Save Our NHS www.NHSFightback.uk
Right wing always want "a mixed funding model!"-ie more US style private health insurance
Many differing levels, cover, coopayments, top-ups
No private chain has the infrastructure or the wish to provide ITU's, birth units, stroke, RTA, fracture, facilities...
Tank the pound DONE
Shrink the State DONE (now a small hamlet)
Spook the markets, who demand cuts DONE
Cut and dismantle the NHS and Social Care NEXT WEEK...
None of the advocates of ‘alternative models’ and more private sector involvement is willing to address the fact that the health insurance industry does not want to recruit older people (who are more likely to make a claim, and more likely to have more than one pre-existing condition) and charges hefty higher age-related premiums to deter them. The growth of “self-pay” private treatment for those without insurance cover has been much slower than the growth of the waiting lists – as the hefty costs and limited range of such treatments act as a barrier to most.
Private hospitals (average size 40 beds) are not geared up in any way to handle emergencies or complex cases, and have never shown any interest in doing so. In other words, even for the wealthiest people needing emergency treatment there is no private sector option that avoids the long queues of ambulances and delays in accessing NHS A&E departments.
What is more worrying is that Liz Truss herself has embraced many of the right
wing policies and “solutions”. She is one of an 8-strong Parliamentary
Board of the 1828 Committee, whose ‘Neoliberal Manifesto’, published
jointly with the Adam Smith Institute in 2019, condemns the NHS record as “deplorable”
and calls for the UK to “emulate the social health insurance systems as
exist in countries such as Switzerland, Belgium, the Netherlands, Germany and
Israel, among others.” The Manifesto is silent on the fact that (with
the exception of the deeply flawed Israeli system) all of its preferred models
spend much more per head on health than the UK.
When we are subjected to ‘alternative facts’ by our own government,
such as claims of ‘record’ numbers of doctors and nurses and investment
in the NHS, one can be forgiven for misunderstanding the depth and severity
of the crisis in healthcare that was predicted and has now befallen the UK.
When deliberate obfuscation of the harms that Covid has caused, and is still causing, is spread by our own government, and select groups of libertarian outriders are falsely claiming that the current collapse of emergency medical care is due to the effects of lockdowns, one needs to ask where this situation of State-sponsored disinformation is leading us.
Worst NHS figures ever recorded
Summer 2022 has brought with it the worst NHS performance figures ever – a true record of this Government. Whilst blaming a heatwave, Brexit and Covid is easy and conveniently tempting, the truth is much deeper and dirtier.
When David Cameron set the £30bn NHS annual funding target to in 2015
to be achieved by 2020, the NHS had just endured the prior £20bn target
of NHS ‘efficiency savings’ cuts in annual funding over 2010-15.
Together with the unspoken (but documented) policy of running down NHS staffing
and bed capacity with predictable results, government policy has also purposefully
allowed NHS capital infrastructure such as CT/MRI scanners, hospitals and GP
Practice buildings to deteriorate. Hospitals were forbidden to spend money on
their own buildings and Government exhausted its central capital spending reserves
– instead using capital funds to pay towards day-to-day operational NHS
As far back as 2012, the ‘Zero Tolerance’ report by the Association
of Ambulance Chief Executives (AACE) and NHS Confederation had highlighted significant
emerging concerns from delayed handover of patients from ambulances to A&E
staff and the potential consequent harms to those patients. An updated review
from AACE in November 2021 lays bare the stark consequences of having ignored
their earlier report. This important piece of research by AACE calculated that
the current levels of handover delays could be leading to 160,000 patients coming
to harm over a year, with 12,000 patients suffering severe harm, including death
from these delays. A staggering 35,000 patients may have come to harm as a result
of ambulance handover delays in August alone.
The latest published in-depth study of the effect of long waiting times for
admission of patients from A&E departments to a hospital bed is extremely
worrying. This research has shown a 16% increase in 30-day death rates of patients
who have waited in A&E between 8hrs and 12hrs (compared to average waiting
time) for admission to a bed. Our government has wilfully ignored and suppressed
data which demonstrates the perilous status of the NHS and our constrained ability
to continue to provide safe care to patients – despite hordes of patients,
clinicians, academics, journalists and commentators having repeatedly raised
the alarm. Further work based on this study – which also incorporated
the effect of Covid on the 10% increased current levels of population excess
deaths – showed evidence that:
There is a plausible case that 500 excess deaths per week are being caused by excessive waiting times in emergency care”
Steve Black, BMJ
Prior to 2017, there weren’t any patients waiting longer than 12hrs on
trolleys in corridors (102,000 in June); there weren’t any ambulances
queueing outside A&E to hand over patients (up to 25 outside Treliske Hospital
in July); there weren’t any patients waiting longer than three months
for cancer treatment. There are now 10,200 patients who have waited longer than
104 days for their cancer treatment to begin, a total of 340,000 patients on
cancer waiting lists – and rising. This crisis hit the NHS before the
coronavirus pandemic and was at least a decade in the making. It was predictable
and it was predicted.
A Government in denial
Government Health policy makers remain in a world of denial of their own making. Amidst Covid, austerity, poverty, homelessness, the energy crisis, and a demonstrable collapse in function of the health service, the new Secretary of State, Therese Coffey, has set out her stall to address the NHS crisis. I have just fallen foul of her most impactful announcement: that the ‘Oxford comma’ must never be used in the NHS…I kid you not.
Unfortunately, there is little to laugh about in a situation where our citizens
are literally dying due to governmental failure and neglect of its duty to provide
healthcare for its population. I wonder if this was the reason why Government
literally altered the wording in the NHS constitution
from “duty to provide” health services, to “duty to promote”
– did they too foresee what was to come?
It is no surprise to see the Tufton Street neoliberals like the Institute of Economic Affairs (IEA) atop their platforms again, eager as ever to trash the NHS with familiar phrases such as: “The NHS model has failed”. But the facts speak otherwise.
Up until 2017, the UK has consistently topped the International Health System Comparison charts, including for clinical measures such as safe care, preventive care, co-ordinated care, chronic disease management, and decline in mortality amenable to healthcare (sorry again, Therese).
When IEA pundits claim (falsely) that Germany’s mixed private and publicly provided Health system is better than the NHS, they omit to inform you of Germany’s poor rankings in the comparisons of international performance.
Germany’s Health spending is 40% higher per person
than the UK and they have more than double our hospital beds, 50-64% more doctors
and nurses, and three times the number of CT and MRI scanners (all per capita,
2017 figures). Yet, despite being much better funded and resourced,
Germany still doesn’t prove itself better than NHS. When the NHS is funded
well, seeking to promote and defend the NHS model, the evidence shows that the
NHS does better, and even with funding cut back, it performs as well or better
than many countries with better funding.
The message is clear: the NHS is an undervalued health system and it has wilfully
been allowed to fall into ruin, with lethal results. I have read the government
documents outlining their plans for privatisation and am in no doubt as to why
the managed decline of the NHS has been relentlessly pursued, to the benefit
only of the private sector, and with now demonstrable harms to the population.
Winter is coming.
Dr Nick Mann is a GP and a member of Keep Our NHS Public