noon in Jubilee Gardens (by the London Eye), followed by a march to the Department of Health and Parliament (sign up on the Facebook page here).

Note: For other opinions on Section 75, see these articles by Dr. Kailash Chand and Randeep Ramesh in the Guardian, and the concerns of a number of charities here on the website of Marie Curie Cancer Care. I hope to have time to look into other aspects of healthcare reform, but if I don’t get the opportunity, please check out this article on GP Online about how other existing legislation might help GPs defeat Section 75, and this Guardian article about the failings of Serco, a private contractor that has £300m worth of contracts in the health sector, which raises important questions about accountability.

Andy Worthington is the author of The Guantánamo Files: The Stories of the 774 Detainees in America’s Illegal Prison (published by Pluto Press, distributed by Macmillan in the US, and available from Amazon — click on the following for the US and the UK) and of two other books: Stonehenge: Celebration and Subversion and The Battle of the Beanfield. To receive new articles in your inbox, please subscribe to my RSS feed — and I can also be found on Facebook, Twitter, Flickr (my photos) and YouTube. Also see my definitive Guantánamo prisoner list, updated in April 2012, “The Complete Guantánamo Files,” a 70-part, million-word series drawing on files released by WikiLeaks in April 2011, and details about the documentary film, “Outside the Law: Stories from Guantánamo” (co-directed by Polly Nash and Andy Worthington, and available on DVD here — or here for the US). Also see my definitive Guantánamo habeas list and the chronological list of all my articles, and please also consider joining the “Close Guantánamo campaign”, and, if you appreciate my work, feel free to make a donation.

37 Responses

  1. Andy Worthington says...

    On Facebook, Lindis Percy wrote:

    I care very much about the NHS. I worked in this great institution for 36 years as nurse, midwife and health visitor – 13 years as HV in inner city Bradford. The Coalition do what they want. It was disgraceful and deceitful that nothing was in their Manifestos – that’s what they do and it’s shocking.

  2. Andy Worthington says...

    George Kenneth Berger wrote:

    Sharing this, Andy. Good article. I hope this will help some friends here understand what happened. If I can, I’ll post it on a national site devoted to “stopping the cuts to care.”

  3. Andy Worthington says...

    Mike Cobley wrote:

    the right and new labour-right have spent 30-odd years steadily undermining the principles and practice of the NHS, and this is the fruit of their ‘labours’. David Owen’s defense of the NHS is highly notable but I think he’s wrong – the change to an unrecognisable health system may only take a few years, not 10, 15 or 20. The situation is urgent, and as doubtful as I am about the Miliband Labour party it is utterly clear that they provide the only route by which we might hit the reset button on the NHS and several other issues. But we would have to hold their feet to the fire to make sure they do what is right.

  4. Andy Worthington says...

    George Kenneth Berger wrote:

    I’ve seen the destruction happen in about two years in Holland (since privatisation on 1 Jan 06). I’ve seen the once-great Akademiska Hospital in Uppsala fail many patients, in three. Twenty years might be enough time for the NHS to be forgotten, not just transformed beyond recognition.

  5. Andy Worthington says...

    Thanks, Lindis, George and Mike. Great to hear from you all. I too share your concerns about David Owen mentioning 20 years, when even five might be optimistic. George, your experience of the erosion of services in Holland – and ow underway in Sweden – is very important, the Dutch example providing what should be the loudest alarm bells for the people of England.
    I didn’t have the time to discuss the Lewisham events as fully as I wanted, but we had a visitor from the Mid Staffordshire campaign, where a failed hospital has turned itself around, but now, following a critical report, the government is wasting no time in taking the hatchet to the improved hospital. The campaign there recently attracted 50,000 people for a protest, which is an amazing development, but the butchers are already at work – and this time they’re from Ernst & Young. I thought you might like to know, as will others keeping tabs on which corporate raiders are behind the various plans underway.
    See a report and video about the Staffordshire campaign here: http://www.thisisstaffordshire.co.uk/50-000-join-rally-save-Stafford-Hospital-video/story-18769536-detail/story.html#axzz2RmAlONdG

  6. Andy Worthington says...

    And Mike, we certainly do need to put pressure on the Labour Party, to make sure they understand that the NHS can be a game-changer for them if they’re prepared to stop slavishly clinging to the demands of the corporate world.

  7. Andy Worthington says...

    George Kenneth Berger wrote, in response to 5, above:

    Indeed, that’s one of the “Big Four,” the others being McKinsey, Price Waterhouse Cooper and KPMG.

  8. Andy Worthington says...

    Yes, that’s very important to know, George. It should be front page news, in fact.

  9. Andy Worthington says...

    Beth Bailey-Kingdon wrote:

    SUCH a bummer

  10. Andy Worthington says...

    Beverly Hendricks wrote:

    This is tragic.

  11. Andy Worthington says...

    Thanks, Beth and Beverly. Yes, that’s about it. The time for resistance is not over, however, as I hope to have pointed out. We need to make sure that the London-wide “Defend London’s NHS” event on May 18 – which anyone anywhere in the country is invited to, of course – is extremely well-attended. Please sign up here: https://www.facebook.com/events/121307804726666/

  12. Andy Worthington says...

    Kassandra Allbright wrote:

    Bravo, Andy! Thank you for keeping the world aware of that which our corporate media would rather we didn’t know. I may never directly benefit from it, but I’ve always loved the NHS.

  13. Andy Worthington says...

    Thanks, Kassandra. Great to hear from you, and thanks for the comments. It really was pretty disgraceful last week how few parts of the British media even bothered to report on the Lords debate.

  14. Andy Worthington says...

    George Kenneth Berger wrote, in response to 8, above:

    I don’t know about front page, but this article shows the ‘honest’ business model of KPMG: http://www.huffingtonpost.co.uk/2013/04/26/tax-avoidance-big-four-accountancy-margaret-hodge_n_3160241.html
    Not only KPMG, which I think is being investigated by the FBI.

  15. Andy Worthington says...

    I do wonder, George, how politicians rationalise that handing over everything they can to companies who try to avoid paying tax is at all helpful. Mind you, I also lament the laissez-faire approach, in the UK at least, to selling British companies to foreign companies, so that all the profits leave the UK even if – a big if – those companies manage to pay any tax to the Exchequer.

  16. Andy Worthington says...

    Mike Cobley wrote:

    the question we keep coming back to is – what principles are Labour’s leadership genuinely committed to? Under Blair it was clear that they were pursuing an Atlanticist, pro-USdemocrat/weak-sauce model (accentuating the pro-biz credentials at every opportunity), and fact is a good number of the Blairite middle and lower ranks are now running the party. They must be closely watched.

  17. Andy Worthington says...

    They must indeed be closely watched, Mike, but also engaged with. I was discussing that just this evening, with a friend from the Save Lewisham Hospital campaign. We were talking about how they need visiting by a delegation pointing out that the NHS and the economy need to be the focus of Labour’s plans, but they seem to be incapable of thinking outside the austerity box, even though austerity is clearly strangling us to death, and even the IMF is deeply concerned. So the IMF is to the left of Labour. That can’t be good …

  18. Andy Worthington says...

    George Kenneth Berger wrote, in response to 15, above:

    Me too. I’ve never seen any rationalisations, except for vague statements that these “accountants” are experts and are politically independent. They are good accountants and advisors, but they soon acquire actual influence, by advising on committees and taking over functions that were once done by civil servants.

  19. Andy Worthington says...

    Yes, exactly. I fear that Thatcher and Reagan were spectacularly successful at convincing even educated, well-informed people that “private” is always better than “public,” George, even though it should be obvious that those in public service are often far more motivated by the common good than any private operator.
    In addition, one of the things politicians never say is that they despise enterprises that can’t make them money. So the NHS can make shareholders money through private companies taking it over, but it can’t do so as the NHS. I don’t see the need for people to always be in search of their cut, but if there’s a problem with state-owned enterprises not delivering profits, then maybe we need to set up some kind of system – bonds, perhaps – to allow for private investment in state-owned enterprises, but not takeovers of those services.

  20. Andy Worthington says...

    Kassandra Allbright wrote, in response to 13, above:

    That saddens me greatly, Andy. Ever since childhood the NHS has seemed quintessentially English to me, sacred. How dare British media not safeguard that!? What’s next, sacking the guards at Buckingham Palace whilst prisoners are set loose and the media show reruns of Big Brother?

  21. Andy Worthington says...

    Kassandra Allbright wrote:

    Mind, I’m no royalist. I’d like to see them paying their own bills and making more of a real difference to the people of the UK.

  22. Andy Worthington says...

    Pauline Kiernan wrote:

    I’m still weeping.

  23. Andy Worthington says...

    Thanks again, Kassandra, and Pauline, I share your despair. The indifference of so much of the mainstream media suggests that they are buying into the NHS/government propaganda machine which says that huge cuts are necessary and that we can’t afford to keep funding the NHS as it is, even though (a) that’s not true, and (b) we’d pay more for the NHS if it can be proven objectively to be necessary. In addition, the steady marketisation of the NHS over the last 30 years has also led people who should know better to believe that the Tories are just a little bit more of the same, rather than dangerously obsessive ideologues. Sadly, I think, most of those who set themselves up to tell us what we need to know can no longer be trusted. They have sold out – not that there was much left to dispose of after Blair’s sustained hatchet job on solidarity and the common good.

  24. damo says...

    sigh..we kinda knew this was gonna be the outcome..this vile repulsive so called government[pathetic useless weak ex public school boys]seem hellbent on turning this country into a ghetto for the rich and corrupt only and the genral publics appathey is only helping..when people start being turned away from a.e departments becouse they havent insurance or credit..then peopl will be screaming outrage..but they have let it happen i didnt even know it had happened i didnt see it in the media..nothing..once again i say if you are youngish ,healthy, have a real world skill get outta here go abroad..this is a country that is becomeing lost…..a place not worth liveing in

  25. damo says...

    unless you are a pathetic public school boy,a corrupt banker[foreign or domestic],a vile saudi prince,dictator,despot,idiot celebrity,lol,lol

  26. Andy Worthington says...

    Yes, Damo, I can confirm that you have secured the job as a careers advisor for Britain under the Tories. Here is your excellent careers advice for young people in Britain today: “Run! Get the hell out of here!”

  27. Andy Worthington says...

    Ah yes, they are all welcome to stay, Damo! Ever since Thatcher, sliming up to the rich has been the only way to go. “I see, Mr — Mr. Satansbottom. And you say you found a way to make a fortune from selling children’s body parts? Lovely. Sooo enterprising.”

  28. damo says...

    yeah but andy what has briton got to offer the young..nothing that i can see,esp if your working class youngsters come on you listen to those youngsters and they feel they have no future here,why stay when if you go abroad ie australia,south america ,new zeland .and you work put your back into it ..you could have a better life than the one your ever gonna have here,,until we in this country abolish the monarchy send them into exile and tear down the retched class system..life for the poorest youngsters in this country will allways,allways be a hard slog…no matter how hard bright and talented they are …becouse it is not a level playing feild..and while the class system is in place it never ever will be..just look at the bloody government theres a prime example and the destroying of the nhs theres another example like sunny comments the other day ..the foul tories have no concept that people wouldnt have the finnances to pay for a harley street doctor

  29. damo says...

    look turn on the telly watch those programs like x factor,britons got talent ect,ect and watch those kids ..singing for there supper..like there lives depend on it..and seeing how crushed they are when they loose..its like …thats there only way out…dxxx

  30. Andy Worthington says...

    I felt that during the Olympics, Damo – another example of us becoming America. Athletes desperate to break out of the hopelessness of their cities, towns and villages, and performing incredibly well. When those in charge no longer articulate a meaningful future, we ought to rise up and challenge it, but at present escapism – or fantasy – is winning out.

  31. Cosmic Surfer says...

    In mourning for the loss of the NHS. It held such promise but was executed for being too humane by those who aren’t. The promise of a Welfare State is just too threatening to greed

  32. Thomas says...

    The Tories have dropped the NHS on the floor, leaving it to rot like a body in a coffin.

  33. damo says...

    only the very rich and priverliged can afford to live in fantasy worlds,lol

  34. damo says...

    were becomeing the america of now corperate america which isnt a good place the old america was magnificent a level playing feild it was a place were if you dreamed worked hard you could turn your dreams into reality look at all those people arriveing in america penniless ,makeing it happen i think that america is now long gone ..how have we all let this happen its becomeing like the film gattica…we live in a country were are young feel they have no future ..and were not ashamed of that…how has all this happened…?

  35. Andy Worthington says...

    The old got greedy. Everyone got greedy. And those who weren’t already rich, or driven, or fortunate, got branded as losers. It makes me feel sick, Damo. Fortunately, not everyone has sold out to the shallows of materialism and status and one-upmanship, but they’re far too prevalent.

  36. Andy Worthington says...

    I think that’s a very good analogy, Thomas. Thanks.

  37. Andy Worthington says...

    The fight for what remains of socialism — there, I’ve said it — will nevertheless be a fight, Cosmic Surfer. I do expect that people will eventually realize that their enemies are the transnational corporations, but we’re not there yet.

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