Solidarity with Health Workers: Capitalism Is Killing the NHS
BY BEAUTY DHLAMINI
The NHS holds a constant place in our news cycles, Twitter feeds, and across all spectrums of political agendas. The attacks against it are endless, with headlines branding it an institution ‘on its knees’ and failing all of us, without providing much nuance on the reasons behind its chronic underfunding – but my desire to defend it has never been stronger.
Hardly a week goes by without different factions of the NHS staff having their professionalism criticised by ministers and the mainstream media fulfilling their agenda. GPs are held responsible for increasing A&E waiting times, while nurses are blamed for ignoring sick and helpless patients. The same nurses who are undermined as they exercise their right to strike for better working conditions, and told by cabinet ministers that they’re “helping Vladimir Putin” in his assault on Ukraine by demanding a pay rise.
What is scarcely reported by mainstream media outlets is how their pay has been frozen for years. Meanwhile, the cost-of-living crisis and inflation are decimating wages in real time, and corporations’ profits are increasing. NHS staff are made to accept the meagre 3% increase (in the ‘unfunded’ deal of last Autumn), respectively for health professionals including doctors, nurses, and ambulance staff. It is no coincidence that these conditions are divorced from the failings of the NHS, and are part of the reason why the NHS is entrenched with deeply rooted inequalities, resulting in poor health outcomes. The underlying cause for all of this? The urban legend of the NHS being an incurable disease, leading to its fatal underfunding.
The scale of cuts in NHS funding is astronomical, and the deteriorating health of the NHS is bound to have a devastating impact on the most marginalised and vulnerable groups in our country, such as disabled people and the trans community, who so crucially need free access to its services. In its quest to achieve its target of efficiency savings, the government has reduced its budget by £330 million out of its total NHS budget of £153 billion for 2022-23. NHS England will also be forced to cover £6 to 7 billion of unexpected extra costs in 2023-24 due to the resurgence of Covid-19 waves, paying NHS staff their well-deserved pay rises, and inflation impacting supply chains. In other words, it’s only going to get worse.
None of this is happening by accident. This government-induced chaos supports the claims made by the cabinet that the NHS is failing as a public funded service, and that reform should be imminent. Ever since the Tory government has been in power 12 years ago, the NHS has moved from being a public funded and provided comprehensive service, to a more partial, privatised service with competing private providers preventing attempts to distribute an integrated, efficient, comprehensive healthcare service within an equitable healthcare system.
With the passing of the Health and Social Care Act last year, the NHS is even more vulnerable to competitive tendering and rapid privatisation. However, this has been an issue across the political spectrum with politicians seeking salvation from private healthcare providers. For example, since 2000, Virgin Healthcare (now HCRG Care Group) has won contracts to provide immunisation, sexual health services, and community health services for the NHS. But the nation’s mental and physical wellbeing continue to be at risk.
In a Guardian analysis* published in October 2022, over 101 hospital trusts were reportedly burdened by the Private Finance Initiative, a form of ‘partnership’ between the public and private sectors in which a group of private companies contracts to provide public facilities, often public buildings such as schools or hospitals, with debts including Barts Health NHS Trust.
Such partnerships often force trusts to cut vacancies to cut within the wider workforce and down-band workers to lower salaries or expect workers to go above and beyond their job descriptions without fairly compensating them. However, for too long, governments endorsed and allowed these parasitic private providers to operate in the NHS. They repeatedly fail to deliver on their contracts, yet they pocket huge margins of taxpayers' money, whilst patient safety and staff financial wellbeing are in jeopardy most of the time.
Despite these obvious links between political agendas, economic structures and health, people are reluctant to admit that capitalism is the root problem when analysing the current issues within our health system - from its profound inequalities to the poverty of proposed solutions. Capitalism is literally killing our national health service.
The NHS as we know it, where treatment is free at the point of need, with ‘access to affordable and universalised healthcare’, no longer exists. The political economy of health, intertwined with healthcare provision under capitalism, means that trying to access healthcare will now virtually always put you out of pocket. Wider determinants of health including social infrastructures, housing, clean air and water, are also essential to our health and are all impacted by capitalism’s purpose: prioritising profits over people. It is clear that no socialised healthcare system can exist and thrive under a capitalistic society without a complete overhaul of it.
Choosing to challenge the inner workings of 21st century capitalism is the strongest - if not the only - option we have in order to improve our health. A complete change in our economic and political systems will devise new governance mechanisms that finally denormalise corporate within public services. In the long run, we can hope this will stop undermining global public health and actually fulfil the aims of a socialist healthcare system.
The strikes of healthcare workers, alongside other industries, should be our wake-up call to the capitalisation and dehumanisation of healthcare delivery - and dehumanisation of workers as a whole. This way, health professionals, and general members of the public are not priced out of participating in civic and political life. Addressing capitalism through a health lens could seek to mobilise all of us to see how interconnected our experiences are, layered within deeper political and economic structures. Hopefully, it will help us identify more powerful strategies for improving health. And at a time when politicians such as Sajid Javid call for patients to pay for GP and A&E visits, protecting our free service from the cruel hands of capitalism has never been more crucial.
* NHS hospital trusts paying hundreds of millions in interest to private firms, The Guardian https://www.theguardian.com/politics/2022/oct/25/nhs-hospital-trusts-paying-hundreds-of-millions-in-interest-to-private-firms
Image credit: Garry Knight on Flickr