Socialist Alternative

Seventy-two years old – and extremely vulnerable: Defend our NHS

The crisis which has gripped the whole of society in this pandemic has been starkly ‘played out’ in our NHS and Social Care system. The UK has one of the highest death tolls in the world whatever index is used. There have been well over 43,000 recorded deaths but the more accurate figure measuring excess deaths is now over 60,000! The deliberate underfunding of the NHS over the last decade, accompanied by the appalling mishandling of this crisis has produced this unprecedented tragedy.

At the same time, we have seen huge public support for all frontline workers and a determination to ensure that the staff are recognised for the huge sacrifices they have made. We cannot afford to let our NHS and Social Care system remain as they are. Urgent and determined change is required but that will not happen without massive public pressure, in the form of protests, strikes, demonstrations and mass campaigns.

That is why Health Campaigns Together and Keep Our NHS Public are calling for a huge mobilisation for the 72nd Anniversary of the NHS over the weekend of 4/5th July. Local protests are being called all over the country, many outside hospitals, to kickstart a national campaign for a transformed NHS. Called under the heading ‘Our NHS Deserves Better’, the protests will be followed by a huge national online rally to launch a manifesto outlining the changes necessary to improve public health in this country. Socialist Alternative is fully involved in helping to organise and build for this event and sees this initiative as the start of a serious and sustained campaign to roll back deliberate closures, cuts and privatisation in our NHS and social care for decades.

How Did We Get in this Mess?

Successive previous governments, under Blair, Brown, Cameron, May and now Johnson, have systematically undermined and underfunded our NHS. Social Care was privatised in the late 90’s by a Labour Government; Blair broke up a national service by bringing in local Trusts to run healthcare using an internal market mechanism; the onset of austerity saw huge cuts to staffing, buildings and services and finally in 2012, the Health and Social Care Act has led for the break-up and gradual privatisation of the NHS.

All these measures created an unprecedented crisis in the NHS long before the pandemic with the loss of up to 30,000 hospital beds, 100,000 staff shortages, at least 5,000 fewer GP’s and a speeding up of hospital closures or downgrades. Cuts to council budgets witnessed a near collapse of local and community services, felt most acutely amongst the elderly and most vulnerable. As part of May’s racist ‘hostile environment’ they also brought in migrant charges and the immigrant health surcharge for treatment.

There could not have been a worse way to prepare for Covid-19. In 2016, the Dept of Health ran its own ‘drill’, codenamed Operation Cygnus, to examine their preparedness for a flu-like pandemic which warned that NHS and Social Care did not have sufficient capacity to cope in almost every area. Their report and warnings were buried and ignored; thousands have paid for this neglect with their lives.

Johnson’s Blunders

Socialist Alternative has accused this government of having blood on its hands. Despite early warnings in January that the new, deadly virus was on its way, the British government did nothing in February, and failed to prepare or take any action until too late. There were complacent assurances in mid-March about preparations and supplies of personal protective equipment (PPE) which swiftly proved to be false: there were neither adequate supplies nor a viable supply chain, and shortages reached crisis levels throughout the NHS and care sector – leading to the huge loss of life across the whole community.

These blunders were compounded by NHS England’s advice to hospitals to discharge their elderly patients to care homes which created a second wave of the pandemic amongst the most vulnerable and frail in society and put care staff under huge strain without any adequate protection.

Prof. Ferguson, one of their chief scientists, who warned the government of the urgent necessity to lock down on 17th March to save 250,000 deaths, has now announced that an earlier lockdown, by even a week, would have halved the death toll. Lack of PPE in care homes and the NHS has led to hundreds more deaths. Scandalously, of the 300 or so deaths in the NHS, almost 90% have been from a black and minority ethnic (BAME) background. The shortage of NHS beds led to hospitals being overwhelmed; staff shortages have put untold stress on existing staff who may never recover.

The government’s panicked measures saw £220 million spent on unused Nightingale Hospitals whilst 40% of hospital beds outside the ‘red’ covid-19 zones went unoccupied. Care homes have had to spend £7billion on PPE and extra staffing and have got back £1.3 bn from the government. The failing track and trace system, along with the testing centres, have been put in the hands of incompetent private sector firms like Deloitte, Serco, Sodexo, Palantir, Amazon and Microsoft, while depleted public health services are expected to ensure the infected self-isolate. Having assured the public that the government was being ‘led’ by the science, following the farce of the Cummings scandal they are now being ‘guided’ by the science and several advisors have disappeared from the briefings. The failure to resource a safe return to school has led to a collapse of their planned reopening of primary schools by June.

The contradictory and muddled lifting of the lockdown will almost inevitably lead to a second spike, yet the daily death toll remains the highest in Europe. Johnson has lost public support and his administration lurches from one expedient to the next. As a result, we will witness many more unnecessary deaths and a long-drawn-out emergence from lockdown.

The 72nd Anniversary of the NHS must be the beginning of a mass movement which must build and intensify towards a much bigger mobilisation, socially distanced if necessary, in September around the State Opening of Parliament. We will not and cannot rest until we see the back of a government which has callously put profit before people’s lives, health and needs.

Build a Public Health and Social Care System

In this movement, Socialist Alternative will be demanding:

  • Rebuild and Fund the NHS! Halt all closures, downgrades and the sell-off of NHS buildings and assets. The NHS requires an immediate injection of billions to bring NHS spending up to at least the European average of 13% of GDP
  • Kick Out the Private Sector! The NHS should be re-nationalised and all private sector debts written off. All staff to be returned to NHS employment and all private sector hospitals to be returned to the NHS
  • Healthcare for All! Scrap all racist immigrant health surcharges
  • Nationalise Social Care! Bring back all Social Care under public control and accountability
  • Proper Pay for all staff! For an immediate decent pay rise for staff and to bring ALL Social Care staff under the same pay and conditions with the NHS. Bring back the Nurses Bursary.
  • No backdoor NHS trade deals
  • For an immediate proper public enquiry into the crisis, led by the unions and workers involved, with powers to act & immediate action around the disproportionate deaths in the BAME community
  • Nationalise the big drug companies under workers’ control and management
  • For a fully democratised and accountable NHS and Social Care System which caters for all our health needs

Covid 19: social care crisis

The Covid crisis gripping the country is being played out across care homes as it is estimated that hundreds have already died from confirmed or suspected Coronavirus. The industry body, Care England, estimates the figure to be closer to 1,000 since the majority of deaths are not being recorded as Covid related and are not being counted as part of the official government daily death toll. They argue that the government is deliberately underestimating the impact of the virus on the most frail and elderly in society.

According to the Alzheimer’s Society, the virus is now active in half of the country’ care settings. The government disputes these figures, claiming it is only 9%! Labour MP Peter Kyle is correct when he claims that the government is sweeping the deaths of older people in our homes under the carpet. Once the virus takes a grip in these settings, it is rapidly infecting residents who are the most vulnerable. One home reported 17 deaths in one week! The situation will only get a lot worse. Care staff are terrified to speak out but those brave enough to speak to their union have reported a chronic lack of basic equipment to deal with the virus, with one wearing a bag over her head for protection!

18 months ago, my mother was admitted to residential care as a result of dementia and failing mobility. The experience has totally opened my eyes. I have so much respect and admiration for the carers who always go above and beyond and get paid nowhere near enough for all the work they have to do, starting at 8am and clocking off at 8pm. And now they are putting their lives and those of their families on the line every day to look after our loved ones. I know that if the virus gets in there, it will very quickly infect so many people.

Before the Covid crisis broke, the social care system was on its knees as a direct result of privatisation, cuts and closures. The scandalous death toll was a disaster waiting to happen and it will now only get worse. Staff are faced with a chronic shortage of PPE and yet when there are outbreaks of the virus, they still have to care for their residents. The same is true of those who are visiting the elderly in their own homes whose only contact with the outside world will be the home carers themselves, a lot of whom also report they have no protective equipment.

Social Care is divided into two main sectors: Residential and home care. Home care is largely, but not wholly, subsidised by local authorities. However, most of it is now provided by the private sector, which is heavily subsidised by council grants. 94% of residential care is now provided by the private sector with 465,000 of the most vulnerable living in supported accommodation. The entire sector has been ravaged by austerity cuts over the last ten years with at least £7 billion being cut from council budgets. This has meant that up to 1.5 million elderly people are now not getting the support and help they need.

The private sector providers of residential care have been extracting profits from this sector for over 20 years. However, a recent report undertaken by the Centre for Health and Public Interest (CHPI) found that the total income for the private sector is around £15 billion, but care home operators are making up to £1.5 billion a year in profits, which include fees to directors and an array of other questionable financial arrangements. Many of the firms that provide most of the UK’s care home beds are owned or backed by hedge funds, while some of the biggest are based in overseas tax havens.

According the to the CHPI, some of the largest care home businesses are extracting a lot of profit disguised as rent and loan repayment costs, which has made it hard for local authorities and individuals to know how much extra funding the industry actually needs and how financially sustainable it really is. Yet many companies are now starting to walk away from the sector or going into insolvency, such as the Four Seasons Company a few years ago. 380 care homes have collapsed since 2010 and councils and families are left with having to pick up the pieces and find new accommodation for the elderly. Many of these companies are now focusing on what they call the ‘high end’ sector, charging £2,000 a week for the most well off, prompting the Care Quality Commission to report that “the social care system is being created for the rich, and nobody is coming along to replace those homes which have closed”.

The same is true of the home care system where the CQC has found that just over half the companies ‘require improvement’, yet the top five providers made an annual profit of £700 million. The whole system is staffed by mainly women workers who work for the minimum wage, or even less! One company, Seymore, was taken to court for not paying the minimum wage to its workers. These are the workers who, just 2 months ago, were described by Priti Patel as ‘unskilled’ and who are now described as ‘heroes and heroines’ for the work they are having to do.

Three weeks ago, I had to kiss my mum goodbye knowing we wouldn’t meet up again until the lockdown is lifted. Every day, I dread the phone ringing. Millions of families, the elderly and carers are going through the same experience every day. Life remains on hold. But with the right equipment and safety precautions it could all be very different. Every home and home care provider should have as a priority:

· compulsory daily testing

· the correct ready supply of PPE

· sufficient funding to ensure there is a full complement of staff

At the moment, this is just not happening so the disaster will unfold before our eyes and yet again this government will have blood on its hands.

This crisis has exposed a care sector and NHS which is drastically underfunded. We must demand:

· The immediate transfer of home and residential care back to the public sector

· Proper public funding to end the scandal of the vulnerable and sick being ripped of by the private sector

· A decent living wage for all carers1

· Free care for all those assessed of being in need at the point of delivery

World map with countries coded by colour. Europe, US and South America showing up as red and Africa and Australia as light pink

Covid-19: as virus spreads to the neo-colonial world, humanitarian catastrophe threatens

Whilst the Coronavirus pandemic has shown it does not discriminate in the way it infects people, as the virus continues to spread rapidly across the world, it’s clear that the effects on those countries and peoples which are the least well prepared and developed economically will likely be the most devastating.

In predicting a global recession as bad or worse than the 2008-9 crisis, Kristalina Georgieva, the Head of the IMF, has reported that more than 80 struggling countries have asked for urgent financial help to deal with the outbreak and its economic consequences. Yet, since the financial markets have been crashing, $83 billion of capital has left emerging markets! The rich elite will not cooperate in seeing their profits decline.

Georgieva went on to say they have never before had more than a handful of requests for urgent help but that all these countries were being hit by falling domestic demand, a drop in exports, capital flight, and a collapse in commodity prices. The poorest economies will be devastated by the pandemic and the IMF and World Bank will not be able to offer more than token assistance. They will be rocked by huge financial and political crises which will add fuel to the raging fire of discontent sweeping the underdeveloped world.

For example, in Brazil it is not applause which has been echoing around the streets but the banging of pots and pans with people demanding that Bolsonaro, the right-wing President, is overthrown. He has described the pandemic as a media trick and has failed to take the urgent steps required to control the disease. Even prisoners have been forced to take matters into their own hands and there have been mass outbreaks as sanitary conditions have deteriorated.

Meanwhile, the Mexican president, Andrés Manuel López Obrador, has resisted taking stiffer measures, such as quarantine and border closures, on the grounds that poor Mexicans are unable to afford not to work and has put more of the population at risk. The governor of Puebla has gone further by claiming that the poor are immune!

However, the greatest threat will come from poor or non-existent health services and inadequate housing. For example, though President Modi has imposed a brutally enforced lockdown in India, it will be impossible for the 64 million living in overcrowded and insanitary slums to socially isolate or maintain healthy lifestyles. Without work, millions will not be able to feed or clothe themselves. In nearby Kashmir, which has endured a military occupation since last October, the healthcare system is on its knees. They have the lowest doctor-to-patient ratio in the sub-continent and have 100 ventilators for a population of 12 million.

Similarly acute problems will emerge in Africa. The World Health Organisation has warned that the disease will cause a major crisis. Although nearly 3,000 cases have so far been reported, this is likely to be a huge underestimate. Health officials across Africa report that hospitals can deal with only a fraction of those needing care if the virus spreads through crowded cities, remote villages and among vulnerable populations such as refugees, malnourished people or those with HIV and other chronic conditions.

Typical of the problems the continent will face were reported in Mali which recorded its first cases last week. Government officials have denied reports the Health Service has only one ventilator for its 17 million inhabitants, saying it had 56!

Lockdowns, which are now being imposed will bring significant hardship for the continent’s poor, many of whom live hand to mouth without formal employment. Half the reported cases in Africa have been in South Africa which has now gone into 21 days of lockdown. Township residents say it will be impossible to self-isolate in homes which typically house over 10 family members. The virus could spread like wildfire through these areas.

A military curfew has been imposed in Kenya where military police are patrolling the streets on mopeds beating up anyone who they come across with long batons, of course forgetting they are likely to be spreading the disease through such unwelcome contact!

As if that were not enough, 10 countries in East Africa and the Arabian gulf have now been engulfed by a locust swarm. The locust population has increased 8,000-fold and is threatening the food supply of 25 million people. The sudden appearance of the locusts has been put down to freak weather conditions in the Arabian desert, all as a result of the developing climate crisis.

Other hotspots around the underdeveloped world will be in those areas wracked by war and conflict. For example, in the West Bank and Gaza, which are now in lockdown, the strict embargo imposed by Israel has left the whole area desperately short of medicine, safety equipment and ventilators. Gaza, for example, has just 62 ventilators for a population of 2 million, all living in cramped and unhygienic conditions. Israel has now shut the borders arguing it has to safeguard Israeli interests, locking in the huge problems the Palestinian people will now endure.

The rapid spread of the disease in Iran was of course partly down to the failures of the Iranian regime which at first tried to hide the outbreak. However, the rigid and ongoing sanctions imposed by the American regime has left the Health Service in a desperate state. Despite this hardship, Trump and his spokespeople have confirmed the sanctions will remain in place! Similar sanctions imposed on the Venezuelan regime of Maduro have crippled the Health Service. As the country goes into lockdown, hospitals report a lack of basic equipment such as gloves, masks, goggles, soap, scrubs and 25% do not even have running water. 80% of doctors in a survey said they did not have the protective equipment in Intensive Care.

The overflowing refugee camps in Greece and Syria, as well as Myanmar, will now be massively vulnerable to a huge health crisis. The massive and ongoing problems of hunger, overcrowding and lack of basic sanitation in these camps will be perfect breeding grounds for Covid-19. Once again, there is the frightening prospect of rapid infection and consequent mass deaths in all these areas. The ongoing civil war in Libya has actually been stepped up as the various warring factions have decided they can settle accounts whilst the rest of the world is preoccupied! The first Covid case has now been reported.

Capitalism has created a world in its own image, with huge wealth imbalances and inequality around the world. The pandemic will bring all these contradictions into very sharp focus. Lenin once said that imperialism will create horrors without end, which is what will now unfold in the poorest regions of the planet. Scientists have even raised the prospect of the worldwide infection coming round a second time with new mutations which could reinfect us all again. It is abundantly clear that this system has caused the crisis and will be totally unable to protect humanity from the tsunami of deaths which will follow.

The Spanish flu wiped out 50 million people out of a total population of 1.7 billion. Scientists have alarmed us all by predicting a death toll of 40 million from Covid-19 if strict measures are not put in place. Whilst some countries may be able to manage the measures of self-isolation, social distancing and health intervention, it is abundantly clear that a large number of people will be unable to do likewise.

The unfolding economic crisis which is likely to be as profound as the Great Depression of 1929 will sweep through the underdeveloped world creating mass hardship, unemployment, and homelessness. The masses will have no choice but to resist and fight back. The conditions for world revolution are being prepared as the great mass of people directly impacted by this crisis draw the conclusion that another world has to be created – and that will be a socialist world.

Four female junior doctors holding placards

NHS in Crisis

As the dust settles from the outcome of the election, the prominence given to the NHS by all political parties has thrust the whole issue centre stage. To assess our future under the NHS, Socialist Alternative looks at some of the campaign themes and charts a way forward:

Just how bad are things?

The NHS is in crisis due to a decade of under-funding, but also creeping privatisation which actually began under the Blair government. Here are some of the facts:

  • £8 billion has been cut from the Social Care Budget in the last decade leaving at least 1.4 million mainly elderly people without any support
  • Hospital Trusts are £14 billion in debt with a backlog of essential building work running up to £6 billion
  • 9,000 acute hospital bed have been lost, including 22% of mental health beds
  • There has been a 1400% increase in trolley waits with 4.54 million on operation waiting lists
  • There are 100,000 staff vacancies across the NHS with 78% of staff saying they face unmanageable workload pressures
  • Since the Tories promised to recruit more GP’s, another 1,000 have given up, leaving primary care in crisis and GP surgeries merging
  • Since the Tories brought in the Health and Social Care Act, 18% of NHS services are now provided by the private sector and rising
  • A & E waiting times have now reached their highest levels since records first began and we are now facing an acute Winter Crisis in the NHS. Recent research by Drs Moulton and Mann has shown 5,500 patients died in the last 3 years due to lack of A & E capacity

So, is the NHS up for sale?

Despite winning the election on the Brexit issue, Johnson’s Tory Government will be approaching the trade talks from a position of weakness. The former UK Ambassador to the USA, Kim Darroch, recently revealed that Donald Trump will put the interests of corporate America first and demand that the NHS pays higher prices for US drugs in a free-trade deal with the UK, and that he would reward his backers in drug firms and farming communities by opening up British markets, while questioning where the UK’s gains would be found. The November 2019 Channel 4’s Despatches programme estimated that the drugs bill could go up 2.5 times from around £17 billion to £48 billion if the US was given unlimited access.

The former British envoy, who left Washington after a leak of his confidential cables to London, said it was doubtful whether the UK had the resources for parallel negotiations with the US and the EU, a strategy championed by Downing Street as a way to give British negotiators leverage in Brussels. The EU will not want to be seen to be making any ‘special concessions’ to the UK for fear that other right-wing populist parties in Europe will seek to begin their own version of Brexit. Johnson needs trade deals with other countries and Trump has already promised a generous deal with the UK.

Strictly speaking that would not be selling off the NHS but opening it up to private corporations to make huge profits. That is not a new thing. The Private Finance Initiative debt in the NHS is around £300 billion with a value of £54.7 bn. To put that into perspective, the PFI debt is 4 times the size of the budget deficit used to justify austerity (Independent 17.2.18). Likewise, private firms have been handed almost £15 bn in NHS contracts over the past 5 years. The value of contracts given to the private sector has soared by 89% since 2015 to £3.6bn a year. This will accelerate under Johnson. All this was made possible by the Health and Social Care Act brought in by the Con Dem Government which obliged all Hospital Trusts to put all NHS work out to private tendering.

It would therefore be more accurate to say the NHS is suffering from creeping privatisation, along with chronic underfunding and unprecedented staff shortages which will undoubtedly get worse under this Tory government (see back page).

Can the NHS be Saved from Johnson’s Government?

There is no doubt this task will now be much harder. The proposed Withdrawal Bill will allow secret negotiations to continue. Many of the new Tory MP’s are firm advocates of a private health insurance system. Despite Johnson’s pledge that they will commit £ 33.9 bn to the NHS over the next 5 years, that will barely touch the huge crisis now facing the NHS as outlined above. It actually represents a real cut in NHS funding when inflation and other on-costs ate taken into account.

NHS England (the national quango appointed by the Tories to ‘run’ the NHS) is now well down the road of centralising and concentrating local NHS services into larger urban areas as well as creating ‘super hubs’ of health care delivery in the community, which will see the disappearance of many local GP surgeries. All these plans will see an acceleration of hospital closures, cuts and privatisation. No-one believes Johnson’s claim that the government will build 40 hospitals; 12 are planned for Dorset alone, and will be cottage hospitals, probably without beds, just for outpatients. The so-called pledge to increase the NHS staff numbers will not be realised due to huge budget constraints and a crisis of morale amongst front line staff. And all these plans are being developed in secret since the introduction of ‘Accountable Care’ bodies which have divided up the oversight and management of health provision across the country. In reality these are appointed bodies with no accountability which have slowly taken over the running of our NHS.

However, the Tories were forced onto the defensive during the election and there will be very close scrutiny of NHS delivery and performance by politicians, unions, community campaign groups and the wider public. There is absolutely no doubt that the British public will fight to save the NHS if they feel it remains under threat. This means that local, regional and national alliances must be forged now to ensure there is close scrutiny of every aspect of NHS care, and resistance organised where services continue to be cut.

So, What Can be Done?

The ongoing strike wave in Northern Ireland shows the way. Determined and direct action can force the Tories back and actually force their hand to go further than they now intend to fund the NHS. Health Unions should immediately convene a Conference of Action, reaching out to all local community action groups. A plan of action needs to be drawn up which will both inspire confidence and offer leadership to save our NHS.

Socialist Alternative supporters would strongly advocate sustained and direct action to push the whole issue to the forefront of consciousness. Unfortunately, the recent Health Campaigns Together National Meeting did not back the proposal from many local action groups for a national demo in the early Spring. Whilst this is a setback, the demand for nationally coordinated protest and strike action must continue. We demand:

For a massive national mobilisation to kickstart a national campaign of action to safeguard our NHS called by health unions and national campaign groups

Proper public funding of the NHS to bring it up to the European average of 13% of GDP (the UK currently spends around 7%)

An end to privatisation, direct and indirect in the NHS; for ALL NHS services to be brought back in house

No sell off of any services to private interests; nationalise the big drug companies

A decent living wage for ALL NHS staff – end the pay cap now

Bring the running of our NHS back under democratic control

No to cuts and closures-every local community needs a local hospital with decent primary & community care to protect all health needs

Stop all cuts to Social Care, for all residential and community care to be free at the point of delivery

Issue 5 feature: NHS in crisis

As the dust settles from the outcome of the election, the prominence given to the NHS by all political parties has thrust the whole issue centre stage. To assess our future under the NHS, Socialist Alternative looks at some of the campaign themes and charts a way forward:

Just how bad are things?

The NHS is in crisis due to a decade of under-funding, but also creeping privatisation which actually began under the Blair government. Here are some of the facts:

  • £8 billion has been cut from the Social Care Budget in the last decade leaving at least 1.4 million mainly elderly people without any support
  • Hospital Trusts are £14 billion in debt with a backlog of essential building work running up to £6 billion
  • 9,000 acute hospital bed have been lost, including 22% of mental health beds
  • There has been a 1400% increase in trolley waits with 4.54 million on operation waiting lists
  • There are 100,000 staff vacancies across the NHS with 78% of staff saying they face unmanageable workload pressures
  • Since the Tories promised to recruit more GP’s, another 1,000 have given up, leaving primary care in crisis and GP surgeries merging
  • Since the Tories brought in the Health and Social Care Act, 18% of NHS services are now provided by the private sector and rising
  • A & E waiting times have now reached their highest levels since records first began and we are now facing an acute Winter Crisis in the NHS. Recent research by Drs Moulton and Mann has shown 5,500 patients died in the last 3 years due to lack of A & E capacity

So, is the NHS up for sale?

Despite winning the election on the Brexit issue, Johnson’s Tory Government will be approaching the trade talks from a position of weakness. The former UK Ambassador to the USA, Kim Darroch, recently revealed that Donald Trump will put the interests of corporate America first and demand that the NHS pays higher prices for US drugs in a free-trade deal with the UK, and that he would reward his backers in drug firms and farming communities by opening up British markets, while questioning where the UK’s gains would be found. The November 2019 Channel 4’s Despatches programme estimated that the drugs bill could go up 2.5 times from around £17 billion to £48 billion if the US was given unlimited access.

The former British envoy, who left Washington after a leak of his confidential cables to London, said it was doubtful whether the UK had the resources for parallel negotiations with the US and the EU, a strategy championed by Downing Street as a way to give British negotiators leverage in Brussels. The EU will not want to be seen to be making any ‘special concessions’ to the UK for fear that other right-wing populist parties in Europe will seek to begin their own version of Brexit. Johnson needs trade deals with other countries and Trump has already promised a generous deal with the UK.

Strictly speaking that would not be selling off the NHS but opening it up to private corporations to make huge profits. That is not a new thing. The Private Finance Initiative debt in the NHS is around £300 billion with a value of £54.7 bn. To put that into perspective, the PFI debt is 4 times the size of the budget deficit used to justify austerity (Independent 17.2.18). Likewise, private firms have been handed almost £15 bn in NHS contracts over the past 5 years. The value of contracts given to the private sector has soared by 89% since 2015 to £3.6bn a year. This will accelerate under Johnson. All this was made possible by the Health and Social Care Act brought in by the Con Dem Government which obliged all Hospital Trusts to put all NHS work out to private tendering.

It would therefore be more accurate to say the NHS is suffering from creeping privatisation, along with chronic underfunding and unprecedented staff shortages which will undoubtedly get worse under this Tory government (see back page).

Can the NHS be Saved from Johnson’s Government?

There is no doubt this task will now be much harder. The proposed Withdrawal Bill will allow secret negotiations to continue. Many of the new Tory MP’s are firm advocates of a private health insurance system. Despite Johnson’s pledge that they will commit £ 33.9 bn to the NHS over the next 5 years, that will barely touch the huge crisis now facing the NHS as outlined above. It actually represents a real cut in NHS funding when inflation and other on-costs ate taken into account.

NHS England (the national quango appointed by the Tories to ‘run’ the NHS) is now well down the road of centralising and concentrating local NHS services into larger urban areas as well as creating ‘super hubs’ of health care delivery in the community, which will see the disappearance of many local GP surgeries. All these plans will see an acceleration of hospital closures, cuts and privatisation. No-one believes Johnson’s claim that the government will build 40 hospitals; 12 are planned for Dorset alone, and will be cottage hospitals, probably without beds, just for outpatients. The so-called pledge to increase the NHS staff numbers will not be realised due to huge budget constraints and a crisis of morale amongst front line staff. And all these plans are being developed in secret since the introduction of ‘Accountable Care’ bodies which have divided up the oversight and management of health provision across the country. In reality these are appointed bodies with no accountability which have slowly taken over the running of our NHS.

However, the Tories were forced onto the defensive during the election and there will be very close scrutiny of NHS delivery and performance by politicians, unions, community campaign groups and the wider public. There is absolutely no doubt that the British public will fight to save the NHS if they feel it remains under threat. This means that local, regional and national alliances must be forged now to ensure there is close scrutiny of every aspect of NHS care, and resistance organised where services continue to be cut.

So, What Can be Done?

The ongoing strike wave in Northern Ireland shows the way. Determined and direct action can force the Tories back and actually force their hand to go further than they now intend to fund the NHS. Health Unions should immediately convene a Conference of Action, reaching out to all local community action groups. A plan of action needs to be drawn up which will both inspire confidence and offer leadership to save our NHS.

Socialist Alternative supporters would strongly advocate sustained and direct action to push the whole issue to the forefront of consciousness. Unfortunately, the recent Health Campaigns Together National Meeting did not back the proposal from many local action groups for a national demo in the early Spring. Whilst this is a setback, the demand for nationally coordinated protest and strike action must continue. We demand:

  • For a massive national mobilisation to kickstart a national campaign of action to safeguard our NHS called by health unions and national campaign groups
  • Proper public funding of the NHS to bring it up to the European average of 13% of GDP (the UK currently spends around 7%)
  • An end to privatisation, direct and indirect in the NHS; for ALL NHS services to be brought back in house
  • No sell off of any services to private interests; nationalise the big drug companies
  • A decent living wage for ALL NHS staff – end the pay cap now
  • Bring the running of our NHS back under democratic control
  • No to cuts and closures-every local community needs a local hospital with decent primary & community care to protect all health needs
  • Stop all cuts to Social Care, for all residential and community care to be free at the point of delivery

Organise to stop Johnson’s NHS sell-off

Despite the coordinated efforts of the capitalist media and religious leaders to divert attention back onto their preferred topic of Corbyn’s alleged anti-Semitism, his release of unredacted documents exposing British government talks with the US over the NHS has put Johnson back on the defensive.

These documents reveal what we had already expected, that the government is at an advanced stage of negotiations with giant US drug companies around open market access to our NHS. Currently there are price ceilings on the costs of drugs beyond which the NHS will not go. This allows the NHS to have some say over when and for what price it buys drugs. Big US Pharma feel this is an unfair advantage and have demanded that, as part of any US Trade Deal with the UK, these controls be lifted.

They are demanding ‘full market access’ for US drugs and for future prices to be driven by the ‘market’. As the recent Dispatches programme revealed, this will lead to a tripling of drug prices for patients which will begin the process of opening up the entire NHS to the US private sector.

Johnson knows that the price of any trade deal will be in the interests of US multi nationals and at the expense of our public services, as well as wages, jobs and security. Trump has fumed that the public sector gives the UK an unfair advantage and is demanding all so-called ‘protection’ is removed as a precondition for any future trade talks. Johnson can deny this reality as much as he wants but the US will be in the driving seat since they hold all the cards.

These recent documents must be the springboard for Corbyn to continue and intensify his attack on the privatising agenda of Johnson’s Tories. Every day we continue to hear of NHS horror stories. We are entering into what will be the worst winter crisis yet for the NHS. As one doctor tweeted yesterday, “I have been a doctor for nine years. Almost every doctor I know has an exit plan. So many have already gone without hope that things are going to change. I don’t know how many more NHS winters I’ve got left in me”.

On the NHS, it is now urgent that Labour adds to its demands the nationalisation of the big drug companies; an urgent injection of funds to resolve the critical staffing levels; the renationalisation of the NHS expelling the private sector from ALL health provision; the immediate cancellation of all PFI projects; the restoration of free social and residential care; and a living wage for all NHS staff.

The polls are narrowing and with a bold socialist appeal, Corbyn can and must seize the initiative maintaining all fire power on restoring cuts, ending privatisation and austerity. The NHS crisis is the tip of the iceberg but is an institution which the working class will fight for. Let’s turn this anger into a mass movement which can be mobilised for a Corbyn victory around fighting socialist policies.

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