The promotion of Jeremy Hunt to the position of Health Secretary is a sign of the supreme confidence of David Cameron’s adminstration and the contempt in which they hold the electorate.
Jeremy Hunt is the personification of the glutton and venality of the capitalist class at this time of austerity.
Like the Health and Social Care Act itself, his appointment as Health Secretary only makes sense from the point of view of powerful corporate interests.
Educated in Charterhouse and Oxford University, he is one of the growing number of white, public school boys in the Cabinet. Throughout his career he has distinguished himself as a stooge of corporate interests.
Having failed as a marmalade exporter, he set up a PR company and then followed a natural progression into Tory politics.
Hunt turned to politics as a bourgeois class warrior determined to use the power of government to the benefit of his class.
Since his time in office he has served them and empitomised them well. While still a relatively fresh face in Parliament, Hunt managed to get involved in the MP expenses scandal and then later in a tax dodging scheme.
His real career break came after he told Chancellor George Osborne of his support for Rupert Murdoch’s attempt to take over BSkyB. He was quickly promoted to oversee the BSkyB bid and did all he could to appease the world’s largest media tycoon.
Hunt’s conduct throughout this affair was very far from the free market principles that he prescribes for the NHS. When Murdoch’s operation turned out to be full of phone-hacking sociopaths, Hunt’s career looked likely to collapse.
However, like RBS, Hunt was “too big to fail”. If Hunt was going to be blamed for his slavish devotion to Murdoch then Cameron’s future would also be in question. So he was allowed to stay. His recent promotion is David Cameron giving two fingers to everyone who believes in the NHS or, indeed, basic standards of human integrity.
Hunt’s record on health is alarming.
After the Murdoch fiasco, Hunt returned to his consituency to lobby on behalf of Richard Branson. NHS Surrey were deliberating as to whether or not to hand over seven hospitals and a number of community services to the Virgin Care Group.
NHS Surrey were stalling on the £650 million deal, because their risk register identified that such a massive transfer of management responsibility might put patients at risk. Hunt stepped in to speed up the deal. Under his leadership, it is likely that the whole NHS will follow Surrey’s lead.
Unlike his predecessor Andrew Lansley, Hunt has been quite plain in his vision for the NHS. In 2005 he co-authored a book with the Orwellian title Direct Democracy: Agenda for a New Model Party, where he said: “We should fund patients, either through the tax system or by way of universal insurance, to purchase health care from the provider of their choice. The poor and unemployed would have their contributions supplemented or paid for by the state.”
He is also in favour of privatised provision: “Our ambition should be to break down the barriers between private and public provision, in effect denationalising the provision of health care in Britain.”
In 2008 he endorsed a Tory pamphlet called The Plan: Twelve Months to Renew Britain, which said of the NHS: “Outcomes are poor, it costs too much and would be better broken up into an insurance based system.”
Lansley’s Health and Social Care Act is a dense, repetitive, obscurantist piece of legislation based on nearly a decade of study into how to privatise the NHS while pretending to be doing something else.
Cameron has now sacked the only person who can make sense of it. The job of deciphering the Act has fallen to an army of bureaucrats organised into no less than seven different layers of bureaucracy across a wide variety of new organisations. Hunt’s only credential to lead this army is an ideological commitment to neoliberal dogma and the destruction of the health service.
So with nothing but his reputation for using public office to help billionaire bosses, he is set up to blunder and exacerbate the chaos that will rip through the NHS.
His first act as Health Secretary was to announce plans to sell off 912 specialist services for rare and uncommon conditions. This is, in fact, the third of three planned waves of sell-offs; the first (of community services) starts this month.
The specialist areas (due to be privatised in April 2013) are areas of exceptional brilliance where all the finest minds in the NHS work on the most complex medical problems. The loss of these services is part of Hunt’s aim to create a rump service for the poor. When these services are under private control the best clinicians will also be lost to the NHS.
If the NHS risk register was flashing red on civil unrest and increased mortality rates before the Health and Social Care Act passed through Parliament, Cameron’s appointment of Hunt has turned these risks into near certainties.
The labour movement must set out its own clear alternative.
Social Care White Paper: neglect for our future
The long-awaited government White Paper on social care “Caring for our future” ducks the pivotal issue of funding.
Creating more confusion than clarity, the government hasnow officially agreed to the funding principles set out in the Dilnot Report (2011) whilst making no definite decisions. In particular, it ducked the issue of capping individual liability for care costs (Dilnot suggested a cap of £35,000 and £100,000 for those in residential care).
As early as 2015 the number of people over 60 may outnumber those under 14. Yet, alongside mental health and disability services, older adult services have always been a poor relation within the impoverished social care family. Older adults face increasing isolation and chaotic services, with under-trained workers on long shifts and low pay, leaving little opportunity for engagement. Basic care and support is rushed or delayed for long periods.
The White Paper proposes a number of superficially innovative ideas to tackle these challenges, but they are often undermined in practice or underpinned by hidden motives.
A key plan is to provide £200 million over five years, starting in 2013, to encourage providers to develop new accommodation options for older people. Leaving aside that the source of this funding is unclear, private care homes are less likely to meet minimum regulatory standards in areas such as privacy, hygiene, staff training and quality.
A testament to the disaster of privatisation was the collapse of Southern Cross, the UK’s largest care home operator, in 2011, shunting tens of thousands of older adults towards disruption, confusion and increased health problems.
National standards will allow improved assessment of care — but rather than a person to help you with this, you get a “compare the care market” website. Transition arrangements for service users moving from one local authority to another will be improved but this is underpinned by a desire to ensure proximity to family and shift the duty of care away from the state.
The “Big Society” crops up again in the concept of people caring for others to create a “bank of care” to draw on themselves later.
There’s a welcome abolition of means testing for people on the end-of-life care register but this is often too little too late. “End-of-life” care only relates to the last 12 months of life, by which point life-long disadvantages and inequalities have taken their toll.
In February 2012 the National End of Life Care Intelligence Network reported that working-class people are more likely to die younger and with less control over where and how they die. This stems from a lack of access to resources throughout life; to lack of personal support at home; to an entire system based on undermining working-class people’s sense of entitlement.
The White Paper also restates the government’s commitment to personal budgets, making them a legal right by 2015.
Personal budgets can be a good way for people to have more choice and control over the services they receive. But too often they are a paper commitment, as workers are not given time or resources to plan collaboratively with service users and to ensure meaningful personalisation. Research shows that, in particular, older people are less likely than other groups to have raised expectations from personal budgeting, and are often anxious about planning and managing their own support.
If the cost of community care is greater than the cost of residential care, choice goes out of the window. In just two months of 2011, 120,000 hospital days were used by older people who could have been elsewhere. Age UK and the Royal College of Nursing have warned that the new proposals could see the NHS flooded with tens of thousands of people who can’t afford to pay for care at home.
Older people already contribute heavily to their care — with half total expenditure on older adult social care in 2005-7 provided by self-funding or assessed care charges. The government now plans to allow local authorities to charge, not just for the services they outsource, but also for the administrative and management fees of the outsourcing process.
“Caring for our future” is just another element in the drive to privatise social care and shift responsibility onto individuals and families. In a society that measures social value by contribution to the production of profit, older adults are disempowered and sidelined. They have limited access to advocacy and fewer clear rights as a group.
Older people’s and “pensioners’ action groups” have played a strong role in many local anti-cuts campaigns, but it is vital that social care workers organise alongside service users. As a result of older adults’ often complex support needs, this area offers opportunities for organising in solidarity with health and NHS workers, if union members can force their bureaucratic leaders to move.
We need a coherent plan for a system based on high quality care, accessible to all on the basis of need, not ability to pay; support, training, and a living wage for care workers; and the rebuilding of public sector social services, bringing provision back “in-house”, to improve accountability and the quality of care.
In contrast, “Caring for our future” is, as Jeremy Hughes of the Alzheimer’s Society said, “not worth the paper it’s written on”.
Manchester: Save Trafford General!
The Save Trafford General Campaign has gathered more than 10,000 signatures on a petition to stop the run-down and closure of the hospital’s A&E Department, the closure of Intensive Care and children’s services and the ending of acute surgery.
Local people know that these cuts place the whole future of the hospital in doubt, and the campaign has attracted a lot of support. A meeting of Trafford Council in July voted unanimously to oppose the plans.
But there is still a huge pressure for the NHS to make these cuts, to “balance the books” and improve the finances of the Foundation Trust that took over the services in April this year.
NHS bosses are holding a series of “consultation meetings” over the summer and through to October: staged events with 40 minutes of being “talked at” by NHS managers saying “there’s only one option”.
Where the campaign can ensure a lot of people come along and have their say the mood is very different though!
The campaign has started to link up with campaigners in other areas and hopes to share experiences and look at ways to fight back effectively.
Defend mental health services
In July service users affected by planned cuts in Manchester’s mental health services took the Trust that runs them to court for failing to consult with them or to assess the impact the impact the cuts would have on vulnerable people.
Rather than fight in court the Trust “agreed to reconsider its decision to carry out the community services review”.
So far so good, but the Trust are still planning to cut 40 front line community post and to disband Assertive Outreach Teams who support more than 300 service users who are the hardest to engage. They plan to cut services by 20%.
Manchester Community and Mental Health Branch of Unison is campaigning against these cuts and has organised a meeting on Monday 24 September — “Manchester Mental Health Services in Crisis” — at 7pm at the Mechanics Institute, 103 Princess Street, M1 6DD.
Labour: rebuild the NHS!
Sunday 30 September, 2.30pm
Manchester Central Convention Complex, Peter St, Manchester
tel: 07904 944 771 / web: labournhslobby.wordpress.com
Supporters include: Unite North West region, Unite Women’s Committee, Merseyside Assoc of Trades Councils, Wirral Trades Council, Midlands RMT, Unite Manchester Community Branch, Liverpool Wavertree CLP, Wirral South CLP, Broxtowe CLP, London KONP, Newcastle KONP, Leeds KONP, Sheffield Save Our NHS, Labour Representation Committee
Transport from London: coach leaving RMT Unity House at 9.30am. To book a place (£15) email firstname.lastname@example.org