In 1988, as George HW Bush ran for election as president of the US, he made a statement that swept him to power, as Americans voted for him in droves (as a country, the US is among the most deceived by the ‘small-state’ ideology promoted by the privileged). That statement, which quickly became iconic, ran thus:
‘Read my lips: NO NEW TAXES!’
In 1992, under criticism from his own side and opponents that he had broken this emphatic promise, Bush lost his bid for re-election to Bill Clinton.
In the run-up to the 2010 election, David Cameron made an equally emphatic promise. I don’t believe he ever said ‘Read my lips’, but he might as well have done. What he said was, ‘NO top-down re-organisation of the NHS!’ This statement played a key role in the Tories out-performing Labour at the polls (I won’t say in their winning the election, because they were unable to achieve an outright victory in spite of the deep unpopularity of Gordon Brown), as it served to neutralise a major Conservative weakness in the minds of many British people.
The ramming-through of the Health and Social Care Bill into law showed that Cameron’s promise wasn’t worth the breath he used to say it. But the Tories’ treatment of the NHS is a veritable roll-call of lies, broken promises and hidden agendas. A number of excellent articles have been published recently (I’ll link to some of them in my article) that show specific areas of impact of the Tory lies and actions. But in this post I’m going to try to give, in a clear and hopefully concise way, an overview of the main areas of deception and criminality, and to demonstrate that the Conservatives are not merely untrustworthy when it comes to the NHS, but engaged in an active campaign to dismantle the nation’s most treasured possession until nothing meaningful is left.
1) LIE: ‘No top-down re-organisation’ (see here)
We’ll start with the most obvious! Cameron promised, and yet within 2 years he and his Andrew Lansley had forced their bill through Parliament – a bill that nobody in the service wanted, as we’ll see below, and that most of the public would have disapproved of were it widely known what it meant. And note – this Bill was first proposed in January 2011. It takes many months to prepare a bill this complex and far-reaching. This means that the preparation of this bill was begun as soon as the Tories took office in May 2010, if not before. Which means that this is not a case of Cameron getting into power and then finding out that a change was necessary – he knew, when he made his campaign promise of no more top-down reorganisation, that the Tories were going to conduct, from the top down, the biggest attack on the NHS in its history. In other words, he lied.
To minimise public outcry, the Tories have engaged in a concerted spin campaign that has included systematic attempts to demonise anyone who has tried to resist its measures, aided and abetted by their mates in the media. Regular stories of ‘failing’ hospitals, interviews with relatives slanted to portray isolated incidents as indicative of endemic incompetence/callousness and tales of supposed inefficiency have been used to erode public confidence in and affection for the NHS and its overworked staff. Attempts to resist erosion in pay, conditions and pensions are portrayed as selfishness and a denial of reality, and contrasted with the poor conditions and insecurity faced by many in the private sector (in other words by those whom the Tories’ corporate backers have already robbed – see more) to further undermine the public perception of people of whom we should be justly proud. And now the Bill, in direct contravention of Cameron’s very public promise, is in place and the rate of damage is accelerating rapidly.
2) LIE: ‘Change will be ‘driven by the wishes and needs of NHS professionals and patients’ (source)
A strong statement ndeed – the key drivers of any change in the NHS would be the wishes of the people who work in it, and the people it treats.
So, what did health professionals say about the changes as the Bill was discussed in Parliament? Simple: absolute rejection. Out of all of the health professional bodies, only one did not reject the bill outright – and that one (the Royal College of Surgeons) said it ‘considers that the Health and Social Care Bill, if passed, will damage the NHS and widen healthcare inequalities, with detrimental effects on education, training and patient care in England.’ The comments of the others, as you will imagine since they rejected the bill and called for its immediate withdrawal, were no less damning. You can read them in detail here.
Well, patients haven’t had much time yet to experience the consequences of the new Act, but patient groups were soundly against the bill when it was mooted and in the run-up to its passage into law (For example, see this article in a newspaper which is a natural Tory ally). As for impact on patients after the Act’s implementation, the edited version of the now-famous risk-register (which you can see here) warns of – at the least (remember, this is the edited version, so the worse stuff will be left out!) – closures of health facilities, consortia going bust and an impaired ability of the NHS to respond to emergencies such as epidemics and terrorist attacks. None of which is good for patients. (For more on the consequences highlighted in the Risk Register, see my article on the lowlights of the risk register)
A glimpse into real Tory attitudes to patients was given recently when a Tory councillor in Surrey called for patients with chronic illnesses he considers self-inflicted to be treated more slowly on the NHS, so that they would move away to other areas and drain their health resources while less ill people moved to Surrey, pushing up house prices(!) Health provision as a form of social cleansing – could the true heartlessness of Tory ideology be any more clearly demonstrated?
So, in complete contrast to a promise the Prime Minister made before he came to power, the Act has been forced through Parliament in spite of massive opposition from both health professionals and patients, and in spite of warnings of negative consequences for both patients and staff in the government’s own risk assessment.
In the same speech in which he made his promise that any changes would be driven by the wishes of health workers and patients, Cameron called the NHS ‘one of the greatest achievements of the 20th century’, and even went so far as to say, ‘it is not just a question of saying the NHS is safe in my hands – of course it will be’. And in May 2011, he went so far as to say that only Tories can be trusted with the NHS (see link above).
That’s a big claim, and one that had better stand up to some scrutiny. Except, of course, that it doesn’t. The new Act expressly ends the Health Secretary’s duty to provide or secure health services to the UK people. Abdicating responsibility for health provision?! What else is a Health Secretary there for? In short, Lansley has absolved himself of all responsibility for what happens to the NHS. Hardly the actions of someone who can be trusted with it.
It goes further. In a speech in March of this year, Cabinet Office Minister Francis Maude, in a speech to a right-wing ‘policy think-tank’ said that the Conservatives’ aim was to not just to privatise the NHS but to eradicate all public services! (see more). Tory MP will take part in a discussion next week organised by the odious and shady free-market ‘charity’ the Insitute for Economic Affairs, titled ‘Should we abolish the NHS?’. These are not rogue elements within the Tory party. ‘By their deeds you shall know them‘, and their deeds show they’re all cut from the same cloth, at least at Cabinet level.
This process has already begun. Eoin Clarke’s excellent article on NHS privatisation includes a map showing the extent to which it’s already happening. This article (among others, for example here) by NL Group shows how private cartels are already being formed to force down NHS staff’s pay and conditions in areas outside Tory heartlands, which of course the Tories cushion from the worst of the changes to protect their vote.
It may have escaped the notice of many, but the government has already formed a registered company, PropCo, to manage the NHS’ ‘excess’ land, and has legally obliged every NHS Trust to hand over ownership of this land – worth appr. £5.2 billion – to PropCo, so that it can be sold off. Already 591 hectares of NHS land is being sold to private developers. This money will not go to the NHS, and the government is free to sell off PropCo to private owners. If NHS Trusts need land for expansion, instead of using land they used to have before being forced to hand it over, they will have to buy land at commercial rates (and not necessarily in the most workable locations) – draining funds away from service provision and patient care.
So much for able to be trusted, and the bill not being a back-door route to privatisation.
4) LIE: The NHS is inefficient and needs to be ‘fixed’
This is a lie in so many ways that it’s hard to know where to begin. To support his determination to push through unpopular reforms, Andrew Lansley, claimed that the NHS was inefficient and growing more so, stating that productivity had declined by 15%. Cameron even taunted Labour about this in Parliament. However, an analysis by the Lancet showed that productivity had in fact risen over the last 10 years, making a complete farce of Lansley’s claim.
Moreover, the National Audit Office published an article claiming that the NHS wasted over £500 million because fragmented purchasing meant that higher prices were paid in some areas for the same items than in others. Yet the government’s own risk register – even the edited version – states that fragmentation under the new system will be worse (see ‘Extract 2’ here) and that this will result in a loss of cost-control.
Far from being inefficient, the NHS is actually the 2nd most cost-effective health system in the world, behind only the Irish Republic. Yes, you read that right. In the benefit delivered compared to the amount it costs, the NHS is genuinely world-class and outperforms by light-years the privatised US health system that Lansley and his colleagues so admire. As I pointed out in an earlier blog post, the US spends more than twice as much per head of population as the UK does. In fact, even when you strip out the vast and exorbitant cost of private US health care, the US – without a public healthcare system – spends about 30% more per head (not just on the uninsured, but averaged out across the whole of its population of c. 300 million people) on health provision.
This last fact shows that it’s not just a lie that the NHS is inefficient. It’s also a lie that allowing privatisation and ‘competition’ into the NHS will improve things. In fact, it’s absolute logic that adding a profit layer into the cost equation must make things more expensive. Virgin’s healthcare subsidiary made a formal complaint against Yorkshire NHS regarding a bid Virgin failed to win, on the basis that not charging a profit meant that the public provider was competing unfairly. And again, the Tories’ own risk-register states that the new Bill will (not might!) increase cost.
If a company is to make a profit, it has to either charge more than a non-profit provider – or else it has to cut costs: drive down wages, reduce staff numbers, use lower-quality materials (drugs, bandages etc) or find excuses not to offer treatment to ‘expensive’ patients. Or, most likely, all of these measures combined.
So much for efficiency and cost-reduction as a reason for this invidious Act. And so much for reforms that meet the wishes of NHS staff and patients.
5) LIE: The bill will give choice to NHS patients
Conservatives have long claimed (here, for example) that competition and patient choice are important factors in delivering a quality health service. We’ve already seen that competition not only fails to guarantee better services, but actively works against them and increases cost. So what about choice? Again, what the Tories promised is not what it delivers. Eoin Clarke’s map tells a clear story. Once contracts for NHS services are handed over to a private company for a whole region, patients have no more choice about who provides their healthcare than they had before. In fact, they have less – and they’re forced to look for that care from a company with a vested interest in finding reasons to deny it, as it strives to cut cost and maximise profit.
The picture is clear. Any kind of considered examination of the Tory record on the NHS, of its words versus its actions, shows absolutely clearly that they ‘speak with forked tongue‘.The Tories will say anything to defend their actions and worry about the consequences later, if ever. They will deceive the public in order to rob us – and only on very rare occasions, when they feel secure in speaking to their ideological allies, will they say plainly what their real intentions are. But the facts speak for themselves – the Tories hate the very idea of the NHS, of something being provided by the State to those who can’t afford to pay for it directly. Of treatment provided free and at the point of need. We must not stand passive and allow them to steal it from us.
George Bush paid for his broken promises by failing to win a 2nd term – a relative rarity for an American President. David Cameron has not merely broken promises, but definitively lied to the British people in order to gain office. He must pay the price.
If, like me, you’re unwilling to wait until the next election in 2015 to see Cameron and the other snake-oil salesmen out of office, please go to the petition below, sign it, and get as many others as you can to do so. At the very least it will send a message, and provide ammunition to the opponents of this scandalous Act.