Happy 60th birthday, NHS
1:35 pm - July 1st 2008
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This week marks the 60th anniversary of the NHS.
While its younger, formative years saw ground breaking strides in healthcare provision despite gross underfunding, its middle age has been marked with wastage as it has lurched towards the bloated US system of privatised healthcare and health markets.
For the NHS to survive into old age, it must make lifestyle changes, get fit and start to look after itself.
The Tories skirted with the market in the 1990′s and Labour, despite its pledges to “cut costs by removing the bureaucratic processes of the internal market” in their 1997 manifesto, rushed headlong into the market approach to health emulating the US system. With the US spending around 30% of its entire health care budget to administer their health care market, it is clear that billions are now being wasted in the NHS on our market.
The last ten years has seen a sizeable investment in the NHS, around 40% in relative terms (increasing the proportion of GDP spent on health care from 6.6% in 1997 to around 9.4% in 2007). This investment brings us closer towards the French and Germans (approx. 11%), but still a long way from the US at 15%, and with this investment we should have noticed a step change in health care provision and quality.
Sadly, these increases have brought little improvement; money has largely been used to develop the market and to bring in private companies with the ‘creeping privatisation’ of PFI, polyclinics, ISTC and ICATS. Labour have injected more money into the NHS than ever before and then insisted that the NHS is fed on the most unhealthy diet possible – the US healthcare system. All that cash could have been used to get the NHS into shape but instead it has left it obese and ill.
Private companies have been repeatedly shown to provide poor value to the NHS, using the flawed Payment by Results system to claim that they can provide care and make a profit while they cherry pick and manipulate the system. Private healthcare providers often refuse to treat higher risk patients with co-morbidities as they are more expensive to care for – but as the tariff system under Payment by Results is designed to cover everyone, regardless of medical condition, the private companies get patients that are cheaper to treat and then claim they are efficient.
Meanwhile the NHS picks up the complicated patients and gets labelled as inefficient ’cause they cost more to treat. Private companies also often skimp on small issues like training, so its no wonder they make profits.
Other areas of privatisation, such as the PFI mortgages on our hospitals, increase each year meaning the government is storing up payment problems for the near future. Labour’s latest wheeze is to centralised GPs into polyclinics provided by ‘BigHealth’, reaping profits at the expense of both taxpayer and patient. Rather than tackling the issues in primary care directly, Labour’s answer to a problem is to sell it to the highest (or lowest) bidder.
Labour remains in its blinkered world, ignoring the looming challenges that we are all now beginning to face. The world is starting to see the end of cheap energy and the UK is experiencing rapidly rising costs of fuel, food and goods. These will impact on the NHS as severely as they impact on every other part of society.
The NHS’s 60th birthday should be used to mark a reversal of policy. The NHS needs to ditch the bloated, necrotic mantle of the market and it needs to bring the care provided by the inefficient private companies back into the NHS.
Related: BBC online – NHS at 60
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This is a guest article. Stuart Jefferey is Health spokesperson for the Green Party. He writes at his personal blog and on Green Health Service.
· Other posts by Stuart Jefferey
Story Filed Under: Blog ,Health ,Labour party ,Westminster
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Reader comments
Forcing GP surgeries into polyclinics is not privatization. GPs surgeries are already private companies contracted to the NHS, normally in the form of partnerships.
Deeply sceptical of the strong assertions / complete lack of links combo. Also, presumably you’re aware that a) as Chris says, GPs have always been private; b) in the French system, most providers from GPs to hospitals are publicly funded and privately delivered. The US system is wasteful because of its provision mechanism, not its delivery.
[overall, the piece sounds like a Private Eye "in the back" rant. Note that Phil Hammond, the PE journalist who actually understands medicine, isn't a massive PFI demolitionist - rather, that goes to whichever ignorant Trots wrte the excrable "ooh, it's a private company doing business with the government, let's slate it" In The Back section these days...]
Also, bring polyclinics on. The idea of being able to go to a surgery at a time that suits me, not Monday-Friday 10AM-midday, might actually mean I go and see a doctor from time to time; if they’ve got my medical notes, it doesn’t matter in the slightest whether it’s the same chap who saw me last time or not…
I agree that polyclinics could be introduced in a limited way to some benefit of the system, but that any benefit is lost when they start being seens as a general means to economise by replacing existing facilities, rather than being brought in to improve the service by increasing availablility.
Labour’s centralising tendency spreads its dogmatic tentacles into unnecessary areas – for example a range of smaller surgeries are set to lose their dispensing facilities in a bid to encourage private investment in dispensing chemists (and thereby removing them from smaller and more isolated communities). This is perverse because the very people who use the facilities are those who use them out of necessity, not convenience, so the reality is that such a change is not only unnecessary, but inconvenient and uneconomic in the long-term.
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