THE HEALTH AND SOCIAL
CARE ACT
The HSC Act was passed 27 March 2012
Crucially and most seriously, it removes the UK
government’s obligation to provide universal healthcare in England, something so
fundamental it amounts to the abolition of the NHS http://tinyurl.com/4xdnobo. As Dr Jacky Davis, co-chair of the
NHS Consultants Association says: "After the passage of the unwanted,
unneeded and deeply undemocratic NHS bill, we no longer have a national health
service."
1) THE FORCING THROUGH OF THE HSC BILL
There was overwhelming opposition from the medical profession (eg: from the British Medical Association and all but one of
the 26 royal medical colleges), though this impression was not communicated by
the mainstream media, particularly the BBC. Although the NHS affects every man,
woman and child in England, most remain in the dark about what has happened.
The government has played a big role in this.
It
repeatedly concealed the purpose of the bill - to make possible the gradual
dismantling of the NHS and its replacement in the medium-term (few years) by a
market system, based on ability to pay rather than need. According to Michael
Portillo: "They [the Tories] did not believe they could win an election if
they told you what they were going to do [to the NHS]" http://tinyurl.com/d64qov6
The government also used mis-information to justify
its reforms. According to Portillo, the Tories had to do something about the
"incredible inefficiency" of the NHS http://tinyurl.com/d64qov6. The truth is the NHS is one of the
fairest, most efficient and cost-effective healthcare systems in the world http://tinyurl.com/3qf92zc. It has half the per capita costs of
the US health system - which is not universal - and has a higher life
expectancy and lower infant mortality (OECD figures).
The government defied a legal ruling (Freedom of Information act) to make public
the risk assessment of the bill, despite the commissioner's verdict of
"exceptional public interest".
There
was a massive conflict of interest, with 1/4 of the MPs and Lords who voted for
the Bill having financial stakes in private health companies that stood to
benefit by from the bill's passage http://tinyurl.com/7gcsaqf. “Care UK”, a private health company
donated significant money to the office of health secretary Andrew Lansley.
2) SPECIFICS OF THE HSC ACT
In addition to removing the universal right to healthcare, which has existed
since 1948, the Act also opens the door for charges
(without limit) for NHS services. It permits private providers to take over any
NHS services. And it allows up to 49% of the business of NHS hospitals to be
private. Quite apart from the fact that the intention is almost certainly to eventually increase this percentage to 100% - ie: create a US-style insurance-based system - this will
create a health system with two queues: one for the poor and one for the rich http://tinyurl.com/c7jbd2p
.
In a cash-strapped system, a rich person with a minor ailment will be treated
over a poor person with a more serious ailment. "Care will never again be
according to need but ability to pay," says Dr Clare Gerada,
Chair of the Royal College of GPs.
The Faculty of Public Health's risk assessment warns of 1) Loss of a
comprehensive Health service, 2) Increased costs, 3) Reduced quality of care,
4) Widening health inequalities http://tinyurl.com/7z2nf2f In a nutshell: "NHS:
integrated, comprehensive, cost-effective, accountable. Mix providers:
fragmented, unaccountable, expensive, only profitable services." (‘integrated’ means that data is shared – something which was
not the case with the private companies involved with the recent breast implant
scare – and that patients receive care from a multi-disciplinary team of
doctors, nurses, physios, district nurses, and so on.
‘Comprehensive’ means that all people and all ailments are treated.
‘Accountable’ means that problems are made public and not concealed by
commercial contracts)
But the risks highlighted by the Faculty of Public Health are all short term.
The NHS is being removed gradually (No government would dare remove it in one
go. At the time of the last election, it had the highest-ever public approval
rating). However, the end-game is an insurance-based system like the US where,
without health insurance, you will not be able to get treatment for you and
your family. The term NHS will be meaningless. "The NHS will be reduced to
a logo, a budget and a few qangos," says public
health physician, Dr Alex Scott-Samuel.
3) WHAT HAS HAPPENED SO FAR
Most people remain in the dark about what the HSC Act does because of failure
of the mainstream media. As has often been said on
Twitter, if the BBC covered economics like it has health, nobody would know
there had been a global financial crisis. On the day the Act was passed the
strap-line across the bottom of BBC News broadcasts said "Bill which gives
power to GPs is passed". It would be difficult to find a GP who agreed
with that.
At a time of severe financial pressure, huge
sums of money – estimated at more than £3 billion - are being diverted from
patient care to fund the reorganisation necessary to implement the HSC Act.
The implementation of the HSC Act
is creating huge amounts of duplicated bureaucracy – the principle cause of the
high cost of the US healthcare system. Just some of it is spelled out here by
the editor of Nursing Standard http://tinyurl.com/cu8lkjg
Gradually,
the government is starving the NHS of money. This is deliberate. As hospitals run
out of money - and the exorbitant repayments on PFI deals are a major factor
here - they become prey to takeovers by private companies. This has already
happened, with Serco taking over Newmarket Hospital.
Not only does
a private company cherry-pick profitable services but it gains infrastructure
paid for by the taxpayer. It can also give preferential access to equipment
such as kidney machines, blood and organs that were specifically donated by the
public to the NHS for use by everyone.
NHS services must
be put out to tender. The core business of the transnational corporations that
are bidding is winning government contracts, as they have the experience, deep
pockets and legal expertise to do so. Small enterprises and local GPs cannot
compete with them in tendering for services as has already been seen in the
Virgin takeover of community services in Surrey and children’s' services in
Devon.
When private
companies fail, such as the company with the contract for GP services in
Camden, London, patients are high and dry.
The
starving of the NHS of money to force the pace of its sell off to private
companies has forced the imminent closure of 4 out of 9 A&E departments
serving NW London.
Trusts
are getting together in cartels to force down nurses' pay, though nurses have
experienced a pay freeze (ie: pay decrease, taking
into account inflation) for several years now.
Dr
Peter Carter, Chair of the Royal College of Nurses is predicting the loss of
56,058 nursing jobs.
The
fragmentation of the NHS is reducing data sharing, making it ever more
difficult to assess how healthcare is worsening.
