Green Party leader Natalie Bennett has identified a series of
actions that need to be taken to save and restore our publicly owned and
publicly run NHS.
Bennett was speaking at the Call 999 for the NHS rally in Darlington
yesterday, organised by a concerned group of local campaigners.
She focused particularly on the need to pass Lord Owen's Bill to
restore the duty of the Secretary of State to provide healthcare, and on
the need to allow commissioners to choose "preferred providers",
removing the pressure to put services out to tender.
Here is the full speech:
I have to begin, by congratulating the organiser of this rally,
Joanna Adams. She’s demonstrated what one person can achieve when they
say ‘I’m not going to take this any more’.
And congratulations to you for being hear to listen, on this glorious sunny day when the park looks so attractive.
Earlier this year, I came down with labyrinthitis, an infection of
the inner ear. It isn’t a serious condition, but it is a rather dramatic
one. The world suddenly started to spin wildly, and I found myself in
the Green Party office, head down on the desk, unable to move.
An ambulance was called, and I was carted down in the lift and out of
the office on a stretcher. As I lay on the trolley in that ambulance, a
kind officer offering reassurance while filling in her paperwork, one
political thought did flash through my head – “at least I’m not in
America”.
I didn’t have to think about the cost of the ambulance, the cost of
the high-tech tests to check I hadn’t had a stroke or didn’t have a
brain tumour. I didn’t have to think of the cost of drugs, or have to
leave hospital before I felt ready because of the bills.
So I was thinking – thank Nye Bevan for the NHS, for the principle,
fought for and won more than six decades ago, of treatment on the basis
of need, free at the point of use.
And, later, when the world had stopped spinning, I thought again, often, of how important it is to defend it.
In common with many healthcare experts, I could see even before it
came into effect that the Tory-Lib Dem government’s Health and Social
Care Bill was the gravest threat that the NHS had ever known.
I, with the rest of the Green Party, joined the campaign against the
pernicious Bill, and Green MP Caroline Lucas voted against it.
And we pointed out the democratic deficit: that voters had not been
presented with this option in any party manifesto, and that 70 MPs and
142 peers - a significant proportion of those voting on the bill - have
or have had financial interests in private health care companies. (And
of course we’ve seen an increasing revolving door between private sector
executives and senior public administrators.)
But on that day in January, on the ambulance trolley, the campaign had a new, real, intensity for me.
It has become horrifically, horribly clear since the Bill was passed
and begun to be put into effect that the worst fears of experts like
the Royal College of General Practitioners and Unison who had opposed
the now Act were entirely correct.
We’ve seen an acceleration of the already extensive privatisation of
health services that began in the Thatcher era and was embraced
wholesale by the last Labour government. A privatisation that saw more
than 100 NHS PFI schemes signed off, with projects valued at £11
billion, and index-linked contracts which are already bankrupting NHS
Trusts. (As many as 70 of these are now owned off-shore, meaning the
profits are beyond the reach of British tax.)
The NHS spent £8.7 billion on private medical services last year, out
of a total budget of £104 billion and that figure is expected to rise
fast. As we heard only this morning from the Guardian, the “biggest
privatisation yet” is set to see a single contract worth £1.1bn let for
“care for older people including end of life care” in Cambridgeshire and
Peterborough.
And the existing NHS services are highly unlikely to be
able to bid for it. Virgin, Serco or Circle, the usual roll call, are
expected to bid to make profits out of care for older people.
The former Labour Government explicitly embraced competition, arguing
that it was needed to make NHS providers more productive - the "grit in
the oyster" argument. But in fact, there’s strong evidence that
cooperation, not competition, delivers the best, most cost-effective,
results for patients.
Furthermore, efficiency savings were imposed on the NHS by way of the
"Nicholson Challenge" and Labour didn't commit to maintaining real term
health spending increases in the 2010 election. The current government
has risen to this so-called challenge with relish, overseeing £20
billion of “efficiency savings” that are really just a transparent fig
leaf for cuts.
We’ve seen a huge push towards private-style structures –
particularly “foundation trusts” - in the public hospitals built with
public funds and often also large charitable donations.
But there’s even worse on the horizon. The drive to soften up the
public for “co-payments” – to end the “free at the point of use”
principle that is the most essential NHS principle at all – has clearly
begun.
In April, Malcolm Grant, chair of NHS England, said he personally
wouldn’t support charging for NHS services. But then went on to say:
“It’s something which a future government will wish to reflect [on],
unless the economy has picked up sufficiently, because we can anticipate
demand for NHS services rising.”
That idea was backed by leader articles in the Financial Times and
Daily Telegraph, which also reflected on the supposed “inevitability”
of charging for NHS services. This week we saw a survey of GPs
encouraging the idea.
BUT – it’s not too late. It’s important to say that loudly and clearly.
The public is increasingly concerned about the state, and fate, of our NHS, despite concerted campaigns to run it down.
We’ve seen a clear attempt to stigmatise, to smear, to attack, the
NHS. Clearly, there are problems – some related to privatisation and
the managerialism brought in by Labour to facilitiate it – Private Eye
pointed out this week that all of the hospitals identified as
problematic either were foundation trusts or were seeking that status.
Some of the problems are related to underfunding, and some related to
real problems of management and organisation. And they cause reasonable
concern.
But it’s also clear that the public fears that privatisation – the
introduction of the profit motive into the NHS – is undermining the very
principles and future of their health service. And they are right!
And so there are five clear steps that we can – and must - take.
First, we must back the National Health Service (Amended Duties and Powers) Bill proposed by Lord Owen in the House of Lords.
Most importantly, in Clause 1, the Bill restores the Secretary of State for Health’s duty to
provide the
NHS in England. (This duty was abolished in 2012 – with responsibility
to determine what is provided free transferred to the new clinical
commissioning groups, which have no public accountability.)
This clause will also restore the duty to promote a comprehensive and
integrated service, which the Coalition split between the NHS
Commissioning Board, clinical commissioning groups, Monitor, and Health
and Wellbeing Boards.
Second, we must allow commissioners to use a public
“preferred provider”,
rather than forcing them to put services out to tender and they must be
allowed to make decisions in the public interest without being called
ant-competitive. After all, we know that private companies – not just
multinational healthcare
companies but also giant feeders at the public
teat such as G4S, A4E, Atos, Serco, Virgin, Circle - can demonstrate
their one great skill and competitive advantage: the ability to make
attractive bids for contracts, yet as we’ve all too often found to our
cost, they are not always so successful at delivering on them.
Third, we can encourage patients to give their GPs notes or
postcards, as provided by the Keep Our NHS Public campaign, expressing
their preference for being treated by public rather than private
providers whenever this is possible.
Fourth, we must demand health funding is maintained. Spending on
health fell in real terms by 0.7% in 2010 and a further 1.2% in 2011.
This must not be forgotten, especially after the Coalition promised to
protect NHS spending from cuts.
Finally, we must challenge every person or organisation that pushes us down the slippery slope towards “co-payments”.
We only have to look to the United States of America to see what we
must avoid. We don’t want to mimic a health system that costs 18% of the
GDP of the world’s wealthiest country, yet puts the US 17
th out of 17 developed countries when ranked on the state of its national health.
We don’t want to emulate a system where vast profits are made by a
few giant companies, which want to cherry pick the easy patients, the
simple operations and conditions, while driving staff wages down and
down, and leaving patients with complex needs and needing high-cost
treatments stranded.
And above all we don’t want to copy a system where your access to the
best health care, be it a good local GP or a specialist cancer surgeon,
is determined by your ability to pay, or by a private healthcare
provider’s decision on whether you meet its criteria for treatment.
We have a system which has worked – provided excellent health care
free at the point of use – for 67 years. We do not want a system in
which the standard of healthcare is dictated by cash, where those able
to pay more are simply less likely to die than those who cannot afford
to.
Let’s join together and say NO.
Let’s restore our publicly owned and publicly operated health system
to the proud state that Nye Bevan intended – the health service that was
established to give every Briton the best possible health care, local
to them, when they need it, driven by a philosophy of care, not profit.
That’s what the Green Party believes in, what we are fighting for and
what we have the genuine principles to deliver. And I know many other
individuals and organisations will too. Let’s join together to rescue
the NHS, and win. The principle of publicly provided healthcare free at
the point of use is just too precious to lose.
