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Is it all over for the NHS?

Caitlin Hoyland

For the first time in history, junior and senior NHS doctors in England will strike together. The British Medical Association (BMA) has stated that junior doctors will strike between 2nd and 4th October, having striked from 20th to 22nd September. Moreover, consultants went on strike on 19th and 20th September. This decision follows a lengthy dispute with the government over pay and working conditions. 


The Royal College of Nursing (RCN) General Secretary, Pat Cullen, has said that for years the NHS has been understaffed, and that NHS workers have been undervalued and underpaid – enough is enough. 


In response, Health Secretary Steve Barclay has ordered the BMA to “call an end to this callous and calculated disruption”, claiming that strike action has caused nearly 900,000 medical appointments to be cancelled. 


Callous and calculated are interesting words for the Health Secretary to use against the NHS. I could probably use the same words to describe the UK government’s policy of discharging people from hospital into care homes without being tested for COVID, which resulted in over 40,000 care home residents’ deaths from the virus. Or, perhaps the fact that the Tory government’s virulent and persistent benefit cuts have driven an estimated 1.5 million people into poverty over the last decade. 


If public health is at risk, this is as a result of Conservative government policies, not the striking of NHS workers demanding proper pay and safe working conditions. The same cabinet ministers that urged the nation to applaud NHS workers during the pandemic have spent the last decade denying these same workers a pay rise.


After COVID-19, the NHS is all clapped out. 

The National Health Service was launched on  5th July 1948, despite much resistance from MPs and medical workers. Powered by the national, post-war zest for social equality, the NHS offered free healthcare for all Britons, without judgement and from cradle to grave. Arguably, this has made the NHS one of the world’s fairest healthcare systems, and the foremost source of national pride.


However, the NHS has experienced a decade of underfunding since 2010. While government spending on the NHS has technically reached its highest sustained level since inception, spending per patient has been significantly eroded. NHS waiting lists are also the longest they have ever been in history, reaching seven million in January 2023.  According to OECD figures, the UK spends 39% less per person on healthcare than Germany; it has fewer hospital beds per capita than almost every other OECD country; and has 50,000 fewer doctors than the OECD member average.  Is it any wonder that more and more NHS doctors are moving abroad to work in countries that offer doctors fairer pay and better working conditions?


Unfortunately, the NHS has also been subjected to inimical privatisation over the last forty years.  Indeed, a map created by EveryDoctor reveals the extent to which NHS services in England have been privatised and outsourced, often disguised by using the NHS logo. 


The process of privatisation was in great part catalysed by the 2012 Health and Social Care (HSC) Act, which compelled health services to be put out to competitive tender, thus opening the NHS to involvement from private sector companies. 


A decade later, in May 2022, The Health and Care Act was passed, invoking yet another major restructuring of the NHS. To its credit, the Act removed the competition enforced by the HSC Act. However, the Act completely overlooks policies on workforce planning despite understaffing being one of the most detrimental problems facing the NHS. This means the NHS remains reliant on the private sector for staffing and resources. Surreptitious, back-door privatisation deals also include the use of patient data in trade deals, sending patients to private hospitals, and charging migrants for healthcare.  


Opening healthcare up to private investment has undermined the patient-first commitment of the NHS by prioritising corporate profits over patient wellbeing. Indeed, a study published in The Lancet in 2022 found that the outsourcing of care in England to private companies was linked to increased mortality rates among patients. Perhaps we should consider how effective (read: disastrous) it was for the government to favour private companies over the NHS during the height of the COVID-19 pandemic, using the Test and Trace system as a case study. 


A malnourished healthcare system endangers lives. 


It is estimated that around 500 people each day could die because of NHS delays. People wait painstaking hours for ambulances to arrive. Horrifyingly, it has even become recurrent for dying patients to be left sleeping in corridors or on chairs, waiting for a hospital bed to be made free.


Dr Julia Patterson, author of Critical: Why the NHS is Being Betrayed and How We Can Fight For It, suspects that government underfunding of the NHS is  intentional. If the NHS is seen struggling, then it makes privatisation appealing and appropriate. Privatisation is the lifeblood of Tory governance. However, Labour is also increasingly showing signs of neoliberal obsession, with Shadow Health secretary Wes Streeting preaching the benefits of using private healthcare providers instead of the NHS. This is an utter betrayal of Labour Party values. 


Our NHS is in critical condition, but it can, and must be, revived. 


Public health needs investment; this is two-fold. Firstly, investing in the NHS: increasing workers’ wages; providing worker benefits; enacting social care and healthcare; and creating a clear, strategic staff train and retain scheme. Simultaneously, investing in public vitality to ensure healthy foods are affordable and accessible; expand low-emission zones; provide pedestrians with easy access to greenspaces and gyms; and, most importantly, address social inequalities.


As pithily stated by Dr Nick Mann, campaigner for Keep Our NHS: “The private sector profits from illness while the NHS delivers excellent value for money, without any profit motive: invest in the NHS model, don’t undermine it.”


Image: Peter Byrne/PA Images/Getty Images

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