With privatisation now a tangible reality, NHS employees fear how an already-strained service will change and diminish
In the aftermath of the general elections, in which 37 per cent of voters rejoice in their choice of a Conservative majority government, none are more dismayed at the Tory democratic coup than NHS employees. The NHS was a hot topic in the election lead-up, and yet it was ominously missing from David Cameron’s immediate winner’s speech. This should not have come as a surprise to anyone. Health was also excluded from the Conservative’s list of the top six priorities in their manifesto.
The left wing’s self-righteous anger, and the ensuing mockery, was inevitable. However, these elections have brought politics alive for the masses, for those who were previously apathetic. Britain’s dated electoral system, the personal focus of the debates, the skewed media representations, and the unabashed propaganda from Murdoch’s newspapers; some would say the dissent is justified in its self-righteousness.
But if anything, let the NHS staff play angry martyr. Why? Because we work 100-hour weeks at barely minimum wage per (uncharted) hour we work, only to be told it’s not enough. Because nobody shares the frustration more than us. The guilt we, who are at the forefront, feel as the A&E waiting times get longer and patients pile up in the corridor, is combined with an empathy that is usurped by anger, and a desire to do what’s best replaced by a desire to do what’s quickest. Nonetheless, the knowledge that we are working for an institution in which we believe wholeheartedly is the comforting impetus for most of us.
As a health system, the NHS is unique, and one of the most progressive initiatives in UK history. It is also one of the most socialist, making it almost a miracle that it stayed untarnished for so long. And yet now, the NHS is dying. This is no sudden death or recent development; this has been flowing in the undercurrent for years, a death from chronic disease. It’s clear however, that the acceleration of its demise in the last five years went hand-in-hand with government reforms and budget cuts as A&E departments closed across the country and we moved ever closer to a privatised health system. Once the ethos of the NHS falls, the passion of the workforce will also fall. Your employees, Mr Cameron, are exhausted. Strip them of their morale, and you are left with little more than a skeleton of the National Health Service that was the pride of this country for so many years.
As Aneurin Bevan turns in his grave, it is necessary to examine the facts behind the outcry. Let us return to the beginning. In 1948, Health Minister Bevan introduced a National Health Service, free at the point of entry, devoid of class, creed or financial warfare. His crucial and core principle was that care be given based on clinical need, not ability to pay. Funded by the taxpayer, it flourished into as much a social movement as it was a health system, with some of the best free-at-the-point-of-delivery medical treatment in the world.
Skip some 60 years, and the legacy is a health service with paradoxes at every turn. Hugely positive developments in terms of improved health awareness on a personal scale are marred by an increasing abuse of services due to the growing culture of medicalising any and every symptom. Left at the mercy of the abysmal Jeremy Hunt, there is also an £8 billion funding gap and a constant media rampage against patient care, often shifting the blame onto the employees rather than the overwhelming organisational, financial and bureaucratic problems.
There are several factors independent of government blame which are contributing to a floundering NHS; an ageing population has created huge stresses, particularly alongside altered public expectations and rising costs, as expensive treatment innovations expose a moral dilemma for health trusts, whose good intentions are scuppered by financial instability. But therein lies the first of the government’s failures. The NHS is chronically underfunded – we spend 9.1 per cent of GDP on healthcare, lower than the US, Holland, France, Belgium, Austria, Germany, Canada, Denmark, Japan, New Zealand, Portugal, Norway and Finland to name but a few. This comes alongside predicted mounting strain on services; with £12 billion worth of proposed cuts to the welfare system, the stresses on the health system to pick up the slack in areas of care will rise.
The answer to this problem, according to Conservative proposals, is to encourage “the entrepreneurial spirit of public servants” by introducing a “right to mutualise” for public sector organisations, shifting ownership from government to staff. By proxy, this means to privatise. In 2010, less than 300 NHS officials worked for private firms with a purported community benefit; in 2015, this number stands at 14,000. Thus, we have the second failure – the destruction of the very principles upon which the NHS was founded. We are edging towards the NHS as a business, the patient as a consumer, and health as a commodity.
One overt contribution from the government has been in proposing a seven-day working week for GPs – a poorly thought-out alternative to the current emergency out of hours service – and in influencing training reforms for doctors in the form of the ‘Shape of Training Review’. These seek to shorten training programmes and broaden specialty bases in a manner which has raised serious concerns by the Royal Colleges and General Medical Council regarding the compatibility of the reforms with high quality patient care and safety. Yet there continues to be little consideration for the voice of such eminent organisations, let alone for those employed in the NHS themselves.
As humanity ebbs from a bankrupt health service, the poverty – and thus health quality – gap widens, and an unbridled Conservative government prepares to quietly push the NHS out of its priorities. The Health and Social Care Act of 2012, passed by the former coalition government, which the manifestos of the opposition parties professed they would repeal, is likely to be an abridged version of future bills to come, with a heavy prediction that the NHS will be sold, section by section, to private companies. Financially, that may be a necessity. But morally, socially and conceptually, the bell tolls for the NHS.
Image from: Getty Images