ANY ideas of further reform of the NHS will strike fear into the heart of clinicians and patients who have lived through damaging changes. Decades of so-called “modernisation, integration and reform” have wreaked havoc on the ability of the NHS and social care to deliver for patients, the public or the front-line staff.

The NHS has been utterly transformed from the most efficient healthcare system in the world to a system that is struggling to meet demand. It is simply staggering that any politician would suggest that the cuts and privatisation that have destroyed the NHS are some sort of progressive solution to its problems.

Promises around the integration of health and social care have been made and trialled before and led to services and staffing being moved, merged, and reduced.

When I worked as a community psychiatric nurse in a newly integrated health and social care Community Mental Health Team, staff had to take on double the work as the roles of nurse and social worker were combined. The lack of training meant that many struggled to offer a consistently high standard of service to all their patients.

I remember being surprised at the notion that my new role as a “case manager/care coordinator” should involve the “commissioning of services” for “service users” rather than providing care for patients.

So-called progressive reforms have left patients bewildered and abandoned as the care they relied on has disappeared into a glossy leaflet or a “hub.”

The community nurses who delivered care and support to patients found themselves spending all kinds of time filling in “payment by results” tick sheets on computers, which further compromised our ability to spend time with our patients.

The introduction of “personal budgets” pulled clinicians even further into the bureaucratic web and enabled private companies to get an iron grip on social care. Personalisation led to the closure of day centres and other valuable care facilities under the pretence of “offering choice.”

Services like personal care have been converted and adapted to generate profit for private businesses — now people find their “personal budget” won’t stretch to cover the level of hours of care that are required. Council budgets have not kept pace with the spiralling costs of privatised care packages and placements, which has led to vulnerable people being neglected.

The only people who benefited from decades of service redesign that promised improvements but delivered the exact opposite are the highly paid executives in the NHS and councils, and their friends running the companies on the “approved provider” lists.

History has shown that “reform” has not been progressive at all — it continues to turn both the health and social care sectors into business opportunities for the wealthy at the expense of staff and patients alike.

Decent health and social care are now becoming scarce and costly. Those who can afford to pay are already utilising the private sector, creating a two-tier system by default. Sajid Javid is softening up the public for what is to come by suggesting that private health insurance should be considered to pay for the NHS.

This is the goal of all NHS modernisation: opening things up to the private sector and creating an insurance-based model of provision. Ultimately, we will all be pushed to pay for the health and social care services that we have taken for granted throughout our lifetimes. Those who can’t afford to pay will be left to rely on patchy services from charities and churches, or put in the hands of unregulated cowboy practitioners.

Any idea that the private sector can come to the rescue of the NHS and cut down the 7 million-strong waiting list is also untrue. The private health barons are funding MPs to enable them to cash in on the current NHS crisis.

The waiting list will be opened to private hospitals that will cherry-pick the fittest, easiest to treat patients and leave the remaining ones lingering on in pain. It seems that memories are short and no lessons have been learnt from the 2015 Hinchingbrooke Hospital catastrophe. After Circle took over the management of the hospital it received the worst rating for caring because of the financially driven cuts in staffing to satisfy investors.

It is difficult to imagine how capacity can be rebuilt within the NHS, as the billions splurged on the private sector have left such a gaping financial hole in the middle of the health budget that more patients are being shut out of the NHS than ever before.

All the political parties offer no diagnosis, but the same old prescription of cuts and privatisation. Retaining the NHS staff who deliver care, rather than ramping up the cuts and privatisation agenda that is driving them out, is necessary to ensure the NHS functions properly, but the mainstream parties are only antagonistic to the reasonable demands of the health unions.

Striking NHS and ambulance workers are desperate for the NHS crisis to be solved for their own sake and the sake of their patients. They are sick and tired of the constant changes that are turning their lives upside down.

They are proud of their jobs and want to offer high-quality healthcare to everyone that needs it. They can no longer cope with the impact of their colleagues leaving in droves.

Due to the cost-of-living crisis, they see their patients living in conditions that will exacerbate ill health which will increase the dependence on NHS services. They are crushed by the knowledge that the patients they see will never be able to get adequate treatment by the visit to the local pharmacy or the “wellbeing apps” that are now being aggressively promoted as the solution for everyone.

They know that talk of “preventative medicine” in a climate of rising poverty is shallow and meaningless. They don’t want to be outsourced or forced to work for the private sector and lose sick pay, holiday pay and access to a decent pension scheme.

They are striking because they have had enough and they want their voices to be heard. They are calling on the public to stand with them on their picket lines because the NHS is for all of us.

Politicians who claim to represent the working class should support the health workers’ strikes, join pickets and spend some time really talking and listening to these workers and their unions — because the solutions to the healthcare crisis will come from them, not from the private health bosses intent on destroying the NHS for profit.

Helen O’Connor is a trade union organiser and former nurse. Follow her on Twitter @HelenOConnorNHS.