The notion of madness is widely understood as a health condition that requires treatment. Market madness is not. If we are to save the National Health Service, there must be treatment for this appalling condition that now afflicts our hospitals and GP surgeries.
In South London, a hospital trust is collapsing due to its debts. Fifty more hospital trusts around the country are in a similar position. Why? Because both Labour and Conservative governments insisted on cooking the books to make it look like they were investing in our healthcare. They did this by giving private companies very lucrative contracts to build and maintain hospitals. These contracts allowed these companies to charges huge interest rates on loans that they gave to allow the NHS to build hospitals. Because these loans would need to be paid off over 25-30 years in most cases, the cost would be more than ten times the cost of direct government investment to build a hospital and would entail a very large amount of profit for the private financers. This policy was called the Private Finance Initiative (PFI). It is a disaster for the NHS and government finances.
The capital cost of rebuilding Calderdale Royal Hospital in Yorkshire is £64.6m but the scheme will end up costing Calderdale and Huddersfield NHS Foundation Trust a total of £773.2m. Building the new Walsgrave district general hospital in Coventry will jump from an initial £379m to an eventual £4bn.
Current estimates of the final cost of the PFI programme in health and education are £301billion in repayments. These repayments do not come from the idiotic politicians obsessed with the notion that the private sector does things better (take a look at the mess in the banking system) who organized and negotiated these awful contracts. They do not come from the politicians and private financiers who cheerlead this private money making scheme at the expense of our health. It comes from the taxpayer who now has huge governmental debt built in for the next 30 years when all the investment could have come at less than a tenth of the cost.
The Labour government moved to creating an internal market in the NHS by launching the Foundation hospitals and trusts. The layer of managers and accountants that Margaret Thatcher brought into the NHS swelled in this internal market. Now the logic of a market has hit home as some will be wealthy while others collapse. The problem is that this means hospitals closing, poorer standards of care, less staff being paid lower wages and more selective healthcare with those most in need being turned away.
What is the solution of the ConDems? To increase the market in healthcare by getting GPs involved and letting private companies take over parts of the health service. When a cure doesn’t work, just do it more and more while looking the other way and hoping no one blames you. Since sliding into government, the ConDems have quietly added 39 new PFI contracts and £5.36billion to the debt. It has been quiet because both parties attacked Labour for going for PFI.
The National Health Service is one of the greatest prides of British social life. It is the most wonderful gain for working people in the last hundred years. It is now in real danger from the profit takers and the politicians who do their bidding. It must be stopped.
These contracts should be scrapped and replaced with direct government investment in health care. If effective taxes were levied against the financial sector and the private hospitals that make people pay for health care, the government could afford this investment. If the layer of managers and accountants were removed from the NHS, it would free significant resources for health. If the false market was removed, health care could be more organized and effective.
This country needs more nurses, more hospitals and clinics and less debt so why are the politicians helping the corporate looters to destroy our NHS. It is too important to lose and an alternative strategy is urgently needed.
by Dr Kay Phillips, a GP in Manchester. 