5 March 2005

Is our NHS being killed?

By Rupert Read

Last week, I stood alongside 80 'support' workers (cleaners, porters etc.) protesting at the doors of the Norfolk and Norwich (N&N) Hospital. They were not asking for more money, nor for better conditions, for hospital workers. They were simply asking for those of them who work for a private company there (SERCO) to be allowed the same pay and conditions as those of them who work directly for the NHS. At present, SERCO workers in some cases do exactly the same job as others working for the NHS - and yet get paid less, and work longer hours. Is that fair?

This is the result of long-standing Westminster policies of 'contracting out' an increasing proportion of NHS work. In plain English: the NHS is gradually being privatised. It is gradually ceasing to exist as a state-run service for all - it is gradually being opened up to profiteers. That's why hundreds of workers at the N&N are now reluctantly contemplating strike action: to abolish the 'two-tier' workforce. To stop the otherwise relentless privatisation of our beloved National Health Service.

The government says that improvements in health care depend on the 'modernisation' of the NHS. Does 'modernisation' mean simply privatisation by stealth? 'Modernisation' means patients being given 'choice' in where they are treated for non-emergency conditions. According to my near-namesake, John Reid, the Health Secretary, we will be able to choose between up to 5 hospitals - of which at least one would be private. Those hospitals that get the thumbs-down from patients would be regarded as 'failing' and might well be closed.

According to this view, decisions to close hospitals would of course not be government decisions, but the result of 'consumer choice'…

Mr Reid assures us all that even if a local hospital were to be closed down, everyone would still have emergency and acute services within easy reach. But how? Effective accident and emergency (A&E) departments depend on other hospital departments to which patients can be referred, often very urgently.

We have already seen the loss of A&E departments within Norwich, since the opening of the N&N at Colney. And this newspaper has recently covered in depth the threatened closure of Wells Hospital. There is a pattern here. With fewer hospitals open, where are these hospitals going to be that we can 'choose' between? Will an ill person have to go to Cambridge, or London, in order to get the treatment they deserve?

Let me be frank: I don't want to choose which hospital I go to, when I am ill. All I want is for there to be a good, reliable NHS hospital fairly near to where I live, a hospital I can trust. Is that too much to ask?

Do we 'choose' as tax-payers to have private companies providing essential services at public expense? Come to that, did we ever choose to have private consortia paid enormous sums over decades in return for building new hospitals? The Private Finance Initiative (PFI) seems now to be the main way of funding investments in public services - but, as Mark Nicholls's reporting in this newspaper has clearly illustrated, it is highly questionable whether this appallingly complicated scheme is the most economical and effective way of funding the building of hospitals (or of anything else!). In the Norwich area, we had a graphic illustration of the perils of relying on PFI, when it was revealed that the consortium which built the N&N University Hospital had made up to £100 million from 'refinancing' the loan they raised for the purpose, at a much lower rate of interest. Public good - or private profit?

Meanwhile, PFI schemes across Norfolk have descended into chaos. Again, it is the EDP that has documented in dramatic detail the fiasco of the PFI funding of improvements to Norfolk's schools. Jarvis, the firm responsible for this disaster, is now in effect being bailed out by the County and the government: so it seems that PFI does not really spread financial risk to the private sector after all? Because when they get into real trouble, it is we who end up footing the bill. Private profit? - public loss.

If you care about the NHS, if you want to stop and reverse its privatisation, then do express your solidarity with the N&N's support workers. Brussels and Westminster are at present threatening the NHS with more privatisation than it has ever had to endure; this really is the last chance saloon for a National Health Service, that still stands as a beacon to the world.

My thanks to UNISON at the N&N and to Jean Davis for invaluable help researching this article.