Tag Archives: austerity

Newspeak and the NHS

NHSpace is fed up with the various catchphrases used by the government and the media to spin stories about the NHS. Here are our top five, handily debunked and translated.

1 – Excessive demand / high bed usage

The NHS has seen a steady reduction in the number of inpatient beds, whereas the population has steadily risen and social care needs upon discharge have increased.

The overall number of ‘finished admission episodes‘ has increased by 2-3% each year, in a reasonably predictable manner. The same goes for emergency admissions, and the recently reported ‘unprecedented increase’ in emergencies is again only a 3% rise.

When the government say that hospitals are under strain from unprecedented demand, they actually mean unprecedented bed reductions and a lack of social care. If social care was properly funded then many patients could be discharged from hospital in a more timely fashion. And rather than year-on-year cuts, bed numbers need to at least increase in line with the population (around 1% each year).

2 – Overspending / hospitals in debt

The NHS budget has fallen in recent years, in real terms. We also spend less per head of population on healthcare than many other westernised countries. It should be clear that hospitals aren’t overspending, but are actually spending less than they should on their patients, all thanks to significant underfunding.

But the story goes further than that. To whom are the hospitals in debt? “The government had to lend cash-strapped hospitals a record £2.825bn in the last financial year” the Guardian reported in July this year. So state-funded hospitals are in debt to the state. Regardless of the fact that hospitals are being turned into independent businesses, they are still really underfunded rather than being in debt.

3 – No money left

The UK government cannot actually run out of money per se. If they spend too much and don’t apply enough taxation, then inflation will rise, but an increase in NHS funding doesn’t have to mean an immediate ‘NHS tax’. (Government spending is a matter of macroeconomics, and isn’t like a household budget.) The government could choose to provide an additional investment in our NHS in order to bring NHS funding in line with our European neighbours.

Every additional £1 spent on the NHS would boost the economy by £3 by supporting jobs and keeping people healthy. That means a £30bn injection of funding, which would represent a 3.8% of GDP increase in state spending, could increase the UK’s GDP by 4.4%. And this is nothing compared to what the King’s Fund think we could support. Their analysis suggests that, in the next few decades, the NHS could be funded to a much greater extent and still be affordable.

So far from there being no money left, the government could invest in the NHS and reap the economic rewards. Instead there is a political choice not to spend.

4 – 7 day NHS / weekend effect

The NHS is already open on weekends, and most specialties have consultants on-call and doctors on-site 24/7.

Hunt’s 7-day NHS is actually part of a top-down reform, pushed upon doctors at a time when government-enforced cuts mean that the NHS is already stretched too far. Forcing staff to work longer hours whilst using STP hospital closure plans to close departments isn’t safe, so Hunt needed a stick to beat them with.

This is where the weekend effect came in. A study commissioned by Hunt’s department, interpreted wrongly by Hunt, and quoted in press releases before it was even published, was used to attack doctors for working safe hours. How dare they only work one-in-four weekends when Hunt had proof that patients were coming to harm? But, as academics have revealed, Hunt’s weekend effect was based on flawed data and a downright flawed interpretation.

With his weekend effect rubbished, Hunt is now trying to make the conversation about doctors’ salaries, when in fact it’s about overstretching an understaffed service.

5 – Sustainability and Transformation

The Sustainability and Transformation Plans are supposedly about creating a modernised NHS. In reality, sustainability actually means financial restrictions and transformation means enforced closures and outsourcing. Any NHS organisation failing to follow the STPs will be denied what little new funding there is to be had, and will face a ‘failure regime’.

The end game here is for the government to whittle the NHS down into an basics-only service with a few large hospitals offering emergency and major illness care only. A two tier system will emerge, where a significant amount of routine care will be available privately and not funded by the NHS.

5 Reasons We Can’t Trust The Tories’ Latest NHS Pledge

Dr Louise Irvine, candidate for South West Surrey standing against Health Secretary Jeremy Hunt, tells us why we cannot trust the Conservative Party’s latest NHS pledge:

1 – It’s too woolly

The Tory chancellor George Osborne has pledged “a minimum real-terms increase in NHS funding of £8bn in the next five years”. NHS England CEO Simon Stevens has asked for an increase in funding of £8bn per year by 2020. Given that the National Audit Office had to call out the Tories on claims of ‘real terms growth’ previously, it’s not unfair to suspect the Tories of being deliberately woolly with their wording.

2 – It’s unfunded

This morning ​Jeremy Hunt told the Today Programme the NHS will be funded by “economic confidence”. ​This would be laughable if it weren’t so serious. The Tories want us to look at their record and trust them. This from the party that promised no more top-down reorganisations – and then launched a top-down reorganisation so big it could be seen from ‘outer space’ (words of ex NHS boss David Nicholson). They are unable to tell us where the £12bn welfare spending axe will fall, and now they can’t tell us where the £8bn NHS money will come from either.

3 – It’s unpredictable

The Tories have thus resorted to their mantra: “a strong NHS relies on a strong economy”. So if they fail to deliver a strong economy, where does that leave the NHS? If continuing Tory cuts and austerity measures lead us into so-called “stagflation”, will we just have to cope with a weak economy and a weak NHS?

4 – It’s not enough

Even if the Tories manage to provide £8bn per year by 2020, it won’t be enough. To meet a predicted NHS funding gap of £30bn, the Simon Stevens plan relies on a further £22bn of efficiency savings. That’s 2-3% of the NHS budget saved each year, and is just not feasible.

Firstly, the NHS has already been cut to the bone with the previous £20bn round of savings. Emergency services, general practice and mental health are at breaking point, targets are being missed for routine operations and cancer treatment, thousands of hospital beds axes and scores of A&E departments, maternity units, walk-in centres and ambulance stations have been closed down.

Secondly ability of the NHS to make efficiency savings is “substantially below” previous estimates, averaging at just 0.4% a year over this parliament. This means the scale of efficiency savings needed is genuinely not possible.

5 – It’s spin

First there was that pledge of “no top-down reorganisation of the NHS”. Later, the Tories made claims of protecting and increasing NHS funding. This is pure spin. In real terms, once you take into account inflation, our increasing and ageing population, the cost of new drugs, and lifestyle factors, the Tories have actually cut NHS funding. Plus there are massive knock-on effects on the NHS from savage social care cuts due to the Tory axing of local authority funding.​ The Tories tell us they’ve increased doctors and nurses but there’s actually been a fall in real terms when you take into account the population increase.

No Child Wasted: Why We Have A Responsibility To Vote

An NHS campaigner shares their thoughts on why it is vital to exercise our right to vote.

Children can’t vote. So they rely on the rest of us to cast ou​r votes in a way that will protect them. Protect them from hunger, deprivation, exploitation, lack of hope, so that they can grow up healthy, happy and productive. And therefore able, in their turn, to exercise the same protection for the next generation. That is why voting is not just a privilege of adulthood but a responsibility – however onerous and frustrating it may be.

Most of us in Britain have grown up protected, at least in principle, by a system that was created after the Second World War to ensure that no child should ever again be wasted – as poverty, ill-health and inequality had wasted British children by the million in generations gone by.

After 1948, a child born in the NHS would be nurtured and cared for – free – until he or she reached adulthood. Would be educated – free – to reach their full potential as citizens. And, if his or her potential was such, would be supported through a – free – university education. And when these children had children of their own, they too would all have access to decent housing – privately or council-owned – regular employment and world-class healthcare, free at the point of need.

In this way, it was hoped, no child in the post-war world would suffer the full effects of the poverty or disability or death or separation of their parents. No child would be penalised for their parents’ inability to advance the career of their children through their own wealth and contacts.

A terrible war had shown that every person had something to offer; henceforth no child would be wasted. That was the promise the post-war Welfare State made to all the people who had fought, together, for freedom against the forces of darkness and destruction.

It wan’t a promise that was always fulfilled by any means. But for the passage of a generation there was no real challenge to the idea that the protection of all our children, collectively undertaken and collectively paid for, was a noble – a sacred – trust.

But then, even as the nation as a whole became richer, a new force, a new idea, started to gain ground in some elevated circles, which argued, “Why should the rich and powerful pay to put their children on a level playing field with the children of the poor?” This was not an electoral pitch that would gain sufficient votes to secure power from the necessary non-rich of course, so it had to be couched by the grandees in slightly different terms if it was to appeal to the masses.

The appeal to selfishness of, “Why should you pay to support the well-being, and the prospects, of someone else’s child?” – which attracted the immediate, obvious, riposte of mutual benefit and therefore greater security for all – also required that the “someone else” be demonised in order to work to an electoral asset. Demonised as foreigners wherever possible of course but, as Enoch Powell showed, that could be counterproductive. However no one seemed to have any interest in defending the foreigner within – the “undeserving poor” of the Victorian era, now revived and reinvented to play The Other again in right-wing demonology.

The more recent pejorative of “council-house kid” was clearly no longer of any use as an alienation tool once doctors, lawyers, movie stars and Cabinet ministers nurtured by the Welfare State could boast proudly of having been a council-house kid themselves (thus showing that it was nurture, not nature that had kept the poor down for so long). But, in this new vision, anyone who was lucky enough to secure one of the deliberately dwindling supply of council houses was to be envied by many, and so could be dubbed with the working-class insult “scrounger” – and if they could be shown to be foreign too, so much the better.

And, even if not literally foreign, they could be made to seem so. With the eager assistance of a crass and compliant media, the affectionate chavi, meaning child in the Romani language, quickly became a viral hit of hatred that dubbed the disadvantaged child as a separate nationality, confirming just how alien it was to respectable society: The Chav. Even if they had money, and few did, they spent it on the wrong things, the wrong clothes, the wrong food, the wrong home gadgets. So there was no point in taxing away your hard-earned money just to waste it on a Chav child.

Even before the coining of the term ‘Chav’, the groundwork for this was well-laid. In 1974, Sir Keith Joseph warned that “our human stock is threatened” by the breeding of young mothers in social classes 4 and 5. Where once our proud British commitment was to every child that was born,now we were told that: “A high proportion of these births are a tragedy for the mother, the child and for us.”

And by the time these “tragedies” had reached the age of 11, their educational future was in the hands of this same Sir Keith Joseph. It had been placed there by Margaret Thatcher who, in her own “milk-snatcher” days at Education had, according to Cabinet minutes: “Said that she had been able to offer the Chief Secretary, Treasury, rather larger savings than he had sought on school meals, school milk, further education and library charges.”

And it was Thatcher who, as Prime Minister, destroyed our manufacturing base in which so many of these “tragedies” one day hoped to work, sold off our houses in which they one day hoped to live and raise a family, and gave away our national and municipal assets that served to keep those families’ needs within the reach of a single living wage.

A consensus on the utter worthlessness of The Others was built up through a co-operative media under the governments of Margaret Thatcher and John Major, but did not die with the massive public rejection of Toryism in 1997. Tragically, it remained largely unchallenged through the ruthlessly vote-chasing years of New Labour, which abandoned Old Labour’s principles of solidarity for its “hard-working families” mantra. For reasons of its own, the party machine shunned association with the millions cast to the bottom of the pile by unemployment – even in areas strip-mined of employment by Tory policies.

By the time New Labour collapsed in a morass of unregulated bankers, super-casinos and ID cards, even Dave “hug a hoodie” Cameron and Nick “scrap tuition fees“ Clegg offered a more hopeful and humane vision to a wavering, betrayed and bewildered electorate.

Once in power, of course, it was business as usual with the likes of Lansley and Duncan-Smith unleashing a venomous assault on The Others that Thatcher and Joseph could have only dreamed of.

Money is drained from the budgets of the poorest families with a VAT hike that subsid​is​es a cut in the higher tax income rate for the rich. Money is drained from the education of all our children to subsidise the education of those in new, privately run “academies”. Money is drained from the benefits safety-net we all pay into, in order to subsidise corporation tax cuts for below-living-wage employers. Money is drained from our National Health System to subsidise tax-dodging corporations who spy a profit to be made by taking small bites out of it, and who walk away leaving a service bleeding if it turns out there isn’t.

In 2015, the ranks of The Others are now bursting at the seams and, it seems, could soon encompass us all. If you are a child whose parents are unemployed, you’re in. If they are working, you still have a pretty good chance of being in. If they – or you – are disabled or have mental health needs then you are definitely in.

And even if you are not included in the ranks of The Others today, your prospects of staying out for long are dwindling fast. By 2020, on this government’s own figures, 21% of British children will be living in absolute – not relative – poverty, up from 17%  in 2010-11.

So take five children: one will live in a financially secure home 2020 (so long as it is spared family bereavement or bankruptcy); one will be in absolute poverty (and possibly homeless); the other three teeter somewhere between, hopeful to rise and fearful to fall.

Currently, at least all five would be guaranteed the very best medical care available, free at the point of need, through our NHS – although hunger and poor housing would put some in more need of it than others. In 2020 that may no longer be so. In a Britain incalculably richer than the one that set up the Welfare State, it seems we will no longer be able to afford, as they did, to give them even an equal chance to be born healthy.

Already we can see how, as in Morecambe, the drive to marketise the NHS has helped to cause the actual deaths of actual babies. Get used to it. As the drive to privatise our National Health System drains more and more money from what it offers,​ free and equal to all, and pushes more and more services into ability-to-pay disparity, this will only get worse.

And, horribly, all that this Labour Party seems to be offering is that it will all get worse a fraction more slowly.

But look back to the beginning of this article and to the commitment that the post-war Labour government made to all the children of Britain – born and yet-to-be – in 1948. If it still seems to be as sane, humane and worthwhile a commitment to you as it seems to us, then all you have to do is vote for it to bring it back into our national life. Not just in the coming general election, but there and within your union and within any other bodies you belong to and with your feet and with your voice and on the streets and wherever you can make yourself heard.

How can it make sense to vote for anything else?

We need democratic reform – urgently

Deborah Harrington gives us her view on the current two party system.

If there are only two parties which can achieve power in the current system then, even if Labour is successful in 2015, we will inevitably revert to a Tory government at a future date. And this need not even be a Tory majority – by forming a coalition with a smaller party, the Tories are willing to lever themselves into power from a minority position. Whenever they do return, they will wreak havoc on the NHS and the Welfare State. The civil service is smaller now than at any time since 1948 and the Tories have sold off 20% of all our public land and assets in the last 4 years. We are running out of things to save.

If the predictions of another market crash in the next couple of years are true and Labour is in government then, as far as the public and the Tory spin machine are concerned, Labour will be held responsible for two successive crashes. That leads to the real possibility of a Tory government being returned in 2020.

The main thrust of much of Labour’s politics at the moment appears to be ‘we’re not the Tories’. That seems to me to be an absolute argument for political reform. Give us a parliament with more Independents, more Greens, SNP and Plaid, to represent the major environmental concerns and devolution/local agenda issues. Let’s have some political presence to really represent the NHS, and Left Unity and TUSC to stand up for the working classes, the unemployed and the disabled. Let’s have a politics where voters feel they can choose the party they agree with, not just the party that ‘isn’t the Tories’.

I would like to vote for a party that has solid core principles. At the moment the Labour Party has substituted ‘compassion’ for social justice. Not the same thing at all. Until – or unless – it regains its senses I hope all left wing voters will opt for getting together behind whichever candidate genuinely best represents their views, regardless of party (although I assume Tory and UKIP are not in the running for those votes in any circumstance whatsoever!).

I shall be thinking of the future when I cast my vote this year, not just about the short term. I hope you do too.

Who Is To Blame?

In this week’s Question Time, Farage and Brand squared off, each making it clear whom they thought was to blame for the nation’s woes. Like the broken record he is, Farage blamed immigration for every conceivable ill that might have befallen Middle England. Brand, on the other hand, blamed the politicians for letting the rich stash away large amounts of cash whilst the poor live hand-to-mouth.

Who is really to blame? In such a complex society as ours, are we really able to single out one group and place all the blame upon them? It’s easy to see that Farage’s rhetoric is hollow – he is scapegoating a minority to further his career as a populist right-winger.  But does Brand really mean to say that the political classes are the only ones to blame, and that no-one else could change our ailing society?

That is the self-fulfilling prophecy at the roots of our corrupt modern politics – if we all believe strongly enough that there is nothing we can do, and that everything is the fault of ‘the bankers’ or ‘the politicians’, then it becomes a reality. If we allow it, then our political establishment will run away with itself, unchecked, unjust, and unstoppable.

The people never give up their liberties but under some delusion.

All that is necessary for the triumph of evil is that good men do nothing.

When bad men combine, the good must associate; else they will fall one by one, an unpitied sacrifice in a contemptible struggle.

These remarks from the very quotable Edmund Burke are all you should need to convince yourself that there is another way. Our society has been through so many changes, moving from feudalism all the way to universal suffrage. It is in our genes, in our very lifeblood to be the ‘good’ of which Burke speaks. It is for us to rail against any system which deprives individuals of their rights and liberties.

To do otherwise would be to accept a share of the blame.

So, dear reader, I put it to you: do not seek simply to blame others for what is happening to our society. Do not fall into the illusion that politics is for other people, and that you might merely watch from the sidelines. Stand for what you believe in, or else share the blame for its failure.

Why Abolish Tuition Fees?

Until 1998, there wasn’t such a thing as a fee for going to university. Higher education was free and accessible to all, regardless of economic background. Then things changed.

Although the inquiry into tuition fees was launched by John Major’s Conservative government, it was a Tony Blair’s Labour government that voted to introduce fees of up to £1,000 per year. Future Mayor of London Ken Livingstone reportedly accused Labour of “whipping away a ladder of opportunity which they themselves had climbed”. Labour stated in their 2001 manifesto that they would “not introduce top-up fees”, but in 2004 raised the fee limit to £3,000 per year. And while it was the Conservatives and Liberal Democrats who subsequently raised the limit to £9,000 in 2010, they acted on the findings of a report commissioned by Gordon Brown’s Labour government.

Labour are supposedly promising to cut fees to £6,000 per year, but if Nick Clegg’s previous empty pledge not to raise tuition fees is anything to go by then we shouldn’t hold our breath. Regardless, the National Health Action Party believes that the government should end tuition fees entirely, as has already been done in Scotland and in Germany. But why should we abolish tuition fees? Here are a few reasons:

  • Equal access – if you believed what some Tory candidates have said in the past, then your children apparently need to come from a rich, private school background in order to get a university place. Historically this has been complete nonsense, with a combination of free higher education and grants for poorer students allowing everyone access to university. Now, an Ipsos Mori poll has found that the increase in tuition fees is putting off the majority of students from disadvantaged backgrounds from applying. To have a strong, healthy society, higher education cannot be the preserve of the rich – universities must be accessible to all.
  • The graduate premium – it is often claimed that graduates from university enjoy an overall increase in lifetime earnings of up to £100k, thanks to their increased earning potential. This ‘graduate premium’ is calculated based on various assumptions – that the student spends three years in university and then gets a job commensurate with their degree on leaving university. There are many obvious exceptions, such as medics and vets who spend at least five years at university, and teachers and nurses whose starting salaries may not reflect their level of education. Even for those who enter a high-earning job straight out of university, the graduate premium is already shrinking thanks to rising fees and competition from an ever-growing body of fellow students. Is it really fair to sell students a dream of a better future, then leave them saddled with debts while they struggle as an over-qualified employee of the catering or retail sector?
  • Affordability – as mentioned, fees didn’t exist in the UK until 1998, and Scotland has already done away with them entirely. And believe it or not, it was a conservative government in Germany who abolished fees after only a brief flirtation with the idea of charging. Both countries recognise that free higher education is entirely affordable, and that charging students to go to university is both unfair and deeply unpopular.