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Proletarian issue 76 (February 2017)
NHS in the firing line
The end of free healthcare for all those who need it really is nigh.
Our NHS has been under attack for many years now by every bourgeois party that has taken its turn in government, and many people heavily involved in the health service are saying that the coup de grace is about to be delivered by the current incumbents.

The proposed method of execution is cunningly entitled ‘the Sustainability and Transformation plan’ (STP). The crisis affecting Accident and Emergency (A&E) units up and down the country has become common knowledge, with countless vulnerable and gravely ill patients crowded on trollies and in wheelchairs, often for nine or ten hours waiting for beds, with ambulance crews standing idle, unable to leave their patients until they are signed into the care of the hospital, and hundreds of people who have managed to get to A&E under their own steam also waiting, often in severe pain and distress.

This situation has become so routine that many of the busiest hospitals now assign nurses and healthcare assistants to work in the corridors during every shift, since they know that cubicles simply won’t come free in time. Thus an emergency measure is slowly becoming routine practice.

Now Simon Stevens, the chief executive of NHS England, has a cunning plan: he wants to close lots more A&E departments! His logic is brutally simple: if they don’t exist, sick people and ambulance workers can’t fill them up. Therefore, no waiting crisis and huge financial savings.

This may sound absurd, but, needless to say, money is the real problem. The NHS is being starved of funds, or as Mr Stevens would have it, it is making itself unaffordable by treating all these sick people, so he has sat at a map and split the country into 44 areas that he has called ‘footprints’. Each ‘footprint’ was told last autumn that it must have a plan in place by 30 June this year to alter completely the way the NHS works. In short, each area has to be able to prove it can clear its massive debts within a year, and to do that they will inevitably have to close services and sell land and hospitals.

Stevens is on record as saying that the NHS will soon become “unaffordable” without radical reforms, designed to move care away from hospital and closer to people’s homes. He also claims that the needs of patients have “evolved” since the NHS was set up in 1948, and that the traditional separation between health and council-funded care has to end.

What does that mean? The new organisations controlling healthcare within the ‘footprints’ could be the current Clinical Commissioning Groups (CCGs) by another name or they could be run by corporations, or be a mixture of both. These bodies will control the budgets and decide what care will be provided and who can get it. Such is the ugly reality behind such a seemingly innocuous term as ‘sustainability and transformation’.

The NHS does not exist outside of society and a quick glance across that society shows that just as healthcare is based on profits for the few, so education is not based on the needs of the masses of students, or housing, or food production based on the needs of ordinary, that is working class, people. There is an inherent and unavoidable crisis within capitalism caused by producing more than can be sold (not to be confused with producing more than is needed) and it is we who have been selected to boost the sinking profits of the biggest parasites by receiving, whether directly or indirectly, an even smaller percentage of the fruits of our labour.

It is not only our wages that will be cut to salvage the threatened profits for the few. The benefits of those too ill to work or who are unemployed will be cut, and all the services that workers and their families rely on are also to be slashed in the name of the financial greed of the powerful, whilst we are forced to see our children and elderly people, in particular, suffer as a result.

The NHS is an emotive issue, but if we want to save, and even improve it, as the overwhelming majority of people undoubtedly do, then we will have to step up and work for the end of the capitalist system and its replacement with socialism. There is no other path, and the time to act is getting shorter.
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