Nye Bevan’s famous quote that the Tories were “lower than vermin” was a direct and forthright response to the sustained and bitter attempts to wreck the NHS before it had even started. Similar arguments have appeared in the years since then.
It is said that the NHS is unfundable, unwieldy, overly bureaucratic. They are the perfect arguments for today’s modern politicians, containing a small kernel of truth that can then be spun into an obscure, maddening distraction from the real debate. We are hearing some of those arguments over the current dispute over junior doctors’ contracts. What’s really going on.
The Conservative Party’s pre-election pledge of £8 billion in extra funding was a perfect example of obscuring the truth. “We are the party which will fund the NHS” they claimed. No mention of the estimated £30 billion spending deficit.
No mention of the savage cuts to social care which have increased the pressure on the National Health Service.
No mention of PFI, the Health and Social Care Act, the chaos which is commissioning in the NHS at present. The problem of budget deficits within the NHS are not a new problem, like the ruinous Health and Social Care Act they have been “visible from space” for a long time.
Last week it was announced that providers of NHS services in England exceeded their budgets by £935 million in the first three months of this financial year. This is on top of a known perilous situation for the finances of a number of Foundation Trusts.
The blame for these increasingly ruinous deficits has been placed on current events, likely high agency staffing. But the deeper more systemic issues have existed within the NHS for much longer.
We are seeing the culmination of a decade of NHS mismanagement.
The introduction of financially independent Foundation Trusts by the then Labour Government created a system where individual groupings of hospital could go bust. At the same time this system appeared to allow them more freedom from central government control. But central government retained a steely grip on most of the purse strings, and in order to meet the financially-motivated targets set by government many hospitals struggled to focus on providing quality care. The most famous of these was Mid Staffordshire Foundation Trust, involved in an appalling care scandal.
Their financial freedom allowed Foundation Trusts to launch big infrastructure projects with funding from Private backers. Private Finance Initiatives (PFIs) will end up costing the NHS in excess of £300 billion pounds, 12 times the worth of the infrastructure that has been built.
Then the Health and Social Care Act tightened the market’s grip on the slowly suffocating NHS. Not only was the NHS being set up to fail, but a bigger space was being created for a private health market within England. This is exactly where the Conservative Party want the NHS to be.
In this environment, it is not surprising that previously passive forces are beginning to wake up to the situation. Junior Doctors are not the only ones protesting, although they seem to be doing a better job than the NHS Providers, the organisational grouping who argue for Foundation Trusts and other providers of NHS care.
They have been rowing with the government about “tariffs” for the past year. This is the amount of money they get paid for the work they do. It is being cut, just like everything else, and they appear powerless to stop it.
Junior Doctors across the UK have a direct understanding of the crisis which is facing the NHS. Our current contractual dispute centres around working patterns, staffing, recruitment, education and training, all key issues. In order for the NHS to return to sustainability, a huge shift in political will is required. This is why the junior doctor contract could be key to turning the tide in the war on the NHS.
The government have decreed that the NHS is not too big to fail, and they are all to happy to become “deficit deniers”.
Junior doctors have clear demands, which focus on protecting patient safety, protecting education, training and doctors who work less than full time. We have been clear that we will not accept a contract imposed upon us. Our fight is about the long term future of the NHS.
Join us on 17 October in London, and on 24 October in Newcastle. This is our chance to stand up for our NHS and its workers.