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.

‘Chickens coming home to roost’ as number of debt-ridden NHS trusts rise

The Audit Commission report highlighting the increasing number of NHS organisations in debt shows that “chickens are coming home to roost” for David Cameron, Unite, the largest union in the country, said today (Thursday, 20 September).

Unite’s head of health, Rachael Maskell said: “We now know why the risk register into the coalition’s so-called NHS reforms never saw the light of day, despite the best efforts of the Information Commissioner, Christopher Graham.
“The financial risks of Cameron’s reforms have resulted in trusts rapidly sinking into debt, leaving them ripe for accelerated privatisation.

“Services are being rationed which means patients have to wait longer or travel further for treatment which, in turn, puts the public at greater risk. No wonder Cameron exercised the Cabinet veto to stop the risk register being published.

“The new health secretary, Jeremy Hunt is on holiday in France, sipping fine wine, when he should be at his desk getting to grips with the chaos left by his predecessor, Andrew Lansley. The chickens are coming home to roost.”

The Audit Commission reported that the number of NHS trusts and foundation trusts in deficit increased from 13 in 2010/11 to 31 in 2011/12. Thirty nine NHS trusts reported a poorer financial position in 2011/12 than in the previous year, and 18 NHS trusts and foundation trusts received financial support from the Department of Health.

Increasing use of “zero-hours” contracts in Britain’s National Health Service

“Zero-Hours” contracts, which restrict workers to on call working, no guaranteed income or employment rights have been widely implemented across the National Health Service (NHS). The Independent recently reported that zero-hours contracts are increasingly being used “in core services such as cardiac, psychiatric therapy, respiratory diagnostics and adult hearing” describing this as “a key change to the fabric of NHS employment.”

Zero-Hours contracts are part of the Conservative/Liberal Democrat government’s plans to drive down wages and working conditions across the NHS and prepare it for full privatisation. The Independent report identifies the concerns of critics and experts, who warn of a “G4S-style” fiasco within the NHS, referring to the inability of private security firm G4S to provide the required amount of staff at the London Olympics due to the scandalous pay and conditions offered.

NHS workers have already suffered a two year pay freeze, attacks on pensions and increases in the retirement age. They will now be in danger of losing welfare benefits that top up their salaries, such as child tax credits. Qualification for these requires a person to work a minimum 16 hours a week. According to the Citizen Information Board workers on zero-hours contracts “are protected by the Organisation of Working Time Act 1997 but this does not apply to casual employment.”

The protection offered by the Act is nothing but a rubber a stamp for slashing wages even further.

If a worker “under a zero-hours contract works less than 25 percent of their hours in any week they are entitled to be compensated. The level of compensation depends on whether the employee got any work or none at all. If the employee got no work, then the compensation should be either for 25 percent of the possible available hours or for 15 hours, whichever is less. If the employee got some work, they should be compensated to bring them up to 25 percent of the possible available hours.”

But as the report in the Independent outlined, the contracts being offered by the NHS Trusts and private firms “do not guarantee any specified number of hours”. NHS workers will be on call but will have no guarantee on hours, pay or employments rights and will only get paid for the actual time spent at work—meaning they are “in work, but not always at work” as one expert explained.

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NHS faces £8bn cuts ‘after next election’

The National Health Service could face cuts of almost £8bn immediately after the next general election, according to the first analysis of the Government’s own figures as it draws up another round of spending reductions.

In a report published today, the Institute for Public Policy Research (IPPR) think tank reveals the stark choices facing all three main parties at the 2015 election. Although most attention has focused on George Osborne’s plan for a further £10bn of welfare cuts, that would not ease the pressure on other budgets such as health, education, defence and law and order.

David Cameron has pledged to increase NHS spending by more than inflation every year but that might not be extended beyond the election. The Chancellor has already conceded that more cuts will be needed in the first two years of the next parliament because he will not clear the deficit as quickly as he originally planned after the economy went back into recession.

According to the IPPR, the Government’s fiscal targets imply real terms cuts of 3.8 per cent in 2015-16 and 2016-17 – higher than the 2.3 per cent average reduction now being implemented across Whitehall departments. Unless the NHS pledge is extended – a move the Treasury may oppose – its budget would be cut by £7.8bn in 2016-17. If the cuts were spread evenly, education spending would fall by £3.8bn, defence by £1.7bn, local government by £1.6bn and the Home Office by £500m.

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£20bn opportunity for private sector in NHS

Changes in healthcare policy and pressures on public finances represent a “£20bn opportunity” for the private sector to increase its NHS provision, according to a research report out this week.

A report by Catalyst, the corporate finance adviser, said the private sector is becoming increasingly involved in delivering healthcare services as the NHS struggles to cope with the demands of an ageing population and the need to make efficiency savings of £20bn by 2015.

It said there is a significant opportunity for the private sector in primary and secondary care in particular, markets it estimates to be worth around £20bn.

The report noted that while the private sector currently delivers a very small proportion of primary and secondary care, “if the Government is to manage funding pressures and achieve improved outcomes for patients this will need to increase”.

It said that landmark contracts awarded to providers such as Circle, Virgin Care and Serco show growing “recognition from the public sector that leveraging the private sector’s ability to invest capital and use more efficient delivery models is necessary for the Government to reduce costs while improving the quality of healthcare”.

Justin Crowther, director at Catalyst and co-author of the report, said: “Despite many challenges, the private sector is increasingly providing healthcare services, whether paid for by the taxpayer or directly by consumers at the point of use.

“Whether this is to turn around underperforming hospitals, operate GP surgeries, deliver community services or create centres of excellence in areas such as pathology, [NHS] commissioners are increasingly using the skills and capital of the private sector.”

NHS privatisation: Compilation of financial and vested interests

“We do want to break up the NHS. We don’t want to privatise it, we want to break it up.” Nick Clegg.

Nick Clegg’s demand for the NHS to be broken up

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Opponents said the comments about the NHS, in a 2005 interview in the Independent, showed that Mr Clegg had no understanding of the way the health service works.

In the interview, carried out while Charles Kennedy was leader and two years before Mr Clegg took the job, he said: ‘I think breaking up the NHS is exactly what you do need to do to make it a more responsive service.’

Asked whether he favoured a Canadian or European-style social insurance system, he said: ‘I don’t think anything should be ruled out. I do think they deserve to be looked at because frankly the faults of the British health service compared to others still leave much to be desired.

‘We will have to provide alternatives about what a different NHS looks like.’

Under a social insurance system, members pay into an insurance scheme, either themselves or through an employer, to guarantee their healthcare. It means that those who pay into a more expensive scheme can get better care.

Under the NHS, however, everyone pays into the same scheme through taxes – and is then guaranteed care that is ‘free at the point of use’.

In the interview, Mr Clegg said ‘defending the status quo’ is no longer an option. Instead, he called on his party to ‘let its hair down’, ‘break a long-standing taboo’ and be ‘reckless’ in its thinking.

‘We do want to break up the NHS,’ he said. ‘We don’t want to privatise it, we want to break it up. Should the debate be taboo? Of course not, absolutely not.’

A year earlier, Mr Clegg had contributed to the notorious Orange Book in which those on the right of the party discussed how policies should change under Mr Kennedy’s leadership. The conclusion of the book outlines in more detail the type of insurance scheme he was outlining.

‘The NHS is failing to deliver a health service that meets the needs and expectations of today’s population,’ it said.

John Lister, of the lobby group Health Emergency, said: ‘These comments show Mr Clegg does not understand the NHS. He seems to be ignorant of the fact that social insurance schemes in Europe are far more expensive.’

Shadow Health Secretary Andrew Lansley said: ‘The NHS is one of Britain’s most loved institutions. People will be worried that Nick Clegg wants to “break it up”.’ [!!! That’s Andrew Lansley pretending that the NHS is safe in Tory hands before the election !!!]

How the Orange Bookers took over the Lib Dems

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What Britain now has is a blue-orange coalition, with the little-known Orange Book forming the core of current Lib Dem political thinking. To understand how this disreputable arrangement has come about, we need to examine the philosophy laid out in The Orange Book: Reclaiming Liberalism, edited by David Laws (now the Chief Secretary to the Treasury) and Paul Marshall. Particularly interesting are the contributions of the Lib Dems’ present leadership.

Published in 2004, the Orange Book marked the start of the slow decline of progressive values in the Lib Dems and the gradual abandonment of social market values. It also provided the ideological standpoint around which the party’s right wing was able to coalesce and begin their march to power in the Lib Dems. What is remarkable is the failure of former SDP and Labour elements to sound warning bells about the direction the party was taking. Former Labour ministers such as Shirley Williams and Tom McNally should be ashamed of their inaction.

Clegg and his Lib Dem supporters have much in common with David Cameron and his allies in their philosophical approach and with their social liberal solutions to society’s perceived ills. The Orange Book is predicated on an abiding belief in the free market’s ability to address issues such as public healthcare, pensions, environment, globalisation, social and agricultural policy, local government and prisons.

The Lib Dem leadership seems to sit very easily in the Tory-led coalition. This is an arranged marriage between partners of a similar background and belief. Even the Tory-Whig coalition of early 1780s, although its members were from the same class, at least had fundamental political differences. Now we see a Government made up of a single elite that has previously manifested itself as two separate political parties and which is divided more by subtle shades of opinion than any profound ideological difference.
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