From 11 December, figures for A&E waiting times, ambulance delays outside hospitals, last-minute cancellation of operations and the number of patients left on trolleys for longer than four hours will be removed from official updates on the condition of the NHS.
The updates will be released only monthly, rather than every week as they have been in the past, and the Government has redefined “winter” to be a month shorter and thus not directly comparable with previous years.
Thus the Tories hope to reduce the media headlines about crisis in the NHS, though they can’t reduce the crisis itself. Headline waiting times standards for cancer and in emergency departments are now missed routinely; the target minimum wait for diagnostic tests has not been met for the past 18 months; the now-abandoned elective waiting time target was missed in 14 of the past 18 months.
Hospitals had already “overspent” by £1.6 billion halfway through the financial year. 80% of hospitals face deficits of up to £100 million each this year. NHS bosses have reacted by telling hospitals that they no longer have to ensure at least one nurse for every eight patients.
The campaign group Health Emergency says that it is “urgent for Labour’s new front bench to get up to speed with the situation and start hammering the Tories over their despicable record on the NHS and the crisis they have created.
“We need a united campaign of local campaigners, health unions and Labour Party making maximum protest and challenging every local cutback and closures.
“We need to exploit divisions in the enemy. We must take advantage of the fact that the Tory bar on recruitment of nurses from outside the EU has been challenged by Simon Stevens and NHS managers. We need to use the opposition of NHS employers to the brutal anti-union laws now being forced through...
“Labour’s new leadership... need to seek out good expert analysis and advice, reach out to trade unions and local campaigners, and raise a coordinated challenge in a much more professional way than has been done so far. Any Blairites who get out of line on this must be slapped down publicly.
“Labour should ditch the ill-conceived Efford Bill, and sign up to the NHS Reinstatement Bill drafted by Allyson Pollock and Peter Roderick, which aims to sweep away the costly and divisive apparatus of the competitive market in health care.
“It’s time to put the Tories to the sword over their ruinously expensive, chaotic and disastrous ‘reforms’ that have brought the NHS to its knees while Osborne freeze drives it to bankruptcy.
“It’s not the NHS that is unsustainable, for all the Tories tell us: it’s the Tory policies on the NHS which are unsustainable — and Jeremy Corbyn’s team need to be making that point long and loud”.
The “cash boost” for the NHS in Chancellor George Osborne’s 25 November Spending Review still leaves the NHS budget, in the words of the King’s Fund research group, “squeezed as never before”. The relative cuts in the NHS since 2010 are already much bigger than in Thatcher’s 1980s.
The NHS cuts are already killing. Recently-released figures show that in the relatively mild winter of 2014-5 there were an estimated 36,300 “excess” winter deaths among over-75s (compared to monthly deaths in the rest of the year), and 7,700 among under-75s. The long-term trend has been for “excess” winter deaths to decrease. In 2014-5 they increased. 2015-6 is likely to be a stormier and colder winter.
The King’s Fund, a conservative body with low expectations, thought the NHS did relatively well in the Spending Review. But it saw that “the NHS and social care are now set for a decade-long funding squeeze which will see the largest sustained falls in spending as a share of GDP on both services in modern times”.
The NHS faces a “huge challenge” imposed by the Government “of finding £22 billion in efficiency savings by 2020-21”. In fact Government measures tend to decrease NHS “efficiency” by cutting the public health budget and funding for social care, so preventive care suffers and hospital beds are “blocked” by patients who would be better cared for outside hospital but for whom there is no care available outside,
“It is clear that a large chunk of the additional funding for the NHS has been found through substantial cuts to other Department of Health budgets. Cutting the public health budget is a false economy... New powers to increase Council Tax will provide some financial flexibility for councils but will disadvantage deprived areas with the highest needs for publicly funded care. These measures... are not a substitute for sustainable funding”.
The junior hospital doctors have forced the Tories to step back on their plans to worsen their conditions, but so far only temporarily.
As Jeremy Corbyn said on 6 December: “We’ve a crisis in A&E, hospital wards understaffed and people waiting longer and longer — and the Tory response is to try and stop people finding out. These deeply cynical attempts to hide the truth reveal one thing: the Tories are failing patients”.
Junior doctors: keep up the pressure!
Prospects for negotiators for junior doctors in renewed talks with the Department of Health/NHS Employers now look stronger .
This is down to the hard work of junior doctors, their protests, and a strong 98% vote for strike action.
The government is now saying it will maintain some form of financial safeguard under any new contract and offering other concessions. But there is still a lot to be won, and one of the clearest sticking points is around unsocial hours.
Junior doctors believe it is important that the Treasury are part of negotiations, so that a deal will stick. At the same time no one will want the government to make cuts elsewhere in order to make this issue go away. In the autumn statement we saw cuts to nursing bursaries, junior doctors’ training and public health. These cuts also need to be fought against.
In agreeing to suspend the strikes, the British Medical Association got a deal from the government not to invoke the law which states the first industrial action under a ballot must be taken within 27 days of the ballot ending. The BMA have been allowed to extend their ballot′s mandate until 13 January.
Realistically this means that the BMA Junior Doctors’ Executive must decide before Christmas whether or not negotiations are progressing meaningfully. It’s a short time frame.
Junior doctors should continue to build for strikes in the future and keep the pressure up on both the government and on the BMA. A victory on this dispute will help build the fight to defend the NHS.