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The Weekly paper of the New Communist Party of Britain

Reclaim our NHS!

by Daphne Liddle

AROUND 60 people assembled in London’s Tramshed in Woolwich on the evening of Tuesday 10th May to support a meeting organised by Reclaim the NHS.

The purpose of the meeting was to raise awareness of the dangers of the Health and Care Bill 2021, which has recently been enacted, and how it will drive our NHS further along the route towards the system in the USA where health care is controlled by the insurance industry and where profit is prioritised over the needs of patients.

Long-standing NHS campaigner Dr Bob Gill addressed the meeting in a pre-recorded video, where he spoke of the need to get the public in Britain actively on our side to prevent the demise of our National Health Service.

The Act means there is now no statutory duty on anybody to arrange provision of secondary (ie hospital) medical services, only a power for the new Integrated Care Boards (ICBs) to do so.

These ICBs cover all the health-care provision over large swathes of the population. The ICB for south-east London covers six boroughs: Bexley, Greenwich, Bromley, Lewisham, Southwark and Lambeth – a population of nearly two million people. But the board has only one elected representative of those people. It is mostly run by business people.

Their main aim will be to reduce services, limit expenditure, further degrade local accountability and entrench the market. These ICBs will organise hospital care, not the patients’ Gps.

The ICBs will only have a “core responsibility” for a “group of people” in accordance with enrolment rules made by NHS England (Scotland, Wales and the occupied north of Ireland have their own systems). The ICBs are following the definition of a health maintenance organisation that provides “basic and supplemental health service to its members”.

It will be possible for ICBs to award and extend contracts for health-care services of unlimited value without advertising, including to private companies.

Private health companies will be able to be members of ICBs, their committees and sub-committees, which will plan NHS services and decide how to spend NHS money.

NHS England will have powers to impose limits on expenditure by NHS trusts and NHS foundation trusts.

Integrated care partnerships will be set up as joint committees of local authorities and ICBs to draw up integrated strategies, with no restrictions on membership and without clear transparency of obligation.

Local authority representation on ICBs will be limited to one member, covering several boroughs.

Dr Gill spoke of the steady decline in healthcare provision – and working conditions for healthcare workers – for over a decade before the COVID-19 pandemic hit. The pandemic just showed up the deficiencies.

This new Act will do nothing to restore the NHS – but has put it under the control of business people who will see cutting costs (and improving their profits) as the primary goal. GPs will become distanced from their patients and rewarded financially for referring fewer patients for hospital care.

NHS staff will no longer be employed on a national basis but by the ICBs, breaking-up their nationwide bargaining on wages and conditions.

The triage of patients – the initial examination to determine what they need – will be done using computers and less qualified staff, increasing the risk of error.

Jane Lethbridge, a local academic expert on social care provision, told the meeting that 90 per cent of the provision for social care for the elderly, disabled and young has been privatised. She called for the setting up of a National Care Service.

She pointed out: “We will all need social care at some time in our lives, whether it is in a residential care home or in our own homes.”

Local authorities no longer provide care but commission care. Jane called for a public sector National Care Service, with the ability to plan and assess the level of support needed.

Assessing the needs of individual patients will require highly qualified staff and also high-quality well-trained staff to deliver it. The system will need democratic accountability – like the old community care councils.

The Reverend Kim Yaeger, who has first-hand experience of the health system in the USA, in his words: “As a patient, a worker, a lawyer, a union rep and a priest”, described it as “a jungle, dominated by insurance companies”. As a union rep he helped hundreds of desperate people file for bankruptcy and told the meeting that health care costs are the major cause (67 per cent) of personal bankruptcies in the USA.

He was at one stage a hospital chaplain in Chicago and said: “As a chaplain, when the bell rings for you to come, you know what it means. Someone has just died or is just about to.” And the biggest factor in the distress of the families was how they were going to pay the medical and funeral bills.

He said: “The insurance companies take your money and disappear it. The insurance company assessors are instructed to reject claims.”

He also said the fire department was also under the thumb of the insurance companies. He said that when called out to a house fire they will always check first if the house is insured. If it is not, they will not come out unless it is next to one that is insured. In that case they will turn up but do nothing unless the fire starts to spread to the house that is insured.