“To reverse the trend of increased NHS spending on private providers – while NHS trusts lack the capital and revenue funding they need to expand services – we need to inject new investment into the NHS. This demands a change of policy.”
By John Lister, Editor of Health Campaigns Together
A powerful new alliance of campaigners and trade unions has launched the SOSNHS campaign, demanding an immediate injection of another £20 billion in capital and revenue to help put England’s crisis-ridden NHS back on its feet.
The need for it is obvious from all the stories of patients dying in ambulances queuing outside A&E, the waiting list, set to soar above 6 million, the inadequate provision of beds and staff in the NHS compared with other countries, and desperate shortages and delays accessing mental health services – not to mention the dire state of social care.
£20 billion sounds like – and is – a lot of money: but after more than a decade of real terms freeze or cuts in NHS funding it would only be a down payment to address some of the most pressing problems. Much more investment will be needed – not least to fulfil government promises of building 48 new hospitals, expanding the workforce, and fixing social care.
To put £20bn in context we also need to remember the huge sums of money Rishi Sunak threw at the private sector with little or no accountability during the Covid pandemic.
£48bn was shelled out on ‘bounce back loans’: the National Audit Office has found that that at least 37% of loans (£17.3bn) will not be repaid, and that 11%, worth £4.9bn, were fraudulent.
Billions were squandered on dodgy deals for overpriced or useless PPE and equipment. Billions more were wasted on the disastrous privatised test and trace system.
And let’s not forget more than £2bn forked out for use of private hospital beds in 2020 – few of which were used – and another £10bn over 4 years to treat NHS waiting list patients, which will also line the pockets of private hospital bosses and shareholders, while thousands of NHS beds remain closed or empty.
Now Sajid Javid has instructed NHS England to sign yet another rip-off 3 month, £200m-plus ‘standby’ deal with private hospitals that guarantees them profits even if no private beds are used – and commits to pay at least 10% above NHS tariff prices for some operations.
The money wasted on these three things alone would have been more than enough to put the NHS back on track. If money can be raised to waste, it can be raised to invest.
But there is a common factor to these different ways of wasting money: the beneficiaries are always the private sector, and the loser is always the public purse and public services.
In recent years the main driver of privatisation and so-called “partnership” deals between NHS and the private sector has been the lack of adequate NHS capital, capacity and resources.
That’s why private sector partnerships have been proposed or implemented in building new community diagnostic hubs, and for major contracts for laboratory and pathology services and imaging, why private hospitals are contracted to fill gaps, and provide the majority of some mental health services, and why a majority of hip and knee replacements are now being done in private hospitals rather than the NHS.
So to reverse the trend of increased NHS spending on private providers – while NHS trusts lack the capital and revenue funding they need to expand services – we need to inject new investment into the NHS. This demands a change of policy.
Since 2010 even the BBC has noted that real terms spending on the NHS has increased by only a fraction of the previous average rate of 4% per year. By 2019 NHS Providers calculated that the gap between actual spending and what it would have been was £35bn per year.
The consequence was huge deficits in NHS trusts, lack of capital for new projects, a sharply rising bill for backlog maintenance – and NHS staff pay falling ever further behind equivalent 2010 levels.
Theresa May as Prime Minister claimed to be spending “record amounts” on the NHS: but increasing cash allocations each year does not necessarily match the increased costs and demands on the NHS. In 2018 Chancellor Phillip Hammond announced a “£33.9bn” increase in NHS funding – which the Treasury admitted was only £20.5bn in real terms.
Boris Johnson was still cynically claiming to be spending the same “£34bn extra” on the NHS in the 2019 election, coupled with even more far-fetched promises to build 40 – and later 48 – new hospitals, although the PR spin on what constitutes a ‘new hospital’ has since been revealed.
While extra funding was found to tackle Covid, the lion’s share of this was channelled in to private contractors and suppliers: and last autumn’s spending review Chancellor Rishi Sunak made clear there would be little added to the deceptive £36 billion “health and care levy” to run over 3 years from April 2022, and raised through the least progressive taxation, hitting the lowest-paid hardest.
Of this £36bn just £15.6bn was allocated to NHS England, over three years, falling well short of the £10bn extra for 2022-3 called for by NHS bosses, and just £1.8bn a year for social care: by contrast the Health Foundation estimated an extra £17bn was needed by 2024 just to shrink waiting times to 18-week target levels.
The Spending Review locks in this limited spending to 2024-5, failing to fund even the miserly 3% 2021 pay award: Rishi Sunak has set the NHS on course for a second decade of decline, and warned Sajid Javid that the NHS budget will not cover the extra costs of booster jabs to tackle the Omicron variant of Coronavirus. There is no money in the kitty for a proper pay increase for staff or the recruitment of the promised 50,000 extra nurses.
A change of course is vital to repair and rebuild crumbling infrastructure and reopen beds left empty since Covid-19 struck, invest in the NHS as a public service, squeeze out parasitic private contractors, invest in staff to ensure high quality and safe services – and restore the performance levels that have been declining since George Osborne’s austerity regime kicked in in 2010.
That’s why we are building SOSNHS: to rescue our NHS before more patients and staff lose confidence that things can ever get better. Join the online rally on January 19 and local events across the country on February 26.
- John Lister is the Editor of Health Campaigns Together, you can show your support for them on Facebook and twitter.
- Find out more about the SOSNHS and their urgent call for increased funding, proper pay for NHS staff and an end to profiteering in the health service.