Posts tagged ‘NHS’

November 5, 2017

The Making of the NHS: from Tannochbrae to the Highlands and Islands

dr finlays

Dr Finlay’s Casebook, a hugely popular television series in the 1960s and ’70s, had something of a reputation for being a bit twee with a good dollop of Scottish sentimentality rolled in; human interest stories of everyday people and a heroic doctor who tried to turn their lives around; except, of course, he couldn’t.

The stories were set in a fictional Tannochbrae somewhere in Scotland during the 1930s – the hungry thirties of the Great Depression when vast swathes of Britain led a hand-to-mouth existence with very little help coming from the state. Those most badly affected were dependent on charities, local health schemes, friends and their own families.

Tannochbrae was not as obviously impoverished as other places – this was no filthy, ugly, disease-ridden inner city but impoverished it was – bonnie but disease-ridden this rural village shared with its urban neighbours hunger, poverty and ill-health. The taciturn Dr Finlay who assisted the inscrutable Dr Cameron was surely the author A J Cronin himself for there is much in the writer that appears in Finlay’s character.  

Underlying the stories is a strong sense of decency – of humanity, a benevolent outlook by Tannochbrae’s doctors who breathed air that was fresher and purer than many of their patients yet were driven by their sense of duty and consideration to ease their lives, as far as they were able; behaviour not always typical of their profession with its share of uncaring snobs, over-ambitious dilettantes and ignorant oafs, if Cronin’s characterisations are anything to go by.

Far from being happy-ever-after frippery the Tannochbrae stories exposed the bleak reality of life for so many before the advent of the National Health Service. Poverty not only produced despair but starvation, susceptibility to illness and premature and avoidable death. Poverty in a world where money is king and the king-makers include respected members of parliament often reluctant to change a system built on inequality because inequality benefits those at the top which often included them. Money didn’t guarantee you didn’t get sick but it did buy medicine and treatment and it did buy better housing, clean running water, a warm fire and with those came better odds, an improved chance, to avoid contagions, work-related accidents and to survive serious illness.

aj cronin portrrait

A J Cronin

Cronin dealt with much of the awkward social divisions that consigned the working classes to unbelievable misery for as a young Scots doctor he found himself thrown into working class communities where life was a daily grind that offered spartan comforts.  

I re-discovered Cronin when clearing out the house of a deceased relative and picked up a copy of The Stars Look Down that had belonged to my late uncle, also a doctor. I was captivated by the book, a tale of miners in northeast England who were victims of political opportunism and betrayal. It is, in my opinion, Cronin’s finest work – hugely impressive and its description of a mining accident is truly memorable. The Stars Look Down should be read by everyone in this country, and should be on school reading lists for not only is it well-written it is our social history in easy bites. But it is not this book that’s being spoken about at the moment. The Citadel has been resurrected for its influence in the debate that led to the creation of the National Health Service in 1948.

The Citadel

Set in Wales and London during the 1920s and 1930s The Citadel draws from Cronin’s own experience as a doctor in both places. The young Cronin had his sights on a Harley Street practice and he did get there but by a circuitous route that opened his eyes to the dreadful impact on the poor of Britain’s ramshackle medical services – a rag-bag of medical chance – postcode lottery before postcodes.

Corruption features a great deal in Cronin’s works – the medical officer of health who doesn’t care a fig for the sick, the conscientious doctor driven to drink by a system that overburdens him as an individual, the ambitious practitioner blithely striding forward in his career at the expense of his patients, manipulative politicians on the make – they were Cronin’s colleagues and acquaintances and a rich source of characters for his writing.  

Hatter’s Castle was Cronin’s first book but it was The Citadel published in 1937 that attracted huge attention – and fame and riches for its author when it was made into a Hollywood film with four Oscar nominations in 1938. The Citadel was credited with shifting opinion towards a universal health care system – a national health service. In it a young doctor, much like Cronin, struggled to make a difference to the lives of his Welsh patients in a small mining community. Cronin worked in the Welsh mining town of Tredegar and was employed at the its hospital which was financed locally through contributions paid into Tredegar Medical Aid Society (MAS) in return for medical treatment for contributors and their families. Tredegar MAS was an amalgamation of smaller benevolent or friendly societies. Around Britain in the 19th and 20th centuries there were many similar organisations that helped their working class members – providing a doctor service and sick pay but as they were linked to particular industries and their members largely men women and children were not covered. The Tredegar MAS broadened the range of benefits to include payouts for work accidents, sickness, unemployment and death expenses. Doctors were attached to a society by a ballot of members and in turn he could employ an assistant, the role of Dr Manson in Cronin’s The Citadel.

welsh village

Welsh mining village

Local friendly societies were run by powerful individuals so open to corruption. Medicine was then near wholly privatised with everything having its price as it is in private practice today: consultations, examinations, operations, x-rays, scans, every pill and plaster. Young doctors cut their teeth working as assistants to more senior colleagues who sometimes creamed off a sizeable portion of the little income they earned. Such corrupt practices were exposed in The Citadel. By shining a spotlight on the paucity of health care in Britain Cronin was able to educate and influence people, to alter attitudes towards the ramshackle health (don’t) care system.

“I have written in The Citadel all I feel about the medical profession, its injustices, its hide-bound unscientific stubbornness, its humbug … The horrors and iniquities detailed in the story I have personally witnessed. This is not an attack against individuals, but against a system”

Cronin’s hero, Dr Manson – a Scot like himself – is shocked at what he finds on his arrival firstly at Drineffy, a little Welsh coal mining town. Underpaid and undervalued, Manson struggles to cope so early into his career as the only fit and sober doctor in the town but he also struggles against penury for most of his salary is retained by the senior society doctor. Driven to resign Manson finds himself in a bigger town where there is greater scope to practise and undertake scientific research into the lung disease that he has become all too familiar with since arriving in Wales for it was a major killer in the coal mining communities. Again Cronin draws on his own experience with Manson eventually building his reputation and moving into private practice in search of wealthy patients easily conned to shell out for useless bottles of ‘tonics.’ This was not meant to be a book review so I won’t reveal more of the story for the real value is in its description of an alternative system of health care that stood out amidst all the various styles practised around the UK.

The_Independent_(1849)_(14595849278)

Lord Northcliffe at work

But let us back-pedal a little. A National Insurance Act came into being in 1912, despite the British press loudly opposing it. Most of Britain’s major newspapers were then owned and controlled by Tory press baron Lord Northcliffe whose empire Associated Newspapers Ltd produced such titles as the Daily Mail, The Times and The Observer. They all used their columns to churn out propaganda against the scheme. Northcliffe had no sympathy for working class people and was hostile to old age pensions while at the same time he demanded, through his newspapers, increased government spending on armaments. There is little doubt he was an unpleasant and violent bully and not untypical of his class. He could not stomach a scheme to help protect the most vulnerable which involved employer and government contributions along with workers’ own in order to provide such basic benefits as sick pay, free treatment for tuberculosis, care by a panel doctor and maternity benefits. Despite fierce opposition from Northcliffe and other loud voices the Act became law but it was far from perfect. It was fine in urban areas and much of Britain but Scotland’s topography is markedly different from the south in that it is far more widespread (don’t go by weather maps on television) which meant the Act was unworkable across half of Scotland’s land mass and its crofting communities.

An answer here in Scotland came in 1913 with the establishment of a centralised state-run health service which operated across the Highlands and Islands as The Highlands and Islands Medical Service (HIMS) and it continued until superseded by the UK-wide National Health Service in the summer of 1948. It was the Dewar Report of 1912 which revealed major problems in Scotland’s rural areas with the National Insurance Act so a bespoke alternative scheme was put in place whereby doctors, nurses and midwives were subsidised to live and work in sparsely populated areas with few opportunities to rake in substantial earnings. A medical laboratory was set up in Inverness (which Cronin would have approved of) and an air ambulance eventually provided. This bold endeavour became a model for similar schemes in rural Canada and the USA and in the 1940s influenced the design of the NHS.

The Highlands and Islands Medical Service was not identical to the later NHS for it was not free to patients but it did establish a body that attempted universality of cover and was a vast improvement in what had gone before.

Britain in the 1930s was riven by extremes of wealth and degrees of poverty unimaginable to us today. There was virtually no state help and having nothing then meant nothing to buy food, keep a roof over a head, buy clothing or keep healthy. Living conditions in towns especially were quite atrocious. Cronin’s candid writing about health inequalities helped raise popular awareness and highlighted a system that put patients at its centre. Such was the appetite for his books it was clear public opinion demanded change to lift Britain’s millions of families struggling against the odds out of perpetual misery and despair while others worked the system – political, social, industrial and medical – to amass riches way beyond most people’s comprehension. Then came the Second World War.

During the war a study into the provision of social care in the UK resulted in the Beveridge Report which identified five areas requiring attention by government: squalor, ignorance, want, idleness and disease. Discussions between the government and the medical professions including the Tredegar Society and the Highlands and Islands Medical Service led to proposals for fundamental reforms in health and social care. At the end of the war there was such a groundswell of opinion for change that the Labour Party was swept into government on the promise it would set up a National Health Service. Central to this was Aneurin Bevan, one-time a health board colleague of Cronin’s in Tredegar. It should be said that Cronin did not support the NHS when it first emerged and his scepticism and opposition was shared by a fair number of the medical establishment. Reading his biography it’s fair to say he comes across as something of a snob, tediously religious in a judgemental way, attached to the very hierarchies that maintain inequality and he was vehemently hostile to abortion (and, yes, I recognise the time he was writing but there were many doctors in Scotland and elsewhere, his contemporaries, who recognised the need for offering abortion in particular circumstances [and in Scotland medical abortion was not the criminal act it was in England and Wales] .) I know from that same uncle that rekindled my interest in Cronin’s works just how split over the prospect of an NHS were doctors – many regarding it as socialism, an anathema to the mostly ultra-conservative medical profession. Cronin shared this view. And, contrary to what you might expect, the NHS was launched not with a bang but a whimper, certainly as far as newspapers I’ve looked at were concerned. The main story of the 5 July 1948 was Britain’s worst air crash or concern over the Russians. 

download

Cronin was born in 1896 at Cardross in Dunbartonshire and as a schoolboy exhibited a talent for writing at Dumbarton Academy. Torn between a career in the church or medicine he said he chose the lesser of two evils, so medicine it was. He won a Carnegie scholarship and graduated from Glasgow University in 1919 and from there went on to obtain further qualifications. He practised medicine in Scotland, England and Wales where he was confronted by life in the raw in a dirty, alien village smothered in coal dust and scarred by distress. He was made Medical Inspector of Mines for Great Britain in 1924 which provided scope for his research into lung diseases brought on by breathing in industrial dust, such as coal dust, and rife among miners. The link seems obvious to us today but it was not when Cronin studied it. Once he found success as a doctor the work seemed to bore him; prescribing medicines and dispensing advice to his then wealthy patients in Harley Street and Notting Hill in London and he abandoned his medical practice for life back in Scotland to try his hand at writing.

Cronin’s itchy feet saw him move to more places around the world than there is room for here. He became a major name in the world of celebrity and wealthy as Croesus and I suppose it is an irony that he made his money from his gritty depictions of the powerless and exploited during some of Britain’s bleakest and most impoverished times. While not great literary works Cronin’s easy style of writing and his eye for detail makes reading his books a pleasure rarely a chore.

stars look down

I know one or two people, all male, who never – that’s never ever- read books. Literature is not only an enjoyable (mostly) pastime it is a vehicle to encounter experiences we would otherwise never know about. It offers us opportunities to confront issues in a palatable way which might alter our preconceptions. I hope some of you will pick up a Cronin novel – I recommend The Stars Look Down and be prepared to have your eyes opened to a world that is hard to imagine today. In the meantime when you next visit the doctor or are admitted to hospital spare a thought for how the NHS came about and worry that its days might be numbered in which case we might all be closer than we’d like to experiencing the pre-NHS world of Cronin’s sick and vulnerable patients.

February 20, 2017

British-American Project – grooming leaders

You will all be familiar with the British-American Project. No? Here’s a clue – it is a British/American networking organisation sponsored by several well-known businesses including Monsanto, Philip Morris (tobacco), Apple, British Airways, BP Coca-Cola, Unilever.

In the words of BAP:

“The British-American Project is a transatlantic fellowship of over 1,200 leaders, rising stars and opinion formers from a broad spectrum of occupations, backgrounds and political views. It is an extraordinarily diverse network of high-achievers on rising career paths in public, professional and business life.

naughtie

BAP operates on a not-for-profit basis, funded through its membership and a small amount of support from corporate partners. We also receive support in kind from a number of bodies [see above] who share our values and objectives.”

 In 2007 the journalist John Pilger wrote that:

‘The BAP rarely gets publicity, which may have something to do with the high proportion of journalists who are alumni. Prominent BAP journalists are David LipseyYasmin Alibhai-Brown and assorted Murdochites. The BBC is well represented. On the Today programmeJames Naughtie, whose broadcasting has long reflected his own transatlantic interests, has been an alumnus since 1989. Today’s newest voice, Evan Davis, formerly the BBC’s zealous economics editor, is a member. And at the top of the BAP website home page is a photograph of Jeremy Paxman and his endorsement. “A marvellous way of meeting a varied cross-section of transatlantic friends,” says he’[21].

BAP has been described as a Trojan horse for American foreign policy/business/influence in the world – the Special Relationship grown large. I’ve read it has folded yet its website is still up and BAP’s annual conference is advertised for Newcastle later this year so it looks as though it is alive and kicking.

Untitled.jpg

The Labour Party features largely, New Labour’s usual suspects, along with several Conservatives and assorted others. Tony Blair, not a member, described BAP as a wide-ranging pro-active organisation for “young leaders.”

Wendy Alexander, remember her? was one of those expected to take on a leadership role. Blink and you would have missed her leadership of Labour in Scotland but get there she did.

“BAP network …committed to “grooming leaders”

“Casual freemasonry” was Pilger’s description – and “by far the most influential transatlantic network of politicians, journalists and academics.”

isabel-hilton

It appears this self-selective organisation of like-minded people who saw themselves as movers and shakers able to influence all of our lives and mould attitudes relating to politics, culture, trade, defence, war and so on grew out of an idea of the late US president Ronald Reagan to develop a network of co-operation between the UK and America then developed by Sir Charles Villiers (Etonian banker and former member of Special Operations Executive) and Lewis Van Dusen. This was no peace organisation, very anti-CND.

“In the summer of 1997, a few weeks after New Labour won power, a striking article about the election appeared in a privately circulated newsletter. Under the cryptic headline Big Swing To BAP, the article began, “No less than four British-American Project fellows and one advisory board member have been appointed to ministerial posts in the new Labour government.” A list of the names of these five people and of other New Labour appointees who were members of BAP followed: “Mo Mowlam … Chris Smith … Peter Mandelson … Baroness Symons … George Robertson … Jonathan Powell … Geoff Mulgan … Matthew Taylor …” The article ended with a self-congratulatory flourish and the names of two more notable BAP members: “James Naughtie and Jeremy Paxman gave them all a hard time on BBC radio and television. Other fellows, too numerous to list, popped up throughout the national media commenting, criticising and celebrating.”

https://www.theguardian.com/world/2004/nov/06/usa.politics1

In 2003 John Pilger noted that “Five members of Blair’s first cabinet, along with his chief of staff, Jonathan Powell, were members of the British American Project for a Successor Generation, a masonry of chosen politicians and journalists, conceived by the far-right oil baron J. Howard Pew and launched by Ronald Reagan and Rupert Murdoch.” 

In the beginning advisory boards were established in the US and Britain through the School of Advanced International Studies (SAIS) of the Johns Hopkins University, Washington DC in the US and in Britain the rightwing Royal Institute of International Affairs at Chatham House in London currently headed by Eliz Manningham-Buller, former DG of the Security Services. Former presidents include Douglas Hurd, George Robertson and Paddy Ashdown.  It describes itself as ‘independent’ and not funded by government-

“The institute receives no subsidy from the UK government or any other source.” although, curiously, among its funders, those who do not wish to remain anonymous, is the British Army, Ministry of Defence and the BBC.

The BBC? Explains why it uses is so much in its news reports. Isn’t there a question over BBC’s independence when it pays into this think tank? How many others does it help fund?

See more at:

https://www.chathamhouse.org/sites/files/chathamhouse/Fundingbands15-16A.pdf

Let’s cut to the chase – who are/were some of these anointed if not by predestination then something not dissimilar?

imgres

Apart from Wendy Alexander, sister of former Labour foreign and trade minister, Douglas Alexander, other alumni include – well, Douglas Alexander, Labour Party Foreign and Trade minister; Stephen Dorrell, former Conservative minister; Alan Sked founder of Ukip, David Miliband, Labour Party; Baron Mandelson, Labour Party, EU trade commissioner; Baron Robertson of Port Ellen, ex-Labour Party Minister, Adviser to BP, on Board of Equilibrium Gulf Ltd; Baroness Symons, Labour Party former Foreign Office minister; Jonathan Powell, Labour Party former chief of staff to Blair;  Baroness Scotland, Labour Home Office minister; Geoff Mulgan, former head of Downing Street’s policy and strategy unit; Sadiq Khan, Labour Party, Mayor of London; Matthew Taylor, Downing Street head of policy; David Willetts, Conservative minister; journalists Jeremy Paxman, BBC; Evan Davis, BBC; James Naughtie, BBC; William Crawley, BBC; Jane Hill, BBC; Ben Hammersley, BBC; Trevor Phillips, BBC; Isabel Hilton, BBC, the Independent, the Guardian; Margaret Hill, BBC producer of current affairs; Yasmin Alibhai-Brown, The Independent, London Evening Standard; Charles Moore, Daily Telegraph, Sunday Telegraph, The Spectator; Rowan Pelling, Daily Telegraph and many, many more.

bbc-employee

BAP was designed to be an active professional networking medium for young professionals so many in the list above will have dropped out to be replaced by the future. And on the subject of the future at a time when there is great concern at the erosion of the NHS and the prospect of the Transatlantic Trade and Investment Partnership aka TTIP I think there are reasons to be very worried indeed over this close and cagey liaison.

 http://powerbase.info/index.php/British_American_Project

https://www.theguardian.com/world/2004/nov/06/usa.politics1

 http://www.britishamericanproject.org/

October 15, 2014

A man, a dodgy arm and the NHS

The experience of a friend today – I haven’t used his name in case a mad medic attacks his dodgy army with something sharp.

By the way he’s at pains to point out he’s a supporter of the NHS but not the people populating Health Boards.

‘I think I’ve discovered ONE reason why the NHS is losing money. I got a letter this morning saying they’d been trying to contact me about an appointment at Woodend Hospital and would I contact them to find out why I wasn’t available on the phone.

I phoned the NHS and told them that the reason I hadn’t been available on the phone was because I hadn’t received any phone message from the NHS about any appointment. I said that if nobody left a message asking me to call them, it was unlikely I would somehow intuit* (*look it up) that the NHS was trying to contact me.

I added that, if the NHS was calling me from a withheld number (which was highly fucking likely) they wouldn’t get an answer because I get umpteen telemarketing calls ever week from withheld numbers so I never answer those type of calls.

Agreeing that it seemed a pretty stupid idea to phone folk and not leave a message, the NHS person then asked me what the problem was that they had been phoning me about. It seems they had lost/mislaid/eaten the letter from my GP about the trapped nerve in my left arm which has been causing me discomfort for several months. We eventually decided that someone should see me about this problem and I was asked if I’d like to travel to Edinburgh for a swift consult.

I said I wouldn’t, so I was then told that I would remain on Grampian Health Board’s waiting list but that it might take several months before a letter is sent out with an appointment date.

I said this was OK but would they mind not phoning me about it and not leaving a message until I have completed my training as a psychic.’

Tags: , ,
July 10, 2014

Vote No and we lose our free NHS in Scotland: leading surgeon speaks out

March 25, 2014

Reasons to Vote Yes: Privatisation and the NHS

Private businesses operating within the National Health Service must be pretty pleased with how policies pushed by successive governments at Westminster have allowed their interests to flourish. Why would they not be? Opportunities in this area of social provision are staggering and perfect to boost company profits. Shareholders must be drooling at the prospect.

There was a time when those responsible for safeguarding and running the NHS – politicians – were proud to declare it the best health service in the world  and one of the greatest achievements in history – and some still do though what they mean by this now is less clear. The NHS became something of a sacred cow – a marker for how civilised the UK was compared with other countries with their piecemeal services based on health insurance and unequal access to care.  

You don’t hear so much of that now – now that the NHS is steadily heading towards the American health care model – the steady incursion of private providers such as Serco and Circle increasingly managing aspects of public health care.  Serco’s expertise takes in everything from nuclear weapons to health. Circle, established by former banker Ali Parsa,  is run along mutual lines with doctors holding a stake in the business.  I should point out in passing that just last week Serco’s finance director of outsourcing was on the point of resigning over a financial scandal involving the government.

National Health Service

In 1948 the NHS was started as a comprehensive health and rehabilitation service for the prevention and cure of diseases  in response to the miserable health provision available to the majority of people in the UK. The NHS was established as free at the point of delivery and available to all, paid for by the people through public taxation.

We all know how successful the NHS proved to be, and rather than fewer people accessing its services the healthier the population became, the scale and variety of specialist care led to increasing numbers turning to the NHS with issues never envisaged at its initiation e.g. IVF treatment for fertility problems and gastric bypasses.

When a national health service was proposed opposition from some quarters, notably well-off doctors who feared a loss of income through restrictions on private practice, were well aired. For most ordinary people, however, the NHS was welcomed and proved a revelation. Lives were saved and improved enormously. It is not possible for any of us in the UK today who didn’t live through the years before 1948 to fully comprehend the awful misery inflicted on the poor having to make choices between paying out paltry earnings on keeping a roof over their heads, putting something in their bellies or paying for essential medical treatment.

Over the last half century the lives of people in the UK have been transformed by the opportunities for decent care provided by the National Health Service and life expectancy as a result has risen by around 10 years.

The cost of upkeep of the NHS has also risen year on year which is why Westminster governments have looked to ways of offsetting some of that financial burden  onto the private sector – outsourcing to private companies to manage aspects of care. The private sector is regarded by some as more efficient than the public. That efficiency does come at a price – private is more ruthless in regards to its employees but it is not per se any better at the job it does although it does bring in alternative means of funding such as raising cash through shareholders.

So where is the NHS heading?

I fear that in England there is little chance of what today we would recognise as the NHS still being around in another 10 to 15 years time with increasing numbers of health trusts outsourcing multi-million pound contracts on the open market for everything from mental health provision to tests and diagnosis. In Scotland things are a little different. Here there has been strong resistance to interfering with what is regarded as a vital system of health care.

But in England there is a different perspective, from government at least. A choice between direct infusion of funds into the NHS or outsourcing to the private sector has come down firmly in favour of private. Austerity measures drive this to an extent, it is argued, but that doesn’t wash in a country that supports Trident. Funding for the NHS is ideologically driven and pretty well shared by Labour, Conservative and Liberal Democrats.

England’s move into privatisation will no doubt lead to patients becoming clients and will be accompanied by the well-rehearsed refrain of those clients being provided with greater choices over their care. That  great myth of choice and the right to choose – such choices are always conditional in such circumstances.  The concept of choice so loved by rightwing commentators from both Labour and Conservative sides is not absolute – in some areas there will never be real choices of provision and moreover choice is mainly exercised by the wealthy and the middle classes creating gulfs in what was once a fairly equitable health service.  

A health care system operated by the markets will have as its number one goal, irrespective of claims from business people and politicians (sometimes the same people), the company’s profits.  Why would they not? That after all is their raison d’être.

Why are privately operated companies more likely to employ temporary rather than permanent employees? How does having transitory staff in hospitals fit in with putting the patients’ interests first?

Any private health care business will think carefully about where it operates to try to ensure success. Their bottom line is never going to be the service to be provided irrespective of cost. So what happens to the universal provision of care – does it become ghettoised? Like schools? Replacing the notion of universal care for competition at the heart of health planning has meant private providers are able to get more snouts into more troughs of readily available public cash.

In these so-called times of austerity NHS budgets are squeezed. Deciding that aspects of NHS care should be opened up to private companies is a political decision. It is dressed up as opportunities to improve care through competition therefore enabling ‘best value’ for patients or taxpayers or whoever – ie us. The slick, market-oriented operators breathing down the necks of cash-strapped health trusts are having a field day.

A second rate service provided by the state as a kind of safety net for the socially excluded and those not willing or capable of exercising their choices  will probably jog along for a time but the best service, the one that will be held up at election times as epitomising the best of British, will be that which is used by the better-off and the determined or pushy.

Of the billions of pounds paid out by UK taxpayers to provide essential services much will be siphoned off to pay for outsourced services from enterprising agencies and this is a national disgrace.  

Such a trend has meant ‘putting multinational companies in the driving seat of the NHS,’ according to former health secretary Frank Dobson. He was talking about the Labour government’s push to contract out to private and third sector providers.

Health care in England is being transformed and unlike the public body that is the NHS private enterprise does not have a duty to provide a comprehensive range of services only ‘such services or facilities as it considers appropriate.’

 

Who then is making decisions about health priorities in the UK?

Circle’s profits have risen from £170.3million to £192.7million encouraging the company to build more private hospitals in England. It and Capita (the UK’s biggest outsourcing company which earns half its turnover from the public sector) expect to continue to pick up contracts from NHS trusts whose incomes are stretched to breaking point. Privatisation in England is there to stay – hospitals and clinics springing up in Cambridgeshire, Manchester, Birmingham, Bedfordshire, Nuneaton, Bath, Reading – anywhere and everywhere.

For those who judge the NHS by the state of its waiting rooms and chipped paint corridors such rampant privatisation will be just what the doctor ordered. For those who recognise that each time a contract is put out to tender and won by a company operating for profit another part of the NHS is being undermined. At some point the whole edifice will go in all but name with implications for staff as well as patients. Actually the terminology has already changed from National Health Service with all that suggests to healthcare market.

Health care is devolved thank goodness. In Scotland at present the SNP government is adamant that the structure of the NHS is safe and there are no moves into the kind of health privatisation happening in England.

I don’t think we should be complacent however. Scotland has seen examples of reckless behaviour from Holyrood. In 2005 when Scottish Labour was in coalition with the Scottish Liberal Democrats Andy Kerr then Minister for Health and Community Care announced a Scottish Regional Treatment Centre pilot at Stracathro funded under PPI which was duly opened in a blaze of publicity in 2007 by Jack McConnell then First Minister. The white elephant of the Golden Jubilee National hospital in Clydebank also established under New Labour had to be bought by the NHS.

While both the Scottish National Party and the Green Party in Holyrood have stated opposition to any privatisation of clinical services in Scotland’s NHS  there must be a question mark over what will happen in the future if Scottish Labour and the Liberal Democrats and Tories (those two in coalition presumably) get back into power.

 http://www.keepournhspublic.com/pdf/SRTCshort.pdf

Scottish Labour and the Scottish Liberal Democrats  have been criticised for their underhand methods when it comes to privatising health care – omitting mention of it in their election manifestos.  The Labour Party, very keen on Public Private Initiates, did include references to mixing private and public health care in its Westminster manifesto of 2005 – all in the guise of providing better, ‘more quality healthcare’ to ‘expand provision’ and ‘reduce waiting times’ but there was nothing in its Scottish manifesto before setting up the pilot at Stracathro and the National Waiting Times Centre later renamed Golden Jubilee National hospital –  all £180million of it built in 1994 and having consequently failed, bought by the public purse as an NHS hospital in 2002.

John Reid one-time Health Secretary at Westminster under Tony Blair tried to persuade Scots the ‘the medical market place’ was the way to go. Reid would no doubt welcome chief executive of LaingBusiness (a so-called healthcare intelligence company) William Laing’s observation that Circle’s success is ‘significant for all private sector providers to the NHS.

There doesn’t seem any way back for the NHS in England but here in Scotland we have a chance to hold onto what has proved an excellent provision for the past 60 plus years. Voting no in the referendum will put Scotland’s NHS at risk of going the way of England’s. It’s time for people to wake up to the real danger of losing this brilliant health service.

A positive vote for independence is the only chance we have to retain our universal health service, free at the point of use. Use your vote well.