The New Worker

The Weekly paper of the New Communist Party of Britain

Week commencing 14th October 2005

  Concern about transport safety continues

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by Daphne Liddle

GOVERNMENT policies that have introduced market pressures into the NHS are likely to destabilise some services, including accident and emergency units, according to a report issued last week by the Audit Commission.

The “payment by results” policy – which echoes Tory policy of a decade ago – will put pressure on hospital managers to close wards and departments that do not attract enough money-generating patients.

 Under this scheme NHS trusts are paid directly according to the number of patients treated. Under a similar scheme in the 1990s, thousands of patients were rushed through hospitals – the buzzword was “throughput” – and discharged too early to make way for more admissions.

 Many had to be re-admitted soon after because they had not had enough treatment or time to recover. From the hospital managers’ point of view this was a good thing because each admission pushed up the figures and attracted more funding. But from the patients’ point of view it was hell. This was one of the main reasons that the electorate rejected the Tories in 1997.

Under this system, each time a patient was sent from one department for a treatment in another; it was recorded as a separate event and pushed up the accounting figures – giving hospital managers a strong motive to shunt patients about from one place to another.

 The commission has called on the Government to protect emergency services from the full force of market-driven policies. It said: “The level of risk inherent in the current policy is too great”. But the Department of Health said it would continue with the plans regardless.

 Already the current payment by results policy is causing chaos. And, like its Tory predecessor, it generates huge mountains of bureaucracy and form filling.

 The Audit Commission said: “In the first year, payment by results proved to be a more complex, time-consuming and challenging process for the early implementers than they anticipated.

 “It requires investment of time and resources. The organisations in our sample spent approximately £100,000 each, equivalent to £50 million nationally.” No wonder there is so little money left over to pay hospital workers properly!

 The Royal College of Nursing has warned that 1,000 nursing posts could be axed this year as NHS trusts try to balance their books.

 The commission fears that keeping some Accident and Emergency units open will be seen by managers as uneconomical and bad business.

 Meanwhile the Government is continuing with its plans to give large – potentially profitable – chunks of NHS property to the private sector. The successful new South West London Elective Orthopaedic Centre (SWLEOC) in Epsom has been handed to a private American company – along with legal costs, a project manager and promises to underwrite any additional costs to primary care trusts that might arise from the transfer.

 The Government claims this is being done to provide alternative choices for NHS patients.

 In another instance University College Hospital London is preparing to parcel up profitable parts of its NHS care and, with a private partner, sub-contract them out to a shell company.

 Last week former Labour Health Secretary Frank Dobson warned that increased patient choice simply meant the NHS would no longer be a healthcare service, but become a health insurance system with customers shopping around for treatment.

 He also criticised the way private healthcare providers are given the most profitable operations, leaving the NHS with less money to deal with the most difficult and urgent cases.

 “Because private operators are encouraged by the government to cream off the easier, cheaper, and less risky treatments, public hospitals are left with the more complex, expensive jobs,” he said.
by profits

“An NHS driven not by patient need, but by profits and markets: Is that really our vision?” he asked. “I can think of nothing more important, nothing where the stakes are higher, not just for us but for future generations.”

 At the recent Labour Party conference he led a successful motion calling for an urgent review of the role of markets and competition in the NHS before any further increase in the private sector presence.


Booting out Blair

  LABOUR MP Glenda Jackson last week said she would be prepared to act as a “stalking horse” in order to trigger a leadership contest within the Parliamentary Labour Party – if Blair tries to stay in power for longer than another year. This is good news as far as it goes. Blair should have been driven from office long ago for taking the country into an illegal war on the basis of lies and deceit.

 But the Highgate and Hampstead MP said she thought she would be “extremely unlikely” to get enough votes. That does not say much for the courage of her fellow MPs. Perhaps the results of the local elections next May will stiffen their resolve. If Labour is still led by Blair, it is likely to do very badly. Labour supporters will not bother to turn out and millions of people will end up decidedly worse off with Liberal Democrat or Tory controlled local councils. A low turn-out will increase the danger of fascist BNP candidates doing proportionately better.

 Just after last May’s general election Erith and Thamesmead MP John Austin said he was prepared to act as a “stalking horse” if Blair was still in Number 10 by Christmas. Between the election and the Labour conference it seems the resolve of our elected representatives faltered and faded. This is definitely a reason to remind them more often and in more ways that the people of Britain want Blair out – and his warmongering policies.

Getting off the sofa

Work and Pensions Secretary David Blunkett has taken up the perennial habit of Labour and Tory government ministers of bashing benefit claimants whenever things get tough. There is always a claim that hundreds of thousands of claimants are frauds and millions of pounds of taxpayers’ money is being wasted. The next stage of the ritual is to force claimants through another set of humiliating hoops only to discover later, and with no publicity fanfare, that the vast majority of them are absolutely genuine. And there is always the traditional harassing of single parents as a sideshow.

 If any of them were really concerned about the rising numbers of workers claiming benefits – forced into this demeaning, impoverished half-existence, they would look at the real causes. The two highest causes of long-term illness are back pain or injury and stress-related depression and anxiety. They would invest in prevention by tightening health and safety at work rules and by training hundreds more doctors, psychiatrists and physiotherapists so incapacity benefit claimants did not have to wait years to get the help they need to get back to work. Instead the Government boasts about cutting “red tape” for the bosses and NHS trusts in financial trouble invariably apply the scalpel first to mental health services. And Blunkett wonders why the numbers of long-term claimants continues to grow!

 Meanwhile the National Audit Office has pointed out that anything that may be lost to claimant fraud is being dwarfed to the amount of taxpayers’ money lost through sheer error on the part of the civil servants administering it – especially the tax credit benefit system. The Government has had to write off £1 billion in tax credit overpayments through error.

 Blunkett has blamed the system – set up by Gordon Brown – for being too complex. Logic says it also indicates a desperate shortage of civil servants and a lack of proper training for them. Yet they continue to hack away at civil service jobs, making the situation worse.

 The NAO also last week refused, for the umpteenth time, to sign the Inland Revenue’s annual accounts. Apart from £2.2 billion in overpaid tax credits, there were “significant and widespread” errors in collection of PAYE and around £575 millions of revenues a year not pursued. In other words, rich people are getting away with not paying their taxes but the Government isn’t too bothered. It’s easier to bash the sick and single parents.

 The underlying Government/capitalist policy is to gradually phase out direct taxation based on income and replace it with indirect taxation on spending, like VAT. It means that the working class pay proportionately more while the rich pay less.

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