Assault on the NHS

by Daphne Liddle

THE NATIONAL Health Service is under a two-pronged attack from the Con-Dem Coalition on the one hand to force market values on it with profits taking priority over patients’ needs, and on the other hand to starve the service of staff and resources so that patients’ experience of NHS care is so awful that those who can pay will prefer to do so.

In the early months of 2011 the Government was locked in a grim battle to get its Health and Social Care Bill through Parliament in the face of a lot of opposition.

So Cameron declared a “pause for thought” and dropped some of the more extreme impositions of marketisation on different parts of the NHS.

Now the Health and Social Care Act has just come into full force, the Government wants to put those full marketization regulations back in, in the shape of “Section 75”.

If not overturned, the widespread view is that regulations will force commissioners to open up to private sector competition any part of the NHS that companies are interested in, with very few exceptions.

Local health decision makers will be able to do little or nothing to protect local NHS hospitals which could be starved of funds as a result of losing their services.

The regulations require all NHS services to be put out to competition unless the commissioners can prove there is only one provider capable of delivering them. Such decisions could be exposed to costly legal challenges.


These measures explicitly contradict repeated ministerial promises that “it would be for commissioners to decide when to use competition” and that there was “absolutely nothing in the Act that promotes or permits the transfer of NHS activities to the private sector”.

Labour peer Lord Phil Hunt laid down a rarely used “fatal motion” in the Lords, ensuring the regulations will be the subject of a parliamentary battle this month with a debate and vote on the 24th April.

He told NHS campaigners: “Parliament was assured that clinicians would be under no legal obligation to create new markets. The regulations being debated in Parliament provide no such re-assurance. They will promote and permit privatisation and extend competition into every quarter of the NHS regardless of patients interests.

“The Lords reported that many NHS professional institutions believe that the regulations make competition the default approach, whilst imposing a burden of proof on commissioners wishing to restrict competition. Indeed, there is a real risk that it will be the courts rather than doctors who will decide the extent of competition and the tendering of services.”

Meanwhile reports are emerging from nursing union annual conferences that are ringing alarm bells.

Staff at over-stretched Accident and Emergency (A&E) departments across the country are being forced to take desperate measures to cope with the demands of a system which is running at full capacity, the Royal College of Nursing revealed on Wednesday.

Patients are waiting so long on trolleys for treatment — often 24 hours or more — that hospitals are now employing specialist “queue nurses” to tend to these patients as they wait.

When they do get a bed it could be in almost any department of the hospital so that consultants often have no idea of where their patients have been sent.

Dr Peter Carter, RCN chief executive and general secretary, said: “We need to see an immediate end to the shortterm, slash and burn cuts to nursing staff levels and the failure to plan for the long term, which are damaging patient care and bringing the health service to its knees.”

Furthermore the RCN has expressed concern about the “culture of fear and intimidation” in some workplaces as new survey results reveal around a quarter of nurses (24 per cent) have been discouraged or warned off raising concerns.

The scandalous levels of neglect at the Mid Staffordshire Hospital Trust may become the norm if this process continues. Anyone who possibly can afford to pay for private care will do so, leaving the NHS a broken shadow of its former self offering sub-standard care for those who cannot afford anything else.

This is a class issue and the organised working class must fight tooth and nail to overthrow this Government which is determined to break the NHS for the benefit of profiteers.