In the run-up to the election, The Lowdown is inviting a range of NHS commentators, staff and campaigners to give us their policy priorities for the NHS. Here Tony O’Sullivan, co-chair of Keep Our NHS Public, outlines the arguments and principles behind the call to restore a people’s NHS
In the countdown to this year’s General Election, one thing is evident: the NHS will be one of the most important election issues. The stakes are high. The Conservative Party’s rule has wrought unprecedented devastation on the NHS. For the future of the NHS, just as for the rest of life in Britain, positive change is crucial. The country desperately needs a change of government, but also needs a radical change of policies, not least on the NHS and social care. But the solutions on offer from the Labour Party have also disappointed. Labour’s message is that the NHS needs reform, that the call for urgent funding is the simplistic demand of ‘some on the Left’. It argues that the NHS is wasteful and inefficient, and that staff are reluctant to put patients first and ‘modernise’.
Labour’s promise to offer an open door to the private sector is especially troubling. They are mirroring arguments made by the Conservative Government that the NHS model is irreparably flawed. They are wrong and it means the work to restore the NHS will inevitably have to continue whoever wins the next election.
What is sorely needed is the political will to re-establish a national NHS that is publicly funded and delivered, and universally accessible again. The NHS must be funded to extend its capacity, to be there to meet patients’ needs, and to be more open and accountable.
‘Top lines’
But what messages should be prioritised? How much detail, how much ambition? We have produced a set of demands, with the evidence to support them, to enable campaigners to argue positively for a restored NHS, to tackle the myths and misinformation over the coming months. We have to get these messages over to the public and politicians and in the media, through well-informed and fact-based campaigning. And through this, a stronger base can be built for campaigning in defence of publicly funded and provided national NHS and care services beyond the General Election – we surely will need to do so whatever the result.
The NHS when funded to succeed, not defunded to fail, was and will be again one of the very best healthcare systems. Any service, public or private, can be degraded and undermined if it is underfunded to the point of failure. Without an urgent large increase in funding, including capital funds, the NHS cannot recover. But the investment must go into rebuilding capacity in the publicly provided NHS, not haemorrhaging billions into private hospital contracts such as for orthopaedics and cataract surgery – a case study in how private encroachment is seriously endangering NHS eye services, including emergency eye care. The private sector is fatally undermining the NHS model, and without extra funding the NHS cannot build back its capacity, attack waiting lists, improve safety and performance and restore the population’s confidence.
The crisis of policy
Year-round the NHS is under enormous stress and every week 500 people are dying avoidably from delayed urgent care. Tens of thousands have died from over 7 million delayed tests and treatments affecting over 6 million people. This winter, influenza and Covid are piling extra pressures on NHS staff already under intense stress after four years of Covid and more than a year of industrial action. The austerity years of underfunding, coupled with the decades-long drive to privatisation, have resulted in what is now the worst performance in the NHS’s history. Demoralised, underpaid staff are leaving in their thousands and public satisfaction with the NHS is dangerously low. It does not have to be this way.
The NHS has not failed – it is the Government that has failed the NHS
There is a concerted attack on the model of the NHS – from previous Health Secretaries, Matt Hancock, Sajid Javid and Steve Barclay to right-wing organisations led by the Institute of Economic Affairs and parroted by too many in the media. We must not allow the NHS to be abused in this way. We must reverse the two-tier system that is now in place. The truth is that the model of a public NHS, when funded adequately, has delivered the best health care this country has ever had. Our campaign makes the case for a restoration of the ‘People’s NHS’ and is a call to act before it’s too late.
Hearts and minds: making NHS an important election issue
The NHS, when funded for need and not defunded for ideological reasons, was and will again be one of the best health systems in the world. The country cannot afford not to have a well-functioning NHS – the funding simply has to be found. The NHS was built successfully at the most difficult of times, in the aftermath of World War II. Its founding principles of health care for all are still sound. During most of the last 75 years, the NHS has consistently delivered some of the best healthcare outcomes in the world and was ‘best in class’ up to 2015 data (reported 2017).
Diverting £billions to private sector contracts under the headline of using the private sector to bring efficiency is ill-informed at best. At worst it is feeding the beast: there is no spare capacity in the private sector that does not further undermine the NHS. The private sector’s profit margin relies on the NHS in so many ways. And – bottom line – the economy of this country needs a strong and efficient, effective and equitable NHS.
Restore the people’s NHS
Our vision to restore and expand the NHS is based on five main principles:
- A publicly provided NHS with a commitment to end private healthcare involvement
- An NHS funded to succeed, not defunded to fail.
- An NHS workforce that is respected, with restored morale and its value recognised through decent pay & conditions.
- A Public Health service rebuilt to lead the protection and restoration of the nation’s health and the tackling of health inequalities.
- A rebuilt NHS, restored and expanded; enabled to tackle health inequalities and help deliver a healthy population.
Conversations with the public
Facts alone will not alter the course of this coming election. But before entering the voting booth, the public needs to know how to vote on the NHS. It is important that voters engage candidates and parties in political discussion to challenge false claims and false promises.
They need answers on why they can’t see their GP or find an NHS dentist; why maternity and mental health services are so dangerously stretched; why social care is on its knees. They need answers to why charging undocumented people living in Britain for NHS care is wrong and part of a policy of victimising a vulnerable section of society. And they need the truth behind the lies that the NHS has never been better funded and has record levels of nurses and doctors. Voters must hear again how the Government let down the people during the pandemic, that Covid is not over, that our Public Health system needs to be rebuilt; that the private sector is not the answer to NHS problems but a contributory danger; and why we must not trust private corporations with our personal health data. The electorate must hear how austerity further deepened inequalities in society – and caused a million excess deaths from 2011 to 2019; how inequality causes deaths and suffering; and how the NHS can combat inequity by restoring free prescriptions and eyecare, and universal access to an NHS dentist.
A challenge to all parties
The political choice at the general election is stark: the government of the last 14 years simply has to be removed. But the parties hoping to be part of a new government must offer to adopt radically different policies to earn the electorate’s vote. Nowhere is that more clear than in the NHS and Care systems. There is an opportunity over the months before the General Election, a chance to highlight the importance of the call for restoration and rebuilding of the People’s NHS; an opportunity to enable the electorate to see behind the myths and false facts in government and right-wing narratives; a chance for them to engage with and challenge politicians who are asking for their vote.
The call to Restore the People’s NHS will empower health campaigners and unions We will provide anyone, including candidates who request them, with factsheets and briefings on the important issues listed. Posters and social media materials will be helpful to local NHS campaigners organising public meetings and street activities. Nationally more in-depth online public forum discussions will focus on the key issues. We have allies in the trade unions and organisations who are part of SOS NHS. They will help get pro-NHS messages out to their members. And, once election day is announced, hustings around the country will enable debate on the NHS policies with the parties competing for the electorate’s vote.
The NHS model is second to none. It requires urgent funding, an end to private interests exploiting and undermining the NHS, and a restoration of a national service, comprehensive and available to all, promoting health and health equity, and delivering high quality, safe clinical care for physical and mental health. The responsibility to continue this work will, without doubt, continue in the years following, whatever the election outcome.
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