Raiding the NHS budget or scrapping plans to rebuild crumbling hospitals would plunge the health service into its deepest crisis in decades. This was the stark warning this weekend from Matthew Taylor, chief executive of the NHS Confederation, who said the government is “living in a fantasy land” if it believes it can cut funds to the NHS without endangering patients.
Jeremy Hunt promised spending cuts of “eye-watering difficulty” last week after becoming chancellor of the exchequer. Yet he also did not reverse his predecessor Kwasi Kwarteng’s decision to scrap the £7bn health and social levy that had been earmarked for the NHS.
Taylor, whose organisation represents hospitals, ambulance trusts, mental health care, community care and GP services, said his members were issuing the “starkest warning” about “the huge and growing gulf between what the NHS is being asked to deliver and the funding and capacity it has available”.
“I want to use this election to raise awareness of the imminent danger posed to the NHS by the EU/US trade agreement which will allow American companies to carve up the NHS and make the privatisation process irreversible.
“I also want to alert the public to the gravity of the threat to the NHS from this government with its programme of cuts, hospital closures and privatisation and to send a powerful message to politicians in Westminster and Brussels that people will not stand by and let their NHS be destroyed.
“If elected, I will strive to ensure that EU regulations don’t adversely affect the NHS and are always in the best interests of the health of British people. The health of the nation spans all areas of policy from the environment to the economy”.
Stormy scenes are likely in parliament today as the government tries to “rush through” changes that will make it far easier to close hospitals without public consultation. The changes,which OurNHS has campaigned on from the start, now face fierce opposition from doctors, 38 Degrees, the British Medical Association, NHS campaigners and charities.
On Friday Ed Miliband tabled a motion of opposition to the Bill, saying it “includes provisions which could put NHS hospitals at risk of having services reconfigured without adequate consultation and without clinical support”.
The hospital closure clause gives Trust Special Administrators greater powers including the power to make changes in neighbouring trusts without consultation. It was added to the Care Bill just as the government was being defeated by Lewisham Hospital campaigners, in an attempt to ensure that campaigners could not challenge such closure plans in the future. But the new Bill could be applied anywhere in the country.
Louise Irvine, Chair of the Save Lewisham Hospital campaign, said “If services need redesigning the law must ensure this is with proper and extensive consultation with local people. This process cannot be rushed. Decisions should not be based on the needs of investment banks. What happened to the government promises that in the NHS there would be ‘no decision about me, without me’?”
Ed Miliband commits to doubling the number of homes built each year. The move is likely to prove very popular. I think that he’s correct in recognising development and building as a racket concerned with profiteering. I would also like to see the renovation of properties and the conversion of buildings to homes or other forms of social housing.
Profiteering property developers that hoard land and councils that block developments will be swept aside in a “non-stop drive” to more than double the number of homes being built each year in England, Ed Miliband will promise on Monday.
Attacking “stick-in-the-mud councils”, the Labour leader will say he would order a national planning inspectorate to give priority to local authorities that want to expand if they are being blocked by neighbouring councils refusing to release land.
Under the Labour plans, councils would be empowered to compulsorily purchase land or charge fees if developers fail to build on land for which they have planning permission. Michael Lyons, the chair of Labour’s new independent commission on housing and a former BBC chairman, told the Guardian that Britain needed to recapture the postwar spirit when building homes was the national priority.
Almost half a million fewer old and disabled people are receiving care and support from the public purse than would have been the case before the financial crash, according to an expert study.
The research comes as MPs vote on Monday on the coalition’s care bill, which aims to overhaul the care system in England but threatens to tighten still further the rules of eligibility for state support.
Charities and care organisations are calling on ministers to address a “black hole” in social care funding which they say has left the system short of £2.8bn a year that would be necessary to meet people’s needs assessed as “moderate”.
Bridget Warr, chief executive of the United Kingdom Homecare Association, said: “Funding good care which helps people stay in their own home is not only a moral responsibility for any civilised society, but is also cost-efficient as it extends people’s wellbeing, reducing admissions to A&E, and helps people return home from hospital quicker.”
Homelessness has increased for three consecutive years, partly because of housing shortages and cuts to benefits, with an estimated 185,000 people a year now affected in England, a report says.
Research by the Joseph Rowntree Foundation and Crisis found almost one in 10 people experience homelessness at some point in their life, with one in 50 experiencing it in the last five years.
Responding to the report, Emma Reynolds, the shadow housing minister, accused David Cameron of breaking his promises to tackle homelessness and get Britain building.
“Homelessness has risen every year under this government, the number of families with children living in bed and breakfasts is at a 10-year high and house-building is at its lowest in peacetime since the 1920s,” she said.
Leslie Morphy, chief executive of Crisis, urged the government to address a chronic lack of affordable housing and consider the impact of its cuts to housing benefit, such as the bedroom tax, welfare cap and shared accommodation rate.
Hundreds of patients are being forced to wait more than four hours to be seen by accident and emergency departments as the winter crisis begins.
It is the first time since April that emergency departments have struggled to hit their four-hour targets as admissions to A&E hit the highest level since data started being collected in November 2010.
According to NHS England figures, 3,678 patients across the country were forced to wait between four and 12 hours for treatment.
Five patients were not seen for more than 12 hours last week – the busiest week of the year with 415,000 people visiting A&E departments.
Waiting times were worst in major A&E wards where just 92.2% of patients were seen within four hours.
Idiot Johnson is not the only one setting a poor example. As a cyclist, I advise you to wear a helmet as I was advised by my GP (doctor). If you fall from a bike, you’re falling six feet or so possibly with your head impacting the ground. Even presidents can have a ‘bicycle accident’.
FOI requests reveal ‘hidden workforce crisis’ at odds with official statistics
Freedom of Information requests submitted by the Royal College of Nursing (RCN) to dozens of NHS hospitals in England have exposed a “hidden workforce crisis” that has been missed by government statistics.
While official figures say that just 3,859 full-time nurse, midwife and health visitor posts have been lost since the Coalition came to power in May 2010, the RCN said that thousands more nursing vacancies have been created because hospitals have not been replacing staff that have retired or moved on due to reduced budgets.
Staffing shortages have been highlighted in a number of reports into NHS care. Robert Francis drew attention to understaffed wards at the Mid Staffordshire NHS Trust in his report into one of the worst care scandals in the health service’s history.
Howard Catton, the RCN’s head of policy, said that Government figures had not been “fully reflecting the shortages [that nurses] are experiencing at ward level”.
The report came as Downing Street confirmed that the Prime Minister is personally overseeing the NHS’s response to what A&E doctors have warned could be “our worst winter yet”. Many trusts missed their A&E targets last winter and there are fears that amid rising demand and reduced resources, the system may struggle to cope with expected spikes in admissions.
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Monitor says closures of 53 popular clinics could leave vulnerable people unable to access GP care
Despite huge popularity, nearly a quarter of NHS walk-in clinics offering seven-day care and evening opening have closed in the past three years, according to research by Monitor, the health service regulator.
It said there was a danger that closures could leave some patients unable to access GP care, particularly those unable to register with a surgery, as well as low-income working families and high-risk socially excluded groups such as homeless people, refugees and drug addicts.
More than 230 centres offering family doctor services were set up in England in the decade to 2010 under a Labour government initiative to improve access to care for patients who found it hard to register with their local GP or were unable to get a speedy appointment at a time that suited them.
Ironically, some of the closures appear to be the result of the centres being too successful. NHS commissioning authorities that have closed walk-in centres told Monitor that the clinics triggered “unwarranted” demand among “worried well” patients for often minor conditions. Some said they had closed centres to make savings as they could “no longer afford the convenience that walk-in centres offer”.
The closures are widely spread around England including in London, Plymouth, Southampton, Bristol, York, Manchester, Blackpool and Colchester. Six so-called “commuter” walk-in centres based at major railway stations in Manchester, London, Leeds and Newcastle, have closed in recent years after for failing to attract enough patients.
Monitor’s research found nearly two-thirds of patients who attended walk-in centres were already registered with a GP. Of these, just over a fifth said they had contacted their GP practice beforehand but were unable to get an appointment. A further 24% said they did not even bother to contact their GP because they anticipated there would be no convenient appointments available.
Figures undermine David Cameron’s claims that health service bureaucracy is being cut
The number of elite NHS “super-managers” being paid up to £240,000 a year to implement the government’s controversial health service reforms has soared to more than four times the level originally expected by ministers, the Observer can reveal.
The latest official figures – which show a total of 428 “very senior managers” (VSMs) working in the newly constituted NHS bureaucracy – undermine David Cameron’s repeated claims to be slashing management posts and costs at every level in the service.
The figures will also anger more than a million NHS employees at the other end of the pay scale, including nurses and non-medical staff, such as cleaners, who have been warned that their planned 1% increase for 2014 could be cancelled because there is not enough money to fund it.
In 2010, as the coalition embarked on its controversial reforms aimed at opening the service up to more private competition, ministers told the Senior Salaries Review Body (SSRB) that by the time the changes were completed in April this year, there would be fewer than 100 very senior managers working in the top salary bracket of between £70,000 and £240,000 a year. But the Department of Health last night confirmed recent SSRB data which shows the number is now 428, including 211 super-managers at NHS England, the new body which oversees the budget and delivery of day-to-day services. The average pay of these managers is around £123,000 a year.
Pay review body documents also show that in May 2012, at the height of controversy over the changes, pioneered by the former health secretary, Andrew Lansley, there were 770 VSMs in post “during transition from old to new NHS structures”.
The figures do not include the 259 chief executives of NHS trusts whose pay is set by their own organisations’ remuneration committees and in some cases is more than £240,000 a year.
The revelations will pile more pressure on ministers after it emerged that some 2,200 NHS managers have been made redundant with large payoffs, only to be re-employed soon after.
Britain is an extreme oddity regarding privatisation: nowhere else in the advanced world is there such a willingness to sell everything that isn’t nailed down. Time and again the British public is ripped off and sold out by its leaders.
A few weeks ago, London was the scene of a heist of spectacular proportions. We may never know the full extent of what was stolen, but the indications are that it was anywhere between £1 billion and an eye-watering £6 billion. Although the robbery was carried out in broad daylight, it is unlikely the money will ever be recovered or the perpetrators brought to justice. This is because they were sitting in some of the world’s largest financial institutions – Goldman Sachs, Barclays, Bank of America and UBS – and acting on behalf of the British government.
Their instrument was the undervaluation of shares in Royal Mail, which with the initial public offering immediately soared from 330p to above 500p. The company was sold at £3.3 billion but in J.P. Morgan’s estimation the real value may have been as high as £10 billion. No wonder the IPO was oversubscribed. It was, as TUC General Secretary Frances O’Grady pointed out, akin to “selling five pound notes for four quid.” The biggest private shareholder is now the hedge fund TCI, which snagged 5.8 per cent of the company. The principal victim of this daylight robbery is, of course, the British public.
There has been plenty of public and media commentary – and even a little outrage – at this latest instance of the looting of Britain’s dwindling public sector. After all, even Margaret Thatcher was “not prepared to have the Queen’s head privatised.” The sell-off was conducted in the teeth of sceptical public opinion as well as fierce opposition from postal workers, with 96 per cent opposed in a recent ballot. Billy Hayes, General Secretary of the Communication Workers Union, denounced the manner in which a centuries-old public company, returning regular profits to the Treasury, was “flogged on the cheap for no good reason.” Postal workers have voted for industrial action, seeking guarantees on pay and working conditions.
Missing from most of the discussion, however, is any recognition of just how extraordinary all of this is. Business Secretary Vince Cable may have faced some tough questions about the handling of the flotation but it will blow over. No heads will roll. Asset-stripping of the public sector has become a fact of life. Even among the British left, battered by the serial privatisations of the 1980s and 1990s, there is a certain wearied resignation, a sense of going through the motions in the face of the seemingly unalterable order of things.
We should resist this normalisation. Viewed from an international perspective, Britain is an extreme outlier regarding privatisation. In no other advanced industrial country would quite so flagrant a rip-off have been engineered and tolerated. Nowhere else – not even in the corporate-dominated United States – is there such a degree of nonchalance about ownership and control over vital infrastructure and public services. In the UK, the attitude seems to be that if it isn’t nailed down then it is for sale. Privatisation is increasingly the British disease.
From Pinochet to perestroika
Privatisation has been a prominent feature of the British political landscape for decades, but on the basis of an assumed international policy consensus about how to improve efficiency and economic performance. It is true that, since the 1980s, privatisation has been a key instrument in the toolkit of neoliberal globalisation, enforced from Latin America to Asia to Africa wherever the writ of the IMF and World Bank could be made to run. By 2009, 132 of the world’s 500 most valuable corporations were privatised former state enterprises. But within this neoliberal framework, very few countries were actually prepared to go quite so far quite so fast as the UK.
In a 2002 encomium to privatisation, HM Treasury calculated that, all told, between 1980 and 1996 Britain had racked up fully 40 per cent of the total value of all assets privatised across the OECD. This is an astounding figure. Elsewhere, the only remotely comparable experiences occurred in countries – Pinochet’s Chile and the disintegrating Soviet Union – that were undergoing exceptional transitions and in which the rule of law was basically inoperative.
Chile was the original laboratory. Between 1975 and 1989, under the jackboot of the Pinochet regime and at the urging of carpetbagging Chicago school economists, the country implemented two waves of privatisation. Not merely companies nationalised by Allende but a host of older public concerns – including 16 banks and thousands of mines, real estate holdings and agricultural enterprises – were auctioned off to elites at bargain-basement prices.
Given the accolades afforded the “Chilean miracle” by Milton Friedman and others, it is worth noting that the first wave of Chilean privatisation was a major embarrassment. All but five of the banks and many of the other enterprises failed and had to be taken back into public hands. By 1983 the government-controlled portion of the economy again equalled that under Allende, and critics mockingly referred to a “Chicago road to socialism.” (The second wave of privatisation, beginning in 1985, eventually returned many of these firms to the private sector).
Road tested in Chile, privatisation was then exported out across Latin America and worldwide. Under Margaret Thatcher, Britain served as the most prominent conduit and cheerleader. With free market economists again hectoring from the sidelines (see Thatcher’s correspondence with Hayek), all memory of capitalist mismanagement of factories and mines in the interwar years was forgotten as the commanding heights of the economy – electricity, gas, water, steel, civil aviation, telecoms and railways – were delivered up for auction. It was a massive transfer of wealth from public to private interests, marketed to the people with soothing promises of a shareholder democracy.
As with Royal Mail, the brazenness of the theft was stunning. In his magnificent recent book on public ownership, Andrew Cumbers, Professor of Geographical Political Economy at the University of Glasgow, found “considerable evidence that state assets were sold off at remarkably cheap prices.” Shares in BT jumped from 130p at privatisation to £15 by 1999. Railtrack was sold for £1.9 billion, but within two years had soared in value to £8 billion. The rolling stock company Porterbrook Leasing, privatised for £528 million, was re-sold just eight months later for £826 million, while the other two rolling stock companies were subsequently sold for £900 million more than their privatisation price. The architects of privatisation could barely be bothered to disguise what they were up to. Former Chancellor Nigel Lawson went so far as to state in his memoirs that undervaluation was a deliberate government tactic.
Hugely important strategic considerations were at work, as was evident in the subsequent development of the UK economy. Privatisation not only allowed for attacks on the trade unions but also – together with big bang deregulation – contributed to the build-out of London-based capital markets. The £3.9 billion rollout of shares in BT in 1984, for example, was six times bigger than any previous IPO and four times the size of any other capital-raising exercise in the world at the time. In this way, the privatisations of the eighties and nineties helped secure the City’s continuing place as a world financial capital.
In addition, the sale of 2.5 million council houses at a total value of £86 billion – more than all other privatisations combined – helped generate the real estate boom and (as Stephen Wilks notes) ultimately contributed to the property credit bubble. Revenues from the sale of other public assets – totalling £69 billion between 1979 and 1997 – allowed successive Tory governments to maintain public spending while cutting taxes for short-term electoral gain. Leon Brittan insisted that “people always overestimated Mrs Thatcher’s grasp of economics while underestimating her grasp of politics.”
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.