THE NHS spend in 2021-22 was £152 billion but in spite of this, NHS trusts have suffered budgetary shortfalls of approximately £2bn each year since 2015. The relentless demand for efficiency savings and non-stop restructuring has led to ward closures, bed counts dropping, and services being privatised. 

Over the last 10 years the NHS has lost 25,000 beds on the pretext of “care being moved into the community” but what has happened is that the public are waiting longer than ever before for care and treatment on the NHS. Eye-watering sums of public money are flowing into the private sector with minimum scrutiny, contract compliance or accountability.

Even before the pandemic struck, the “modernisation of the NHS” driven by a ruthless programme of cuts and privatisation had led to a rise in waiting lists for elective care. 

Waiting lists had increased from 2.5 million in April 2012 to 4.6 million by February 2020. The hollowing out of the NHS is starting to drive the sort of desperation that forces people to consider using private healthcare. The private sector charges people up to £10-12,000 for operations like a hip replacement. 

The rising numbers of people who can’t even afford to put the lights on won’t have the luxury of affording costs like these. These are the people who will sit on waiting lists in pain and die prematurely. 

To compound the problem, the impact of Covid-19 has increased the NHS waiting list to over seven million. When patients are forced to wait for treatment, whether it’s a mental health or physical health issue, the condition they are suffering from can deteriorate further and become even more complex and costly to treat. 

Years of the implementation of “lean methods” involving cutting the wage bill, the highest part of NHS expenditure, has led to nurses losing up to 20 per cent of the value of their take-home pay, vacancies not being filled, and posts being downgraded. Statistics from the Nuffield Trust reveal that staff absences were over a fifth higher in February 2022 than they were in the same month in 2021, with almost a third of those absences attributed to Covid. 

Plummeting wages, hellish working conditions arising out of chronic staffing shortages, and outsourcing are driving even more staff out of the NHS for good. The health service now has a vacancy rate of 47,000 and rising which is highly dangerous for patients. Staffing shortages mean that patients are not getting the highest quality care and some have suffered harm and died as a result.

In spite of mounting evidence that market methods are failing NHS staff and patients, this government is planning more of the same. 

The Health and Social Care Bill will accelerate the intention to get rid of free healthcare in this country because private companies are now involved in choosing and buying healthcare services. The Bill lacks any NHS workforce planning and a recent health secretary has publicly stated that NHS staff are welcome to leave.
Huge sums of money will continue to flow out of the public purse to the private sector and NHS trusts will continue to be incentivised to make the type of cuts to services and staffing that will gut the NHS for good. 

Figures from the NHS confederation reveal it would take an extra £4-5bn a year to clear the NHS Covid backlog. According to research from the British Medical Association (BMA), the government’s plan to reduce the Covid backlog via the “national increasing capacity framework” involves handing over an additional £2.5bn a year to private healthcare companies or ISPs (independent-sector providers). This government is making a political choice to ignore the stark evidence from the pandemic that using the private sector is costly and cannot be relied upon to deliver for the public.

Not only have private companies a proven track record of driving down pay, terms and conditions for workers, private hospitals cherry-pick the most lucrative, least complex treatments and they don’t have the capacity, staffing or resources to deal with any emergencies that may arise. Emergency cases get shipped straight back into the NHS — brilliantly portrayed in the TV series This is Going to Hurt. 

Integrated Care Boards (ICSs) which have been opened up to the private sector are predicted to strip out a further £5bn from NHS trusts this year. In addition, inflationary pressures will drive up all other costs associated with running the NHS. 

Years of cuts and privatisation has clearly failed both staff and patients alike. When Jeremy Hunt was health secretary he attacked junior doctors’ contracts, discouraged patients from attending A&E and both performance and the bed count dropped. 

His Autumn Statement will deliver further real-terms funding cuts to the NHS and increase the flow of funding over to the private sector as the Tories stay fixed to their core ideology to destroy the NHS and public services.

What is called for is a radically different approach to running the NHS involving ensuring stability of services, the in-sourcing of contracts and real-terms investment in the wages, terms and conditions of the staff delivering services. 

We must ramp up the battle for the NHS by ensuring that striking nurses’ picket lines are the biggest the country has ever seen and demand an end to cuts and privatisation. We must demand accountability for the public funding that flows into the NHS and ensure that this funding is spent to give existing NHS staff the inflation-busting pay rise they need and deserve. We must unequivocally oppose the privatisation that is undermining the safety of the NHS and the ending right to free healthcare in this country.  

On December 10 GMB Southern Region is leading a march against outsourcing, which will be spearheaded by outsourced Croydon University hospital workers who are demanding to get taken back in house. Our members, currently employed by G4S, are calling for the biggest turnout possible and for the entire movement to unite together and put pressure on this government to end cuts and privatisation in our NHS before it’s too late.

Helen O’Connor is GMB Southern Region organiser.