Update 6/7/16: Jeremy Hunt is to impose the new contract on junior doctors, and has rejected the idea of further talks with the doctors’ union.
This article was written during the strikes earlier this year:
This week sees a decisive escalation of industrial action in the dispute between the government and the BMA. Junior doctors are on strike over the imposition of a contract, which would remove safeguards to prevent excessive work. This would be dangerous for patients. The contract does not value junior doctors by redefining antisocial working hours and thus cutting pay significantly for certain specialties, such as emergency medicine.
But this is part of a bigger picture. Contracts for GPs, consultants and other NHS staff are in the pipeline. Restructuring the workforce is paramount to paving the way for privatisation. I’m a GP in Tower Hamlets in London, and I wrote my book How to Dismantle the NHS in 10 Easy Steps to inform the public about what is really happening to our NHS.
When I wrote it, my direct experiences of healthcare had been as a son. I had watched the NHS save my father’s life after he spent two months in hospital, including a spell in intensive care. Around the same time, I had my own brief patient experience when I ruptured my Achilles tendon playing football and spent four months hobbling on crutches. That was three years ago. I assumed it would be the nadir of ill health in my thirties.
Although I wrote the book for the public, I soon found that its message would become far more personal than I had ever anticipated. As a young doctor, you are accustomed to looking after patients but you do not stop to think about your own health. Then last autumn, my life changed overnight. I was diagnosed with Hodgkin’s lymphoma – a rare, blood cancer that often affects younger people.
I have been under the care of a world-class centre – Guy’s & St Thomas’ hospitals, where I was treated with chemotherapy followed by radiotherapy. The intensive treatment lasted several months and I am now recuperating. Fortunately, I have not had to worry, for a single moment, about the provision of my care because of the wonder of universal healthcare under our NHS – a “milestone in history, the most civilised step any country has ever taken” said its founder Aneurin Bevan.
Yet if David Cameron and the Conservatives have their way, universal, free healthcare is exactly what is at stake.
The Health & Social Care Act 2012, which came into effect three years ago, is essentially a privatisation act. It axes the government’s direct responsibility for the NHS. It reduces the legal obligations of the NHS to provide comprehensive care. Lastly, it opens up NHS contracts to potentially unlimited privatisation. A whole raft of other policies, such as Private Finance Initiative (PFI) debts and stealth cuts, are also generating a manufactured crisis and running the NHS into the ground.
What does this mean in practice? We are now seeing rationing of care being ramped up across the country. Services that were previously available, such as hearing aids, cataracts, hip and knee replacements are being restricted. Private companies are profiting by cherry-picking lucrative contracts, thus permanently siphoning off money that should be spent on patient care as corporate profits. PFI debts are also draining resources, in order to profit private consortia, forcing hospitals into deficit.
This will only serve to undermine the kind of fantastic care I received from a multidisciplinary team – my GP, medical specialists, clinical nurse specialists, radiotherapists and A&E staff. One cannot even begin to convey the gratitude felt towards those, who have saved your life. It is disturbing to think that much of this is at risk in future.
Remarkably, David Cameron’s government never asked our permission to do this. In fact, quite the reverse. They continue to insist that the NHS is safe in their hands only because NHS privatisation is taking place by stealth. On the surface, nothing appears to have fundamentally changed. But gradually these insidious developments are translating into the end of the NHS.
Since writing the book, it has become clearer that the agenda to privatise the NHS is being driven by powerful interests intent on opening up the oyster of over £100bn for global capital.
Simon Stevens’ Five Year Forward View – the five-year plan for the NHS – explicitly speaks of modelling CCGs on US style insurance groups. This would mean that healthcare will become privatised and means-tested like social care. The rolling out of personal health budgets – patients given a budget to spend on their health – paves the way for top-up or co-payments thus opening the door for private health insurance.
Most Americans are only ever a serious illness away from bankruptcy. A 2009 Harvard study showed that over 60 per cent of bankruptcies in the US were related to healthcare costs. One is left wondering why on earth we would want to lose our NHS?
However, there are plenty of reasons for optimism. For example, the NHS Reinstatement Bill provides the legislative framework to restore the NHS as a publicly owned healthcare system. Only six months ago, one could never have imagined that the junior doctor movement would be in the vanguard of the anti-austerity fight against the Conservatives.
As for myself, this is now a personal crusade. My illness has reinforced my desire to fight to preserve the NHS. After all, the cliché that you never know when you will need the NHS applies to all of us and our loved ones no matter how fit or healthy you are.
How to Dismantle the NHS in 10 Easy Steps is published by Zero books. Youssef El-Gingihy tweets at @ElGingihy.
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