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Author Archives: Irwin Brown

Irwin Brown has been the editor of Socialism and Health since it was founded in 1965.

As news arrives from Cambridge of yet another privatisation inspired project going horribly and expensively wrong let’s hope people in Staffordshire, South Warwickshire, Southport and elsewhere are thinking long and hard. The Stafford Cancer contract saga is long running and is now so hopelessly flawed that it should simply be wound up. The use of a complicated procurement process which was supposed to be about a competitive dialogue between various qualified providers bringing new ideas has ended with a negotiation with the obvious NHS providers. The attempt to outsource commissioning has been unpicked. It matters because even if everything else […]
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For some time it has been apparent that the second era of the NHS is coming to an end. The era of markets and competition is over. What comes next is up for discussion and the progressive left has to have a narrative. For now the basis of a universal, comprehensive health care system funded out of taxation will remain. The NHS will no longer be truly national and it will somehow be melded with a means tested social care approach. How Public Health gets into the picture and how the whole links to other parts of the public sector […]
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The NHS Reinstatement Bill is expected to have its second reading in March 2016. It would replace the current NHS architecture with a return to Regional and District Health Authorities. It seeks to address some genuine problems but it is the wrong solution. Nobody believes the Bill can become law but it raises some key issues about the NHS. What is important is that looking at such a narrow and technical issue should not be allowed to drown out more important discussions around social care and funding. There are no solutions any more looking at the NHS in isolation. Trying […]
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For many years there have been local campaigns against closures and reconfigurations, some of which have had success. Lewisham and Stafford both spring to mind – very different campaigns but both with huge widely based local support. Trade unions have often led successful campaigns against changes such as outsourcing of services or the spectacularly futile attempt to privatise the management of George Eliot. A reasonable question is how can there be some scaling up of the local approach into some kind of national campaign – with what aims? Getting a broad campaign to Kill the Bill was relatively easy. It’s […]
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The NHS Bill is expected to have its second reading in March 2016.  It would replace the current NHS architecture with a return to Regional and District Health Authorities.  It may seek to address some genuine problems but it is the wrong solution. Its supporters say the Bill would prevent privatisation and save the NHS.  Passing legislation cannot do that.  Any determined administration would just pass its own legislation.  The only way to prevent privatisation is to elect a government that is against it. The NHS does not need another redisorganisation.  To implement the Bill would require the biggest ever top down […]
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In the real world the health agenda is dominated by the huge strains within the care system due to chronic underfunding.  Social care is close to collapse and the health system is running at a significant deficit – with unknown consequences.  On further destabilising factor is the lack of any strategic bodies and the huge gaps in management capacity and capability.  The main task for the party for now could be to hold the government to account for the increasing failings in the system. Much of what the NHS is trying to do is similar to what we supported as […]
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Five years ago the SHA was raising awareness about the dangers posed to our NHS by the emerging Lansley proposals – which many at that time appeared to support. The Lansley project has failed but the desire of powerful elites to end the ‘socialist’ NHS – free at the point of need and funded from taxation – has not gone away.  Plan B is emerging. In fact Plan B is not new.  It goes back to the previous Tory strategy of causing the perception that the NHS is failing and then using that to argue that the old NHS model […]
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It is probably no longer plausible to claim we have 48 hours, one week or one election to save the NHS, but it does feel that in some sense we are at a significant juncture in thinking about the care system; a time for a fundamental rethink. There are some things we don’t need to think about too much.  There are some obvious fixtures that all but those on the fringes would agree on. Our healthcare service should be free at the point of need and funded predominantly through (progressive) taxation. (A big genuine question is why we think of […]
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The SHA has not discussed the proposed NHS Reinstatement Bill but established SHA policy as set out on the web site would appear to rule out full support.  However, much is still unknown and it would be helpful if the advocates of the Bill could give a lot more details than they have so far.  Little by way of supporting information has been provided that would allow for a proper discussion. Some important questions are unanswered. The Bill effectively repeats the legislative background that applied 30 years ago.  Over the last 30 years there have been some positive developments into […]
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A majority Tory government, a fixed term parliament and the collective failure to persuade the voters that saving the NHS means defeating the Tories is a very hard reality.  What now? Many have said that the NHS as we know it will not survive 5 years of the Tories, we have to make sure they are wrong by defending it.  We must also recognise that this strident message about an NHS in danger made little impact on how people voted. As with much else the polls were wrong; the economy, immigration and nationalism dominated. We know the NHS and social […]
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I am the only one fed up to the back teeth about the 5 Year Forward View and how everyone is supposed to spell out how they would fund it? To start with it is not a plan in any sense just a few principles that nobody other than possibly Lansley would disagree with.  It says much of what everyone else is saying and so in general there is a sense of agreement – but it’s superficial. Rightly Andy Burnham is cautious – saying that he agrees with the principles, like better investment towards prevention, but is not prepared to […]
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The Private Finance Initiative is in the news again as Barts with a huge PFI hits financial trouble. The total cost of all PFI schemes in the NHS is £2bn.  Around £1bn of that is payments for facilities management services.  The total expenditure of the NHS is £110bn. If all PFIs were somehow “nationalised” there would still be facilities management costs, repairs and renewals but perhaps they could be provided in house less expensively.  So perhaps £1.3bn could be “saved”. The possibility of simply nationalising all the PFIs is remote (to say the least) – it would require all kinds […]
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