In towns and villages throughout Britain, an invisible army
of NHS foot soldiers have been fighting cuts, closures and the creep of
privatisation for years. On Saturday, the army will march on London and I’ll be
there with my placard wielding 9 year old.
Ever since my child was nurtured back to health by the NHS
having been seriously injured in a car crash, I’ve been part of a local campaign to safeguard both
of the county’s A&Es. I live in one of the most rural counties in Britain,
with journey times to hospital of over 1 hour already for some. Our Clinical Commissioning
Group (CCG) wants to reduce a population the size of 19 Birmingham’s to just
one A&E. What started as a handful of people is now one of the most
formidable health campaigns in the country, with thousands of members who have
seen off 2 health chiefs, thwarted 4 attempts to close an A&E and won the
respect of the local press, who were initially hostile.
The clue
is in the name, accident & emergency. When patients are faced with life threatening
injuries/illnesses, time is absolutely of the essence. There was a 25% increase
in deaths when Newark A&E was closed, even though that increased the
average travel time from 7minutes to 12 minutes. The distances to A&E where
I live, are already further than anywhere else in the country.
The Royal College of Emergency Medicine cautioned recently, ‘Emergency care pressures are not going to
go away, just by closing an A&E department. In many adjacent areas, most
A&Es are already pretty full, and most hospitals are pretty full with
regards to admissions. It only takes a small change to tip the balance to a
hospital being congested. To close a department is likely to have a domino
effect on other hospitals.’
A legal Requirement for any major
restructuring within the NHS is to do a patient & public needs assessment
& an impact assessment on neighbouring hospitals, primary care, social care
& planning data. None of this
have been done and not a shred of clinical evidence has been forthcoming.
We were promised a network of rural
urgent care centres and increased community investment to support the huge
predicted transfer of care into the community. Instead, urgent care centres
have been scrapped, community hospital wards have been closed and GPs are
creaking under the strain of increased workload with no additional resources.
That’s before they shut an A&E.
Both A&Es are already stretched
beyond capacity. Ambulances are regularly held up in a queue outside both
hospitals preventing them from being able to respond to blue light calls. The
ambulance service is underfunded and under resourced & they’re regularly
taking over 1 hour to get to patients in my region. The air ambulance is a
charity staffed by 6-7 volunteers. The fleet is old, can’t land in dark, fog,
even drizzle.
In
September, the architect of the Health and Social Care Act, Lord lansley, said the act was supposed to be
about promoting better services to patients but admits the focus is becoming
increasingly about reducing costs – not improving quality of patient care....
“We must not allow reconfiguration to
be used as a means of constraining demand – by restricting supply. The NHS must
have the resources it needs for a sustainable future. These necessary resources
are not anticipated in the current spending review”.
Having failed
to invest in social care & the community infrastructure necessary to take
pressure off hospitals - the founding tenet of this act - acute service cuts
cannot be allowed to proceed. Having immersed myself in consultant speak for
over 2 years, I’ve spotted that “improved patient pathways”, and “strategic
Transformation Plans (STPs)
can be translated as “cuts”. The pathways are designed to divert traffic away
from hospitals even if it means into the morgue.
Then
there’s the corporate heist of the NHS by private health providers. The Health
and Social Care Act removes the responsibility of health care provision from
the government. Section 75 compels tendering for contracts, £16bn of which have
been awarded to private contractors since 2013.
While the media lens was focused on Richard Branson’s spat with
Jeremy Corbyn in August, Virgin Care was
quietly signing an NHS contract worth £17.6m a year to co-ordinate adult
community health services in Guildford. Despite operating as a tax
haven and, according to Tax expert, Richard Murphy, Virgin Care is unlikely to pay tax in
the UK in the foreseeable future, the company has been awarded contracts worth
millions to provide NHS services across England. All hidden behind the NHS
logo.
In July, Virgin Care lost its contract to run Croydon’s Urgent
Care Centre in the wake of criticism by the CQC, which found patients were
being streamed by untrained reception staff which compromised safety. 30-year-old Madhumita
Mandal died of multiple organ failure and sepsis caused by a
ruptured ovarian cyst after a receptionist at the urgent care centre failed to
refer her to a medic.
The problem is, private companies are not bound by the same
accountability as public services and they’re driven by profit, not patient care or employee wellbeing. A recent
study showed that mental health related absences in the NHS, due to stress,
depression and anxiety, have doubled under this government. Apart from the
tragic human costs, sickness and absence costs the NHS millions every year.
One senior
A&E sister who left my local hospital in the last few years said, “It’s
like being in a war zone every day. There was never enough staff on duty to
cope with demand, so we were working under constant stress. Every time you’re
forced to deprive a patient of the care they need, it chips away at your soul
until eventually there’s nothing left to chip away at and you just stop caring.
That’s when most of us realise it’s time to leave the profession”.
If we accept the narrative that NHS
cuts are necessary, it follows that we concede privatisation is inevitable. If
we relinquish the principal of public health care for all, we’re signing our
NHS over to corporate providers. That is like
putting Dracula in charge of the blood bank.
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