Dr Louise Irvine had an article published in the Huffington Post yesterday, Time to Raise Your Game – A Team Talk for Andy Burnham and Labour’s Health Squad
It comes to something when Labour’s front-bench spokesman on health has to apologise on Twitter for his poor showing on BBC’s Today programme on the grounds of not being very good at his job. “Labour will soon reveal detailed and costed ten-year plan for NHS and social care. Would’ve mentioned on BBC but struggle to get word in edgeways,” he bleated on Monday.
Forget Labour’s spending plans, Andy, where was your stance on NHS privatisation? All over the place by the sounds of it, as we in the National Health Action Party have been warning the Labour Party for two years now. You have had two years to clean your act up so well that the NHA Party wouldn’t even need to exist. Instead you’ve been congratulating yourself on coming up with undeliverable gimmicks – 48 hours to see your GP; a mansion tax that will deliver only a fraction of the money needed to set the NHS straight – without tackling the elephants in the room of PFI (Private Finance Initiative) and the wasteful English NHS market which favours competition over collaboration and takes the NHS further and faster down the road to privatisation.
You might be able, in the back rooms of Westminster, to convince one another that you can get away with a less-than-coherent health policy and rely on a lot of talk about the1930s to swing overwhelming public support for the NHS your party’s way. But what the Labour Party needs now is a bit more Bevan-style fire in its belly.
Out in the light of day your gimmicks make you a sitting duck for anyone who can put two and two together – even Ukip are scoring hits on PFI, while the presence of the market makes it impossible for Labour to make the vital and pressing case against privatisation. Even Nye Bevan would be wondering whether there’s any point in voting for a Labour Party whose only policy on the NHS is that they’d be slightly less rubbish than the Tories.
While John Humphrys’ scornful tone on NHS privatisation on Today was persuading listeners who didn’t know better that this is a non-issue, you had to spend so much time defending Labour’s own record on using the private sector that you didn’t have a leg to stand on when you should have been kicking that particular ball right out of the park.
Well I’m no striker myself, but as you and your team are clearly in need of a coach Andy, here’s what you should remember next time you run on the pitch:
– See the whole game. When the right-wing claims the percentage of the NHS budget spent on commissioning private providers has barely risen, from 4.9% of in 2010 to 6.1% in 2013/14, kick off by explaining the Health and Social Care Act 2012 is only just getting into its stride. Opening up NHS services to outside bids can’t happen overnight – it’s the direction of travel that matters. And in both scale and scope of NHS services being sold off, we’re on the road to ruin. From frontline cancer services and care of the terminally ill to mental health and musculoskeletal services, nothing is sacred.
– Do your research. There’s no better counter to the Tories’ claim that they’re NOT cutting NHS funding and promoting privatisation than the way private healthcare companies are crowing that this is precisely what they ARE doing: “Private healthcare companies are expecting to see an upturn in business as the NHS continues to see its budget constrained.” Labour Party manifesto? No, Health Investor magazine.
“£5.8bn of NHS work is currently being advertised to the private sector and the number of live tenders is up 14% on the same period the previous year.” Labour Party manifesto? No, Bain and Co for the Financial Times.
“Management of more NHS hospitals could be handed over to private companies.” Labour Party manifesto? No, the government-commissioned Dalton review.
“More than £10billion of NHS funding was spent in the last year on healthcare from private and independent providers such as Virgin and Care UK.” Labour Party manifesto? No, the government’s own figures.
– Look for opponents’ unforced errors. You know the Tories tell porkies as naturally as they breathe in and out (“no top-down reorganisation in the NHS” or “we’ve halved the deficit” anyone?) but some voters don’t. So point out, for example, that while the government claimed their 2012 invention of Clinical Commissioning Groups wouldn’t open up services to competition, 30% of CCGs already do, or are planning to do so.
– Listen to your team mates. Doctors in Nottingham have quit rather than work for a private contractor. Doesn’t that tell you that you should be offering more than a little tinkering around the edges of privatisation?
– Remember why you play. The NHS is pretty much all that remains of the post-war achievement of the greatest Labour government of all – your double-winning side, the one that got you to put your boots on in the first place. Since then you’ve watched on as you’ve lost the mines. You lost the railways. You lost gas, electricity, water – hell, you even lost the Royal Mail. You do not want to go down in history as the Labour Party generation that lost the NHS. You really, really don’t.
– Be honest about past errors. At least to yourself, admit that the healthcare industry and its management consultants simply captured the management of your own team throughout the Blair and Brown years. Listen to former Labour Health Secretary Alan Milburn in May 2013 announcing: “My aim is to bring together a panel of industry experts to drive change across the health sector and PriceWaterhouse Cooper’s growing presence in the health market.”
See your prime minister’s wife, proud co-founder of: “investment funds which invest in high-growth healthcare and technology companies worldwide”. David Cameron and Gordon Brown alike poured praise on the NHS for the magnificent help it had given their own families in time of need. David Cameron and Gordon Brown alike plunged the knife of privatisation into its heart. Admit it. Grieve. And move forward.
– Capitalise on future possibilities. Forget squeezing the rich for a moment (but only for a moment) and see what could be saved by admitting, and correcting, your past mistakes. The internal market that Labour helped introduce has pushed up admin costs from 5% to 15% of the NHS budget (with a US-style 30% always a glittering prize in the thinking of industry leaders). If we approximate NHS England spending to around £100 billion, you can see that the £8 billion a year its chief Simon Stevens is asking for is there for the taking. (Though as an ex-private healthcare appointee, he might not be pointing you in that direction himself.)
– Tell the referee about fouls. The electorate is the referee – and they should be handing out red and yellow cards left, right and centre at the moment as private contractor after private contractor is sacked or shown up for incompetence, putting patients at risk or downright dishonesty. Or when private companies withdraw, leaving patients high and dry, because there isn’t the profit they expected. And yet none of this incompetence or irresponsibility removes them from the game. Sacked by one Trust, they are cordially invited to bid for another. Healthcare is a labour-intensive business – 60% of costs go on the people who provide it – so the only way to squeeze a profit out of it is cutting the numbers of staff, or cutting their salaries. The effects can be guessed by anyone with half a brain, though commercial confidentiality is used to cover up the often-dire consequences – including hundreds of unexpected deaths at private hospitals, as revealed by a recent rare insight into the facts.
In general, the chair of the House of Commons public accounts committee, Margaret Hodge, says that even she can’t break through the wall of secrecy.
– Value teamwork. Most of the gains in cancer, stroke and heart attack care in this country in the last decade or two have come from collaborative work within the NHS. You can’t have collaboration if you’re all supposed to be competing with each other – but this remains Labour Party policy. Why?
– Value the home crowd. People are seeing their valued local hospital services closed down – not on the grounds that they are no longer needed but to address the financial difficulties of their local Trust or, even more iniquitously, the financial difficulties of a neighbouring Trust who needs the extra business to survive. When you can hear them chanting – listen to the words.
– Understand the opposing team’s supporters. The foreign and tax-haven-based funders of the Tory – and, let’s face it, Labour – advocates of privatisation of healthcare to cope with our “ageing population” don’t want to completely eradicate the NHS so you can’t make a good case for saying they do. They need it to do the jobs no one else would take on. And to feed off. Why would a tapeworm kill off its host when it can grow fat and healthy on a constant diet while its sickly host struggles on to nourish it? Saying that New Labour only swilled down a tiny tapeworm egg in its glass of champagne many years ago is not an excuse for the Labour Party not to tackle the current infestation. Switching back to my day job as a GP, I may have to prescribe anthelmintic medication (to expel parasitic worms, in case you’re wondering). There’ll be a lot of messy business with stool samples, but it’ll be worth it. Make an appointment – I may not always be able to see you within 48 hours but for a chance to see a Labour Party returned to health, the doctor will see you now!
Dr Louise Irvine is a founding member of the National Health Action Party, and is standing at the general election against Jeremy Hunt in South West Surrey
Follow Dr Louise Irvine on Twitter: www.twitter.com/drmarielouise