openDemocracyUK: Opinion

We must undo a decade of disastrous NHS reforms

Covid-19 shows how our health service has been undermined

Ameen Kamlana
26 March 2020
Doctors during the Ebola outbreak
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DFID

The London Chest Hospital in Bethnal Green was built in the 19th century in response to the tuberculosis pandemic. In 2015, the government sold it off to a private housing developer as part of its nationwide plan for ‘NHS surplus land disposal’. With London now the epicentre of the UKs coronavirus epidemic, a severe shortage of ITU beds will expose just how reckless and brutal NHS England policy is.

The pandemic is being likened to World War II in its global scale and impact on our way of life. As difficult as it may be to envisage just now, this frightening analogy could also serve as a source of hope for the future. World War II taught us the value of community solidarity and compassion towards others. We came out of it as a stronger, more unified nation. As a direct result, we went on to create the NHS and the welfare state.

In response to the current crisis, we’re already seeing inspiring examples of human resourcefulness that provide clues as to what a new and improved NHS – that once more prioritises our wellbeing – could look like.  The Spanish government has nationalised its private hospitals, an Italian start-up is 3D printing breathing valves and, here in the UK, volunteers have created community mutual aid groups to support people in need.

These developments show the transformative potential of an enterprising state that cares equally about everyone’s health, harnesses open source principles to serve the common good, and devolves power (with adequate resources) to local communities. Co-production, whereby doctors and patients are given mutual agency, responsibility and ownership in the planning, delivery and evaluation of local services, is the key to revitalising our NHS.

The responsiveness required for dealing with pandemics highlights that market competition is no substitute for state coordination. Commercial secrecy cannot replace public scrutiny, and private profiteering is opposed to improving health. The importance of health and its relationship to housing, work, schools, public spaces, and the economy is now self-evident through enforced social distancing. The argument is decisive - health is everything.

Going forward, our health needs be safeguarded as a priority. To effectively combat future pandemics and address the ticking time bomb of antimicrobial resistance, we must demand the reinstatement of the NHS as a public service, progressive reform of the pharmaceutical industry, and serious investment in the social determinants of health.

In order to win big, our movement is going to need to broaden and diversify. Let’s foster and draw on the ideas and experience of the mutual aid group networks that are forming in our communities, and centre the voices of our outsourced NHS colleagues who play such vital role (cleaners, caterers, couriers and others). Modelling the wider change we wish to see in society entails those of us with longstanding platforms relinquishing power.

We can go further than this. Coronavirus is a wake up call, a reminder that we are all part of one global community. It’s clear that in order to keep ourselves safe from the harm in future pandemics, we need to look after our neighbours too. Our movement for health justice must be internationalist – the Congolese still need resources and infrastructure after Ebola, just as Americans will still need Medicare for All after COVID-19.

For all the xenophobia and criticism that came China's way following the outbreak, we are now learning from their approach as to how best to slow the spread of coronavirus and 'flatten the curve'. They say that in locked down Wuhan you could hear the birds singing once more, as traffic subsided and the air cleared. The Chinese word for 'crisis' also bears the meaning of 'opportunity.' There are lessons in this for us too.

Coronavirus: Sign our petition


To: Rishi Sunak, Chancellor of the Exchequer

We welcome the steps already taken by the government to support people and businesses affected by the coronavirus.

But today, we are calling on the government to introduce an immediate liveable income guarantee for everyone living in the UK – without conditions on job seeking, migration status, savings, partner income or any other limiting factors.

This must guarantee every adult in this country an income equivalent to the real living wage (£9.30 per hour, or £372 per week).

It’s grossly unjust that the most vulnerable in our society are hit hardest by this pandemic.

To save lives now, we must urgently catch everyone in the safety net.

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