The NHS should provide healthcare free at the point of use and on the basis of need. Despite repeated attacks, and moves to erode this principle — to introduce profit as a major factor — the principle still holds to a large extent.
The NHS is not all we would like it to be, care can sometimes be abysmal. But when professionals decide on the best treatment for a patient it is based on medical facts, not on how expensive the treatment is, or whether the patient is able to afford it. There might be wrangling with budget holders, delays and inconsistencies, but most patients get the appropriate treatment.
With the passing of the government’s Health and Social Care Bill (on 20 March) all that will end — unless we fight to make it unworkable, and build local campaigns and stronger national networks which can stop wholesale privatisation.
The NHS reforms will mean:
* the fragmentation of the NHS, allowing “any willing provider” to provide healthcare;
* private providers “cherry picking” the most profitable services, leaving the NHS struggling to cover the rest, including some of the more chronic conditions;
* the lifting of the cap on the number of private patients that can be treated in NHS facilities;
* responsibility for “commissioning” (not planning) services will lie with groups of GPs.
Cuts to the NHS are increasing the pace of change and will exacerbate the effects of these reforms.
The changes threaten chaos, and chaos in the NHS costs lives.
There are a number of services women depend on, such as maternity care. We are also generally more responsible for providing contraception; care relating to abortions affects us. These services are already under strain.
While birth rates have increased by 18% since 2001, the number of midwives has only increased by 8%.
I am a union rep, and some midwives came to me close to breaking point. They complained of routinely working 14 hours without a break. Under the strain, sickness and bullying was rife. There were conflicts over competency issues because lots of people can’t maintain standards under such conditions.
When I was pregnant, I often found midwives unapproachable, and seemingly uncaring, they just didn’t have the emotional energy to relate to me. But when things went wrong in labour, the staff were all fantastic, and kept me and my baby safe.
Other women’s services are similarly strained. The main response of the Department of Health seems to be to make sure no one talks about it.
CEMACE, a maternity services monitoring body, and a teenage pregnancy group, were both shut down last year straight after publishing scathing reports.
Family planning and sexual health promotion are facing 28% cuts. As the coalition government’s cuts have already decimated these services, it seems unlikely that a profit hungry regime will be keen to invest in them.
We’re likely to see more women paying to get an abortion so they don’t have to wait for more scarce NHS-provided care; poorer working class women will have later abortions.
Women will also be disproportionately affected as workers in the NHS. 77% of NHS staff are women.
Terms and conditions, negotiated by the unions on a national basis, are going to be smashed up. Already foundation hospitals can vary their terms and conditions. A more fragmented NHS will make it harder for unions to negotiate national agreements. The government wants to introduce regional pay rates for public sector workers.
Moving away from a service which treats people on the basis of need will put a lot of stress on workers.
For many, the fact of knowing that the most urgent cases are dealt with first helps staff cope psychologically with the lack of resources in the NHS.
Knowing that there will be preventable deaths because it has become mandatory to allow the rich to jump the queue routinely will be incredibly stressful for staff.
Women will be affected as carers. Women are more likely to be caring for elderly, sick and disabled relatives as well as children. If the NHS becomes less comprehensive, women will most likely be the ones helping their family cope with the consequences.
Men and women alike must continue to fight not just to defend the NHS from these attacks but to improve it. Our lives do depend on this.
There are a number of campaigns that we should support including Kill the Bill, 38 Degrees and Keep Our NHS Public.
These campaigns have been organising petitions, increasing public awareness, and setting up local groups. But the mobilisations have been surprisingly small given the importance of the issue.
This is not because people don’t care. It is probably a combination of a feeling of powerlessness — after all, the NHS has been chipped away at over many years — and being overwhelmed by so many cuts and increasing economic insecurity.
Trade unions and NHS professional associations have almost unanimously condemned the Bill, but have had little to say and do about how to stop it.
Health Alarm is a campaign that aims to help support existing campaigns as well as set up actions of its own — especially focused on all the privatisation that is coming through.
We need to continue the struggle for comprehensive healthcare for everyone on the basis of need. Get involved in the ongoing campaigns, and put pressure on your union to put their words about saving the NHS into action.