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Authors: Jacky Davis,John Lister,David Wrigley

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Top cancer doctor’s damning letter: ‘NHS cuts will kill patients’

The Mirror
revealed that some of the country’s leading neurosurgeons and doctors were warning that savage cuts are putting cancer patients’ lives at risk.
23
Lead consultant neurosurgeon Matthias Radatz said ‘The changes last year were draconian and patients who wait for radiosurgery have been left totally in limbo. ‘To the layman it’s appalling. To the expert it’s appalling.’ In a damning letter to NHS bosses, he and other experts expressed their frustration and anger at the planned closure of 18 specialist centres to treat victims of brain cancer. They blamed the coalition changes to the NHS and the plan to cut £20bn from the NHS budget by 2015.

Cancer care commissioning is in chaos since NHS reorganisation, says leading charity

The government’s reorganisation of the NHS in England has caused chaos in the commissioning of cancer care services,
24
which now needs radical change to be made fit for purpose, says a report from Cancer Research UK.
25

The charity said that confused structures, unclear accountability, and loss of national oversight, combined with insufficient funding, threatened to reverse hard won gains in survival rates among people with cancer. Harpal Kumar, the charity’s chief executive, said that cancer services were now at a ‘tipping point’, with staff fighting to keep them viable in a context of flat-lined budgets and rising demand from patients.

Outsourcing: same job, same hours, same clients, less pay

An analysis by the Smith Institute think tank has shown that private companies taking over outsourced public sector contracts seek to drive down wage costs.
26
The report showed that low paid workers have been disproportionately affected, in one case losing up to 40 per cent of take home pay after being transferred to new employers. A further example involved the provision of a former NHS-run disability care service.
27
Large cuts to local government budgets meant that the only way to provide any service at all at the new lower contract values was for the provider to radically drive down employee terms and conditions. The main impact of outsourcing is therefore not to raise quality but to drive down wages.

NHS Trusts focusing more on private patient income to make up revenue gaps

NHS Trusts are placing a greater emphasis on the income they can receive from private patients, as a result of the decision
to allow them to raise up to 49 per cent of their revenue from private treatment – up from 2 per cent – which was part of the NHS reforms in 2012. Some trusts have more than doubled the amount of income they receive from private work in the last two years.
28

The patients who can’t leave hospital – as no one will make a profit

Some patients who are otherwise fit to be discharged are unable to leave hospital as the private providers who are there to provide social care are unwilling to provide a care package which would enable the patient to return home, as it is not profitable for them to do so. The number of patients who suffer a ‘Delayed Transfer Of Care’ (DTOC, commonly termed ‘bedblocking’) is currently at its highest ever recorded level – in January 2015 figures showed that delayed discharges had risen by a third when compared to the same period a year earlier, with 62,000 ‘bed days’ lost in the preceding month.
29

Safety concerns over private sector surgery

The series of botched cataract removals carried out by a private clinic in Somerset which was given NHS work has raised concerns about the proportion of eye procedures done by the private sector, with one in every ten NHS cataract operations now being done by private health providers. The Royal National Institute of Blind People (RNIB) said that the need to guarantee patient safety in the private sector had become a ‘key concern’.
30

GP-led local NHS bodies forced to put health services out to tender

Research by
Health Service Journal
shows that 29.1 per cent of the leaders of 93 clinical commissioning groups (CCG) which responded to a survey said they had opened up, or
were opening up, services to competition which they would not have done if they were not concerned about the impact of new rules contained in the controversial HSC Act. They included contracts for out-of-hours GP care, older people’s services, audiology, ultrasound and podiatry.
31
In 2012, the health secretary Andrew Lansley wrote to all the 211 CCGs pledging unequivocally that they individually would be able to decide, rather than ministers or the NHS regulator, Monitor, when to put contracts out to tender.
32
But the same
HSJ
found that 20 per cent of CCGs had encountered a challenge under the new competition rules to a decision they had taken about the commissioning of services, while 57 per cent had experienced ‘informal challenge or questioning’. In addition, 65 per cent of the 103 bosses of the 93 CCGs said that they had incurred extra costs related to commissioning as a result of the regulations, while 36 per cent said they had hampered plans for local hospitals to merge or become foundation trusts.

3. The views of NHS staff and users

The vast majority of NHS staff say reform had negative impact

Only 5 per cent of health professionals in a survey by Dods said that there was a positive impact for the NHS changes. Of the 3,628 NHS staff questioned many believe that improving patient care now comes second to making savings. ‘Money is a prime concern with only 2 per cent saying their organisation had sufficient financial resource and 71 per cent disagreeing with the idea that they have enough budgetary support to support their organisation.’
33

Two in five fear the NHS will soon cease to be free

More than two out of five people fear the NHS will cease to be a free service over the next twenty years. 44 per cent
said it was unlikely and 37 per cent thought it was likely to be the case. The findings came from a survey of 1,030 adults in England by pollsters Populus and were publised shortly after several think tanks, groups of health professionals and ex-Labour health minister Lord Warner had proposed that the NHS should introduce charges, notably for visiting GPs, as a way of reducing the burden on the taxpayer.
34

85 per cent of GPs believe the NHS will be privatised within ten years

Almost 85 per cent of GPs believe the NHS will be privatised within ten years, with 45 per cent predicting it will occur within five years, a survey of 1,137 NHS staff has revealed. The survey, conducted by Cogora, which publishes
Pulse,
also revealed that GPs felt less engaged in the CCG decisionmaking than practice managers. It found that 91 per cent of GPs felt the reforms resulted in more work, while 97 per cent of practice managers believe workload had increased. The survey questioned 548 GPs, 418 nurses and 171 practice managers. It found that exactly half of practice managers felt that privatisation will happen within seven years, compared with 45 per cent of GPs. Only 14 per cent of GPs and 11 per cent of practice managers felt that privatisation will not occur in the next ten years.
35

Practice survey reveals just one fifth of GPs expect their practice to survive

Only a fifth of GPs expect their practice to still exist in ten years, according to devastating results of a wide-ranging survey of practice staff on the future of general practice published by the GP magazine
Pulse.
36
The poll was initiated locally by a practice manager in Oxford and ended up being cascaded right across England, receiving over 2,700 responses, three-quarters of which were from GPs. The final results showed
only 20 per cent of respondents were confident their practice would exist in 10 years, while a third said the exact opposite.

Almost all the respondents – 97 per cent – agreed their practice was ‘experiencing an ever increasing and unsustainable pressure of work’, while 68 per cent told an
HSJ
poll their referral rate was likely to increase in order to cope with increased demands on general practice.

Four-fifths of respondents said they believed one or more GPs in their practice was suffering from ‘burnout’.
37

Junior doctors raise patient care concerns

Most junior doctors do not feel they have enough time to care for patients, according to a new poll. Of the 1,000 training medics polled by the Medical Protection Society, 70 per cent said they feel as though they do not have enough time to give patients the care they need.
38
And half said that they had concerns about quality of care in their workplace. Meanwhile, 82 per cent said they struggled with long hours in the last year, and almost two-thirds said they had difficulty with heavy workloads.

Keep politics out of NHS, says poll

The vast majority of the public believe that MPs play political football with the NHS, a new poll suggests, as doctors called for the government’s controversial reforms of the NHS to be scrapped. Almost three-quarters of people – 73 per cent – told the pollsters that political parties design health policy to win votes rather than do what is best for the health service.
39
Meanwhile, the questionnaire of 2,000 people from across Britain shows that two in three believe the NHS should manage itself without the involvement of politicians. Only one in three said that parliament should set targets for the health service.

Information and Campaigning: some starting points

Selected Campaigning Organisations and Parties

Centre for Health and Public Interest:
research and reports on public health politics,
http://chpi.org.uk/reports/e.g
.: Calum Paton,
At what cost? Paying the price for the market in the English NHS.
http://chpi.org.uk/
; twitter @CHPIthinktank.

Doctors for the NHS (NHS Consultants Association):
campaigning against privatisation; briefings, policy research.
http://www.nhsca.org.uk/
.

Green Party:
Maintain a publicly funded, publicly provided health service, and oppose NHS privatisation and treating health care as a market.
http://greenparty.org.uk/values/nhs-2010/nhs-detail.html
; twitter @TheGreenParty.

Keep Our NHS Public:
campaigns for a publicly funded, publicly delivered and publicly accountable NHS; a national organisation with local groups.
www.keepournhspublic.com
; twitter @keepnhspublic.

London Health Emergency:
news, analysis, campaigns. See especially John Lister,
Briefings for Cynical Commissioning Groups,
2014.
http://www.healthemergency.org.uk/pdf/CynicalCommissioningGroups1.pdf
http://www.healthemergency.org.uk
; twitter @JohnRLister.

Medsin:
works amongst students on global and local health issues.
http://www.medsin.org/
; twitter @medsinuk.

National Health Action Party:
campaigns for a publicly funded, publicly delivered and publicly accountable NHS.
http://nhap.org/our-policies-1/
.
http://www.nationalhealthaction.org.uk
; twitter @NHAparty.

NHS Support Federation:
campaigns to improve and protect the NHS in keeping with its founding principles. Maps, statistics, news.
http://www.nhscampaign.org
; twitter @nhs_supporters.

OpenDemocracy:
‘free thinking for the world’. See especially: ‘OurNHS’,working for a decent National Health Service in England.
http://www.opendemocracy.net/ournhs/about
; twitter @OurNHS_oD.

People vs. PFI:
campaign against PFI; ‘private interests make profit through the Private Finance Initiative – quietly killing off our public services.’
http://www.peoplevspfi.org.uk/
.

People’s vote for the NHS:
‘we have to save the NHS from the greed & corruption of private companies. NHS for people, not profit.’
http://999callfornhs.org.uk
;
http://www.peoplesvotefornhs.org.uk/
.

Spinwatch:
lobbies for transparency, and seeks to uncover commercial lobbies, PR and propaganda.
http://www.spinwatch.org/
; twitter @Spinwatch.

UNISON Health Care:
campaigns on policies, cuts, pay, pensions, and more.
http://www.unison.org.uk/at-work/health-care/
; twitter @ourNHS.

Unite the Union:
runs a Save our NHS campaign
http://www.unitetheunion.org/how-we-help/list-of-sectors/healthsector/healthsectorcampaigns/unite4ournhs/
and has published a very useful and informative
Guide to NHS Privatisation:
http://www.unitetheunion.org/uploaded/documents/GuideToNHSPrivatisation11-10734.pdf
.
http://www.unitetheunion.org
; twitter @unitetheunion.

Further Reading

Jacky Davis & Raymond Tallis – editors,
NHS SOS: how the NHS was betrayed – and how we can save it,
Oneworld, 2013.

Colin Leys & Stewart Player,
The Plot against the NHS,
Merlin Press, 2011.

—, Confuse and Conceal,
Merlin Press, 2008.

John Lister,
Health Policy Reform: Global Health versus
Private Profit,
Libri Publishing, 2013.

—, The NHS After 60 – For patients or profits?
Libri, 2008.

People’s Inquiry into London’s NHS,
http://www.peoplesinquiry.org/pdf/NHSattheCrossroadsfulldoc.pdf
.

Allyson M. Pollock,
The End of the NHS,
Verso, 2015.

—, NHS plc: The Privatisation of Our Health Care,
Verso Books, 2004.

NHS England policy documents, for example
Five Year Forward View,
reveal certain future perspectives,
http://www.england.nhs.uk/wp-content/uploads/2014/10/5yfv-web.pdf
. Their website and that of other public bodies, are listed on
pages viii–x.

BOOK: NHS for Sale: Myths, Lies & Deception
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