ANYONE who has worked on the front lines of the NHS delivering services to patients knows that workloads are increasing and pay is not keeping up with the cost of living. 

Some will even have been around long enough to remember the false claims that private investment would improve services and being told that carving up NHS services would bring modern and innovative healthcare solutions closer to peoples homes while enabling NHS organisations and their staff to deliver “seamless services.”

What has developed is that the public are faced with a confusing array of services that are further away from the home than ever before and family homes are being traded in for the spiralling costs of privatised care placements. 

Emergency care has been hollowed out to the point that it no longer has the capacity to keep people alive which would have been unthinkable when I first started as a nurse in the NHS in the ’90s. 

The public are finding it progressively harder to get a simple face-to-face GP appointment while we are bombarded with propaganda telling us online telemedicine is more convenient. 

People with health conditions are suffering pain and discomfort for longer as they await treatment and accidental deaths and patient neglect are on the rise across the country. 

NHS and social care staff have become so desperate from the impact of cutbacks, deskilling and privatisation that they can’t leave the NHS and the care homes fast enough and this is accelerating a deepening health and social care crisis. 

The Health and Social Care Bill 2021 makes the same old promises to deliver integrated health and social care that will improve tech, efficiency and innovation. 

We are told that the Bill will enable clinicians  across the NHS and local authorities to work together in a collaborative way. 

The government is telling us that the new legislation seeks to dispose of unnecessary bureaucracy and create a health system that can “flex” to meet changing need. 

All of this may sound very attractive to patients and to staff suffering the effects of health and social care being deliberately ripped apart at the seams from decades of brutal cuts and privatisation, but the same agenda that has created this health and social care crisis is being advanced further by the Health and Social Care Bill. 

What the Health and Social Care Bill will do is grant unbridled powers to the secretary of state of a Tory government with a majority in the house. 

The secretary of state will then have a free hand to directly intervene in future local NHS reconfigurations and there is little doubt he will continue implementing further shrinkage or outsourcing of all services that are currently provided in-house and within the NHS.

The secretary of state will also be granted new powers to dismantle the regulation of NHS professionals. 

Professionals are regulated to ensure safe and competent care is delivered to patients so plans to deregulate are particularly concerning given the fact that the Integrated Care Systems currently do not have any accountability mechanisms around either the safety or quality of care.

Competition rules will also be removed as part of the drive to reduce unnecessary “bureaucracy,” which is likely to ramp up privatisation. 

Legitimate concerns being raised that scrutiny of contracts, which is already light touch at best, will be eroded even further. 

It is simply staggering that no lessons have been learnt from the failure of the private sector to deliver PPE or a test, track and trace system during the course of the pandemic in spite of billions being spent.

No thought whatsoever has been given to workforce planning in the Health and Social Care Bill even though the efforts of front-line staff will be absolutely crucial to the delivery of health and social care plans. 

Social care staff will continue to be paid peanuts while the companies they work for rake in huge profits, and only some NHS staff will receive the insulting and negligible 3 per cent pay rise. 

Keeping the entire workforce within both sectors on low pay is a deliberate part of the overall strategy to demoralise staff, ensure they are employed on a temporary basis only and then recruit new layers of staff on even worse terms and conditions.

We are now being told by this government that further taxation is required to boost the privatised social care sector as insurance companies wait in the wings for the entire health and social care system to move over to a lucrative insurance-based model. 

Once again market methods are being posed as the solution to the growing NHS and social care crisis.

Not only must the Health and Social Care Bill be vigorously opposed, the entire labour and trade union movement must make key demands of our own over the quality and standards of care, how services are run, who runs services, who delivers them, who pays for them. 

It’s important to move away from merely responding to Tory initiatives and put forward our own health and social care programme.

Central to our opposition must be demands around the pay, terms and conditions of the health and social care workforce, without which quality care cannot be delivered in any setting. 

Therefore the role of the trade unions and our members will be central to this struggle because there are no walls between the needs of the staff and the interests of the public and patients in this struggle.  

We will have a hard fight ahead to secure an aspiration that health and social care is delivered at a decent standard, accessible to everyone and free at the point of need. 

This should be the very basic premise of our social contract and we must start from a position that the drive to ramp up private profit by exploiting the workforce and driving down the quality of care has no place in this. 

After all, a decent standard of care when needed is a human right and not a privilege and let’s never lose sight of this. 

Helen O’Connor is GMB Southern Region organiser.