London, United Kingdom - "The National Health Service is the closest thing the English have to a religion," declared former Conservative Chancellor Nigel Lawson in 1992. How ironic it is then, 20 years later, the entirety of England is being forced into a new form of atheism by the Tory-led British government. It is now only a matter of days before the deeply contested and controversial Health and Social Care Bill is expected to become law. A summary of the proposed reforms are as follows:
While writing this piece, not one person I spoke to was willing to go on record to be quoted as supporting this bill - just one illustration of just how detested and despised it is. The introduction of the Health and Social Care Bill
London, United Kingdom - "The National Health Service is the closest thing the English have to a religion," declared former Conservative Chancellor Nigel Lawson in 1992. How ironic it is then, 20 years later, the entirety of England is being forced into a new form of atheism by the Tory-led British government.
It is now only a matter of days before the deeply contested and controversial Health and Social Care Bill is expected to become law. As you read this, Britain's House of Lords giving the bill its third and final reading. Commentators have suggested any of the Lords' amendments may be considered, and Royal Assent granted, signing the law into effect, as quickly as tomorrow, March 20.
A summary of the proposed reforms are as follows:
- Abolishing Primary Care Trusts (PCTs) and giving their powers to groups of GPs
- Introducing more "competition", so patients can choose where they are treated
- More focus on locally run services; budgets and facilities to be "managed and run" by GPs.
- Establishing an "independent" NHS Board for commissioning guidance and allocation of resources.
While writing this piece, not one person I spoke to was willing to go on record to be quoted as supporting this bill - just one illustration of just how detested and despised it is. The introduction of the Health and Social Care Bill is destroying a right - a fundamental right to free healthcare at point-of-need for all Britons. This right exists in this country, regardless of your age, health, wealth, background or beliefs and has been so since 1948. This is our NHS - from cradle to grave. We own it and we pay for it, but soon it is to be ripped from the hands that have carefully cherished it for decades and placed into the grasping claws of profit driven, private providers.
Quite how we've reached this devastating point, where the Conservatives and their Liberal Democrat coalition allies have been able to bulldoze ahead with an entirely unwanted NHS reform bill, is somewhat of a mystery. Does anyone remember a little document in May 2010 called The Coalition: our programme for government? Writing it, David Cameron and Nick Clegg must have desperately hoped no one would pay any attention to the lies they spun, while promising us the world, gushing how they were going to "make lives better".
David Cameron promised, before being elected, not to impose 'top-down' reorganisations on the NHS [REUTERS]
I also wonder if the prime minister and deputy prime minister can recall committing to an "NHS that is free at the point of use and available to everyone based on need, not the ability to pay". The pair also claimed: "We want to free NHS staff from political micromanagement, increase democratic participation in the NHS and make the NHS more accountable to the patients that it serves."
And of course, this golden promise: "We will stop the top-down reorganisations of the NHS that have got in the way of patient care." How ironic it is then that the proposed Health and Social Care Bill marks the biggest reorganisation of the NHS since it was launched in 1948. In fact, this reform has been described as so large "you can see it from outer space".
There was no mention of any NHS reforms in the election manifestos of either the Liberal Democrats or Conservatives, therefore they have no mandate for what they are doing. Also, if any further proof was needed that big changes were being planned, look no further than the appearance of Andrew Lansley, brandishing his white paper, Equity and excellence: Liberating the NHS, just two months after the coalition agreement. Now, as this white paper was never previously on the radar, one can only presume that Mr Lansley must have had some seriously late nights, drafting the 61-page proposal in just eight weeks.
And just in case we needed further clarification that this coalition government (which managed to worm its way into Downing Street) has no regard or respect for the electorate - after trebling tuition fees, capping benefits, forcing people to work for free or face losing jobseekers' benefits and savaging disability reform - then surely this Health and Social Care Bill is the most illustrative example yet? I struggle to understand why Cameron and Clegg can't grasp just how much the NHS means to people. Choosing not to listen to anyone or anybody outside No.10 will surely cost them dearly in the next election.
Do our gullible leaders really believe the "chosen" private healthcare firms will treat all patients fairly, and not just select those based on the criteria of how much profit will be returned? Also, let's stop with the sloppy stereotype, that "private equals best". The NHS is rated as one of the finest health services in the world, according to the latest Commonwealth Fund study. Of course, it would be naive to believe that the NHS is a flawless, faultless public service devoid of bureaucracy and waste. It is by no means perfect, but of the 11 countries surveyed, the UK came out on top with the fastest access to GPs, the fewest medical errors and the best coordinated care.
On a simplistic level, the NHS care you receive is based on your level of "need", not how much you can afford to pay. No one knows just how much care one will "need" at different stages of life. On a personal level, I witnessed and appreciated just how valuable the NHS is during and after the birth of my son. Having to spend a week in hospital with an unexpectedly complicated delivery and recovery made me realise how cherished this jewel of a service is.
From the dedicated, exhausted surgeons in theatre, right through to the nurses who stayed behind after their 12-hour shifts had finished, to ensure my drip was changed and medication up to date, unconditional care is generously given at every level (with limited resources and staff, I hasten to add). With a somewhat ironic sense of timing, as I was starting to write this piece, my son fell ill, and yet again, I was starkly reminded how the NHS is there for reassurance and trust. Knowing I can take my sick baby to see my GP or drive him to the nearest hospital - with free access to a wealth of knowledge, advice and care - is just invaluable.
The elderly lead the fight-back
Someone else who thinks the NHS is invaluable is June Hautot, a 75-year-old resident of Tooting, South London, who has been hitting the headlines over her relentless "Kill the Bill" protesting. The Keep Our NHS Public campaigner has been fighting hospital closures and creeping privatisation for 25 years and told me of her own experiences of the NHS.
"I've been on vital medication for 50 years and my first child died only five days old," she said. "My second child was very sick and was transferred to another hospital - without the NHS, he wouldn't be here today. The NHS came in just six months before my mother died, but the difference it made to her and my father was vital. Things were so much easier for them both and I am so grateful for that."
Grandmother June Hautot confronts Health Secretary Andrew Lansley [BBC/YouTube]
June, who has become something of a heroine to many, has been described as "Wonderful", "Woman of the week" and "The granny who bo***cked Lansley". This is the moment she confronted and cornered Health Secretary Andrew Lansley outside Downing Street. Lansley, as you can see in the video, was startled out of his wits at being caught off the cuff, and was trapped by an angry June as he attempted to escape to attend a meeting.
"I honestly had no idea that Lansley was going to be anywhere near Downing Street that day," explains June. "I went there to protest against Cameron's summit on the future of NHS reforms, then out of nowhere Lansley appeared and walked smugly across the street towards me with his hands in his pockets. I thought to myself, no, you're not getting past me until you answer my questions."
As Lansley tried to get past, she shouted: "You can wait, you can wait for a change, just like people are waiting for beds now." She told me that he then "did his usual", and denied the health service was being privatised. June screamed at him: "Don't you dare lie to me; you've been privatising the NHS since 1979."
June is just one of a number of elderly protesters pounding the pavements, passionately protesting. She laughs as she tells me: "People say: 'June what are you bothering to campaign for?' I say to them: 'You know why, us older people have grown up with the NHS and we remember what it's like not to have it.' The younger people don't know any difference, but I remember going without, because we had to go to a little office and pay for our health. We need to fight to make sure it doesn't go back to that for our future generations. The ones that will really suffer will be the vulnerable, the ones that can't afford private healthcare. It is morally wrong to make profit out of people's misfortune."
Shirley Murgraff, an 81-year-old activist who spoke to Al Jazeera last year, is a lifelong campaigner for the NHS. She joined UK Uncut on a recent protest outside the House of Lords. The protesters blocked the road in front of parliament, and UK Uncut filmed the moment Shirley was picked up and carried away by police.
"David Cameron bangs on about his 'Big Society'," said Shirley, who has vowed never to stop protesting, "but what he doesn't seem to realise is the NHS is the best example we've got of a big society. It’s a unique example of a civilised society, caring and helping those not so fortunate."
Police carry 81-year-old Shirley Murgraff away from blocking the road outside parliament [UKUncut/YouTube]
She tells me that she "normally" protests with the National Pensioners Convention and that it's been very encouraging to see older people leading the NHS protests.
"I always say to other pensioners, we don't give up just because we're old. We need to keep fighting, make our voices heard - and if they're not getting heard, make them heard by increasing the tempo, pace and ferocity until we are heard."
As protests continue in opposition to the bill, professional bodies are lining up to make their positions clear. Not one professional body which represents specialists in the NHS has endorsed this bill. Those that oppose it include the Faculty of Public Health, The Royal College of Paediatrics and Health, as well as the Royal Colleges of Pathologists, Psychiatrists, Anaesthetists, Ophthalmologists and Radiologists.
Those group that have concerns, but say they are "critically engaging" with the government are Faculty of Occupational Medicine, Royal College of Surgeons of England and Royal College of Obstetricians and Gynaecologists. The Royal College of GPs are calling for the withdrawal of the bill, but have written to David Cameron to ask him to find an "acceptable way forward" in securing the future stability of the NHS in England.
Dr Kailash Chand OBE, a member of the Royal College of GPs, created the e-petition calling on the government to drop the Health and Social Care Bill. The petition is the number one campaign on Number 10's official petition site, and currently has more than 175,000 signatures.
Dr Chand, who has been a GP for more than 30 years, explains that the evidence supporting increased competition in healthcare is deeply contested, and not supported by those who will need to implement it.
"This is about legalising fewer treatments to fewer people," Dr Chand told me. "Yes, we are living longer, but with more diseases. The ones that will suffer in every sense are the ones who can't afford to pay insurance or costly hospital bills. A GP's number one priority is making the care of your patient your first concern, but juggling the ethical and moral decisions of privatisation is, without a doubt, compromising the position of NHS GPs."
Dr Chand shudders as he told me his worst nightmare now looks to become a reality: "This bill will turn healthcare in England into a postcode and taxcode lottery."
Deputy Prime Minister Nick Clegg has become even more isolated from his party after they refused to back the bill at their spring conference this month. The Liberal Democrats must be sick and tired of their leader putting his own interests and position as deputy PM before the leadership of his party. It is painfully obvious that Clegg is pushing himself further away from the electorate and losing all credibility, as he clings to Cameron's coat-tails, in a desperate bid to stay in power.
Standing side by side with his party, declaring: "No, I oppose this bill, it must be withdrawn," would have been a golden opportunity for Clegg to claw back some much needed credibility. He would have gained renewed respect and reaffirmed strong leadership within his own party, and ultimately reaped what he and the Liberal Democrats need most - votes.
Dr Charles West, a senior GP and chairman of Shrewsbury Lib Dems, was at the Lib Dem spring conference and has met Nick Clegg a number of times on the party's campaign trails.
The 'reforms' to the NHS have been described as akin to setting up a lottery for healthcare [REUTERS]
"Nick Clegg is hard working and highly intelligent," said Dr West. "He decided, with all the backing of the Lib Dems, to enter into this coalition agreement. We were under no illusions that the partnership would damage us electorally, but, as time has progressed, it has become apparent that Nick is not keen to break ranks with David Cameron.
"In the instance of the Health and Social Care Bill, the leadership has not consulted with the membership, or those within the party with relevant expertise. He has chosen to ignore party policy. If this bill does go through on March 20, Nick will subsequently have to justify his decisions and position to the party, and then ultimately, the party will have to decide whether he carries on as leader."
Dr West, who has advised the NHS on national policy and worked as a GP appraiser, has published a paper, Health and Social Care Bill: what concerns remain? It was requested by Minister of State for Care Services Paul Burstow. Dr West is terrified, like Dr Chand, of the effect that a two-tier health system will have, particularly in regard with how care will be rationed. "Say for example, a patient needs a cataract operation. They will be at the mercy of a private provider and when they see fit to operate," he said. "I can quite clearly see a situation where patients have to reach a particular level of 'severity' to be operated on, and of course the bigger the operation, the bigger the profit."
Across the Atlantic
Looking at the healthcare system in the US further reiterates the point that privatisation is not something that is wanted or welcomed in England. The US spends more on healthcare than any other nation, close to $2.4tn a year. That amounts to 16.2 per cent total expenditure of GDP and $7,410 per capita, according to the latest data from the World Health Organisation.
In the United States, because of inconsistent healthcare packages, the rich are sorted and poor are screwed - the poor desperately hoping and praying they don't get sick, even if they struggle to pay for basic insurance. The US Census Bureau found 49.9 million people are without health insurance, whilst the latest research from the Commonwealth Fund found more than one in four (27 per cent) of adults were unable to pay, or encountered serious problems paying, medical bills.
Moreover, 42 per cent of patients surveyed in the US reported not visiting a doctor, not filling a prescription, or not getting recommended care.
Someone who has direct experience of both the US and UK healthcare systems is Gail Flor, a 28-year-old teacher from Monroe County, Michigan, who lived in London for three years. Ms Flor described the US healthcare experience as extremely variable, depending on which state you live in, and what occupation you have. She cites the example of how teachers in unionised states have better benefits than teachers in non-unionised states.
Ms Flor, who has now finished teaching in London and moved back to US, told me: "The American system is flawed due to the fact that individuals without employment, working part-time or struggling to make ends meet are not likely to participate in costly schemes to have healthcare. Moving back to the States, trying to find work, and knowing that, in the meantime, all medical treatment would be considered 'out of pocket' was extremely alarming. I realise no system is perfect, but when living in England, it was a relief not to have the additional worry of finding insurance while finding employment."
As the clock ticks closer to D-Day and the protests intensify, reports are now emerging of children's services in South West England that could be privatised. Richard Branson's company, Virgin Care, is one of two private, profit-making companies hoping to win the bid. This is the devastating future, and a warning of things to come, unless we save the NHS and kill the bill.
The great Aneurin Bevan said of the NHS: "It will survive as long as there are folk left with the faith to fight for it."
Siobhan Courtney is a British freelance broadcast journalist and writer. She is a former BBC World News presenter and BBC News journalist who has reported and written for BBC Newsnight.
Source: Al Jazeera