Technorati href="http://www.technorProfile Thinking Nurse: Blair's NHS: The Effects of Foundation Hospitals and PFI

Thinking Nurse

This blog will reflect my interests in learning disabilities, nursing, nursing theory, philosophy and politics and my general interests in the arts and literature. (Nursing is an art as well as a science!) Philosophy and nursing have been intrinsically linked since the days of Socrates, his mother was a midwife, and taught him everything he knew!

Friday, March 18, 2005

Blair's NHS: The Effects of Foundation Hospitals and PFI

I found this extract analysing the state of the NHS, and the direction and consequences of government policies on the NHS, in a much longer socialist analysis of the state of Britain, written in Feb 2005, which you will find by clicking on this link: Socialist Party
then clicking onto "Socialist Party Statement on Britain" in the sidebar.

I am publishing it here because it is an excellent collection of facts and figures on the condition of the NHS, and gives an alternative point of view to the rosy corporate gloss that we get from most 'official' sources. Nurses and other health workers need to be strong advocates for the rights of our clients to decent healthcare, particularly as our clients are often not in a position to speak up for themselves.


"The NHS has suffered badly from the government's onslaught on the public sector in a number of ways.

Although the government has tried to promote their increased NHS funding of recent years, which is now an unprecedented 9% of GDP, the amounts being put in are nowhere near enough, coming after previous decades of underfunding including the continuation of the Tories' spending levels during New Labour's first few years in power.

The Audit Commission has said that 107 NHS organisations (hospital trusts, primary care trusts and strategic health authorities) failed to break even last financial year, about a sixth of the total, compared with 71 the previous year. Only one out of 28 English strategic health authorities is predicting a surplus for this financial year.

The latest cost-cutting scandal is that of MRSA, caught by 100,000 patients last year and causing the deaths of about 5,000 people each year. A recent study by Unison showed that the number of hospital cleaners has halved over the last ten years; there were 100,000 in 1984, yet there are now just 55,000.

Coupled with underfunding has been the ongoing privatisation drive, handing public money to private hands while worsening services at the same time. Blairand his co-'modernisers' want to turn the clock back to the pre-NHS days when the ill could only be treated if they had the money to pay for it, or if a charity stepped in to help them.

But as the NHS is so popular, won by the working class through great pressure in the post-war period, Blair has been unable initially to go for charges at the point of use(though there are charges for dental care, glasses and prescriptions), and is instead destroying the service by introducing privatisation into treatment provision.

This process of privatisation is now turning into a fiasco as great as that in the rail industry. The last round of 'reforms' in the NHS, presently being forced through, are causing immense problems in many areas for NHS workers and patients. NHS and private fast-track treatment centres are being opened, in market competition with existing NHS hospitals. The government intends that from 2008, patients will be able to choose any hospital 'that meets NHS prices and standards'. By then, all are supposed to be foundation trusts, run like businesses but without shareholders.

In the meantime, the Department of Health is insisting that 8-10% of hospitals' non-emergency work is bought from the 'independent' sector. But the independent treatment centres take the easiest and most 'profitable' treatments, leaving the mainstream NHS hospitals with the more difficult and expensive cases. The 'independent' sector is also in most cases giving more expensive treatment, for instance: "Birmingham and Black Country Strategic Health Authority is being told it has by 2008 to shift 20-30,000 cases out of its hospitals and into the independent sector on contracts that cost around 15% more per case than average NHS treatment". And the contracts stipulate that the NHS has to pay for operating slots in the private centres whether or not it uses them! All this has raised the spectre of NHS hospitals going bust.

The British Medical Association's conference of senior hospital doctors warned last June that after the next election, the government's policies would lead to "the biggest hospital closure programme ever. It will spell the end of the NHS and it must be stopped". Even the hand-picked bureaucrats at the top of the NHS, the chief executives, are feeling forced to voice opposition to the government. In a survey by the Health Service Journal, three quarters of them do not believe the government's use of private sector treatment centres is good value for money, and almost 80% say that they divert resources from the NHS.

Fearing hospitals collapsing before the general election, the Department of Health has decided to throw more money at private consultants to set up a "failure regime" aimed at "identifying the warning signs of failure". This has been triggered by the experience of hospitals like the Bradford Royal Infirmary, one of the first hospitals to be declared a 'foundation trust' - chosen because it was considered to be a leading hospital in relatively good financial health. However, a report in the Observer revealed that the hospital has gone into dire crisis since its new status was awarded, suffering a dramatic decline in its finances in just a few months. The Financial Times subsequently reported that "The Bradford Teaching Hospitals went from a projected £1m surplus into a possible £11m-plus deficit within four months of starting operation". Now emergency cuts are affecting all aspects of the hospital, including clean linen and basic equipment like tubing.

Foundation hospitals were a project spearheaded by Blair's favoured successor Alan Milburn, now promoted to be New Labour's election organiser.

Money for provision of new health service buildings continues to be poured into private hands through the Private Finance Initiative. The Association of Chartered Certified Accountants recently confirmed that the government has paid up to 30% more to construct PFI hospitals and concluded that "PFI is likely to lead to redistribution of income from the public at large to the corporate sector" and that "the chief beneficiaries are the providers of finance, leading to a redistribution not from the rich to the poor but from the mass of the population to the financial elite".

Health workers not only face constant stress as a result of all the above turmoil, but are also suffering attacks on their pensions and changes to their working arrangements and pay as a result of the Agenda for Change agreement.
This latter deal brings in a small increase in the NHS minimum wage, to £5.69 an hour (£5.88 from April), from £4.85, but increases flexibility in the interest of management and means that around 80,000 workers have to have 'protection' to stop their wages from falling, will face several years with no pay increases and could have their pay cut after 2011."

Anyone have any comments on the issues raised in this assessment of the NHS? I would be interested to hear of any experiences of PFI, foundation hospitals and 'Agenda For Change' from the 'sharp end'.

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