Longer waiting lists, delayed treatment, redundancies, staff training slashed, patients discharged from hospital too quickly, public health programmes at risk - the NHS is in crisis.
increasing its budget from £34 billion in 1997 to £92 billion this year the NHS is facing a deficit of around £800 million. How did it go wrong?
According to Patricia Hewitt Secretary of State for Health it is all the fault of the workers. “It has been clear for a while” she said that new pay deals for nurses, porters, care assistants, doctors and others “are all costing rather more than anticipated”. It is widely expected that NHS staff’s pay increase this year will be low and staged.
One of the government’s flag ship Foundation trusts University College London is forecast to be £40 million in the red. Yet it has only put half of its staff on the new contracts casting doubt on Hewitt’s claim that the new pay deals are at the heart of the current crisis.
When Sir Nigel Crisp NHS chief executive resigned over the deficit he was given a peerage and pension worth £3.5 million. The thousands of NHS staff currently facing redundancy, some compulsory, won’t be in line for a huge pension payout or a seat in the House of Lords. They face a much bleaker future than Sir Nigel.
Rather than causing the problem health workers are actually paying the price for the failure of government policy. North Staffordshire NHS trust has said it will cut 1,000 jobs from its 7,000 workforce, while NHS Direct has announced hundreds of jobs are to go.
The Royal Cornwall is over £8 million in debt is closing wards and operating theatres and making 300 staff redundant. The trust points to a number of reasons for its debt including the cost of providing better services, government targets and competition from the private sector.
Unison’s head of health Karen Jennings said “more than £5bn has gone to Independent Sector Treatment Centres that don’t come under the tariff system and are guaranteed the contract price, regardless of how many operations they actually carry out. By contrast the NHS is paid less for dealing with patients who have multiple conditions and then they are accused of under-performing.“
Yet rather than look at these issues the government points its finger at staff costs. Hewitt has actually claimed that job cuts are a good thing because they “give hospitals more incentives to improve patient care and get value for money”.
For decades NHS staff have been underpaid and the pay system riddled with unequal pay. While far from perfect Agenda for Change has at least given the opportunity for staff to earn a decent wage. Rumours are that the pay deal is just £200 million over budget, raising the question where does the rest of the deficit come from?
The coming year will see hospitals competing against each other for patients under the payment by results system. The private sector will also increase the share of the NHS it runs as primary care trusts pull back from providing services. This privatisation is already creating resistance from communities.
As the influential think tank the Kings Fund has pointed out payment by results and the introduction of the market will mean hospitals closing as they are unable to attract sufficient ‘business’ (patients to you and me).
The government is keen on choice. It has a choice. At the moment it is choosing to blame workers for the NHS’ problems while continuing down the road of privatisation. The NHS is £800 million in the red. ID cards will cost £12,000 million to bring in. What would you spend the money on?
Richard Griffin
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