What the NHS needs: what we can do

Felicity Dowling writes: We protest at the lives lost, lives shortened, and the stress endured by families and staff in the NHS. This winter the staff of the NHS have worked hard, often in terrible conditions. The Royal College of Nursing report from December is heartbreaking for patients and for staff. The Royal College of Emergency Medicine published this on their Facebook page and asked: How has this been allowed to happen again?

Starmer and Streeting are so wrong in their NHS policies and actions.

The Government knows that the winter crisis kills people. They published the statistics about it. According to the Royal College of Emergency Medicine, “these long waits are likely to be causing an additional 14,000 more deaths a year – more than double all British armed forces’ combat deaths since the health service was founded in 1948”. Starmer made speeches about it before the election.

Labour should have had plans ready to go, to restore the NHS when they won the election.

The system has been crippled by shortage of staff, shortage of beds, shortage of space, shortage of funds, privatisation in its many forms, and the structural problems caused by breaking the NHS into 42 Integrated Care Systems.

People across the country are furious, others are in despair. It is the responsibility of all socialists to get the alternatives out about the NHS, across the country. The response from the public when asked to support such campaigns is amazing. The NHS came from the socialist movement, from movements of working-class women, like the Women’s Cooperative Guild. Let’s rekindle those struggles.

• Demand no more privatisation. Commandeer the private hospitals if needs be, as Spain did in the Covid crisis.
• Demand full funding.
• Demand that the government treat the staff well.
• Fill the vacancies.
• Bring back bursaries.
• Restore full funding to GPs, fill vacancies, and stop the incursion of private companies that is leeching cash from the NHS.
• End the Integrated Care Boards (ICB) system.

If you want to do something and are not sure about what or how to do so, please do get in touch.

What you can do

We call upon our readers to take action. We are not saying this action will be easy. The NHS is hugely valuable to international health and insurance corporations, who have huge resources at their hands to counter us. But we can have the working class on our side and workers have huge unused power. Raise the matter in your union branch and in your workplace. Get involved if you can with local and national campaigns for the NHS, write to your MP expressing your anger and disgust, demand action from your council who have a role in the ICBs.

Join the national Rally for the NHS in London on Wednesday 26th February – 12 noon at Old Palace Yard, opposite Parliament. It’s part of the Keep our NHS Public Month of Action.

Contact Left Unity (info@leftunity.org) to link with other health campaigners in Left Unity. Raise it with your political party or an organisation you are involved with. Above all, talk about it to your family and friends.

Labour has overseen one of the worst winter crises in NHS history this winter, 2024-25. Not one of their excuses holds water. The “Temporary Escalation Spaces” (corridors to you and me) were in use before flu took hold. The flu was not huge, Covid, though still a danger, did not flood the accident and emergency services. Sick people did. There was not a flood of people arriving at A and E for stupid reasons There was no sudden drop in Care Home spaces. There were insufficient Care Home beds in the system before winter, and everyone involved knew that. There is no national system for Care Home beds. We rely on the privatised sector, which runs for profit. The acuity, the extent of the illness of the people presenting in accident and emergency, was worse than expected. Our people are ill, waiting a long time for treatment, and some are dying because of the ridiculous waiting times in A & E, or dying waiting for an ambulance. The cost of food and the cost of heating our homes makes things worse – run down people get sicker quicker.

The staff are working hard, but the structures, organisational, financial and physical that they work with, are not designed to make people better but to mimic the US system, and deeply increase privatisation. Again and again, this and the last government have brought in managers and advisers from the appalling US system to reorganise the NHS. Even our most intimate data is in the hands of such organisations.

The Government put out a consultation Change NHS, claiming to listen to people, but has made change after change, all embedding or increasing privatisation before it even closes.

Healthcare is an excellent investment in the country, with excellent returns on that investment in terms of health and wealth. The investment must be in the publicly owned and delivered service, otherwise our taxes are going into shareholders’ and directors’ profits. The huge US corporations pushing their way into our NHS are rightly hated in the US.

The National Health Service, our NHS, founded by the work of women’s campaigns and the trade union movement, has been split into 42 Integrated Care Boards, and this split is fundamentally damaging.

Each ICB board runs a “system”(ICS) based on Providers, which is Hospitals, Primary Care including GPs and the other aspects of NHS care, which are paid for by the NHS but run by private companies. The ICBs supposedly make policy and ensure that all their area has equitable treatment. The reality is that poor people die long before the wealthy, and struggle to get GP care, dentistry or hospital care. In theory they also control social care in partnership with councils.

The hospitals are short of resources, the GPs are undergoing a reorganisation aimed at reducing the numbers of GPs, despite long waits for treatment and unemployed GPs. The councils have largely privatised the care homes during austerity, and the care service generally is long privatised. All the ICBs can do is bargain over prices with the private providers.

This winter crisis was on Labour’s watch, and so much more could have been done to resolve these issues in the time since the election. The Labour Government chose, and chooses, to continue with the previous governments’ structures, procedures, and financial controls which meant that hospital trusts had little choice but to focus on meeting their Cost Improvement Programmes rather than planning for the winter. In Cheshire and Merseyside where campaigners attend the ICB meetings as members of the public, when plans should have been being made with the hospitals to prepare for winter, instead Price Waterhouse Cooper were sent in to have regular meetings with the board to show them how to ‘balance their books’, the balancing of which included 6% CIPs (cuts to the rest of us). Winter comes every year, and a country like the UK with huge poverty, poor housing, expensive food, inadequate “benefits,” and soaring heating bills, will get more sick people each winter.

The NHS came out of the period of Conservative rule with insufficient hospital beds, doctors, nurses, midwives and allied professionals. It lacked key equipment and many hospital buildings are in perilous physical condition. It lacked adequate funding and far too much of its funding was syphoned off to private companies. The remodelling on US lines really hurt the NHS.

They continued with the restructuring into Integrated Care Boards which are based on the Accountable Care Organisations (ACOs) in the USA, with personnel from the big US corporations having a key role in the restructuring codified in the 2022 Health and Social Care Act.

In the US, government money for medical care in a distinct area, is given to a for-profit ACO (Accountable as in counting money, not as in being answerable, Care as in healthcare, Organisation). The lump sum of government money is given and the organisation’s profit is largely created by NOT providing treatment. This is not a countrywide system in the US, but it is nationwide in the UK. We are not yet in as brutal a system as the USA, but the ICBs can only balance their books through cuts. They don’t have enough money to provide healthcare for all their people. This though, does not stop the system directing huge sums to privateers.

Our NHS must be:

• Free at the point of need.
• A national organisation.
• Government-funded.
• Not for profit.
• Publicly provided.
• Respectful of the needs of women and children.
• A great place to work, with decent pay and respect from the employer for staff.

Outsourced work must be brought in house, treatment must be timely, the NHS must be funded at least to the level of other advanced countries, but preferably to US levels. (Yes, the US has more government spending on healthcare than the UK, but the money doesn’t all reach the patients), and a full programme of building and repair should be started.

This weekend there was action in some cities. We need more of this.

Campaigners call for delayed Leeds hospital project to start – BBC News

This picture from Nick – Leeds Left Unity.