Credit: Peter Byrne/PA Images, all rights reserved.
Yesterday’s budget was a government playing to the gallery, desperately hoping to distract from its role in creating what promises to be the worse winter crisis since records began.
The Chancellor announced that mental health services would be getting £2bn a year by 2023-24. It’s not ‘extra’, though – it’s part of the £20.5bn already announced by the government in June. An amount that all independent experts agree fails to meet the needs of the health service.
The Chancellor also announced that the government would be rolling out a new mental health service, providing crisis provision in every A&E. Yet again, a laudable aim. But, also one with limited efficacy. Focusing solely on crisis care won’t reduce demand on those services, nor will it address the root causes of crises. Furthermore, the money has not been ringfenced. So, there is a strong possibility that no new services will materialise irrespective of the announcement.
We were also informed that local councils will be receiving extra funding for social care – on top of the £240m announced earlier this month – of £650m. Of course, this hardly offsets the overall £7bn cut that social care has sustained since 2010. In short, the Chancellor was laying the terrain for an imminent exercise in blame avoidance.
The National Health Action Party has consistently argued that austerity doesn’t work. It fails to secure sustainable long-term savings in the economy and public services and it fails to increase productivity.
A report released last week by NHS Providers, ‘Steeling Ourselves for Winter 2018/19’ highlights how NHS Trusts are in a worse position to cope with a forthcoming winter crisis than they were last year – due primarily to “financial savings”.
The report sets out how Trusts are failing to reach the 95% target of attending to those admitted to A&E within 4 hours of admission; that the waiting list for elective surgery is at its longest since records began; that the eight key standards for the treatment of cancer are not being met; and at a national level the 62-day target for admitting cancer patients for initial treatment has been missed since 2013/14.
The report also notes that in terms of community care many NHS Trusts are being “left marginalised, underfunded and short staffed”. And the Chancellor’s announcement of an extra £650m won’t even fill the gap of current planned social care cuts of £700m.
Nor will this budget ease the pressure that A&Es will be facing this winter. Under the Conservatives there has been an increase of 62% in elderly people being rushed from care homes to A&E.
Through underfunding, cuts, spending squeezes and austerity we are seeing patient safety imperilled. The Government will, as usual, seek to find scapegoats, ranging from blaming NHS staff for safety failings that are actually system failings, to blaming patients. They’ll probably end up blaming winter itself, too.
These are long running government tactics. Only last week the government announced that the NHS will be piloting a new initiative to tackle fraud in the health service. The government and NHS Counter Fraud Authority (NHSCFA) claim the health service lost an estimated £1.25bn to fraud in 2016/17.
The initiative will begin with an attempt to halve prescription fraud which supposedly costs the health service £256m a year, by giving pharmacists access to digital records of prescription exemptions. It has also committed to dedicating 400 counter-fraud professionals to tackle fraud in the health service - with fraudulent dentists and pharmacists being particular targets.
Of course, whilst it is right to tackle fraud, it is politically opportunistic to frame this issue as being one of the root causes of the crisis in the health service. Taking the NHSCFA’s figures at face-value – although it should be noted that calculating the costs of fraud is difficult by its very nature – the costs of fraud to the health service pale in comparison to the costs of PFI which costs the NHS nearly twice as much per year, at £2bn.
Although he won headlines for “scrapping PFI”, the Chancellor pledged that he wouldn’t scrap existing PFI contracts, which the health service is locked into paying for til 2050. And he said he remained “committed to the use of public-private partnership”.
Scrapping anything that looks remotely like PFI should be at the top of the Conservatives agenda. Doing so would free up tax revenue, save money and increase productivity gains. But it would require the Conservatives to rethink their approach to economic and social policy. It would entail the rejection of a financialised economy which has outsourced public services to private creditors.
This is something the Conservatives can’t and won’t do. Instead, they are continuing to rollout Integrated Care Providers which, in terms of private sector involvement in the NHS, make PFI look like small beer. And, by continuing to push through further austerity measures, the government will continue to push the health service and social care to the limit. But it suits this Government to attempt to deflect responsibility for the state of the NHS by blaming a supposed fifth column of fraudulent dentists and pharmacists undermining it from within.
Those who care about the NHS and wish to defend it, irrespective of party allegiances, now have to work together to protect the safety of patients and staff.
Health Campaigns Together’s ‘NHS Safe for All’ campaign is an attempt to do this. Backed by Health Campaigns Together’s affiliated organisations including UNISON, Unite the Union and the British Medical Association, the campaign will fight for policies that address staff shortages and unsafe systems which have been worsened by cuts and the fragmentation of services.
The conference, ‘Make Our NHS Safe for All’, planned for the spring of 2019, will be an opportunity for all those who wish to oppose the government’s policies and fight for a safe, high quality, NHS for all.
Now more than ever, we need to let the public know, that the Tories are a danger to their and our safety.
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