On the critical list

Who would have ever thought that pathologists would be locked out of their own lab? That ambulance workers would go on strike? That a private equity group would run a hospital?

And yet these are just some of the things that staff have had to fight under the Coalition government.

“There was a clear commitment from the last Labour government to develop and modernise the NHS, which was achieved,” explains Unite national officer, Barrie Brown. “There had been the highest levels of patient satisfaction ever recorded. That’s what the Coalition inherited.”

And how that inheritance has been recklessly spent. A&E departments in meltdown with the worst performance since records began. Over three million patients waiting for operations. And NHS staff suffering work-related stress is up by 40 per cent.

Speech and language therapist Frances Ridgway sees how the cuts affect her colleagues. “The pressure is to see new patients. This means people wait longer for treatment. Staff are trying to juggle all this and as a result, some are leaving or taking early retirement or having to take sickness retirement as they get burned out.”

Frances is not alone. “If staff are off sick, then they bring in other colleagues who are also stressed, or they bring in agency staff,” Barrie Brown reports. “The use of agency staff itself does not provide the best service and it costs hundreds of hundreds of millions.”

And staff are not just off with the musculo-skeletal problems you might expect. “The second reason for ill-health related retirement in the NHS that we’ve seen more of in recent years is mental health,” adds Barrie.

The Coalition has been a disaster for the NHS – staff and patients both.

Before the 2010 election the Tories made the NHS a central part of its strategy – promising to protect it from cuts and “no more top down reorganisations.”

Yet without any mandate the government forced through the largest top down reorganisation in NHS history.

It’s estimated the reorganisation from the Health and Social Care Act 2012 has cost £3bn.

The number of NHS organisations has doubled. Chaos has ensued with rising waiting times, overcrowding in A&E and failure to meet targets such as those for cancer treatment. Patient satisfaction has plummeted to just 58 per cent in a year.

Worse still the Act introduced the need for compulsory market tendering to virtually all areas of the NHS – with increasing swathes of the service contracted out to private providers.

Even costs for areas not privatised have soared as organisations were forced to spend millions bidding to run services they already provided.

 
“Lansley presented the act as a way to give patients choice,” says Barrie. “But patient choice is in no way at all dependent on giving opportunities to hundreds of private organisations to bid on and run services.”

And some of these private providers are quickly showing their true colours. Scandals are mounting – cases so far have included falsifying data, providing poor quality care, patient safety fears and unnecessary deaths.

Scandals

 
Even the government’s flagship private hospital, Hinchingbrooke, has come under scrutiny after the private equity-owned Circle group decided to pull out of the contract following criticisms from the care quality commission.

“Circle was brought in as a sort of cavalry to save that hospital,” reports Barrie.

“Four years later, in January, they pulled out. They weren’t making money, which is what they expected to do.”

The government’s response, rather than rolling back these contracts, has been to push on regardless including plans to entrench their market system in the international TTIP trade agreement with the USA.

Barrie is rightly concerned. “There is still no unequivocal statement from the government that the NHS will be excluded from TTIP. If it’s not excluded the health service will become completely fragmented.”

The government’s multi-million pound shake up, coupled with an unprecedented £20bn of so-called efficiency savings has put our NHS at grave risk.

The NHS has been losing money in real terms under the ConDems – with funding expected to decrease back down to a level significantly lower than most comparable countries.

With the NHS now £30bn short of funds, there’s a limit to how much more any service can do with less money.
Despite everything this government has thrown at them, NHS staff are working harder than ever – a truly heroic achievement.

But our health workers are under unprecedented attacks and criticism from this government.

After four years of the Coalition most NHS staff have lost around 15-20 per cent of their real terms basic pay with thousands of NHS staff being pushed into poverty, earning below the living wage level.

So it was absolutely no surprise that last October staff took the difficult decision to take strike action over pay. They’d simply had enough. As we go to press members are voting on a pay deal.

Hope?

 
But is there any hope? Probably not if the Conservatives return. As for Labour? Labour has pledged to repeal the Health and Social Care Act – a major step forward.

“An incoming Labour government needs to do two things – they need to ensure NHS funding reflects the additional costs that have arisen that haven’t been met by this government,” believes Barrie.

“Secondly, to restore confidence in staff morale, there should be a genuinely independent pay review body that can make recommendations to restore the value of our members pay.”

Jackie Applebee is an inner London GP. She believes, “If there’s a Conservative government the NHS will be history.

“They will quickly move to finish the job, parcel it up and sell it off. Many people don’t realise what’s happening to the NHS because it still looks to them, more or less, the same as it did in 2010.

“What they don’t realise is the foundations are being dug out under their feet and they won’t notice until it collapses.”

*This feature first appeared in Unite Works magazine, Spring 2015 edition