By Canterbury Labour Party / Health / 0 Comments

Myth: The NHS is inefficient and unaffordable – it can’t go on like this

  • International studies have consistently shown the NHS to be one of the most cost-effective health services in the world. It is accessible to all and delivers high-quality care.
  • This is achieved despite the UK spending less of our GDP on health care than most European countries – UK: 8% of GDP, France/Germany: 11%.
  • People who claim we can’t afford the NHS must answer the question – if we can’t afford the most cost-effective health service in the world, what can we afford? 

Myth: The NHS budget is not being cut

  • Since 2010 £20 biliion have been cut from the NHS budget, and cuts totaling a further £20 billion are planned up to 2020.
  • Until 2010 annual spending on the NHS rose by an average 4.8%, which more than covered increased activity. Since 2010, the average has dropped to 1.2%, and is planned to fall even further over the next 4 years to 1.1%.
  • This has forced major cuts in services; by October 2014 66 maternity and A&E units had been closed or downgraded and 8649 beds had been lost.
  • This why so many hospitals are in deficit – they not being paid enough for the work they do.
  • The deficits are now being used as the justification for another major top-down reorganisation of the NHS – Sustainability & Transformation Plans (STPs).
  • STPs are likely to involve major cuts in hospital beds and other services.

Myth: The NHS is not being privatised

  • Private contractors use the trusted NHS logo, so patients may not even know they’re receiving treatment from a private company. 

  • Large corporates such as Virgin and Serco now run 10% of our GP services
  • Private companies “cherry pick” services seen as profitable. – typically elective surgery, community health and mental health – leaving complex expensive work to the NHS. Recent figures suggest they have won up to 60% of contracts in community and mental health.
  • The commercial sector also hides behind ‘commercial confidentiality so that we the tax payers can’t find out the most basic facts about their costs, profits and outcomes 

Myth: The private sector is more efficient and cost effective than the public sector 

  • Evidence shows that when private companies deliver care, costs increase and services may well get worse as the private sector typically cuts and/or downgrades staff and reduces the services on offer.
  • The fiasco of hospital cleaning has shown the reality of privatisation: apparent short-term savings, but at the expense of lower hygiene standards, higher rates of hospital-acquired infection, the break-up of established ward teams and casualisation of the workforce. 

  • Other recent failures have included a contract for cataract surgery that had to be terminated after a few days because of disastrous outcomes, and the discovery of unexplained deaths in private hospitals delivering care to NHS patients 

Myth: ‘Health tourism’ is bankrupting the system 

  • The government has encouraged scaremongering as a useful distraction from the real problem of £20 billion in cuts to the service.
  • The most reliable figures suggest that unrecovered costs from treating foreign nationals account for less than 0.2 per cent of the NHS budget.

Myth: We are cutting bureaucracy and saving money 

  • For most of its life, the NHS had the lowest administration costs – about 6% of the total budget – but now money is being wasted on running the English NHS as a market, in which services compete rather than cooperate, and people commissioning services are legally required to spend scarce resources on expensive and lengthy tendering processes.
  • As a result the proportion of the NHS budget spent on administration has increased dramatically, rising to around 15%. Running the English NHS as a market is estimated to cost between £5 and £10 billion each year. 

  • Large amounts of money are being lost through PFI, with the NHS getting about £11 billion in infrastructure for an eventual cost of over £70 billion.
  • If we abandoned the costly and unnecessary market and dealt with the outrageous PFI debts, we would save billions for frontline care. 

Myth: Patients now have more choice

  • Now GPs are frequently constrained by the contracts they have with providers, and patients have less choice now than they did 20 years ago, when a GP could send a patient to any part of the NHS anywhere in the country.
  • Many GPs are now given targets to lower their referrals to hospital.
  • Referrals may pass through a management centre where they are checked and may be redirected by people with little or no clinical training and no knowledge of the patient.
  • One in eight referrals is rejected altogether. (In the USA where this system is the norm, it is called “denial of care”). Operations once available from the NHS, such as joint replacements and hernia repairs, are increasingly being rationed or withdrawn. 

By Canterbury Labour Party / Miscellaneous / / 0 Comments

It’s key to a con artist’s success to be able to establish their point of view in the mind of the intended victim, to quickly define and limit the boundaries of what is possible. Stopping the “mark” from looking at the fraudster’s credentials or what lies behind the claims being made is absolutely essential for the sting to work, because it stops any questioning the truth of what is being said. This, some might think, is the same method being used in the “Business case” issued last week on the possible merger of Canterbury with three other East Kent councils.

Does that seem a little harsh? Well, perhaps the absence of scepticism is the first sign that the con trick is working, if everyone is accepting the basic proposition – that merger is the only way forward – as correct. I’m not saying this because I’m wedded to the idea of Canterbury unchanging, nor because I think that local government couldn’t possibly be better organised, or that our current structures are unchangeable. In fact I think our local Council is a system rigged for one Party. I take this view simply because the basis of the proposed merger is utterly flawed, and if it was implemented it have consequences which are much more significant than the mere loss of independence of Canterbury and Whitstable. The likely impacts include the virtual destruction of democratic oversight of the Council, the establishment of one political Party as the permanent dominant force in the region, and the imposition of continual cuts to services as the underlying purpose of the Council.

That is really the game that’s being played through this merger: you’re meant to accept the premise that because Councils are under severe financial pressure, the only way to deal with that is to merge four Councils. This is dressed up as a strategic plan, although Ashford Council’s unilateral withdrawal from the scheme suggests it’s more a marriage of convenience than a serious commitment. It’s also a plan in which the potential to include some or all of Swale has never even been considered, which is odd if Faversham is so naturally aligned with Canterbury that we are to form one parliamentary constituency.

But anyway, the underlying justification for the change is cost cutting. It seems our Council accepts without question that Government cuts to their funding are impossible to challenge, mitigate, avoid or discuss. The plan therefore assumes a need to cut (they say “save”, but you can be sure that they mean “cut”) an astonishing £59.9 million over six years. The so-called “business case” produced to support the merger looks at absolutely no other means of achieving savings other than merger, or at any means by which Councils might try raising more funds – it’s a “one solution” review intended to cheerlead for merger rather than look at it objectively.

And here’s the key to the con: the root cause of all this is the Government’s imposition of austerity. You remember austerity, right? Imposed by George Osborne in 2010, against all proven economic rationale and experience, it was going to sort out the deficit caused by having to bail-out the banks, and it was going to do that before 2015. Of course it failed. So of course the Government’s prescription is that it should continue – because that’s how ideologists work: the reason this hasn’t succeeded is because we haven’t done enough of it, not because it was a stupid idea in the first place.

Now, having created the crisis in local government funding in the first place, the Conservatives want to use that to change forever the nature of the relationship between voters and their Councils. Conservatives, you’ll have noticed, love the private sector. So they want Councils to do nothing more than issue contracts to commercial businesses to do their work. Of course, as you’ll have noticed if your bins haven’t been collected or your council house repairs not carried out, there seems to be nothing Councillors can do even in the current structures to actually get contractors to do their job properly. So how will that work when there are going to be only 4 Councillors covering the whole of Canterbury City?

If you still doubt that there is a hidden agenda then think about this. The business case produced in support of the merger plan includes an economic case, a business case, a financial case and a commercial case. It does not include a democratic case, or even a discussion of democratic impact. And that’s because they don’t want you, or anyone else, bothering to think about whether a larger Council with fewer Councillors and an almost certain permanent Tory majority will deliver the services that you need or expect from a Council, and they don’t want you thinking about whether an end to meaningful democratic scrutiny might lead to incompetence, the imposition of unpopular planning decisions, or a lack of oversight and accountability of the sort that very often leads to large-scale corruption. And if you’re not thinking about all that, it really would suit the Government.