The Health and Care Bill breaks England into 42 American-style Integrated Care Systems, effectively de-nationalising the NHS. Until now, NHS funding has come from a central pot of public money; but each ICS will have its own fixed, publicly-funded budget controlled by private corporations free to extract profits by cutting routine and emergency services and denying care. Corporations including American insurance giant UnitedHealth (UK arm: Optum) will decide who gets care from private providers. Long waiting lists and loss of public confidence will push those able to afford it to buy top-up cover from insurers. In the US model, the rich are routinely sold treatments they don’t need; the insured pay some £5,500 per person or £16,000 per family of four each year and risk being dumped by their insurer when treatment gets pricey; medical bills are the No 1 cause of US household bankruptcy despite three quarters of those bankrupted having medical insurance. We demand that government set up a task force to reverse 40 years of privatising legislation to fully renationalise the NHS, including dental care.
Since the 1980s, over 100 A&Es have been closed, and half of hospital beds have been cut at a time when the UK population has grown by about 10 million. Shrinking NHS capacity in this way is designed to undermine the NHS by creating inadequate provision, eroding public confidence and stimulating the growth of private care. The running down and concentrating of NHS services also creates economies of scale to cut costs for the private sector ready for the 2022 Health & Care Act to begin the switch to for-profit American-style care. Privatisation, austerity and the mishandling of the pandemic have put 6 million people on non-urgent waiting lists, delayed life-threatening diagnoses and treatments, and threatened patient survival. Since 2010, 10,000 mental health beds have been cut, creating a severe mental health crisis worsened by Covid. Since 2020, the government has had 2 years to invest in more beds to treat the 10% increase in patients due to Covid, but instead shrank NHS capacity by 8%, creating a further 18% shortage of beds and contributing to 100,000 excess deaths. We demand that government reverse A&E and hospital closures, invest immediately in at least 20% more beds, and rebuild NHS capacity to safe levels.
The NHS is short of 100,000 doctors and nurses. Business-style performance targets, cuts, closures, exhaustion, burn out, PTSD and financial hardship are pushing doctors and nurses out in droves. In addition, salaries of frontline NHS staff have been frozen at levels less than inflation for many years, resulting in real-terms wage cuts of close to 30% over 10 years for many NHS workers. This has resulted in many talented, dedicated staff quitting the NHS, which in turn has damaged national health outcomes for patients, as well as value for money. We demand that government incentivise recruitment and professional excellence with a 15% pay rise and proper overtime for all low paid staff ie, junior doctors, nurses, midwives, porters, secretaries, physios and occupational therapists, and create a working environment where frontline staff are valued and feel invested in NHS care by providing hot drinks, healthy snacks, overnight rest and shower rooms, free parking and access to mental health professionals.
Since 1990, an army of highly paid bureaucrats has been hired to run the NHS as a business, pushing admin costs from about 4% of the total NHS budget in 1990 to over 20% and rising. £200 billion has been squandered on the internal market, multinational accountancy firms and corporate consultants, £100 billion on private providers, and £37 billion on failed corporate Test and Trace. Some £88 billion of grotesquely expensive Private Finance Initiative (PFI) debt repayments have been pushing NHS hospitals into insolvency. In 2014, the former President of Global Health at American private insurance giant UnitedHealth, was made CEO of NHS England. Simon Stevens spent the next 7 years embedding his former employer throughout NHS England. In 2021, Samantha Jones, former CEO of US health insurer Centene (UK arm: Operose), became the PM’s expert advisor for NHS transformation, then Chief Operating Officer. Centene now owns 70 GP practices around the country. We demand that government use the task force to establish how to legally pull out of PFI contracts and end private sector contracts that divert £billions away from care and into the pockets of executives and shareholders.
The NHS holds the world’s most detailed and comprehensive set of healthcare data, derived from a universal healthcare system which has provided care from the cradle to the grave for three quarters of a century. In a world where big data and machine learning are increasingly transforming our lives, the NHS data store holds huge scientific and commercial value, outweighing any other UK national resource. This data can be used to discover new therapies for cancer, dementia etc, but can also be used by insurance companies to risk-assess patients commercially and deny us care. We demand that government commit to a permanent ban on the sale of our medical data to American big tech corporations or other private interests for commercial exploitation without our consent for uses unrelated to our care and against our interest; instead, invest in NHS data as a high-value resource by building its own big tech infrastructure which develops and analyses our data in-house for the benefit of the patients who provide that data, and re-invest any profits from commercial exploitation of NHS data directly in to a renationalised health service, rather than lining the pockets of big tech shareholders.