The Tories are deliberately destroying the NHS as a public service, but the country can afford to restore it, argues Tom Griffiths

The ‘people’s priorities’

On Wednesday, unelected Prime Minister Rishi Sunak, who with his wife, have a collective net worth higher than the personal fortune of King Charles III, said the Conservative government, ‘will always reflect the people’s priorities’.

It’s not the only lie in what’s probably one of the most disingenuous speeches in the history of British politics. In a speech which put the NHS crisis front and centre, he claimed,

‘You should know we’re taking urgent action: Increasing bed capacity by 7,000 more hospital beds and more people cared for at home. Providing new funding … I want people to clearly understand the government’s position. We hugely value public sector workers like nurses. They do incredibly important work. That’s why we want a reasonable dialogue with the unions about what’s responsible and fair for our country.’

In fact, the government’s intervention on the NHS crisis is drastically inadequate. Taking those points one by one, according to the King’s Fund: ‘The total number of NHS hospital beds in England has more than halved over the past 30 years, from around 299,000 in 1987/88 to 141,000 in 2019/20, while the number of patients treated has increased significantly.’ The British Medical Association reports that: ‘Compared to other nations, the UK has a very low total number of hospital beds relative to its population. The average number of beds per 1,000 people in OECD EU nations is 5, but the UK has just 2.4. Germany, by contrast, has 7.8.’ In this context, 7000 new beds would be laughable if it wasn’t costing so many lives.

As for Sunak’s claims of more funding, in the summer of 2022, the NHS argued the need for an extra £7 billion this year and next to get the post-Covid recovery under way, only to be given less than half of this – just £3.3bn this year and next.’ As Counterfire has recently reported, the huge resentment among NHS workers towards the government makes a mockery of Sunak’s claim that they care one bit about the pay and conditions of public-sector workers.

The truth is that one of the main factors driving the NHS crisis is the staffing shortage across all NHS services. As I wrote in October’s Public Sector Focus magazine, the NHS has an all-time record of 132,000 vacancies. No wonder NHS services are struggling. Even the Financial Times reported: ‘Experts identify interrelated factors from winter infections to under-investment and a depleted and demoralised workforce.’ One of the most shocking aspects of Sunak’s speech was that he failed to address this obvious point: the reason for the staffing shortage is because of poor pay and conditions.

When I asked some nurses about why they were striking recently, one of them told me she was ‘petrified someone might die unnecessarily every time I go on shift.’ The low retention of NHS staff is obviously tied to pay. If you could work in a supermarket and not worry about someone dying for a better salary wouldn’t you? The fact that so many health and care workers do stay at their posts (in the pandemic even risking their lives to do so), is to their great credit. Granting them pay justice is the least the government can do: 3% just won’t cut it. 

Sunak’s speech in fact is an incredibly weak response to a crisis that is now causing up to 500 unnecessary deaths a week, and the news that the total weekly death toll of 14,530, is 21% higher than the average for this time of year.

But that should be no surprise.

The government wants the NHS to fail

The Conservative government’s handling of the NHS over the last thirteen years shows the reality is that the government is committed to undermining and breaking up the NHS to enable further privatisation of our services. When talking earlier this week about the extreme nature of the NHS crisis, Phil Banfield, the chair of the BMA said:

‘It is just not true that the cost of resolving this mess cannot be afforded by this country. This is a political choice and patients are dying unnecessarily because of that choice.’

He’s right. The truth is the government knows exactly what it’s doing. The current crisis is of its own making.

Under Conservative Party rule the NHS has fallen from being the best health care service in the world in 2014 and 2017. This isn’t the distant past, and it proves that if there’s a political will, the NHS model of a free-at-the-point-of-use, fully funded, public NHS works amazingly well. Let’s not be under any illusions, the fall is intentional. At the same time, private-sector involvement in the NHS has grown exponentially. This is no coincidence, and it isn’t only people on the left who make the connection between a failing service and the private sector. According to the Lancet:

‘We found that an annual increase of one percentage point of outsourcing to the private for-profit sector corresponded with an annual increase in treatable mortality of 0·38% (95% CI 0·22–0·55; p=0·0016) or 0·29 (95% CI 0·09–0·49; p=0·0041) deaths per 100 000 population in the following year.’

Despite this, the Conservative government and, it has to be said, even the current leadership of the Labour Party, want more, not less private-sector involvement. Speaking yesterday, Sir Keir Starmer proposed a ‘partnership model’ which sees the state working with private businesses to address the ongoing crisis in the NHS. He adds that reforming the public service will also bring about ‘improvement’.

The recent Health and Care Act, which passed into law despite opposition from Keep Our NHS Public and Unite the Union among others, in fact already signalled this direction of travel. This legislation has led to the separation of the NHS into 42 ‘Integrated Care Boards’, all of which now (in theory at least) can include private-sector leaders. This in truth, creates a less ‘integrated’ service with more opportunities for business to exploit.

The mainstream narrative goes something like this: the NHS is a funding black hole, and the private sector can help make it better. But as we’ve seen, the model of a public NHS has until very recently kept the NHS as the best service in the world, a position from which it is now rapidly falling, and the private sector is making it worse. This is the counter-narrative that we must be arguing at every opportunity we get.

What can we do?

The main arena in which we mount opposition to the government’s sustained attack on the NHS at the present time is to support the NHS workers on strike. Nurses from the RCN, paramedics from Unison and the GMB, ambulance workers in Unite in Wales, and doctors in the BMA have either already gone on strike or are beginning the process of balloting for strike action. This puts the question of decent pay and conditions right at the heart of the debate and also speaks urgently to one of the major factors causing the NHS crisis. We must show them support by discussing the excellent reasons for the strikes with colleagues, friends, and family; we must visit these workers on the picket lines and support their rallies and demonstrations. We should also all order some ‘I Stand with NHS Staff’ flyers, posters, and badges and wear them with pride wherever we go.

We need to encourage people to join trade unions and get involved with their union. We also need to build the campaigns that are fighting for the NHS: Keep Our NHS Public, Health Campaigns Together and SOS NHS. We need to build the organisations that tie all the issues together. One of the main reasons, of course, why low pay is causing such hardship is the dire cost-of-living crisis. The People’s Assembly Against Austerity are campaigning hard against the cost-of-living crisis, the increasing inequality in society, and of course on the NHS. Their upcoming national conference will include a panel of NHS workers, including nurses, doctors and paramedics discussing the realities of the crisis, and how we organise to win better pay and save the NHS.

It’s only five years ago that a public NHS proved itself the most successful model of health-care provision in the world. With the right political will, it can be again. It’s the social movements, trade unions and striking workers that can create the pressure needed to make that happen.

Some dates for you diary:

Saturday 14 January: People’s Assembly Conference
Friends Meeting House, Euston Road, London, NW1 2BJ

Wednesday 18 January: NHS Strike Solidarity March
Assemble 2:30, UCLH, 235 Euston Road, NW1 2BU
Called by NHS Workers Say No and NHS Staff Voices and supported by Keep Our NHS Public

Saturday 4 February: NHS Crisis Day of Action
Called by Keep Our NHS Public and backed by the SOS NHS

And look out for announcement of a national demonstration for the NHS coming soon!