Tag Archives: economy

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 Need A General Election

NHSpace looks at the arguments for calling a snap general election this autumn.

1 – The Country Dislikes ‘Unelected’ Leaders

When Gordon Brown took over the premiership in 2007, there were moans from the press that he was ‘unelected’. This wasn’t strictly true. Brown had been elected by his constituency, inherited the role of Labour leader from Tony Blair, and had been invited by the Queen to form a government. However, he lacked the mandate that many leaders gain by leading their party through a general election. George Osborne later stated that such leaders lack democratic legitimacy, and William Hague claimed that such leaders are “unacceptable” to the majority of the public. Of course they were talking about Brown; they may not feel the same way when the boot is on the other foot.

2 – Cameron and Johnson Have Abdicated Control

Having lost the EU referendum, David Cameron found himself lacking the legitimacy to continue leading the country. But his Brexit counterpart Boris Johnson has pulled out of the Tory leadership race, apparently knifed in the back by the charmless Michael Gove. The favourite for the leadership is now Theresa May, who backed the Remain campaign. With the options for Tory leader now consisting of Remainers and second-tier Leave figures, the public is unlikely to be happy whatever the result.

3 – There Was No Brexit Manifesto

Despite making a range of promises regarding NHS funding, immigration and the single market, the Leave campaign did not have a formal manifesto. (Since the referendum, they have in fact gone back on several promises and deleted almost all the content from their campaign website.) The manifesto on which the Tories were elected last year also did not detail how they would manage a Brexit vote. Nobody in Westminster has a specific mandate from the public on how to deal with Brexit. The public should now be given a chance to elect MPs based upon their plans to deal with the referendum outcome.

4 – The Country Needs Certainty

The Brexit vote has plunged the country into uncertainty. The country is currently leaderless, nobody is certain if or when Article 50 will be triggered, and the markets have responded by plummeting to historic lows. Without a general election, there will continue to be a lack of strong government, and discontent will continue as the country remains divided by the referendum result.

5 – The Public Want An Election

While most are against the idea of a second EU referendum being called, polls indicate that the majority of the British public want a general election this year. This includes 4 out of 10 Leave voters, some of whom feel they were misled by the Brexit campaign claims.

5 Steps For A New Politics

NHSpace looks at five key steps required to achieve true political reform in the UK.

1: Transparent, Evidence-Based Politics

Decisions made by government are often based on political ideology and are not subject to challenges from outside of the Westminster bubble. The result is a system that puts the needs of the government before the needs of the people. What’s needed is an evidence-based approach to politics, where decision making is supported by expert advice and can be transparently justified to the public, without spin.

2: No More Wasted Votes

Unless your favoured candidate won a seat at the last election, you aren’t truly represented in Parliament. With 50% of votes going to losing candidates in last year’s general election, it’s pretty clear that the First Past The Post system is not fit for purpose. We’d like to see a move towards a proportional voting system, so that the wide range of political opinions in this country can be fairly represented in Parliament.

3: A Cleaner Politics

UK politicians are infamous for indulging in self-centred behaviour, as any reader of Private Eye will no doubt be aware. The expenses scandal in 2009 led to some minor reforms, but many problems remain. MPs are permitted to vote on matters despite having vested interests. Parties take large donations from corporations, then hand privatised services to them. And MPs are still free to pass through the “revolving door”, taking jobs from companies in return for political favours. The system is in dire need of reform.

4: Respect For Public Services

Public services in the UK are currently poorly funded and subject to constant political interference. There is little evidence that perennial reforms to healthcare and education have had any beneficial effect, despite costing billions of taxpayers’ money. We believe that public services should be publicly owned, properly funded, and managed at arm’s length from government, by experts rather than politicians.

5: Economic Reform

Political and economic reform are strongly interdependent. The current political system strongly favours the richest 1% of the population, who in return support the two party system. Deregulation has led to a global financial crash and growing inequality. There is a need for economic reform, including greater regulation of the financial sector and an end to the austerity regime. The party also supports a fair living wage and investment in jobs in public services.

United We Stand

Alex Ashman ponders the need for a united left movement.

There are too few houses, because the government don’t build them any more. There are too few jobs, because government austerity is preventing economic growth. The NHS is suffering, because the government refuse to fund it properly.

But with the current system, it is hard to fight back against the government. The 51% win for Brexit looks slim when you consider the 63% who voted against the Tories last year. There was a huge protest vote, with a swing towards the Greens, SNP and UKIP, and yet the Tories remained.

And then people were given another outlet for their discontent. Some of those voting Leave will have done so in protest of the lack of housing, jobs and healthcare, thinking the EU was to blame for their woes. But once more, the government remains the same, and so nothing will change. Who will people blame next, once they realise that the problems are still there? Nationalism is on the rise, and populist right-wingers will continue to blame migrant workers and benefit frauds for all our woes. Just because Farage has won his precious Brexit doesn’t mean he’ll retire and go home. Quite the opposite, in fact.

If ever there were a pressing need for a united left movement, now is the time. Voters protesting against the government need to be offered an alternative narrative. A narrative that recognises that the real villain lies in Westminster, not Calais. A narrative in which austerity is rejected and public services are properly supported. A narrative in which Britain is great because we support each another, instead of blaming one another. Until the left unites, though, the Tories will continue unchecked. Action is needed, and soon.

The NHS Privatisation Bubble

Some investigative work by Private Eye has uncovered a worrying new development in the world of NHS privatisation. Private firms that are failing to turn a profit on NHS work are surviving thanks to the promise of further contracts, thus creating the potential for a huge equity bubble funded by taxpayers’ money.

Until now, we’d assumed that private companies would want to cherry-pick the easier, more profitable work. There’s more money to be had in minor surgery than in complex and unscheduled care, so companies would tend to build surgical centres rather than emergency departments and geriatric wards.

So why, then, are private firms taking on work that doesn’t pay? The answer is that the firms are in many cases owned by hedge funds who make large profits using the money given to the firms by the NHS. This can only continue as long as the firms continue to win new contracts – as the Eye puts it, “private companies losing money from NHS work survive entirely on funding secured on the promise of… yet more NHS work”.

Such a system sounds like a Ponzi scheme, but it also has all the hallmarks of a bubble. Firms desperate to be given more money will take whatever contracts they can get, growing their share of NHS work for as long as they can. If the bubble bursts early on, the firm goes bankrupt and the NHS is left to pick up the pieces. However, if the bubble grows for long enough, these private companies could become too big to fail, leaving the government to choose between a massive bailout and a healthcare collapse.


NHSpace has chosen not to name individual firms, for obvious reasons. You can read about the specifics on page 37 of the current edition of Private Eye (issue 1393).

NHS Funding: The Price Isn’t Right

Here’s an excerpt from an excellent piece on NHS funding by Jonathan Allsopp:

In the midst of the most important election ever for the future of our NHS, the poverty of the debate about the funding of the health service is, at times, astonishing. Too often the NHS is described as “unaffordable” when it was perfectly affordable amidst the ruins of the second world war. Not for the first time there are calls for charging for some NHS services such as GP visits or A&E attendances yet there is barely a mention of the billions spent on propping up the “internal market”.

A 2014 report by the Centre for Health and the Public Interest (CHPI) estimated that the costs of the internal market (with its need for contracts, billing, costing, activity data, computer systems, legal advice etc) at a conservative £5 billion per year. A more likely figure of £10 billion has been suggested by the National Health Action Party.

And this ignores the one-off costs associated with repeated reorganisation and restructuring. The bill for implementing the Health and Social Care Act of 2012 is estimated at more than £3 billion. These are staggering sums of money (as much as 10% of the total NHS budget) that are barely mentioned in any debate around the affordability of the NHS.

You can read the full article on the SHA blog.

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?