Tag: health and social care act

The systematic destruction of the NHS

By Daniel Margrain

Dr Bob Gill who has worked for the NHS for 24 years, and is currently seeking crowdfunding for his documentary filmThe Great NHS Heist, was interviewed as part of a short video presentation produced by the UK journalist co-operative, Real Media.

In the interview, Dr Gill discusses how the move towards privatizing the NHS has been an agenda-driven project continued over many years by successive Conservative and Labour governments’.

Over the course of the twelve minute talk, Dr Gill highlights some of the issues the NHS faces. These are the key 23 assertions he makes in the presentation:

  • The intention of successive governments’ has been to transform a publicly-funded free at the point of delivery healthcare system into something that is driven by the need for profit.
  • The privatization agenda has been a well-planned long-term project.
  • Successive governments’ have understood NHS privatization is not in the public interest and thus they have devised alternative narratives in order to deceive the public.
  • A key component of this deception has been the deliberate cultivation of a ‘scapegoating’ culture in which the elderly, immigrants, overweight etc are blamed for government under-investment in the NHS.
  • This lack of investment is portrayed in the media as NHS Trust ‘overspending’.
  • The hospital network has been deliberately saddled with toxic loans.
  • In legal terms, the 2012 Health and Social Care Act abolished the NHS.
  • The result was the emergence of a Quango headed by NHS England’s Simon Stevens who has the day-to-day power of managing the service.
  • In 2014 Steven’s introduced a five year ‘Sustainability and Transformation’ Plan (STP).
  • The STP will move the NHS closer to the private US insurance system through a process of re-structuring, dismantling, integration, means-testing and merging of existing NHS services.
  • Both the NHS workforce and the general public are largely unaware of these plans which have been made deliberately complex and drawn-out over many years.
  • This drawn-out complexity is yet another part of the plan to deceive the general public and NHS staff alike.
  • NHS reforms are reported in the media in a positive way. This is despite the fact that the said reforms will result in the destruction of the service.
  • The British Medical Association (BMA) is largely complicit in the privatization agenda.
  • Jeremy Hunt, whose powers are limited, is being used by the media as a distraction.
  • Simon Stevens, who has the real power, has been deliberately set-up by the media as a ‘saviour’ for the NHS, whereas Hunt is portrayed as the ‘bad guy’.
  • Simon Stevens ambition for the NHS is to hand it over to his former colleagues at United Health in the U.S and the U.S insurance industry.
  • Stevens is “the most dangerous public servant in the country.”
  • The NHS is subject to competition law and is under constant threat from internationally negotiated trade deals.
  • The service is geared-up to work against the interests of the patient.
  • The NHS is heading in a direction in which doctors will be incentivized to deny patient care.
  • The introduction of the principle of private insurance will result in a more expensive system with worse outcomes.
  • The plan to fully privatize the NHS is “endemically fraudulent”.

Dr Gill alludes that the deliberate asset-stripping of the NHS ranks as one of the greatest crimes inflicted on the British people. The jewel in Britain’s crown is being whittled away in front of the public’s eyes.

All the while the Conservative government has convinced large swaths of the public that Simon Stevens is the saviour of the service when in truth he is its principal destroyer. Like a TV illusionist, the government is involved in an incredible sleight of hand – some may say, collective hypnosis – of the British people.

The Health Secretary, Jeremy Hunt, is essentially a public relations figure for the government and the corporations it represents. Where the blows of both NHS workers and the public alike would arguably be better targeted is towards NHS England boss, Simon Stevens, whose power to be able to shape the future direction of the NHS far exceeds that of Hunt.

Although it’s highly encouraging that an estimated 250,000 people attended one of the biggest national demonstrations against NHS cuts in London in March last year, it is somewhat perplexing to this writer why Labour’s Jeremy Corbyn in his otherwise excellent post-demo speech, failed to mention the nefarious role played by Stevens which is crucial to the entire NHS debate.

How is it possible for activists and campaigners to get anywhere near the bulls eye with their arrows when the correct target hasn’t even been identified by the leader of the opposition?

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Why is Tory economic dogma seen as mainstream, but Corbynism extreme?

Sixty-six years after the foundation of the welfare state, under the current Conservative government, every aspect of it is under attack. The 2012 Health and Social Care Act, for example, will remove the duty on the Secretary of State for Health to provide a comprehensive health service, while the requirement in the act that up to 49 percent of services can be tendered out to “any qualified provider” will rapidly lead to the privatisation of the NHS in England and Wales. Already between a quarter and a half of all community services are now run by Virgin Care [1].

In social care, a combination of cuts of around 30 percent to local authority budgets since 2010, increasingly restrictive eligibility criteria for services, and inadequate personal budgets will leave millions without the support they need and increasingly dependent on the family, and in particular women family members [2].

And in place of what was once called social security, unprecedented cuts across all areas of benefits, especially disability benefits, the introduction of sanctions regimes which have contributed to 500,000 people being forced to use food banks, and a bedroom tax affecting around 600,000 people will increase the number of children living in poverty by 200,000 [3].

All of this has been underpinned by a brutal ideological offensive against people on benefits which explains the reason for the growing rates of sickness benefit claims are for those who suffer from depression and anxiety [4], as well as the increase in the rate of suicide among those on benefits [5].

The ideological attack on the poor is predicated on the governments’ insistence that those able to defend themselves least, pay the costs for a global economic crisis which began in 2008 but was not of their making [6].

Over the last forty years, successive Labour and Tory governments’ have been committed to rolling back the post-war welfare settlement under the guise of debt reduction premised on neoliberalism which involves a change to the function of the state as less ‘welfare provider’ to more ‘pro-business facilitator’.

Many people believe that the neoliberal assault that embody these changes began with the 1979 Thatcher governments’ limited (by today’s standards) publicly-owned asset stripping. But this is a myth. It was actually under the Callaghan administration that preceded Thatcher that the initial structural changes happened  As Colin Leys (p.41) notes:

From 1976 onwards Labour…. became “monetarist”. It’s leaders accepted that full employment could no longer be achieved by government spending but must be sought through private sector growth. For the necessary private investment to take place, prices must reflect real values, and this in turn required “squeezing” inflation out of the system and permitting the free movement of capital. In 1978 Treasury officials began preparing to abolish capital controls

But it is the assault by the trio of Cameron, Duncan Smith and Osborne on, not just the welfare state, but the entire ethos of the public sector in general, that has taken things to a new level. This is demonstrated, in part, by Osborne’s intention to sell off £31bn of public assets in 2015-16. It is clear that the Tories are using austerity and the neoliberal ideology that underpins it, as an excuse to expand the pro-business facilitator model to areas within the public sector that Thatcher could only in her wildest of dreams imagined.

That said, this approach has limits in terms of maximizing utility to capitalists within a modern state. It is precisely this kind of rationale that explains why the former governor of the Bank of England announced that the current situation is “the worst crisis at least since the 1930s” [7].   

As this writer has pointed out previously, even venture capitalists realize that proper welfare provision for those not working as well as a substantial increase in the the minimum wage for those in work, is necessary to prevent the capitalist system that they benefit from collapsing in on itself [8].

In 1943, the Tory MP Quintin Hogg warned that “If you don’t give the people social reform, they will give you social revolution” [9]. This is as relevant today as it was then.

It’s therefore in nobody’s interest that wages are kept depressed and the unemployed and sick are continually made to suffer. The fact they continue to suffer unnecessarily is the reason why a political space has opened up for the likes of Jeremy Corbyn to move into.

Although much of the mainstream media are characterizing Corbyn’s policies as unworkable, misguided and extreme – and seemingly doing everything in their power to undermine and discredit him -, these are nevertheless policies that are, in truth, mainstream and pragmatic. This explains why an increasing number of economists have publicly come out in support of the kinds of economic policies Corbyn articulates [10].

These policies are economically credible, popular with the public and, for most of the world, regarded as mainstream:

In 2009, most of the world was following mainstream economics of the kind that Corbyn is proposing today in undertaking a fiscal stimulus to combat the impact of the financial crisis. But in the UK a certain politician decided to ignore ‘economic credibility’, and instead proposed doing the opposite: what has subsequently become known as austerity [11].

The imposition of 40 years of neoliberal economic dogma pursued by successive Labour and Tory governments’ has failed the people of Britain who rightly, in my view, see Corbyn as the catalyst for change. As time goes on there will be increasing pressure not just from below, but from the top, for the Tories to change course.

As the open letter to the Guardian by over 40 leading economists illustrates, this is already starting to happen. If the government refuse to acknowledge that austerity and neoliberalism have failed, and thus continue to stick rigidly to their failed ideology of cuts and austerity, the British people will eventually elect a figure like Corbyn into power on a mandate to do something about it. That time is coming closer with every passing day.