Tuesday, 28 February 2017

March For The NHS This Saturday: "The NHS Will Last As Long As There Are Folk Left With The Faith To Fight For It" (Nye Bevan)

In towns and villages throughout Britain, an invisible army of NHS foot soldiers have been fighting cuts, closures and the creep of privatisation for years. On Saturday, the army will march on London and I’ll be there with my placard wielding 9 year old.

Ever since my child was nurtured back to health by the NHS having been seriously injured in a car crash, I’ve been part of a local campaign to safeguard both of the county’s A&Es. I live in one of the most rural counties in Britain, with journey times to hospital of over 1 hour already for some. Our Clinical Commissioning Group (CCG) wants to reduce a population the size of 19 Birmingham’s to just one A&E. What started as a handful of people is now one of the most formidable health campaigns in the country, with thousands of members who have seen off 2 health chiefs, thwarted 4 attempts to close an A&E and won the respect of the local press, who were initially hostile.

The clue is in the name, accident & emergency.  When patients are faced with life threatening injuries/illnesses, time is absolutely of the essence. There was a 25% increase in deaths when Newark A&E was closed, even though that increased the average travel time from 7minutes to 12 minutes. The distances to A&E where I live, are already further than anywhere else in the country. 

The Royal College of Emergency Medicine cautioned recently, ‘Emergency care pressures are not going to go away, just by closing an A&E department. In many adjacent areas, most A&Es are already pretty full, and most hospitals are pretty full with regards to admissions. It only takes a small change to tip the balance to a hospital being congested. To close a department is likely to have a domino effect on other hospitals.’

A legal Requirement for any major restructuring within the NHS is to do a patient & public needs assessment & an impact assessment on neighbouring hospitals, primary care, social care & planning data. None of this have been done and not a shred of clinical evidence has been forthcoming.
We were promised a network of rural urgent care centres and increased community investment to support the huge predicted transfer of care into the community. Instead, urgent care centres have been scrapped, community hospital wards have been closed and GPs are creaking under the strain of increased workload with no additional resources. That’s before they shut an A&E.
Both A&Es are already stretched beyond capacity. Ambulances are regularly held up in a queue outside both hospitals preventing them from being able to respond to blue light calls. The ambulance service is underfunded and under resourced & they’re regularly taking over 1 hour to get to patients in my region. The air ambulance is a charity staffed by 6-7 volunteers. The fleet is old, can’t land in dark, fog, even drizzle.
In September, the architect of the Health and Social Care Act, Lord lansley, said the act was supposed to be about promoting better services to patients but admits the focus is becoming increasingly about reducing costs – not improving quality of patient care....

“We must not allow reconfiguration to be used as a means of constraining demand – by restricting supply. The NHS must have the resources it needs for a sustainable future. These necessary resources are not anticipated in the current spending review”.

Having failed to invest in social care & the community infrastructure necessary to take pressure off hospitals - the founding tenet of this act - acute service cuts cannot be allowed to proceed. Having immersed myself in consultant speak for over 2 years, I’ve spotted that “improved patient pathways”, and “strategic Transformation Plans (STPs) can be translated as “cuts”. The pathways are designed to divert traffic away from hospitals even if it means into the morgue.

Then there’s the corporate heist of the NHS by private health providers. The Health and Social Care Act removes the responsibility of health care provision from the government. Section 75 compels tendering for contracts, £16bn of which have been awarded to private contractors since 2013.

While the media lens was focused on Richard Branson’s spat with Jeremy Corbyn in August, Virgin Care was quietly signing an NHS contract worth £17.6m a year to co-ordinate adult community health services in Guildford. Despite operating as a tax haven and, according to Tax expert, Richard Murphy, Virgin Care is unlikely to pay tax in the UK in the foreseeable future, the company has been awarded contracts worth millions to provide NHS services across England. All hidden behind the NHS logo.

In July, Virgin Care lost its contract to run Croydon’s Urgent Care Centre in the wake of criticism by the CQC, which found patients were being streamed by untrained reception staff which compromised safety. 30-year-old Madhumita Mandal died of multiple organ failure and sepsis caused by a ruptured ovarian cyst after a receptionist at the urgent care centre failed to refer her to a medic.

The problem is, private companies are not bound by the same accountability as public services and they’re driven by profit, not patient care or employee wellbeing. A recent study showed that mental health related absences in the NHS, due to stress, depression and anxiety, have doubled under this government. Apart from the tragic human costs, sickness and absence costs the NHS millions every year.

One senior A&E sister who left my local hospital in the last few years said, “It’s like being in a war zone every day. There was never enough staff on duty to cope with demand, so we were working under constant stress. Every time you’re forced to deprive a patient of the care they need, it chips away at your soul until eventually there’s nothing left to chip away at and you just stop caring. That’s when most of us realise it’s time to leave the profession”.


If we accept the narrative that NHS cuts are necessary, it follows that we concede privatisation is inevitable. If we relinquish the principal of public health care for all, we’re signing our NHS over to corporate providers. That is like putting Dracula in charge of the blood bank. 

No comments: