Charlotte Farrell, Green Party Parliamentary Candidate for High Peak writes…
While I was walking home from work today, I was musing about the NHS and in particular wondering what evidence has there ever been to support the idea that ‘marketising’ the NHS would improve the services offered or even reduce costs and save it money? Furthermore what was actually so wrong with the old system?
I began working in the NHS in the late 1970s. I realise that as a nurse I probably wasn’t particularly aware of the management structure, even less the processes that went into providing patient care beyond the wards level. But on the other hand I also wasn’t aware of there ever being problems. Things seemed to run smoothly enough though.
In those days, as I remember, the hospitals were broadly controlled by District Health Authorities and above them the Regional Health Authorities. Then in the 1980s things began to change, the first glimmers of privatisation began, and competitive tendering was introduced for ancillary services.
We began to notice that the wards were suddenly not kept as clean as they used to be, the cleaners were rushing their work and things got overlooked. Hygiene suffered. It was not the cleaners fault though. The concept of tendering meant that the service providers would only secure the contract if they were “competitive” and that meant lower priced bids, which also meant cutting corners. There were fewer ward cleaners, working longer hours for less. By devaluing the staff in this way they also broke some of the public service ethos that had run through the NHS for so long. Interestingly the spread of contracting out cleaning services also coincided with a rise in infection rates including MRSA.
But not to be off put by this, both Labour and Conservative have pressed ahead with the total reorganisation of the NHS into something that Aneurin Bevan would hardly recognise. The idea that the NHS should replicate the private sector has taken root: the private sector knows best and market forces will deliver better care.
Labour introduced PFI funded hospitals, saddling the NHS with debt for years to come with the benefit going to the private funders. It developed foundation trust hospitals so that hospitals could be run as businesses, even to the extent that they could become bankrupt! It introduced the “choose and book” system which opened the door to private hospitals working “alongside” the NHS. Hospitals now had chief executives in control, people often drawn from the private sector on salaries to match. The ethos of public service was further degraded.
The NHS was continually being criticised, waiting list times, poor levels of nursing care, treatments not being provided etc etc (mostly all due to being too underfunded to provide the kind of service people had come to expect, rather than an inherent problem with the staff) – paving the way for the Health and Social Care Act 2011 which promised to make the service more efficient and fit for the 21st century. But all that has been achieved is to change from a system which operated relatively straightforwardly, to one which has become almost Byzantine in complexity.
I don’t know for certain whether this is assertion is true but I would have thought it is not inconceivable that the more layers of management involved, the more labyrinthine the purchasing processes, the more individual transactions involved in providing care and the less affection the providers have for the system, the more costly the service is likely to be.
The NHS Reinstatement Bill aims to rid the NHS of the marketisation, and put it back to how it was conceived. I fully support it.
For further information you can find out more about the Campaign for the NHS Reinstatement Bill 2015 on http://www.nhsbill2015.org/ There is also a link to contact your parliamentary candidates in the run up to the election.