A western catastrophe in the making

A great inspiration could die.

The British people's unique contribution to the conditions of the western working class in the 20th century is on the edge of collapse. The fragile construction of the National Health Service is only sustained by the efforts, self sacrifice and commitment of its 1.7 million workers. The fifth largest employer in the world, the NHS, has been turned into a honey pot for private capital, reorganised to the edge of extinction, starved of funding by successive British governments and has turned front-line working conditions into a war-zone.

The Prime Minister and Health Minister's 'Winter Plan.'

The farcical commentary by the PM and the Health Minister Hunt, who forced himself back into his job, that the NHS had never been so well prepared for the effects of winter, has created an angry explosion of disbelief as national media exposed the truth to all. This state of affairs has a history. In the last 25 years, the only government measure that changed, even reversed the relentless expansion of work and the tighter and tighter rationing of health services to the public in the winter was the brief period in the early 2000s when the Labour government decided to match NHS funding to the EU average. That stopped before 2008. Since 2010, 15,000 beds have been cut in England alone. Again in England £6 billion has been cut from the Social Care budget and there are now 100,000 NHS Social Care and NHS vacancies.

We know the reasons, don't we?

From 2000 to 2011 the number of people over 85 has increased by 40%.  (It is a matter for concern that gains in life expectancy were concentrated between 2005 and 2010, since then life expectancy has improved little for either sex. See 'Age Concern' Report Feb 2017.)  Many NHS managers tell the population that social care is, nevertheless, the great problem. Old people are in Hospitals and should be in care homes. Fix that and the NHS problem goes away. Increased funding for the NHS, yes, but let's also have greater increases in funding for social care system!

Who is that saviour?

Presenting himself as the hero of the hour, it's Foreign Secretary Boris Johnston, who tells every media hack (before mentioning it to the PM) that the Tories should find an extra £5 billion a year from Brexit for the NHS. This is Boris's 'big idea' to stimulate the anxious and stunned Tory faithful, inside and outside Westminster, as health headlines dice the PM's 'Winter Health Plan' into mincemeat. And as Boris is as interested in the health service as the Pope is about children, it might be guessed that as the PM May's leadership slides into the political gutter, it is Boris who could arise and take on Corbyn's Labour Party in an increasingly inevitable early General Election.

What is the real issue here?

Ed Miliband, Labour's failed Prime Minister in the General Election of 2015, criticised himself in a Radio interview for not projecting 'big enough ideas.' (BBC Radio 4 'Today' 23 Jan.) One that he has now chosen is that the funding of the NHS should be ring-fenced. He has not decided what particular chunk of government income would carry that weight. More progressive 'thinkers' have already made proposals, from the restoration of  'National Insurance' to set proportions of the Gross Domestic Product. But all taxes and the GDP go down as well as up. And (currently soft) right wing voices murmur from behind the wall that increasing health and care expenditure could be endless ... Perhaps it is only the market that might resolve this long term dilemma?

Start from the other end.

The reality is that a combination of steps are required to rebuild the NHS. A proportion of GDP and comparison with other developed countries health and care expenditure would be a popular transitional funding measure. But the fundamentals start from the other end of the argument. The Age Concern report (see above) and the Nuffield Trust report (December 2017) reveals astonishing facts. Starting from the health needs of the population they have discovered that the rich in Britain live a decade longer than the poor. Nevertheless, the poor can expect 20 years' more suffering from chronic diseases than the rich. School-aged children from the poorest areas are two and a half times more likely to be admitted to hospital in an emergency for asthma than those in richer areas. And the gap across a wide range of chronic disease in older age (diabetes, dementia, heart-failure etc) has been expanding in the last ten years. In Britain it is poverty that is the driver of the health and care crisis. Just as it was before the NHS was founded.

Don't do nothing; do something; we can win; we have to win!

On Saturday 3 February the Peoples Assembly and 'Health Campaigns Together' (see Dr Louise Irvine on 'You Tube' - NHS Emergency Demonstration.) have launched a mass demonstration, starting at 12pm on Gower Street London WC1. People have to show their anger at the destruction of the greatest institution that the British people, the ordinary people, have ever built. And where else will come the support for those on the front line in this battle? How can the million plus workers in a fundamental service keep their morale, their skills and their faith and hope intact if they do not see that the rest stand with them?