Goodbye NHS – we miss you now you’re gone

Would I lose my job to save the NHS? Yes, in a heartbeat. In a fraction of a heartbeat. Even in this shitty economy with the shitty attacks on the unemployed. If that was all it took to save the NHS I would be typing my notice now.

Would I lose my job in a futile gesture of distress that will be ignored by a minority government with no mandate for what they are doing? Well, no. And it is eating me up. Which is why I am typing this at half past four in the morning.

Today the NHS is 65 years old.

Earlier this year the Tory government and their Lib Dem partners killed it.

In April, the coalition government passed legislation which means that NHS service provision must be put out to tender and so hefty percentage of every pound spent on healthcare in this country must go into the pockets of the likes of Richard Branson and the MPs with financial interests in UK healthcare companies. They were kids voting for Christmas. They passed this legislation despite the fact it was not in their manifesto and they have no mandate to do so. The media were silent while they did it; the good guys found the story too complicated to tell, the frightened guys were silent because they were cowed by the Leveson inquiry, and the venal guys were lined up side by side with the MPs and their friends in the healthcare companies.

The NHS was imperfect, especially after so many years being undermined by New Labour. But it is no where near as imperfect as the smear stories masquerading as news items these last five years would have you believe. The smear stories are propaganda designed to let us assume that it’s not worth saving.

The thing is, if you ask the question “what do we do about the NHS?” the answer must not be “sell it off to the lowest bidder”. We are already seeing that profit-taking companies fail to provide an improved service, that they actually provide worse services, and that they force people who work in the most emotionally demanding jobs in the world to work in perpetual crisis mode. This is not only bleeding patients for profit, it is bullying staff for profit too.

Today those who care to fight for free healthcare for all are marching for the NHS. But I can’t be with them because I have a presentation to give on Monday, and I lost three days this week to migraine, and I am not prepared to lose my job in a futile gesture.

I’ve marched three times in recent years, each time against the Labour government, once for peace, and twice to protest their ignorant destruction of rural life. I did not feel as hopeless then as I do now. But what I learned is that a government driven by dogma will ignore a million peaceful people in the streets. And revolutions since the start of time show that raging mobs produce governments no better than the ones they overthrow.

Democracy is broken. I don’t know if it ever really worked but here it is broken. MPs milk the system for expenses and sell their votes and influence to whoever will pay them. The whores I’ve known have all been infinitely more honest.

What frightens me is that there is no place in the world and no time in the world that I can think of where freedom has been sustained. I think of all those acts of British rebellion from Wat Tyler, to the Levellers, to the Luddites, to the Rebakkah Rioters, to the Jarrow Marchers, to the General Strike of 1929, to the Miners in the 1980s, to the million of us who marched for peace in 2001, and know that all the government have to do is say “la la la, we can’t hear you”. The only way to overturn an established order, it seems, is over their dead bodies, and that’s no solution.

I have come to suspect that the stirling example and unprecedented experiment in justice and social democracy of Europe in the last 65 years was only possible after the shock of a world war, and a war in which fascism was defeated by the collective actions of coalition governments. By, in fact, the will of the people.

The late 1940s were, I suspect, the only moment in history when the NHS could be established, when enough people were used to acting in consort for the greater good of their fellow men and women. At every time before and since we have been fractured into little silos of selfishness and self-interest.

And today I will go to work to keep my job, because I no longer believe that peaceful protest works. And when the election comes round, I shall cast my vote because, like a beleaguered spouse, I keep faith with democracy though I no longer trust it.

And now I shall take some triptanes (which cost me nothing) and some asprin (which cost me 35p) and go back to bed because crying gives me migraines, and migraines are the reason I can’t go to London in the first place.

PS – apologies for spelling mistakes and typos.  This piece is posted as written, which is something I never do these days.

The NHS Reforms and Privatisation in a Nutshell

What has happened to the NHS in England is so shocking that it is impossible to believe it is true.

The Tory / Lib Dem coalition have brought in legislation which requires NHS services in England to be “outsourced” to private companies; this isn’t just ancillary services like the ambulance services, the 111 help-line (which used to be NHS Direct), and diagnostic and testing labs, it’s also clinical services like clinics, surgeries and hospitals. A single hospital will become a mish-mash of several different companies, all with different owners, all with different ways of making profits out of each other.

This is insane? Who benefits from this idea?

Good question.  Putting it bluntly, the 64 MPs and 142 members of the House of Lords who have financial links to “healthcare” companies and who were able to vote on the Health and Social Care Bill into law.

Patients will not benefit because the companies running healthcare services are more interested in profit than safety.  There is a myth that Private Medicine is “better” than the NHS. However, we already know that private hospitals cut corners wherever they can; for example they do not have Intensive Therapy Units so if an operation goes wrong they have to transfer their emergency cases to the local NHS provider.   Private is not safer, though it may be “nicer”.  Here is a story about “chaotic and dangerous care at hospital run by BMI Healthcare“.

In fairness, I should say that privatised NHS hospitals should still have the ancillary services like path labs, ITU, and so on, but they may be run by different companies with different and conflicting service targets.

Why haven’t I heard about this?

The government knew that this would be unpopular so this was not in their manifesto. It has been under-reported in the news because the story was too complicated to understand. It has also been under-reported by the state-owned BBC.

The government brought in the necessary legislation piece-meal over several years and avoided debating the key pieces in Parliament. This started with structures put in place by the Labour governments of Tony Blair and Gordon Brown and the final piece, called Section 75, was hammered into place early in 2013 by the Coalition.

So how did this happen?

This flowchart from the National Health Action party shows how:

What is actually happening?

They key bit is called Section 75 which requires a commercial tendering process; this means the decision will based on money, not expertise or quality of service.  The wording was changed following (some) protest, but it’s been made so complicated that the Clinical Commissioning Groups (ie the local GPs) can be sued if they decide not to put something out to tender, so of course they will take the safe option and put things out to commercial tender.

It’s hard to believe that it might affect clinics,  hospitals and even GP practices, though it’s easy enough to see how G4S might provide an “ambulance” service. But if we compare this with “outsourcing” in other workplaces, it’s clear enough how it could work. If you work in an office you may be aware that your cleaners don’t work for the same company you do but are “outsourced” to a “facilities management company”.  The same may be true for your IT department.  This approach is being applied to all parts of the NHS where the existing job contracts are being sold lock, stock and barrel over the heads of the employees to “service providers”.

But the NHS will still be free to patients, right?

I don’t know. This worries me:

David Cameron’s … new health adviser … advocated … charges to see a family doctor.

And the NHS will always be there, won’t it?

The short asnwer is that it has already gone in England; it is not National and it’s not a Service. The NHS brand will be around for a while but it will just be a brand covering many different companies.   And think about NHS dentistrry: NHS dental services are “there”, but not everywhere. The same could happen to NHS medical services.  Hospitals are being closed all over the place, in particular expensive services like A & E.

The insurance companies are already scaremongering, to profit from the easy work.

You should not need a health insurer to pay your surgeon’s fees.  That is what National Insurance and other contributory taxes are for.

Who is fighting this?

Lots of different groups are fighting this.  The National Health Action Party hope to have parliamentary candidates in key marginal seats in the next general election in 2015. The healthcare unions are fighting it. So are senior doctors and scientists.  So are various petition groups such as 38 Degrees. But the Labour party aren’t.

Unfortunately,  it may already be too late.

But can’t this be undone?

No. Or not easily.  This is being done to “harmonise trade” between the EU and the US,  in other words to enable American healthcare companies to run the NHS. The MPs and others who benefit from this do not want it to be possible to roll the clock back after the next election.  This means  long-term contracts will include such large penalty clauses it will be impossible to buy the service back in.

Surely there MUST be something I can do?

1. Sign this petition  if you have not signed it already.  It is to require the government to ensure the NHS is exempted from the US/EU Free Trade Agreement as a condition of the UK’s agreeing to participate.
2. Join the National Health Action Party so they have the funds to do more.
3. Like the National Health Action Party on Facebook and check their page regularly so you keep up to date and fully informed.
4. Follow the advice on how to make a difference locally in this post in the False Economy blog.
5. Join the marches and other events planned for this summer.
6. Sign any other relevant petitions you see.
7. Follow CCG Watch who provide information and action on the Clinical Commissioning Groups and anything threatening a truly public NHS.
8. Write to your MP or visit their surgery.
9. Keep informed by setting up a Google News search for NHS Reforms
10. TELL PEOPLE.
11. Vote in the next election – abstianing is not seen as a protest, it is seen as consent.
12. Stay well.

Other links

White writing this, I found other links you might like to follow.  (I have not read these in detail, and I cannot vouch for their politics or their accuracy).

• The National Health Action Party – http://www.nationalhealthaction.org.uk/
• Keep our NHS Public – http://www.keepournhspublic.com/index.php
• A Better NHS – http://abetternhs.wordpress.com/
• NHS Reality – http://nhsreality.wordpress.com/
• Google News search for NHS Reforms
• Open Democracy: Our NHS

Videos with Lucy Reynolds who is well informed and scarily accurate where she explains the Section 75 regulations clearly and in detail

• A short video showing an interview with Dr Lucy Reynolds explains the Reform Bill
• The full length interview with Dr Lucy Reynolds
• Follow-up interview with Dr Lucy Reynolds explaining that there is almost no change to the Section 75 regulations

See my other posts on the NHS Privatisation.

Profits before people

“You almost forget what you are doing is providing healthcare”

I realised yesterday why I have a creeping sense of déjà vu about the NHS sale to the private healthcare providers.

It’s the 21st century equivalent of the 18th century Enclosures. MPs and their cronies are taking something which is publicly owned and which benefits everyone; they are taking it into private ownership for private profit, and who cares about peasantry?

Who benefits?

When you ask “who benefits” the answer is MPs and Peers …
http://socialinvestigations.blogspot.co.uk/p/key-facts-of-lords-and-mps-connections.html

206 parliamentarians have recent or present financial private healthcare connections
142 Lords have recent or present financial connections to companies involved in healthcare

… and the head honchos at the BBC, which is why they woefully under-reported the issue:
http://www.opendemocracy.net/ourbeeb/oliver-huitson/how-bbc-betrayed-nhs-exclusive-report-on-two-years-of-censorship-and-distorti

A number of senior BBC staff have links with the healthcare industry…. [but] it is not the intention to suggest … financial interests were a factor … What is far more plausible is that under pressure from the Conservatives, the BBC buckled, they hoped that appeasement on the NHS would protect the BBC from any further swings of the axe.

Profit before patients

People say “so long as it’s free to patients, what does it matter?” It matters because we aren’t customers bringing in money, we are expenses and costs.

The interests of the owners will come first, and that means putting profits before people – here’s Max Pemberton in a clinic that’s NHS-branded but privately-owned:
http://www.telegraph.co.uk/health/healthnews/9962195/NHS-reforms-From-today-the-Coalition-has-put-the-NHS-up-for-grabs.html

“The manager of the clinic, however, was clear: they wouldn’t get paid for this approach … Discharging him back on to the streets was the solution. I was horrified: if I discharged him from the service, we were sending him to certain death.” (My emphasis)

And here’s how it works in the US, the land of free enterprise and expensive healthcare:
http://www.upworthy.com/that-one-itty-bitty-teeny-tiny-pesky-little-thing-that-healthcare-execs-always-f

“At the Executive level, what’s most important is meeting Wall Street’s expectations. You almost forget that what you are doing is providing healthcare”. Wendell Potter. (My emphasis)

That, in a nutshell, is why it’s naive to say “so long as it’s free to patients, why does it matter?”

Why we need not-for-profit healthcare providers

One final thought. Network Rail is a not-for-profit company. Why? Because the investigations into the Hatfield and Potters Bar rail disasters discovered that profits were put before passenger safety at Railtrack, and the way to make locomotives safer was to remove the profit motive.

We KNOW profit doesn’t work when safety is at stake.

The 18th Century landgrab

If something is owned by everyone, that does not mean it’s owned by no-one; it’s not just lying around waiting to be stolen by the rich and the greedy. As I said, this has happened before, and here’s what happened then:

http://en.wikipedia.org/wiki/Enclosure

rich landowners used their control of state processes to appropriate public land for their private benefit. This created a landless working class that provided the labour required in the new industries developing in the north of England… this is perhaps an oversimplification, that the better-off members of the European peasantry encouraged and participated actively in enclosure. (My emphasis again).

Welcome to the 18th century everyone. This government’s making fools of us all.

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This was first published here as a note on Facebook.

Today I want to cry about the NHS.

I am writing to my MP instead. Please write to yours.

It is hard to believe how much will change and how permanent that change will be because in the UK we have been lulled by the slow rate of privatisation in the NHS over the last three decades.  But even with this thin end of the wedge, we have already seen the businesses that want to take a profit putting the health and lives of patients at risk so they can cut costs by cutting back on nurses and doctors.

There is just one month left to make objections to the Health and Social Care Bill before it automatically becomes law.

Here is what will happen then:

The health service is being put out to the highest bidder and profits for a few people will come before people’s lives and health.  For example, if a firm wants to run a hospital or a clinic it will not be able to bid based purely on quality as we were promised. Instead, EU competition laws will apply. This sounds innocuous  but it means companies don’t need any experience in running hospitals, clinics or other health services, instead they must be chosen on a commercial basis.  In fact, the bodies who run the tender process (the Clinical Commissioning Groups or CCGs) will be fined if they require bidders to be experienced health service providers. The CCGs can be sued by disappointed companies who do not get the work, draining away their money and time.

The process will favour big corporations with large teams skilled in bidding for work, but not necessarily skilled in doing it and will disenfranchise all other groups.

Businesses will be able to cherry-pick the services they offer and allowed to undercut the local NHS provider by, taking their money out of the system by offering the “safe”, “easy” and profitable work, and leaving the hard, expensive and unprofitable work to local publicly run services.

There is still time to object, though very little.  Please do what you can

• Contact your MP – Look them up here and write them a letter or email them http://www.theyworkforyou.com/ 
• Pass this on to your friends and relatives and get them to contact their MP

The message is simple:

• The NHS is one of the great achievements of this country, or any country, in the 20th Century (look at the way it was celebrated in the opening ceremony of the Olympics), and its importance transcends party politics.
• Whatever faults and issues there were in the past the NHS should not be made subject to EU competition law or offered up for global corporations to profit form. The fundamental principles are valued by everyone and this legislation will wreck them.
• Take the time to find a better solution. Regulations in the terms currently laid before Parliament should not proceed. And the matter should be properly debated in both Chambers rather than going through on the nod without proper consideration by MPs who are our elected representatives who are being asked to respond to the concerns of their constituents.

What else you can do:

• Sign up to the NHS Action Party’s page on Facebook here https://www.facebook.com/NationalHealthActionParty
• Share their updates so your friends and relatives see them.
• Find out more about them here: http://www.nationalhealthaction.org.uk/
• Follow the NHS Action Party on Twitter www.twitter.com/NHAparty
• Retweet them to spread the word
• Sign petitions and get involved on 38 degrees http://www.38degrees.org.uk/campaigns
• Stay well

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This was first published here as a note on Facebook.