Labour’s NHS promises are not enough

nhs march london

Seven years of Tory funding cuts have driven the NHS into the ground. Spending per patient has fallen, while training and hospital maintenance budgets have been raided in order to keep hospitals from going bankrupt. Rationing hospital services is becoming a norm. The figures speak for themselves:

• NHS spending per patient has fallen by 9.1%.

• Social care spending has been cut by £5bn since 2010; the annual shortfall will rise to £2.1bn by 2019/20 despite the extra money from the council social care precept. 400,000 older people are denied social care, and while 35% of elderly poor people needed some help with daily activities, only 12% received it.

• In real terms, nurses’ pay has been slashed by £2,300 per annum through the government pay freeze.

• GP vacancies have risen six-fold and nurse vacancies three-fold.

• NHS waiting lists, standing at 3.9 million, are the highest for eight years.

• The number of cancelled operations has risen by 37% while the numbers waiting more than four hours for treatment in A&E have risen ten-fold from 57,841 in 2006/07 to 560,398 in 2016/17.

• More than 360,000 people have waited more than 18 weeks for an operation compared to 160,000 five years ago.

• Despite every effort to limit their rate of increase, the number of A&E attendances rose by 2.8% in 2016/17, and the number of emergency admissions from A&E by 4.2%.

• The number of mental health nurses has fallen by 6,700, making acute mental health services dangerous for staff and patients.

• There will be no extra money for the NHS between 2017/18 and 2019/20, while the overall population will increase by 3% and the number of over-75s by 15%.

Clinical Commissioning Groups are seeking to ration services, targeting smokers and those deemed obese, or through review systems which vet GP referrals. Either way, it is the poor who suffer most.

Labour politicians tell us that the NHS will be safe in their hands. However, it was the last Labour government that forced the health service to use ruinously expensive private finance for major building projects. Labour also encouraged the privatisation of NHS services, and its Independent Sector Treatment Centre programme, which excluded NHS organisations and lavished £5.6bn on private companies between 2003 and 2010, remains the largest NHS privatisation ever. With a 3.1% NHS inflation rate and soaring requirement for emergency treatment, commitments to lift the pay cap and restore bursaries for trainee nurses, Labour manifesto promises of £6bn extra a year will have to be spread very thinly.

Fight Racism! Fight Imperialism! 257 May/June 2017 Election Special

Defending the NHS: the real fight has yet to start

On 4 March, 250,000 people marched through London in defence of the NHS. Like so many other anti-austerity marches that have taken place since 2011, there was no idea what to do next. The extra money that came in the Budget the following week was a drop in the ocean: a paltry £100m for GP-led triage in A&E and £325m capital funding over three years for Sustainability and Transformation Plans (STPs) – and then only if they jump certain hurdles. The £2bn promised for social care over three years is non-recurrent and will not meet a growing annual funding shortfall estimated currently at £1.9bn. Social care will continue to be cut, and private care companies will reject more and more the minimal payment rates local councils offer for their services. And within days of the Budget, it was announced that £800m reserves earmarked for mental health services will be used to pay off this year’s hospital debts. Robert Clough reports.

The success of the 44 STPs across England is crucial for the process of re-organising the NHS. The long-term aim is to create an integrated management structure across each of the STP ‘footprints’ or regions which in the short term can slash services sufficiently to keep costs in line with savage funding cuts over the next three years. GP-led Clinical Commissioning Groups (CCGs), over 200 of which were set up under the 2013 Health and Social Care Act, will start to reduce in number. Harbingers of this development are the very recent merger of three CCGs in Manchester and three in Liverpool together with the publication of national guidance on the process in November 2016. That 11 CCGs in the West Yorkshire and Harrogate footprint have agreed to form a joint commissioning group is further evidence of this trend.

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Grinding down the NHS - An attack on the working class

womens hospital

The willingness of the Tory government to drive the NHS into the ground tells us how far the balance of class forces has shifted against the working class over the past decades. Prime Minister Theresa May and Health Secretary Jeremy Hunt are confident that they will face no significant opposition as NHS services are strangled by an unprecedented level of funding cuts. British Red Cross chief executive Mike Adamson has called the situation a ‘humanitarian crisis’ as staff have been called in to assist hospitals and ambulance services. Robert Clough reports.

At a time when there needs to be a massive and militant mobilisation of working class people to defend a service vital for their well-being, Labour-led councils are implementing cuts in social care which will make the crisis worse, and the trade unions are all but invisible. All that is on offer by way of opposition is the ritual of a national demonstration on 4 March – an event that will be tightly managed to ensure it presents no real challenge to the government. Meanwhile more and more people will suffer and die as they are unable to get the care that they need.

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NHS cuts round-up

Save NSH

The wide-ranging attack on NHS services is documented by FRFI supporters from around the country.

STPs and Grantham A&E

Lucy Roberts

In August 2016, it was announced that Grantham and District Hospital Accident and Emergency unit would be closed between the hours of 18:30 and 09:00. United Lincolnshire Hospital Trust (ULHT) has said it does not have enough doctors to staff the department safely while also maintaining services in Lincoln and Boston.

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Fight to save free health and social care

Save the nhs protest

There was no extra money in the Autumn Statement on 23 November for the NHS, despite the fact that it is so obviously in a catastrophic financial crisis, we must now expect savage cuts, with an escalation in rationing services and tightening of eligibility to those that remain. These will be set out in the local Sustainability and Transformation Plans (STPs) that are now being published and whose purpose will be to show how £22bn can be cut from the NHS budget over the next four years. Robert Clough reports.

What is happening to the NHS cannot be explained by Tory ideological hostility to state provision of health care alone. A nationalised health service is the cheapest and most efficient way of meeting the health needs of the working class under capitalism. The ruling class is not opposed to the NHS in principle: it simply regards its level of health care provision as far too generous for the working class. Although it seems that the working class pays through its taxes for the NHS as with any other state service, in fact the worker never sees this money nor has any choice about its deduction. The process obscures the underlying reality: that state expenditure is paid for by part of the surplus value extorted by the ruling class. Taxation is the means by which this transfer to the state takes place, and it reduces the surplus value available for profitable capital accumulation. Furthermore, since most of state health care is directed towards the maintenance of workers who do not produce surplus value for the capitalists, either because they are employed unproductively or because they do not work at all through retirement or disability, there is an added reason for the ruling class to axe it (for a thorough discussion of these issues, see Revolutionary Communist No 3/4: Inflation, the crisis and the post-war boom). The pressure is therefore on: the cost of the NHS must be slashed and slashed again. What will determine the outcome will be the extent of resistance both within and outside the NHS, and this presents a political problem for the ruling class: the popularity of the NHS is likely to generate serious opposition to A&E or hospital closures.

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