Whichever Tory wins, the NHS loses


“Both Rishi Sunak and Liz Truss offer the most simplistic and self-defeating solutions… the escalation of idiocy comes as both candidates apparently target the most ignorant and reactionary layers of their party in a battle of impractical ideas.”

By John Lister, co-editor of The Lowdown and co-author of NHS Under Siege

As the Tory leadership contest degenerates even further into a race to the far right in an effort to win over the peculiar ‘selectorate’ of 160,000 mainly elderly, prosperous Party members, the NHS, locked in a crisis created by 12 brutal years of under-funding, has been one of the last issues to be raised.

According to the Telegraph’s new NHS Data Tracker the result of this sustained neglect is that: “the NHS in England is failing to meet every single one of its key duties of care to patients, with not a single official target being met.”

Both Rishi Sunak and Liz Truss offer the most simplistic and self-defeating solutions. Sunak wants a “task force” driving for tougher targets, presumably to bully NHS staff harder and magically make waiting lists stop growing by next year.

Truss apparently sees the answer as cutting out layers of management. But she angered Tory ministers (and the Tory Mayor of Tees Valley) by her ludicrous claim that – in a cost of living crisis – she can save £11 billion by cutting the pay of civil servants and public sector workers (including health workers) outside London, and has had to drop the policy less than 24 hours after announcing it.

The escalation of idiocy comes as both candidates apparently target the most ignorant and reactionary layers of their party in a battle of impractical ideas.

A Telegraph summary of their positions on the NHS says Sunak’s big idea is a gimmick that even Telegraph readers have ridiculed –  a £10 fine for missed GP and hospital appointments, as part of a “transformative” shake-up of the health system:

“He said that patients would be given “the benefit of the doubt” the first time they miss an appointment, but subsequent absences would incur charges. The system would be “temporary” as the NHS tries to clear the Covid-19 backlog of more than six million patients waiting for planned care.”

With around 1.3 million GP appointments missed (less than one in 12) in March alone, how such fines would be levied or collected, and how much this would cost in additional bureaucracy which would contribute nothing to health care is of course not discussed.

Sunak also apparently wants to increase NHS use of private hospitals. He is apparently also considering “giving patients the right to have a nominated family doctor if they want one rather than being simply attached to a surgery,” although again there are obviously no details or explanation on how this might be done at all – let alone without more GPs and more funding.

We learn from the Times that in a policy based more on King Canute than his idol Margaret Thatcher, Rishi is hell-bent on demanding the impossible, a miraculous improvement for no extra cost: “Sunak wants waiting lists to stop rising next year. Under current plans they will continue to increase until March 2024. He wants one-year waits eliminated by September 2024, six months earlier than existing plans.”

Truss by contrast appears from the Telegraph summary to have no developed policies or views on the NHS, but the Independent summary includes her agreement that there is an urgent need to deal with care backlogs, a promise to install a “strong” health secretary to solve the issue [!] and her assurance she is “completely committed” to current Government promises for NHS spending, despite her plans for the tax cuts which were supposed to pay for them.

In a televised Sun debate, Truss even appeared to accept the government has failed to invest enough in the NHS, pointing out the hospital closest to her constituency, Queen Elizabeth, Kings Lynn, is literally falling down. But neither she nor Sunak has proposed any additional funding to tackle such problems.

Truss’s real position, however, is more ambiguous still, since along with Dido Harding’s husband John Penrose she is one of an 8-strong Parliamentary Board of the 1828 Committee, whose ‘Neoliberal Manifesto’, published jointly with the Adam Smith Institute in 2019, condemns the NHS record as “deplorable” and states:

“We believe that the UK should emulate the social health insurance systems as exist in countries such as Switzerland, Belgium, the Netherlands, Germany and Israel, among others. Under these systems, individuals pay regular contributions — as they currently do for the NHS through taxation — to their chosen insurer. They are then free to seek treatment from a medical provider of their choice and their insurance company subsequently reimburses the provider for the expenses incurred.”

This is obviously a more complex and bureaucratic system than the tax-funded NHS, creating a role for insurance companies to take a cut. How it is supposed to improve health care is not at all clear.

The small consequential detail missed out in this manifesto for privatisation is that with the exception of Israel, all of the preferred systems spend considerably more per head than the UK. While Israel spends less, the most recent (2015) WHO assessment of its healthcare system suggests it far from a model for the NHS to aspire to:

“One of the greatest current challenges for Israeli health care is its growing reliance on private financing. … the ongoing shift from public to private financing has troubling implications for both equity and efficiency.  Why are more and more Israelis signing up for private health insurance? …  motivating factors appear to include concerns that the mainstream, publicly financed system will not give them access to all necessary medical services, will require them to wait inordinately for covered services, will not be sufficiently patient centred and will entrust their operations to surgeons who are not sufficiently experienced or sufficiently talented.”

In other words an under-funded public system in Israel exhibits many of the same problems that are now being relentlessly pilloried by the right wing press here as they step up the propaganda for more “reforms” to the NHS.

As the ambulances queue, hospitals crumble, waiting lists grow, mental health patients lack basic support and burnt-out, exhausted, short-staffed health professionals battle to keep patients safe in the real NHS, they will all be fearing that the next occupant of Number 10 will try to implement some of their zombie ideas, or the crackpot proposals of right wing think tanks – and make things even worse.

Featured image: NHS ribbon, Badge Of Honour. Public Domain image attributed under CC0 1.0 Universal (CC0 1.0) Public Domain Dedication

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