Labour Lords criticise Destroy the NHS / Health and Social Care Bill as a “mess” and a “catalogue of compromises”.
The Kings Fund warns of the health situation in London with nobody responsible and huge deficits forecasted.
Many Clinical Commissioning Groups (CCGs) are behind (over) budget raising the prospect of cuts.
The Royal College of Physicians states that consultants provide many more than their contracted hours for free.
- Conservative election poster 2010
A few recent news articles about the UK’s Conservative and Liberal-Democrat (Conservative) coalition government – the ConDem’s – brutal attack on the National Health Service.
Labour has launched a scathing attack on the Government’s wide-ranging health reforms, branding them a “mess” and a “catalogue of compromises”.
Health spokeswoman Baroness Thornton hit out at the proposed changes as peers began an extended sitting on the Health and Social Care Bill.
The Lords was forced to sit more than three hours earlier than usual in a bid to complete the Bill’s marathon committee stage by the Christmas recess next week. As day 12 of debate got under way, Lady Thornton focused on the role of the independent regulator for all healthcare services, Monitor.
“The Bill is a mess. It is a sad catalogue of compromises,” she said. “We believe that Monitor is being asked to fulfil too many functions, set too many priorities, some of which are potentially in conflict with each other.”
Lady Thornton called for the section of the Bill dealing with Monitor to be rewritten to make it “simpler and more coherent”.
Labour had introduced independent regulation of quality into the NHS. But it did not accept “the handing over of economic regulation of the NHS to a quango”.
She told the House: “There is a place for competition. It is not, and never can be, the main driving force for reform of the NHS. We are against promotion of competition for its own sake as this Bill originally intended.
London’s NHS is in “urgent need of change” but there is a risk there will be no one in charge to push that change through, according to a report.
The King’s Fund said there could be a “responsibility vacuum” in organising services when the strategic health authority is abolished in April 2013.
The independent think tank’s report also warned there were huge health inequalities across the capital.
The report said London’s NHS could face severe financial difficulties over the next few years, with 18 hospitals forecast to have a net deficit of £170m by 2014.
It also said GP performance was often poor with people’s satisfaction with GP services lower than elsewhere in the country.
The charity added many London trusts would struggle to meet the government’s deadline to become foundation trusts by 2014, as currently only 16 out of 42 trusts have foundation status.
Chris Ham, chief executive, said: “London’s NHS is in urgent need of change, but the risk is no-one will be behind the wheel to push through the changes needed to improve patient care.
Exclusive GPs who have taken over budgets from PCTs under the Government’s NHS reforms are sliding millions into the red, according to financial assessments that lay bare the scale of the challenge facing clinical commissioning groups.
A Pulse investigation into CCG budgetary control across 55 PCTs raises questions over their capacity to constrain costs and deliver planned savings, with two-thirds of those reporting figures currently missing their financial targets.
GP commissioning leaders warned the deteriorating financial situation might force them to toughen up restrictions on referrals from practices, despite new figures showing GP referrals fell by 4% last quarter compared with a year ago.
Overall, 29% of PCTs are currently behind budget for 2011/12, with just 9% forecasting they will not meet their financial targets by April 2012.
But among 29 CCGs able to provide figures, 66% were behind budget, while four of the 20 making end-of-year forecasts said they would still be in deficit at the end of the financial year even after bringing in tough measures to catch up.
Consultant physicians are increasingly working above and beyond their contracted hours. The NHS is relying on this good will to deliver the service that patients need. The amount of time consultants have to spend with trainees is decreasing and some specialties are experiencing low levels of growth in consultant numbers.
Dr Andrew Goddard, Director of Royal College of Physicians Medical Workforce Unit, said:
‘This census shows that senior doctor expansion has fallen and that the NHS remains reliant on doctors working longer than their contracted hours. Consultants contracted hours have fallen significantly as hospitals strive to save £20 billion over the next three years. Despite this, consultants continue to work the hours they have done in previous years and so the amount of ‘goodwill work’ is increasing year-on-year.
‘Furthermore, consultants are finding themselves less available to teach trainees, often having to do jobs that would have previously been done by junior doctors. This is really worrying as training of future senior doctors is vital to high quality patient care in the NHS.’
Each week, consultants are working 11.5% of their contracted hours extra free. This figure jumps to 14% for doctors who work part time. Overall, this ‘goodwill’ work accounts for the equivalent of 1,450 fulltime consultants, up by 205 compared to 2009. Despite working longer hours, 51.8% of consultants say that time available to spend with trainees has reduced during the past three years. This change may result from the fact that consultants are spending more time doing jobs that would previously have been done by a junior doctor.
We start with some simple points of agreement. The brutal cuts to services about to be inflicted by the current Government are unnecessary, unfair and ideologically motivated. The coalition are particularly fond of two obscene catchphrases: ‘There is no alternative’ and ‘We’re all in this together.’ Both slogans are empty and untrue. The cuts will dismantle the welfare state, send inequality sky-rocketing and hit the poorest and most vulnerable hardest. A cabinet of millionaires have decided that libraries, healthcare, education funding, voluntary services, sports, the environment, the disabled, the poor and the elderly must pay the price for the recklessness of the rich.
Austerity-economics is the policy of the powerful. It cannot be stopped by asking nicely. We cannot wait until the next election. If we want to win the fight against these cuts (and we can win) then we must make it impossible to ignore our arguments and impossible to resist our demands. This means building a powerful grassroots mass movement, able to resist the Government cuts at every turn.
“There is no alternative.”
We are told that the only way to reduce the deficit is to cut public services. This is certainly not the case. There are alternatives, but the government chooses to ignore them, highlighting the fact that the cuts are based on ideology, not necessity.
- One alternative is to clamp down on tax avoidance by corporations and the rich and tax evasion, estimated to cost the state £95bn a year
- Another is to make the banks pay for free insurance provided to them by the taxpayer: a chief executive at the Bank of England put the cost of this subsidy at £100bn in a single year
“We are all in this together.”
- average pay of FTSE 100 directors has risen 55%,
- corporation tax has been cut,
- the government have not delivered on a manifesto pledge to clamp down on tax avoidance, instead cutting staff at HMRC,
- bank profits and bonuses are back in the many billions (last year banks paid out over £7bn in bonuses and just four banks made £24bn in profit),
- there has been no reform of the banks.
David Cameron himself has said that the cuts will change Britain’s “whole way of life”. Every aspect of what was fought for by generations seems under threat – from selling off the forests, privatising health provision, closing the libraries and swimming pools, to scrapping rural bus routes. What Cameron doesn’t say is that the cuts will also disproportionately hit the poor and vulnerable, with cuts to housing benefit, disability living allowance, the childcare element of working tax credits, EMA, the Every Child a Reader programme, Sure Start and the Future Jobs Fund to name a few.
The facts speak for themselves; we are not all in this together, we are paying for the folly of reckless bankers whilst the rich profit