Former LOTO staffer Dr Phil Bevin on the fate of the NHS and the complicity of Labour and the LibDems in a ‘national scandal’ of profiteering and denial of treatment ‘in the interests of a small elite’
Ed Davey’s Local Lib Dems’ support for NHS sell off reveals a national scandal
In the UK, we are experiencing an anti-democratic merger of state and corporate power in the interests of a small elite and against the needs of everyone else. Though it first emerged in the late seventies and early eighties, this agenda has been pursued by every political party in Government. It is most clearly illuminated by the ongoing fire sale of NHS assets in England.
With the Tory Government’s new Health and Care Bill progressing through parliament, there has been a lot of talk on the left about impending NHS privatisation. This stems from fears that that the combination of allowing representatives of private healthcare to sit on Integrated Care Boards and doing away with the obligation for the commissioning of services to be undertaken through a transparent tendering process, will enable clinical board to hand over NHS contracts to organisations in which board members have a vested interest. This would, it’s rightly feared, widen the scandal of “contract cronyism” that has emerged during the ongoing COVID-19 pandemic.
But though these serious concerns are legitimate, these worries have distracted from the tragic reality: across England, the NHS is already being sold off and the fire sale has been burning fiercely since at least 2013, tearing through NHS trusts throughout England and laying waste to patient services nationwide. Access to services, particularly beds for acute patients, is being reduced, even as the Government is able to boast of more money going into “the NHS”.
What’s been done to the NHS?
Unfortunately, campaign groups have been slow to recognise the reality, with some even defending aspects of the disastrous status quo. Even on the left, too few understand the implications of the 2012 Health and Social Care Act, which effectively abolished the NHS in England by mandating that the tendering of NHS contracts be opened to the private sector, while, for the first time ever, replacing the legal duty of the Secretary of State to provide comprehensive health service, with a duty to only promote a comprehensive health service. In other words, the 2012 Act removed the fundamental safeguards that ensured that the NHS would operate according to the purpose for which it was first established.
What we are left with today is already nothing like a comprehensive health service, offered free at the point of need. Instead, we now have a patchwork postcode lottery of NHS trusts, with fixed budgets allocated according to population numbers not healthcare need, administrated via Clinical Commissioning Groups, who are legally obliged to put NHS contracts out to tender to the private sector. The limited budgets, coupled with outsourcing incentivise the reduction of costly procedures, closure of acute care wards and increased contracting out to private providers offering cheaper “community care”. Nor is solving the issue simply a matter of “the NHS needs more money” because, in a capitalist system of integrated care, the availability of extra cash may just encourage private providers to increase their prices rather than pass the money to patient services: fewer services at a higher price. No matter how much extra money goes in, the system as already set up incentivises the denial of care to maximise income.
This is already an American style model of integrated or “accountable” care. In reality, the new Health and Care Bill will speed up a process already well under way and which has had cross party backing for decades. Though this is taking place under a Conservative Government, simply voting out the Tories at the next election will do nothing to reverse the unfolding disaster, as the capitalist B-teams that currently present as opposition parties are just as committed to destroying the NHS through “integrated care”.
As I’ve highlighted before, Starmer’s Neo-Labour is as committed to privatisation as the rest of the establishment. But perhaps the simplest example of what the NHS fire sale already means for us comes from the Liberal Democrats, or, more specifically, the behaviour of Lib Dem Leader Sir Ed Davey’s local party in Kingston Upon Thames.
A local example, illustrating a national tragedy
Like the Conservative Party and the Labour Right, the Liberal Democrats have long advocated NHS privatisation. In 2004, The Lib Dem’s current leader, Sir Edward Davey, co-wrote The Orange Book: Reclaiming Liberalism, a right-wing policy prospectus for the party. An essay in this book by David Laws – “UK Health Services: a Liberal agenda for reform and renewal” – argued that “the traditional (‘economic liberal’) liberal commitment to the principles of choice, competition and decentralisation, as well as to the value of the private and voluntary sectors, should provide a good starting point for the Liberal Democrats to think constructively and radically about a reform agenda.”
In his own Chapter, “Liberalism and Localism”, Sir Ed Davey, in apparent agreement with Laws, wrote: “Britain’s centralised state is not yet well designed to mirror the private sector’s ability to innovate. From monolithic structures in the NHS to national pay setting across the public sector, the Whitehall model looks increasingly inflexible and unable to embrace difference”.
Many of David Laws’ basic ideas found their way into the disastrous 2012 Health and social Care Act (more accurately described as the NHS Abolition Act) and, through that, into the reality of service provision on the ground in Sir Edward Davey’s own constituency of Kingston Upon Thames.
In 2020, Kingston Council’s Portfolio Holder for Housing, Lady Emily Davey – the wife of Sir Ed Davey – announced “an exciting opportunity”. She was talking about the local Clinical Commissioning Group’s decision to sell a clinic that serves one of the Borough’s largest Council Estates – Cambridge Road Estate – and which presently functions as an essential COVID-19 vaccination centre, after the CCG claimed the site to be “surplus to requirements”. Davey said that the sale could enable the Council to build properties to “provide both private rent” and “new healthcare facilities at the heart of Cambridge Road Estate”. But in truth, with the local CCG designating the existing clinic as “surplus to requirements”, new healthcare services were never likely to be allocated to the estate and it is not something that the Council has the power to decide.
While Kingston Clinical Commissioning Group was flogging NHS assets, Kingston Council has been privatising its own by teaming up with a property developer to form a joint company to push ahead with their plans for estate gentrification. The land of Cambridge Road Estate has been turned over to a new joint venture company bankrolled by council land-assets and developer cash, for the purposes of demolition and redevelopment.
This is not unusual in London, as those familiar with Croydon’s Brick by Brick debacle will know. It’s part of a wider trend through which councils have sought to offset central Government cuts via increased revenue from high-end council tax-payers: demolish an estate, double the density and hike up the prices to ensure an influx of relatively healthy, wealthy people, whose council tax rates will pay for services they don’t themselves use.
Just as Clinical Commissioning Groups are being incentivised to sell assets to pay for care, so councils are being encouraged to buy and sell former NHS land to fund development; supposedly public bodies have become simple facilitators of a system designed to funnel public money into private hands for the enrichment of the few at the expense of the many.
Of course, those playing with fire risk getting burnt. For reasons that have not been officially explained, Kingston Council was unable to buy the clinic site for use in its own enterprise, with another developer submitting a successful bid.
Worse still for Kingston Council, the reduced estimates of London’s population growth have hit its regeneration plans. The redevelopment of Cambridge Road Estate is projected to make a £50 million loss by the Council’s own viability assessment, casting the future of the project into serious doubt.
Davey and Kingston Lib Dems’ endorsement of the sale of local NHS land has backfired badly. The Council won’t profit from gentrification, with only a single expensive privately built and owned tower block likely to result from their schemes as testament to their folly.
The worst outcome is for the residents of Cambridge Road Estate, who, after suffering years of uncertainty over the future of their homes, are now set to lose vital health services: a story being repeated across England.
England’s healthcare crisis is one of the most significant parts of a wider project – in play since the late 1970s – to divest the public of its resources for the enrichment of our society’s elite, a small but powerful group of scroungers, capable of contributing nothing of value and whose existence has always been dedicated to taking other peoples’ wealth.
We can afford a publicly owned health service delivered free at the point of need. We can afford to guarantee everyone a council home. But we can’t afford these essential basic human rights while we are governed by an establishment whose sole purpose and interests lie in selling our resources for their own benefit.
Change starts with ordinary people. If you want to ensure that health services in your area don’t suffer the same fate as they have in Kingston upon Thames, petition your Council using this template.
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