Rishi Sunak, the Tory chancellor whose 2021 Spending Review in November locked the NHS on course for a second decade of decline, is now warning that the limited NHS budget will not cover the extra costs of booster jabs for the latest variant of Coronavirus.

And while further tightening the financial straitjacket on the NHS that has effectively frozen real terms funding since 2010 – while the population, its health needs and cost pressures have grown –Sunak is, according to a recent Spectator article, also leading a cabal of cabinet ministers who are critical of the NHS itself – and, according to the Financial Times, involved in meetings with US health corporation bosses.

Systematically starving the NHS of the revenue it needs to sustain services and the capital it needs to repair and renew hospitals and equipment has emerged as the main driver of privatisation. Desperate NHS bosses lacking the capacity to cope with rising demand have been forced to turn to private hospitals to supply extra beds, contractors to supply cataract and other routine operations, imaging services, laboratory services and mental health care.

The extra costs and inefficiencies of this fragmented system pile further pressures back on the NHS – while the private sector, which trains no staff, can only expand by recruiting from the limited pool of NHS-trained staff.

Now Sunak has reportedly warned Health Secretary Sajid Javid that additional spending on vaccination – the government’s preferred (and only) strategy to combat the virus – will have to be paid for, either by cutting spending elsewhere or by raising taxes. 

The recent socially regressive “levy,” increasing National Insurance payments for even the lowest-paid to raise £36bn for UK health and care services over the next 3 years, showed Sunak has no intention of taxing the rich to raise any additional funds. Now Daily Mail reports the Chancellor warning Javid that “people would feel the effects of [any additional extra] spending in NHS and household budgets.”

Estimates suggest that six-monthly vaccinations could cost an extra £5bn a year; but no such extra cost has been factored in to Sunak’s tight-fisted allocations to the NHS up to 2025.

It also appears that Sunak and the Treasury, eager to recoup its £200m investment in the Vaccine Manufacturing Innovation Centre at Harwell near Oxford, are the force behind the efforts to sell it off to a private corporation, jeopardising its potential future role in pioneering new vaccines and saving lives.

The Chancellor who previously promised the NHS would get “whatever it needs” to fight Covid-19 is now starving it of funds while consorting with US health bosses and apparently seeking to carve up and privatise parts of it.

This coincides with articles in the rightwing press that cynically exploit the lack of NHS capacity as a way of challenging the NHS itself as a publicly-funded and publicly run service. Articles in the Spectator and Daily Telegraph, both by Kate Andrews, the American who so frequently gets BBC and other media platforms to spout the ignorant nonsense of the obscurely-funded Institute for Economic Affairs, argue that the NHS itself is failing. 

Both articles claim – using distorted figures from the pandemic year of 2020-21 (in which most of the Covid-driven increase in “health spending” did not come anywhere near the NHS, but was squandered on private contractors and consultants screwing up Test and Trace and procurement of PPE) – that the NHS is awash with cash.

Both articles ignore the fact that since 2010 the meanest-ever increases in NHS funding have left the NHS at least £35 billion per year short of the level it should be receiving. 

The Spectator article also ignores the resultant dire shortage of NHS beds compared with most high income countries, and compares the NHS unfavourably with other systems in which private insurance and private provision, increased spending and increased capacity play a significant part.

These include Belgium, which has more than twice as many hospital beds per 1,000 population; Germany, which spends almost 28% more per head on health than the UK, and has six times more acute beds per head than England; and even Switzerland, which spends over 35% more than the UK on health, levies sky high user fees, and has almost double the UK provision of beds.

The Telegraph article changes tack, simply attacking NHS performance, proposing no alternative approach. It accuses the NHS of failing to open enough beds: “Take the number of hospital beds. This is estimated to have fallen since 2019…” and failing to employ enough staff: “Understaffing has been a persistent problem for the NHS, and it may soon worsen.”

These attacks on the NHS are happening in the midst of a pandemic that has exposed to all the abject failure of private contractors, and the complete inadequacy of private hospitals – which offer no emergency services and only limited numbers of beds – to fill in for gaps in NHS provision.

The fight by the new SOSNHS campaign for the resources needed to restore and expand NHS capacity is focused on the need to force the government both to fully fund ALL additional costs of fighting Covid, and also for them to tear up the 2021 Spending Review and allocate at least £10bn additional capital plus increased revenue funding to the NHS in the Spring Budget, without which neither bed numbers or staffing levels can be increased. 

John Lister, (first published in Tribune, December 20)

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