Theresa May’s weakened but unchastened Tories are clinging on to power through their shabby deal with the bigots of the DUP that has shown that extra money can be found even in a period of “austerity” when governments see a project as important.
The DUP have made clear that having screwed concessions for Northern Ireland as their cash inducement to prop up the Tories they are more than willing to nod through cuts in welfare for every other part of the UK.
But it’s very clear from the polls and the voting that May’s government have not won the mandate they wanted to drive through more cuts, closures and privatisation of the NHS.
Despite this, every day they remain in office, the NHS is undermined by a relentless freeze on spending, now in its seventh year, aimed at reverse the decade of increased investment in the NHS under Labour which ended in 2010.
Since the election it has emerged that during the so-called purdah period in which information from NHS bodies was withheld, senior NHS bosses were locked in debate on the imposition of new, even more far-reaching cuts on 14 of the areas with the biggest “overspending” of inadequate budgets – the so-called “capped expenditure process”. The public outcry from all sides has forced a partial retreat on this, but the pressure on local NHS managers to drive through cuts in the teeth of local public opposition is intensifying.
This is coupled with a vicious succession of cuts in the real value of NHS and public sector pay that leaves staff 16% worse off in real terms now than they were in 2009.
To make matters worse, NHS staff face worsening conditions and pressure work in hospitals and community services.
This is why, for the first time ever, figures show more nurses leaving the profession than joining it – with the added blow of scrapped bursaries and the Brexit effect deterring recruitment and retention of vital staff from EU countries compounding the problem.
There are growing shortages of key staff – and morale is close to rock bottom, while frustration levels were further cranked up by May’s infamous put-down of a nurse on Question Time who asked whether May would lift the 1% cap on pay increases, telling her that there is no “magic money tree”.
So it’s fitting for campaigners and unions to mark the 69th Birthday of the launch of the NHS on July 5 with events that combine a celebration of its role and importance and the skill and dedication of its staff with calls to lift the cap on pay, an end to cuts and cash-driven closures, and the demand for a fully-funded, publicly owned and provided NHS.
That’s what will take place in gatherings and events at over 30 hospitals across England in a coordinated initiative organised by the TUC and Health Campaigns Together. Giant Birthday cards will be available for people to sign, and leaflets will be distributed: some cake will no doubt be provided and eaten. And in many areas the latest HCT newspaper will also be available.
The organisation for these events was of course dislocated by the election period, but we hope the joint activity is an important step on the road to more coherent joint campaigns involving HCT and the health unions, reviving some of the campaigning spirit that has lain largely dormant for 20 years or more. It’s hoped that each of the local groups will get together in early September to plan future joint campaigning initiatives.
It’s vital that campaigners keep up the pressure on a government that is weakened by the election, but still as savage as ever.
Nowhere is there the slightest evidence that any electorate has been persuaded to support the closure of local hospitals as part of vaguely-defined “reconfiguration” of services or ‘new models of care’.
Nor is there any basis for people to support plans – whether these be the 44 Sustainability and Transformation Plans (STPs) for carving up England’s NHS or the pre-existing and ongoing plans in many areas to downsize, downgrade or close down acute or community hospitals and beds.
These plans have emerged in very different areas of the country, but all have one thing in common – a complete lack of credible evidence that the “new models of care” and alternative “out of hospital” services can either replace existing services or save money.
Across the country STPs have also been drawn up assuming ready availability of capital to develop new services and expand some existing hospitals to serve as centres while others are downsized or closed.
But the reality is that there is next to no capital available. The reason is simple: the freeze on real terms NHS budgets has driven trusts into the red and forced repeated raids on the limited pool of capital available to help cover revenue deficits, while the bill for backlog maintenance in England’s neglected NHS has risen to £5 billion.
Now plans have been hatched up to sell off “under-used” and “surplus” NHS property assets, and borrow new money from the private sector to fund the changes – and bail out trusts in the red.
Once these assets are gone, they are gone – and once long-term private finance contracts are signed, as we have already seen with over 100 disastrous PFI hospital contracts, the NHS is saddled with escalating costs for 30 years at a time. These plans make sense to the construction industry, investors and speculators, but not for the NHS, which needs public sector investment, not the permanent freeze implemented since 2010.
And it’s clear that there is no public acceptance of plans that have either been bulldozed through by unelected NHS bureaucrats in the teeth of local opposition or, in the case of the STPs, drawn up in secret, with no public consultation of involvement, and often with little if any support from supposed “partners” in local government.
We have seen thousands marching against the threat of cuts in places that have not seen anything similar in recent years – Essex, Canterbury, Devon: these concerns will not fade away as long as the threat hangs over local services.
In Canterbury, the threat has increased since the election, as emergency medical services at Kent & Canterbury hospital have closed “temporarily” on June 17, leaving seriously ill patients to travel upwards of 16 extra miles for treatment. No date has been given for this cutback to be reversed: but with the East Kent Hospital Trust’s beds already 94% full, it’s clear the loss of these services at Canterbury will pile pressure onto Ashford and Margate.
Similar problems can be found wherever there is a planned downgrade or closure: in Mid Yorkshire Hospitals and in Leicestershire desperate managers have had to admit that the planned cuts can’t work and reopen beds that have closed. The STPs are not sustainable, not affordable, and not coherent as plans.
The government lacks a majority in parliament and any mandate to close or downgrade local services – and local MPs know it. Some, in places like Bedford, Canterbury, Lincoln and Peterborough have won their seats in 2017 as a result of championing local concerns over the NHS.
Some sitting Tory MPs, even in safe seats, are also painfully aware of the pressure to be seen to defend the NHS against cuts, such as Torridge and West Devon MP Geoffrey Cox, who promised a hustings meeting he would chain himself to the railings of Barnstaple Hospital and resign the Tory whip if the hospital’s A&E is “ever threatened”.
The uncertain period, with the possibility of another election within months or a year or so, and the recent evidence of very large swings by voters (such as Canterbury) putting even substantial majorities at risk, can help campaigners put all MPs under pressure to speak up and lobby for local services or stand discredited.
The growing needs of a growing population mean that the NHS requires investment and development, not cuts and piecemeal privatisation. It needs coherent planning not the cash-driven bodge-job of STPs. It needs proper integration, with the reversal of the disastrous Health & Social Care Act, an end to privatisation of services, and a reinstatement of the NHS without the wasteful bureaucratic costs of the “market” system that has failed consistently to deliver any benefit since its introduction in 1991.
Now is not the time to relent in the fight: we have a great deal of NHS still to defend, and we have a political situation that gives us great leverage to defend it and make the case for the changes we really need rather than the half-baked carve-up proposed by NHS England.
More details including latest issue of HCT’s quarterly tabloid newspaper at www.healthcampaignstogether.com