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, 11.21am
Doctors during the Ebola outbreak

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 healthcare workers 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.

Should we allow artificial intelligence to manage migration?

How is artificial intelligence being used in governing migration? What are the risks and opportunities that the emerging technology raises for both the state and the individual crossing a country’s borders?

Ryerson University’s Canada Excellence Research Chair in Migration and Integration and openDemocracy have teamed up to host this free live discussion on 15 April at 5pm UK time/12pm EDT.

Hear from:

Ana Beduschi Associate professor of law, University of Exeter

Hilary Evans Cameron Assistant professor, faculty of law, Ryerson University

Patrick McEvenue Senior director, Strategic Policy Branch, Immigration, Refugees and Citizenship Canada

Chair: Lucia Nalbandian Researcher, CERC Migration, Ryerson University


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