NHS, fury and activism

I am furious. Absolutely furious. And I don’t know what to do about it. So I am going to rant here.

Arguably the greatest achievement of mankind is in its death throes, because a small number of incredibly privileged people stand to gain.

This paragraph is taken from the BMJ analysis published a couple of weeks ago (hat tip to Ben Goldacre):

“Entitlement to free health services in England will be curtailed by the Health and Social Care Bill currently before parliament. The bill sets out a new statutory framework that would abolish the duty of primary care trusts (PCTs) to secure health services for everyone living in a defined geographical area. New clinical commissioning groups (CCGs) will arrange provision of fewer government funded health services and determine the scope of these services independently of the secretary of state for health. They may delegate this decision to commercial companies. The bill also provides for health services to be arranged by local authorities, with provision for new charging powers for services currently provided free through the NHS (clauses 1, 12, 13, 17, and 49), and it will give the secretary of state an extraordinary power to exclude people from the health service. Taken together the measures would facilitate the transition from tax financed healthcare to the mixed financing model of the United States. We provide an analysis of the key legal reforms that will govern policy development and implementation if the bill is enacted.”

The NHS reforms that are currently going through will require that private, for profit companies manage and administer one of the largest pots of public money. The services they commission will increasingly be provided by private, for profit companies. These providers will be able to discriminate on the services they deliver, with current NHS hospitals able to take 49% of their revenue from privately funded healthcare. This leads to a reduced range of services available on the NHS, deprioritisation of NHS patients, and much greater reliance on insurance policies or personal wealth. We are entering an age of two tier healthcare based on ability to pay.

This means that people will suffer and people will die unnecessarily, because they are poor. I have three questions – two sensible, and one guttural. What can we do to stop this, how can we prevent it getting this close to happening again, and who do we blame?

Who is to blame? There are a number of culpable parties here. Firstly, the Conservative party. They are evil cunts of the highest order – I don’t care that they may improve access to healthcare data, refocus the school ICT curriculum onto something useful, scrap the ID card scheme and allow gay marriage. These are all good things, which should have been done, but they do not come close to making up for the damage this bill will cause, without even considering the damage already done to those on benefits, and especially the disabled.

But this is what they do. They are ideologically commited to privatisation, free markets, leaving those in need to suffer and reducing tax for the wealthiest. Perhaps they justify their actions internally by appeal to ‘trickle-down-economics’, in which case they are idiots rather than cunts. Perhaps they feel that taxes are an unjustified imposition when they are not direct beneficiaries, given their personal wealth, comfortable incomes and expense structures, and lucrative careers post-politics, in which case they are merely self centred idiots. Perhaps they honestly believe that the poor, the disabled and the sick deserve to suffer, as they brought it on themselves somehow, which shows a horrifying lack of understanding of the real world and the situations that people are in through no fault of their own. Whatever, any system that promotes suffering to create profit is abhorent to me, but intrinsicly Conservative.

The Liberal Democrats are also culpable, and have taken quite a lot of the wrath assosciated with the Health and Social Care Bill. This is because people honestly expected better of them. They presented themselves as a left-of-centre, liberal, rationalist party. I would have happily voted for them at the last election had I lived in a Lib Dem / Tory marginal. Since the election, the party leadership have openly admitted that they were lying toward the end of the election campaign, gone back on publicly signed pledges, and generally enabled the most Tory government in living memory – including Thatcher. I suspect they will suffer the after effects of this for a long time to come.

It is worth thinking about what the Liberal Democrats have achieved in return for this, as I could happily accept that some poor policies could be balanced out against strides made in other areas. Having a quick think about it, I suggest they have achieved fuck all that is good and of any significance.

They were in a hard place at the election, and I understand that – join a coalition or let a minority Tory government rule until they held another election and got a Tory majority. There was no winning, and I can see why they felt they should join the coalition. However, they didn’t need to kill the NHS on the way – the privileges of being in governement must be sufficiently good that all the leadership no longer care about the principles they once said they had.

I am also angry at you and me. The student fees caused sustained mass protests, and I’m not even sure that the new system is particularly worse than the old system, even if it should all be paid out of general taxation. The new healthcare system will lead directly and inexorably to people suffering and dying, and there has hardly been a peep. I know that there was some protest, which was woefully under-reported in the mainstream media, but nothing like the scale it should have been. I wrote to my MP, I signed a couple of petitions, and I tweeted Lib Dem MPs and peers. I was probably one of the more active members of the public around.

But how can that be enough? How can I justify my actions? When our grandchildren first hear of the magical time when the people who could afford it all contributed to look after each other and everyone else, and ask why it stopped, what can I say? ‘Well sweetie, I wrote to one of the people who was sort of in charge, but he was more interested in preserving his job and getting richer.’ That hardly cuts it for me, and I can’t believe it does for you. We need to do something in a last ditch attempt to save the NHS.

What I can do that will have an effect I don’t know. I will write again to each of the local parliamentary candidates (your local MP can be found here), I will ask the Labour party leadership to pledge to undo at least the privatisation aspects of the bill and preferably the marketisation of the previous Labour government, I will let the Liberal Democrat leadership know that this has cost them any chance of having my vote at least until the party kicks them out and repeals the more Tory parts of their policies, I will go to any protests I can.

That’s still not enough though – everyone else needs to get involved too. Possibly, hopefully, we can still create enough pressure and noise that the process breaks down, or at least a future government will undo the damage that the Tories and Lib Dems are visiting on us.

Our long term innoculation against this sort of damage has to be that enough people who give a shit about social justice get really involved in politics, to the extent that they can change it. I need to have a proper think about how I do that.

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    • Donald
    • March 20th, 2012

    Good piece Miles. Your list of responsible parties (the Tories, lib dems, the public) omits one major ‘non’ player – the so called opposition, labour leadership and shadow health minister in particular – from whom the silence has been pretty much deafening throughout the passage of the bill (apart from a mild mannered squeak in the last moments before the bill was passed into law). To be fair to the other two showers of shits at least you know where you stand – Tories are very open about being profit driven scumbags and anyone who believed that Cleg and his ilk would be anything other than spineless toadies happy to be swayed any direction in return for a sniff at power is clearly deluded.

    But the total inability of Labour to offer any resistance, let alone an effective one is baffling at best and is enough to further my righteous rage to boiling point!
    You are so right about us sleepwalking into the death of the NHS, probably because we a so used to very successive government insisting on reorganising the NHS as soon as they come to power that we all have ‘re-org fatigue’. In years to come our grandkids will ask… “Grandpa, what did you do when they handed over the greatest healthcare system the world had ever seen to multinational corporations?” and we’ll all answer “ Oh bugger all son, bugger all” (and hopefully hang our collective heads in shame)

    • M
    • March 21st, 2012

    great article, thanks. I’ll be requesting a pledge from my Labour MP too

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