Last year, the British Red Cross declared a humanitarian crisis inside the NHS. New year. New NHS winter crisis. But pretty much the identical script to last year from Jeremy Hunt and Theresa May. 55,000 routine operations cancelled. Make-shift wards. Patients on trolleys in corridors. A&E doctors tweeting about third-world conditions in one of the wealthiest countries in the world.

May’s claim that there are more beds available across the system is an astonishing example of alternative facts/post truth/fake news. It is a fact-free claim. The reality is that the government plans to reduce the number of A&Es in England down to between 40–70 as part of a nationwide drive to create chains of super hospitals with the closure, merger or downgrade of tens of hospital trusts.

There is a huge NHS bed crisis. England’s bed to population ratios are now below some Eastern European countries. The NHS has lost something like a third to half of its bed capacity since the 1980s. Yet remarkably the NHS crisis is blamed on the ageing population and increased demand!

NHS England chief executive Simon Stevens was one of the architects of privatisation in the Blair years when he helped expand the limited internal market into an extensive market as first Milburn then Blair’s main health advisor. He then spent a decade working for UnitedHealth — the largest American healthcare and insurance corporation.

Stevens even led the projects at the World Economic Forum at Davos looking into transforming global healthcare systems in 2012. In fact, many of the proposals from Davos have magically translated into NHS policy documents — such as the Five Year Forward View and the Sustainability and Transformation Plans — under the stewardship of Stevens.

So what do these documents propose for the future of the NHS in its 70th anniversary year? Stevens is currently pushing through US style Accountable Care Organisations. This American model restricts access to hospital care (because it is expensive) and purports to deliver care in the community. The reality is that care will not be delivered in the community when the same policies plan to reduce the number of GP surgeries from 7500 to 1500 super hubs. Simultaneously, there are massive cuts to social care and welfare budgets.

The same documents also propose £22 billion in NHS cuts (or efficiency savings if you are drinking the kool aid) by 2020. This would take the total amount of cuts to approaching £40 Billion over this decade — the biggest funding squeeze in the history of the NHS.

The results so far have been catastrophic. According to one paper, there were 30,000 extra deaths in health and social care in 2015 largely attributable to austerity. Cuts have meant that ambulances are unable to attend urgent calls in time and that patients are not seen quickly enough in A&E amongst many other things. A British Medical Journal paper puts the total for the past 7 years at 120,000 extra deaths.

In other words, austerity has killed tens of thousands of patients. This is otherwise known as having blood on your hands.

The NHS winter crisis is essentially a manufactured crisis generated by deliberate policies. And whilst we have heard a fair amount about cuts and under-funding, we have heard much less about the other half of this equation — the massive drive towards NHS privatisation, insurance and charging.

The privatisation and corporate takeover of the NHS is siphoning billions and possibly tens of billions — diverting public, taxpayer funds towards corporate profits instead of patient care.

The agenda to privatise has seen the government bring in the Health & Social Care Act 2012. This opened up NHS contracts to potentially unlimited private sector outsourcing. As a result, multinationals such as Virgin, Serco and UnitedHealth have been winning NHS contracts at breakneck speed. Money that would have previously been reinvested into expensive, risky healthcare (such as emergency medicine and intensive care) is now siphoned off as corporate profits often offshore.

The Health & Social Care Act 2012 also enabled hospitals — already set up as semi-independent businesses by the name of foundation trusts in the New Labour years — to make up to half their income from private patients.

The cost of running the NHS market is estimated at between £4.5–10 billion a year. The amount of private sector outsourcing has doubled in recent years to nearly £9 billion (just under 8%) according to the Department of Health’s own figures. However, the real figure could be over £20 billion according to the Centre for Health and the Public Interest.

The cost of Private Finance Initiative (PFI) for hospital mortgages — which are repaid to corporate consortia that build, run and own over 100 NHS hospitals — is in the region of £2–3 billion annually.

Big banks, such as RBS and HSBC, responsible for the global financial crisis, now have controlling stakes in NHS hospitals. In a few cases, big banks own NHS hospitals outright.

And on top of all that, millions are being paid in fees to big three management consultancies ( such as McKinsey), big four accountancy firms and magic circle law firms for corporate restructuring of the NHS.

At the same time, we are seeing a ramping up of rationing of all manner of treatments from hip and knee replacements, cataracts, hearing aids and IVF as well as restrictions for certain categories of patients — for example obese patients and smokers . This is conveniently blamed on the fact that individuals are largely responsible for their health when, in fact, the evidence shows that health correlates massively with socio-economic status. Put bluntly, the more affluent you are, the better your health and longer your life expectancy will be.

The solution? Remove private sector outsourcing, PFI and the NHS market. This would release billions to invest in a 21st century NHS that is publicly funded, publicly run and publicly owned with healthcare professionals, patients and communities running our NHS.

Youssef El-Gingihy is a GP & author of ‘How to dismantle the NHS in 10 easy steps’ http://www.zero-books.net/books/how-dismantle-nhs-10-easy-steps



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