Thursday, 27 December 2012

NHS The year the public discovered the Truth about Hospital closures and privatisation

We are grinding towards the end of a momentous year, which for millions will be remembered for all the wrong reasons.
Yes, there was Danny Boyle's celebration of the NHS before the sunshine and gold of the Olympics, but 2012 was also the year that Andrew Lansley's reactionary Health and Social Care Bill was passed into law on the basis of Lib Dem votes.
Coupled with the brutal imposition of £20 billion in cuts by 2014, and the continued haemorrhage of NHS cash to the private sector through the private finance initiative (PFI) - soon to be accelerated with its barely distinguishable offspring PF2 - the HSC Act is set to sweep away the NHS as we know it from April.
The pattern is clear - all of the cuts fall on public-sector providers, while all the expansion and opportunities are being offered to the private sector.
Grasping companies like Serco, Richard Branson's Virgin Health, Care UK and others are cashing in as an ever wider range of services are opened up for private profit, while those that don't offer profits are run down, reconfigured and closed.
And behind every reconfiguration, reprofiling and tendering exercise is a consultancy firm charging a fortune for duff advice, dodgy figures, phoney theories and failed policies, snapping up fat profits from the crisis.
Like the cockroaches that are thought to be the most likely survivors of a nuclear holocaust, the lowest forms of life - management consultants who borrow your watch to tell you the time and charge you £3,000 - seem to be the main beneficiaries of the Tory-created crisis in the NHS.
They will be cashing in soon on more and more "commissioning support services" set up to advise GPs on the new clinical commissioning groups on how to spend the budgets they will now be made to feel responsible for, even though it's plain that GPs will have little real discretion or control.
GPs have been press-ganged into these bodies despite a majority of GPs consistently opposing Lansley's Bill.
In the run-up to the launch of the clinical commissioning groups they are now bombarded with bureaucratic rules and paperwork, and by deliberately confusing policy guidance from the NHS Commissioning Board - while the organisations that should have led the fight to stop the Bill stand by paralysed, like rabbits in car headlights.
Behind all this apparatus of a new market being expensively wheeled into place comes another parasitic group - the lawyers, picking up fat fees from all sides at every stage.
One thing they seem agreed upon is that little should be done to challenge the Act - or even to encourage GPs and clinical commissioning groups to exploit the few loopholes that have been left in the guidance.
For example clinical commissioning groups should be taking full advantage of the NHS Commissioning Board guidance that they are not obliged to operate the "any qualified provider" policy - they should be lining up four-square against a policy that would deprive GPs of any actual control, and which is designed to impose maximum fragmentation and to let a host of new and untested providers into the new healthcare "market."
Instead, lawyers working for campaign group 38 Degrees have drafted up weak-kneed general statements which are so vague they offer no real challenge to the NHS Commissioning Board.
Rather than test the government's willingness to use competition law and the NHS Commissioning Board's willingness to intervene in local clinical commissioning group decisions, this approach dodges all conflict - just when we need a real fight.
In the background, we are always told, are European competition laws - which were of course hatched up and backed to the hilt by British governments.
It's like an old war movie in which gallant allied troops are warned "resistance is futile."
But is it? How will we know unless somebody tests it out, has a go, makes a fight of it?
How will this happen if the BMA and the royal colleges which are supposed to uphold ethical values don't encourage doctors to stand up and fight, or even to assert any real control as commissioners of services?
And how likely is this to happen when the TUC health unions are taking such an ambiguous position, occasionally talking a good fight but challenging so little on the ground?
The unions tend to take their lead from the Labour Party, which is sitting on a hefty lead in opinion polls - and doing as little as possible to draw attention to the fact that Lansley's Bill, and most of the current problems in the NHS, trace back to Tony Blair's disastrous experiments in marketising the NHS.
Ed Balls and Andy Burnham still doggedly defend PFI and their stupidity in office in rubber-stamping unaffordable deals which are now dragging trusts like South London Healthcare and Peterborough into massive, unpayable debt.
South London has gone bust, and Peterborough ran out of money to pay bills on November 30.
Labour has nothing to say on how these and other crises that they created must now be resolved.
New Labour ministers also set up the so-called Co-operation and Competition Panel, which is now used to prise open local NHS contracts to let the private sector pick off the bits it wants - and leave the rest.
It was Labour which commissioned the 2009 McKinsey proposals on cost-cutting, the bogus assumptions and evidence-free policies which are now the basic management bible for cuts up and down the NHS.
Labour lined up the Circle takeover of Hinchingbrooke Hospital. And Labour first began the carve-up of community health services and coined the term "any willing provider," welcoming in profiteering private companies to run treatment centres, GP surgeries and a host of other contracts.
Of course the Tories are going much further, faster and doing far more lasting damage.
They are cutting not only acute hospitals but also mental health services. The mental health budget is now falling for the first time in 10 years.
Community mental health is cut, broken up and privatised. Disability benefit cuts clobber the mentally ill.
Social care is slashed to ribbons, along with crisis services and home support, while employment and day centres for mental health sufferers have also been slashed back.
But where is the co-ordinated Labour campaign to stop the cuts and keep private hands off our NHS?
Why won't they declare they will support all of the tens of thousands of local people protesting against cuts and closures, rejecting the feeble pretence that threatened A&E services will be replaced by community health care for which there is no money, plan or political commitment?
The stakes are growing ever higher. In south-east London the trust special administrator, using dictatorial powers drawn up by Labour, is trying to prop up the disastrous PFI contracts for two hospitals in Woolwich and Orpington by a smash-and-grab raid on neighbouring Lewisham Hospital.
Upwards of 30,000 emergencies and seriously ill patients a year in one of the most deprived English boroughs would be unable to access treatment locally at Lewisham Hospital, and face long and arduous journeys for care in other hospitals - which are already full to the rafters.
Some 4,000 women in labour each year would have to trek out to surrounding hospitals with the closure of Lewisham's maternity unit.
Children's services are also to be cut. Hundreds of jobs would go, upwards of 400 hospital beds, and 60 per cent of the Lewisham hospital site and most of Queen Mary's, Sidcup, would be flogged off.
In north-west London, health chiefs want to axe 28 per cent of beds by 2016, close four A&E units and cut 5,600 jobs, most of them clinical staff.
In north-east London King George's Hospital faces dismemberment in a desperate bid to bail out the bankrupt PFI-funded Queen's Hospital in Romford.
Other A&E units and emergency services are under threat with reconfigurations threatened across England, from the south coast to Bolton, Yorkshire and beyond.
The reconfigurations, like that in south-east London, are all based on spurious claims, figures and assumptions.
But from next April the HSC Act will mean that when gaps appear and services are thrown into crisis there is no strategic planning body able to intervene.
Our NHS has effectively been stolen - but we must still fight to minimise the damage, oppose the privatisation, keep services intact and defend those GPs who take a stand and the brave doctors, consultants and health workers who have challenged the cutbacks at Lewisham Hospital.
We must find every way to delay, obstruct and frustrate those implementing the new system, deter the private profiteers, encourage those who stand for NHS values and demand Labour spell out plans to roll back the Tory counter-reforms.
We've got three months before the Act kicks in, and immediate battles against cuts. Let's make sure January campaigning gets off to a flier and not a minute is wasted.
All together now, in the panto spirit - Jeremy Hunt thinks he's going to flog off your NHS. Oh no he isnt.

Sign the People before Profit Petition, go to the petitution opposing PFI, or sign direct via People before Profit website then forward the link to every one on your email list.
We need 100.000 people to sign petition to ban PFI.
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