While the snow delights children and Instagram users, it is confirmation for our NHS staff that winter is most definitely here. Already hospitals have had to divert patients away because of over-capacity and 20,000 patients were stuck in the back of an ambulance for over 30 minutes in a period of just two weeks.

The state of the NHS under the Tories gets worse each day with ever-lengthening queues of the sick as waiting lists climb beyond four million. Last year 2.5 million people waited more than four hours in A&E, while over 560,000 people were designated as “trolley waits” because of acute bed shortages.

Austerity for the NHS has meant the biggest financial squeeze in its history, public health budgets cut and social care slashed severely by billions.

Some 14,000 beds have disappeared from the NHS and hospitals are now often occupied at unsafe levels. Over 400,000 elderly and vulnerable people are without the social care support they otherwise would have received. Community walk-in-centres have closed and local pharmacies seen their budgets cut all putting more pressure on A&E departments.

There are vacancies for more than 35,000 nurses, despite promises to recruit more GPs, we have 1,000 less than a year ago and we have seen district nurses and health visitors lost from the front line. The abandonment of the 18 week target for “non urgent” operations will mean more and more of our constituents waiting longer in treatment in pain and distress.

The news earlier this year that increasing numbers are now paying for operations such as hip replacements or knee replacements, because of escalating waiting times, should send alarm bells ringing for campaigners who share my belief that we must restore a fully-funded, comprehensive, universal, publicly-provided and owned national health service.

Meanwhile, advertisements have emerged across the London Underground for private healthcare – “topdoctors” – telling London commuters that when you need a doctor you need the “best one” implying the best aren’t in our NHS. I’m not sure they could be more offensive and crass if they tried.

This are all the very real implications of Tory underfunding and we’ll make no apology for continuing to highlight the impact on patients. Indeed we’ll redouble our campaigning efforts to demand our health service is given the investment it needs as we head into the 70th anniversary of the NHS.

And as we celebrate 70th years of the NHS we’ll continue to campaign to end the toxic privatisation agenda that destroys the very soul of the NHS too.

In our recent manifesto we pledged to repeal the health and social care act, and to reinstate the powers of the secretary of state for health to have overall responsibility for the NHS. We are determined to reverse the Tory privatisation of our NHS.

That’s why earlier this year I raised warnings about a possible fire sale of NHS assets after my research showed that ministers had doubled the amount of land  – now up to 1,332 hectares including many used for medical purposes – they’re looking to sell off.

And at our party conference John McDonnell confirmed his intention to deal with the PFI deals that see taxpayers’ money drain out to private companies.

But perhaps the urgency of our commitment to end privatisation was laid bare last week with the shocking revelation that Virgin Care had successfully sued our NHS, some say for possibly up to £2m, after losing out on an £82m contract to provide children’s health services across Surrey.

This action has drawn widespread condemnation with thousands signing a petition demanding Virgin “give the money back”. A tweet from Richard Branson asking whether it’s possible to fall in love with a brand seems particularly ill judged in this context.

Meanwhile Babylon have been given a contract for an online GP service effectively cherry picking the patients easiest to treat.

Under the Tories more of the NHS budget has gone to private health firms, many of whom have become increasingly aggressive in pursuit of contracts. Department of Health figures show that the percentage of its funding allocated to the private sector is about 7.6 per cent, the equivalent of £8.7bn of the total NHS budget.

In fact the real figure is most likely far higher: much private work is masked from official records by complex operating arrangements with large private-sector health corporations whose sole concern is creaming off profits from public money.

NHS staff will be the first to tell you just how harmful this needless privatisation has been. A survey earlier this year of BMA doctors found that more than two thirds were fairly or very uncomfortable with independent sector provision of NHS services. Many were rightly concerned that the primary motivation for many independent sector providers is profit, rather than providing the highest possible standard of care for patients.

The source for this privatisation agenda is the Tory health and social care act. Despite vociferous opposition from Labour, patients and the public, Part 3 of the 2012 Act extended market-based approaches to health care, resulting in far greater private sector involvement as competition became the preferred means of improving health care.

Prior to the act, hospitals were only allowed to make 2 per cent of their income from private sources, but with the legislation’s passing the cap was egregiously lifted to 49 per cent.

Unsurprisingly, the Tories’ expansion of the internal market has led to one third of contracts being awarded to private providers since the act came into force in April 2013.

Some of these private contracts are vast and their failures have wasted millions of pounds worth of public money. A contract in Staffordshire to deliver end-of-life and cancer care worth £1.2bn was dropped in April- the procurement for the cancer element alone cost the four Staffordshire CCGs more than £840,000.

UnitingCare Partnership in Cambridgeshire and Peterborough is another controversial example of a procurement collapsing. Over £1m of public sector cash was wasted after an £800m, five-year contract to provide older peoples care collapsed just eight months after going live.

Similarly, in January 2015 the private sector operator, Circle, pulled out of a 10 year contract to run Hinchingbrooke Health Care Trust, a privately managed NHS district general hospital. This left the NHS with the subsequent operational risk when the franchise failed: Circle were only liable to cover financial deficits of up to £7m over the ten years, which was far below the total deficit incurred during the three years the private firm were in charge.

Private meddling is equally damaging on the commissioning side. Just a few months ago Burton Hospitals Foundation Trust was forced to pay £300,000 in VAT charges due to a controversial “prime provider” contract involving Virgin Care. These charges would not have been incurred had services been commissioned directly by the CCG rather than Virgin Care, which is outside the group of NHS organisations that can recover VAT costs.

In many instances, because of underfunding local health bosses feel compelled to turn to the private sector. The resultant lack of capacity means mental health and community services in particular have often had to rely on the private sector for short-term fixes.

Similarly, in the acute sector, drastic bed shortages have forced NHS hospitals to turn to the private sector to carry out non-emergency services. NHS Improvement reports that expenditure on outsourcing elective treatments to the private sector rose significantly from £241m in 2015/16 to £381m in 2016/17. For example, earlier this year we learnt that more than one-third of hip and knee operations are being carried out by companies such as Spire Healthcare, BMI and Nuffield.

Desperate NHS Trusts have also been forced to increase their expenditure on private ambulances by a fifth in just two years, despite serious patient safety ramifications. Indeed, the Care Quality Commission has highlighted that some private firms use less qualified staff who are forced to work in poorly equipped ambulances, with insufficient infection prevention and inadequate clinical governance.

For example, one patient transport contract was handed to a private company who sub-contracted to 20 other companies. When some of these companies ceased trading they couldn’t pay their ambulance drivers for eight weeks. Patients were routinely left stranded for hours often missing important appointments. Eventually this shambolic privatisation was ended and brought back in house.

The unprecedented financial squeeze on the NHS, coupled with the private sectors’ ability to undercut NHS providers, means CCGs will increasingly be under pressure to outsource more contracts, despite concerns about the quality of service that may ensue. This is another reason why campaigners must join us in demanding the underfunding of the NHS comes to an end.

Moreover, there have been shocking increases in hospital car parking charges, much of which has been contracted out to the private sector. Whilst thousands of disabled drivers and low-paid staff lost their free hospital parking last year, one of Britain’s biggest parking firms celebrated a 38 per cent jump in profits. It’s why Jeremy Corbyn committed Labour to abolishing car parking charges across the NHS.

The sad truth is that privatisation schemes like these are increasingly, and disproportionately, affecting the most vulnerable people using our health service.

But we can fight back.

Just a few months ago my shadow ministerial colleague Justin Madders secured a major victory by forcing the government to back down on their outrageous plan to privatise NHS Professionals. This effective and successful public body saves the taxpayer around £70m a year, by ensuring hospitals don’t have to rely on expensive private staffing agencies.

New privatisation fronts could well emerge too. There are fears that not only will Accountable Care Organisations (ACO) be a means to control local health spending through greater rationing and service cuts but that also they will be used as backdoor to private sector involvement in commissioning and providing local services too.

It’s why last week I tabled EDM 660 demanding a Commons vote and full parliamentary scrutiny on Tory plans to push through the creation of these Accountable Care Organisations.

And as the government attempts to negotiate new international trade deals we will be watching carefully, ready to call out any attempt to include the NHS in free trade agreements.

Next year is the 70th anniversary of the national health service, our party’s greatest achievement built by Nye Bevan and opposed tooth and nail by Tory parliamentarians who voted against its creation over 20 times.

Our commitment 70 years later is a fully funded NHS, reinstated and reintegrated NHS. An NHS restored as a public service, publicly provided with its democratic accountability strengthened.

I’m calling on Labour members, trade unions, NHS campaigners, and patients to join me as we campaign for the future of our NHS. Just as Labour created the NHS and rebuilt it in government, we will again fight to save our NHS today keeping it universal in scope and there for everyone when you need it.

First published by LabourList

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4 Comments

  1. The long-overdue condemnation of the privatisation of the NHS from Labour is certainly welcome, but it is still politically defensive. Labour should be putting not just the defence but the development and enlargement of the NHS at the centre of its programme, emphasising that the NHS represents solidarity with the sick and the disabled in action.

    Fighting defensively for the NHS over the past few decades has been important in expressing solidarity and it has been occasionally successful in saving hospitals or services, but it has not stopped the erosion which is now threatening to topple it. Tories see public attachment to NHS services being solely about their being free at the point of use – hiding the fact they are already compromised in that respect by prescription charges, eye test and dental charges. The solidarity with the sick and the disabled that is represented by the NHS, and expressed in public willingness to defend it needs to be expressed more clearly in a vision for its future and turned into positive demands for a new, fundamentally collective vision. Underlying this is the simple moral assertion that a democratic society will not allow the vulnerability of personal catastrophe, whether it be acute sickness, disability or destitution to be the occasion for financial exploitation. Those who come to the site of a disastrous accident and start asking who has the money that they want in exchange for care, instead of triaging the victims in terms of need, should rightly be regarded as criminal predators.

    Making a reasonable income out of providing health care services is both necessary and moral, and all workers from cleaners to nurses to doctors to the highest administrators should be fairly paid for working reasonable hours (and no more). Making private profit out of provision of health care services is exploiting people when they are at their most vulnerable, and not at all fit to function in any supposed “marketplace”. This applies to doctors and nurses, but also to the owners of capital who invest in buildings, or to management organisations, and indeed it also applies to drug producers. A vast majority of people in this country agree with this ethical position and it should be reflected in the structure and function as well as the ideology of the NHS.

    People should be encouraged to train for roles in this NHS structure, and being a student or apprentice should be paid, since the best part of all the trainings is essentially practical – it uses the plight of the currently sick for supervised experience to the benefit of future sick people – but this means that they have made a vocational commitment and should not be free to go into a profiteering health sector without penalty.

    Private investment in the NHS should be welcome as long as all profit goes into reasonable remuneration for actual documented work done at an agreed rate of pay or is re-invested in expansion, and there is no other profit. It is possible that such investment could be encouraged in lieu of other restitution in the case of proven tax evasion, and to a limited extent it could become a legitimised form of tax avoidance.

    The NHS should produce some of its own drugs – certainly old patent-expired generic ones and possibly new ones developed in partnership with academic departments of pharmacology. We need an exemplary drug-producing institution, that does not advertise to consumers or bribe prescribers, that does not hide negative trial results, that does not have overpaid senior managers, and that makes no profit except for re-investment.

    All NHS institutions should be accountable to the government and to local government and this accountability should be exercised through systems of scrutiny and report. They should also have systems of accountability to users. They should be run by their own staff, with as wide a distribution of responsibility amongst them as is possible. That is, whatever the original source of capital for the building, or the source of funding for the staff, “ownership” should be internal, diffuse, collective and accountable.

    There is no need to buy back all the elements of NHS property or services that have been sold to the private sector; or to buy up care institutions that exist for the chronically sick in the private sector: they just need to have the simple moral imperative applied – no exploitation of the sick or disabled, nor of those who have been trained to help them, nor of the community that is funding its own health and social security.

    The NHS must be available to anyone who needs its services whenever they need it, irrespective of their passport or status – the moral and ethical principle on which it stands must come first, and it should be a beacon of what solidarity with suffering, which knows no borders or passports, really means.

    Pharmacies, social care institutions, and possibly youth and exercise facilities, housing for the chronically ill, and for its staff, as well as primary care institutions should be encouraged to join this transformed, sustainable expanding morally and politically purified NHS on the same basis – that of renouncing profiting from other people’s misfortunes and from their vulnerability.

    Labour should be fighting, on its 70th birthday, for this renewed NHS which everyone would want to work in, and be proud to contribute to, as well as be grateful and proud too to be reliant on.

  2. vincit veritas says:

    Johnathan Ashworth does not support the NHS reinstatement bill and would not repeal the health and Social Care Act. So I find these comments a bit lacking in credibility. If Mr Ashworth cannot get behind Labour policy he must be replaced

  3. rotzeichen says:

    The reinstatement bill is the only game in town, there is no place for any private intervention, as we have witnessed the private sector profits from the misery of others, low wages, cutting corners and wholesale worse delivery.

    For those that understand how money enters the economy, realise that we have all the money we need for all our public services, it is the political policy of underfunding that has been used to transfer public services into the private sector, purely and simply so that private companies can profit from sick people.

    The NHS is the cheapest, most efficient, most comprehensive health service in the world and Neo-Liberal politicians of all colours want to destroy it, it is therefore essential to renationalise it using the reinstatement bill as soon as we enter government.

    We have the money, all we need is a government that works in favour of people instead of the corporate sector and the few.

  4. Mike Squires says:

    One thing that could be done straight away is to put all providers on a level playing field be they private or public.
    If an NHS provider wins a contract then any surplus made from that contract comes back into the NHS.
    Private providers should make the same commitment.
    This should be written into all contracts.
    Once we have abolished the enormously expensive purchaser provider split of course this will not be necessary. We will no longer need need the huge bureaucracy that the market in the NHS brings.

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