The Tories’ Approach to the NHS is Austerity by Stealth

The medics and volunteers of the Red Cross, who usually respond to humanitarian crises such as floods and famines, have been drafted into NHS hospitals across England, where accident and emergency units have been pushed to breaking point.

Red Cross jeeps pulling up at hospitals where patients are dying on trolleys in corridors and being treated in the makeshift surgeries of tents and staff rooms, as understaffing is so chronic, is unworthy of a developed nation and major economy.

In the first Prime Minister’s Questions of 2017, Jeremy Corbyn mentioned the case of an infant boy with meningitis being forced to sleep on two chairs pushed together due to a lack of beds.

Despite 23 hospitals declaring critical “black alerts”, Health Secretary Jeremy Hunt denies a “humanitarian crisis”, yet suggests that the four hour target for A&E waits should be relaxed to treat acute emergencies more quickly. This sounds like national contingency planning.

In October last year a relative of mine, who suffers from a chronic heart condition, needed an ambulance call out. The paramedics who treated them at the scene decided against transporting them to hospital, as A&E was so overcrowded.

The first responders decided that the care we provided at home was better than that which A&E staff could provide - an improvised triage system that put the patient at a heightened risk. Their only option was to tell us to call back if the relative’s condition worsened.

Who, or what, is to blame for this systemic collapse?

When David Cameron was leader of the opposition, he claimed that his priority in government could be summarised in three letters: NHS. He also promised that the NHS would be protected from top-down reorganisation.

Then when elected in 2010, he imposed a top-down reorganisation. The Health and Social Care Act devised by Hunt’s predecessor Andrew Lansley (and helped through parliament by the Liberal Democrats) has cost the NHS an estimated £4.5 billion per year since it took effect in 2012.

This has coincided with the “Nicholson challenge” to carry out £20 billion of NHS cuts, euphemistically called “efficiency savings”, by 2015. Frontline services have inevitably been impacted, with ambulance, surgery and cancer treatment delays all the on the rise, and frontline staff numbers under threat. Closures of general practice surgeries are at “record levels”, piling the pressure on A&Es.

Unless she drastically changes course, May’s speeches on the “injustices” in mental health care are completely hypocritical

Since 2010 the government claims to have protected and increased NHS spending. But the head of NHS England, Simon Stevens, has contradicted Theresa May in stating that NHS spending will have decreased in real terms by 2018/19. And the Tories’ overall approach to health and social care services can be described as austerity by stealth.

The NHS has been left to pick up the pieces of £4.6 billion of cuts imposed on local authority care services since 2011, which has inevitably left vulnerable adults more at risk and dependent on emergency services.

The crisis in A&Es is matched by that in mental health services, which have seen a 15% reduction in nurses since 2010. Despite the government’s pledge to ensure funding parity of mental and physical health, 40% of NHS trusts in England had their mental health funding reduced in 2015/16, while funding for children and young people’s mental health services have been diverted to other NHS spending areas.

Unless she drastically changes course, May’s speeches on the “injustices” in mental health care are completely hypocritical, given that she has gone along with these policies since 2010 and now presides over them.

Young people and adults alike face long waiting lists for mental health therapies and diagnostic assessments, while those in mental health crisis are being forced to travel long distances just to access available beds.

Those with nowhere else to turn resort to A&Es, hectic environments that are totally inappropriate for those suicidal or at risk of self-harm.

165,000 people in psychiatric crisis attended A&Es in 2015/16, an increase of 50% from 2011/12. I was one of them. On most occasions, I have left A&E after waiting for hours for no treatment. On the one occasion I was referred for acute assessment (in 2014), I was forced to sleep on the floor. The relative who accompanied me had to buy everyone in the room drinking water.

We witnessed a schizophrenic patient left unattended until eventually being sectioned and sent to a psychiatric unit over 20 miles away. After all of the occasions I attended hospital, the follow-up care from the community mental health team was non-existent.

Politicians often make glowing tributes to the NHS frontline, but actions speak louder than words

However, austerity is not the only culprit, and Labour does bear some responsibility for the A&E situation. It was a Labour government that expanded NHS spending, but it also designed a general practice contract that has contributed to patients with urgent health concerns resorting to A&E when unable get a GP appointment.

It was also Labour which pioneered private finance initiatives that have ended up costing the NHS £2 billion per year, and which re-introduced an NHS “internal market” that facilitated Lansley’s Health and Social Care Act. But at least Labour, with a parliamentary “common ground” on NHS policy identified by Corbyn, seems willing to learn from its mistakes.

Although austerity has had an impact on frontline staffing, as have issues in training and recruitment, but it’s not as if we’re cultivating or encouraging careers in medicine or nursing.

The contract Jeremy Hunt imposed on junior doctors extends the already staggering workloads of A&E doctors, increasing the risk of staff burnout and further endangering the safety of patients.

Politicians often make glowing tributes to the NHS frontline, but actions speak louder than words. Cuts to public sector pay have left NHS staff, including nurses and midwives, increasingly struggling with financial hardship.

A poll by Unison of 21,000 NHS staff showed thousands have resorted to payday loans and food banks to survive, and more than half have considered quitting the NHS. On top of this, training bursaries for would-be nursing students have been axed.

In one of the richest countries on the earth, the NHS crisis - which has left patients and staff suffering in equal measure - should be a cause for national shame.

To close a £30 billion funding gap the NHS is expected to reduce its annual spending by up to three percent. The government’s own estimate for the “tax gap” stands at £36 billion - considered an underestimate by economists when accounting the cost of international tax dodging by multinational companies and high-earners. Need more be said?

Many suspect that the Tories’ approach to NHS policy is motivated by an ideological desire for privatisation - a scheme of “managed decline” to groom the public into accepting more radical market-friendly reforms.

Margaret Thatcher secretly drew up plans to privatise the NHS, and Oliver Letwin once promised that the NHS would “not exist” after five years of a Tory government after New Labour.

But in regards to the Cameron and May governments, perhaps we should remind ourselves of Hanlon’s razor: what could be attributed to malice can usually be attributed to incompetence.

More about the author

About the author

Jacob Richardson began his career with Disclaimer and writes on culture, politics and society. Politically he is a democratic socialist and Labour Party supporter. His other interests include cinema, psychoanalysis and professional wrestling.

Follow Jacob on Twitter.

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