UK: Attack on NHS would continue under Labour government

By Jean Shaoul
3 June 2017

The Labour Party gives pride of place in its manifesto for the June 8 general election to its National Health Service (NHS) policies.

It promises to provide an extra £30 billion funding over the next parliament, reverse the privatisation of the NHS, repeal the 2012 Health and Social Care Act and reinstate the powers of the secretary of state for health to have overall responsibility for the NHS.

Workers should put no trust in such promises. In reality, Labour, the Conservatives and the Liberal Democrats are all committed to running down the NHS and allowing the private sector to continue its profiteering from the public health care budget.

Labour’s extra £30 billion funding on health is equivalent to £6 billion a year, slightly more than the Liberal Democrats pledge of £6 billion a year extra for both health and social care. The Tories are committed to an £8 billion real term increase over five years, but this is a moot point given their pledge to cut more than £40 billion from the NHS budget through “efficiency savings” by 2020.

Labour has made no commitment to reversing the £20 billion cuts imposed so far, or ending them.

These pledges are a drop in the ocean, given a growing and ageing population, rising chronic disease levels due to pollution, stressful work, and increasing social, economic and cultural deprivation and the scandalous lack of facilities for those in need of mental health treatment.

Neither will Labour’s pledge do anything to redress the decades of underfunding of health care and the cutbacks that have led to a fall in life expectancy.

Labour states that it “will scrap the NHS pay cap, put pay decisions back into the hands of the independent review body and give our NHS workers the pay they deserve.” This was a nod in the direction of Britain’s 270,000 nurses whose wages, since the global financial crisis, have fallen 14 percent in real terms with a registered nurse earning an average of just £23,319 per year. Had nurses’ pay kept up with inflation, they would now earn £26,584 (£3,265 more).

This empty promise should be treated with derision. For decades, Labour and the trade unions have not lifted a finger to defend NHS workers’ jobs and conditions. Last year junior hospital doctors struck repeatedly in opposition to the Tory government’s enforcing of an inferior contract. Labour leader Jeremy Corbyn and his Shadow Chancellor John McDonnell appeared on the picket lines “in a personal capacity,” but did nothing else other than urge Tory Health Secretary Jeremy Hunt to reach a negotiated settlement with the British Medical Association. The result was the defeat of the junior doctors, with the contract enforced with the BMA’s collaboration.

Behind the bold headlines, Labour’s NHS pledge is just half the Office for Budget Responsibility’s (OBR) projection of funding pressures—over 4 percent a year above inflation. Thus, all three major parties’ proposals would leave a significant funding gap on current cost projections by 2020-21, varying between £7 billion for Labour and £12 billion for the Tories, according to the Health Foundation.

Labour has made a vague promise to boost capital funding for the NHS. Similarly, having frozen the NHS capital budget, the Conservatives are now promising “the most ambitious programme of investment in buildings and technology the NHS has ever seen.” However, with both parties committed to “responsible budgets,” this can only mean some form of leasing buildings and equipment from the private sector. This would be a repackaging of or a return to the Private Finance Initiative (PFI) that has cost the NHS millions in excessive repayments.

In any event, Labour has included plenty of escape clauses. All its paltry proposals on public spending—including the extra funding for the NHS—will be subject to Labour’s Fiscal Credibility Rule, which stipulates, “that Government should not be borrowing for day-to-day spending.”

Labour is to introduce a new OBR for Health to “oversee health spending and scrutinise how it is spent” and check it is in line with its Fiscal Credibility Rule, with the OBR “responsible to parliament with a clear mandate to ‘blow the whistle’ on government breaching these rules.” Thus, the OBR would be able to veto any public spending outlined in the manifesto.

Likewise, Labour’s promise “to protect patients and legislate to ensure safe staffing levels in the NHS” means that in the absence of funding, facilities can be closed on safety grounds.

Labour says it will introduce a new quality, safety and excellence regulator, to be called “NHS Excellence.” Like all the quality and inspection regimes in the public sector, it will provide the public legitimation for victimisation, speed-ups, “special measures” and the privatisation of “failing” services.

Jeremy Corbyn claims that Labour will reverse NHS privatisation. But this comes from the party that, when last in government, pioneered various forms of privatisations in health, education, social services and social infrastructure.

Corbyn’s privatisation “reversal” is a meaningless pledge to ensure that “excess private profits are not made out of the NHS at the expense of patient care.” Whatever “excess” means is anyone’s guess, but the private sector takeover of health care will proceed apace.

The manifesto states, “Labour will repeal the Health and Social Care Act that puts profits before patients, and make the NHS the preferred provider” (emphasis added). Similarly, the Tories’ “Sustainability and Transformation Plans” aimed at closing health services across England are to be subject only to a “review.”

This is nothing less than a veiled commitment not to oppose the Tories’ plans for a form of insurance-based service, with the NHS continuing as only one of many providers and the state system acting as a milch-cow for the numerous private operators working within it.

It was the 1997 Blair Labour government that embarked on the remodelling of the NHS as a low-cost, no-frills system with a view to moving to an insurance-based system along the lines of the already decimated NHS dental service, which provides a limited range of treatments with co-payments. The co-payments form such a high proportion of the cost that many dentists withdrew from the NHS in order to avoid the administrative burden of claiming reimbursement. In many areas, NHS dentists are now non-existent.

While Labour promises to reinstate the secretary of state for health’s overall responsibility for the NHS, this is not a commitment to reinstate the secretary of state for health’s core duty to provide or secure comprehensive and universal health care. Only a tiny minority of Labour MPs have backed a campaign to get the key provisions of 2012 Health and Social Care Act overturned in Parliament.

Labour’s promises on social care are just as cynical and pro-business. It pledges a further £8 billion over the next five years, which it claims is enough for “providers”—meaning the private sector—to pay a real living wage and end 15-minute care visits, as well as increase the carer’s allowance.

In contrast, the Age UK charity estimates that an additional £4.8 billion a year would be required to ensure that every older person, who currently has one or more unmet needs, has access to social care—rising to £5.75 billion by 2020-21.

Labour, no less than the Conservatives and Liberal Democrats, has abandoned a commitment to what was once taken as axiomatic—that society would seek to improve health care via the provision of better social and living conditions and the funding of new technologies and medical advances.

The right to a universal and comprehensive public health care system cannot be secured by returning Labour to office. It demands the working class mobilising in an independent political offensive against the policies of austerity and war espoused by all the main political parties.

For more information visit NHSFightBack.org