Look Left – The fight for the soul of the NHS goes on


 

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Save-the-NHS-campaigners

• The battle against the health and social care bill continued apace this week, with the petition to scrap it soaring past 100,000 – the level for it to be eligible for a parliamentary debate.

The petition is now closing in on the 150,000 mark, having hit 1,000 signatures an hour earlier in the week, gaining celebrity support from the likes of Stephen Fry, Rio Ferdinand and Jamie Oliver.

Launching the campaign last November, petition organiser Dr Kailash Chand wrote on Left Foot Forward of the need to “drop Lansley’s monster”, and that the claims of the health secretary and David Cameron “do not stand up to scrutiny”, concluding:

There is every possibility that the reformed NHS under these proposals will become exclusive rather than inclusive. Removal of a cap over private income will see Foundation Trusts competing over costs rather than quality, so that those that are run by poor management will risk the stability of the hospital to a much greater extent than prevails now.

I’ve spent my life working for the NHS as a doctor, a GP and as a PCT Chair, as well as for the British Medical Association. I believe this is the wrong reform at the wrong time and I am passionately opposed to the Bill for the reasons stated above. That’s why I’m asking you to help by signing this petition.

If we get 100,000 signatures, Number 10 will surely finally be forced to listen and drop this bill.

Well, we’re now well past that 100,000 mark, with the list of opponents growing by the day – yet still no sign of Andrew Lansley or his boss listening to reason and thinking again.

This morning, more than 150 paediatricians became the latest group of health service professionals to call for the bill to be dropped, warning of the “extremely damaging effect on the healthcare of children and their families” of the bill.

The members of the Royal College of Paediatrics say the bill will affect their access to “high quality” and “effective” services, with “no prospect for improvement to the bill sufficient to safeguard the rights of access to health care by children and their families”.

In a letter (pdf) to the Lancet, they say “no adequate justification for the bill has been made”, concluding:

The bill is misrepresented by the UK government as being necessary and as the only way to support greater patient choice and control. On both counts that claim does not stand up to scrutiny.

Far from increasing choice, there is plenty of evidence amassing that these proposed reforms will in fact limit choice for all children and their families, increase inequalities, and harm those who are most vulnerable. Continuous quality improvement in our already high-quality NHS does not require this legislation.

Children and their families will be worse off because of the health and social care bill.

Our training, clinical expertise, and professional commitment to securing health and wellbeing for all children leads us to join with many others working to protect the interests of families and their children to call on the government to drop this bill.

Further undermining their cause, the government this week continued to bury the risk assessment of the reforms, the NHS Risk Register, and, given the warnings, given what it is likely to say, no wonder.

On Monday, the Mirror had an exclusive on the impact assessment, revealing:

NHS bosses have warned the shake-up will endanger patients, lead to staff cuts and do lasting damage to the reputation of the service… The risk registers reveal the deep anxiety across the NHS at the potentially disastrous consequences of the Government’s reforms.

They warn many GPs are not ready to take over their new commissioning roles and that the shake-up has led to low staff morale, the loss of key NHS workers and widespread instability within the health service. As well as warning of deaths, the South Central authority fears the reforms could also lead to abuse of patients, such as that at Winterbourne View care home…

The dossiers will pile pressure on David Cameron to ditch his controversial health and social care bill.

His legislation will scrap primary care trusts – the local bodies which run hospitals – and hand control of the vast majority of the NHS budget to groups of GPs called clinical commissioning groups. It will also see private health companies take over more of the work done by public hospitals.

As we reported this week, the government’s been keeping the dossier secret since 2010:

The fight over the release of the document has been going on for almost eighteen months now. It started in November 2010, when John Healey MP requested a copy. In December that year, he was rejected, and his appeal took until July 2011 to conclude.

In November last year, he made a second request to the Department of Health, under the Freedom of Information act. The government again stalled, and, after the information commissioner ruled in Healey’s favour, took the appeal to a tribunal.

The government is clearly – transparently – attempting to stall release of the information until after the health bill goes through the Lords and Commons. If their opposition is forced to rely on leaks and minor excepts, which is the best we have, then they will find it harder to put together the strong argument against the reorganisation that this bill is prompting.

Also this week on Left Foot Forward, read Dr Chand’s open letter to the prime minister, signed by more than 400 professionals, calling on him to “put this increasingly confused legislation out of its misery”; and read Daniel Elton’s report on how productivity gain in the NHS is more evidence of socialised evidence bringing down costs.

There’s more on the mounting evidence against the coalition health reforms in ‘Evidence of the week’ below.

• As is now the depressing tradition around the middle of the month, the latest labour market stats brought more grim tidings.

The headline unemployment rate rose 0.1 points to 8.4 per cent, taking it above the US unemployment rate for the first time since the start of the Great Recession. As we reported this week, the US rate is now 8.3 per cent, at its lowest level in almost three years while UK unemployment is at the highest rate since 1995.

There was, however, better news on employment, with the number of people in employment up 60,000 on the quarter – though as Duncan Weldon noted on Left Foot Forward, looking at the data in more detail gives reason to be cautious:

Yesterday the TUC warned about rising under-employment. In the UK we tend to view unemployment as a very black and white issue – people are either in work or out of it. In reality there are many shades of grey in between, people who whilst not unemployed don’t have all of the work they want to be doing…

The number of under-employed workers rose by 103,000 in the last quarter of 2011, more than explaining the 60,000 rise in employment. It now stands at 1,948,000, the highest number since the records began in 1992. Precarious work is on the rise in the UK with the number of people under-employed having nearly doubled since the recession began in 2008.

In 2011 the number of workers under-employed grew by 181,000 whilst the overall number of people in employment grew by just 7,000. In other words a large rise in under-employment has massaged the labour market statistics and may have made the numbers appear stronger than they actually are…

When one takes under-employment into account the underlying performance of the UK labour market over 2011 may be a lot weaker than the headline figures suggest.

It gets worse. The scandal of the government’s workfare program was exposed to greater scrutiny this week, with advert on a government job seekers’ website revealing the extent of Tesco’s involvement with the work experience scheme, which involves claimants being forced to work or else face the removal of their benefits.

As we reported this week, the scheme represents a significant transfer of wealth from the taxpayer to Tesco, a business which, in a disappointing half year, made only £1.9 billion of profit:

Just as when they refuse to pay their employees the living wage, every person working for the supermarket chain while still receiving state benefits is an in-kind subsidy from the government; this is just more transparently the case when Tesco pays no wage at all.

Tesco has a choice in this matter. Many of their competitors, such as Sainsbury’s and the Co-op, have confirmed that they will not be using work experience labour; but Tesco insists the decision is up to individual store managers, and as a result the allure of free employees seems to tempting to resist.

At its heart, however, the problem lies with the government program which legitimises this practice.

The claim that it is aimed towards providing useful work experience that will lead to jobs is demonstrably untrue; both from the preponderance of placements which provide ‘experience’ in jobs which require none, and from the evidence provided by cases like Cait Reilly’s – taken off valuable work experience in Birmingham Museum and Art Gallery to stack shelves in Poundland.

Instead, it is looking more and more like this workfare program is driven by populist anger against ‘benefit scroungers’: The logic seems to be that if they can work, they should work; and if there are no jobs available, they should work for free until there are.

It is policy by demonisation, and it is shameful.

Also this week on Left Foot Forward, read Harriet Williams’s first-hand experience of youth unemployment, a personal account of life on Job Seeker’s Allowance and her efforts to find a job; and read Tony Burke’s report on the latest attempts to undermine our employment rights.

• Internationally, in Syria, the situation gets ever worse, though the UN has, finally, spoken with clarity on the issue.

This morning, the United Nations General Assembly voted in favour of an Arab-backed resolution condemning human rights violations, calling for an end to the violence and demanding the resignation of Bashar al-Assad, by 137 votes to 12, with 17 abstentions.

However, unlike the earlier Security Council resolution, which was vetoed by China and Russia, it has no legal authority, as the BBC’s Barbara Plett explains:

The General Assembly was very much a Plan B – the Arab sponsors of the resolution and their Western allies had wanted the legal weight of the Security Council backing their political plan to end Syria’s crisis.

But with the Council blocked by Russian and Chinese vetoes, they turned to what is in effect the “world’s parliament”, hoping that a non-binding endorsement from the 193-member body would lend moral and political clout to their initiative. They hailed the strong majority vote as a clear message of international support to the Syrian people and a demonstration that Bashar al-Assad had never been more isolated.

But there was no disguising that the major powers are as deeply divided as ever. Russia continued to argue that the text was unbalanced, because it made no specific demands of the armed opposition and attempted to sideline the Syrian leadership.

Even some countries which voted yes said Russia had a point (these issues will have to be addressed sooner or later, said Serbia; India said much the same). But in the meantime the impasse continues, which suggests diplomacy will increasingly look elsewhere for a solution, and the violence in Syria will probably get worse.

On the ground, Syrian troops continue to shell Homs, described by witnesses as “their heaviest pounding yet” of rebel-held areas of the central city, with agencies reporting:

Rockets crashed into strongholds of resistance at the rate of four a minute, according to one opposition activist who warned the city was facing a humanitarian crisis.

“It’s the most violent in 14 days. It’s unbelievable – extreme violence the like of which we have never seen before,” said Hadi Abdullah of the General Commission of the Syrian Revolution.

”There are thousands of people isolated in Homs… There are neighbourhoods that we know nothing about. I myself do not know if my parents are okay. I have had no news from them for 14 days,” he told AFP by phone.

“The regime troops are still shelling… but are reluctant to enter Baba Amr. They are on the periphery and are moving slowly. The army will lose if it begins urban warfare,” activist Omar Shakir said later on Skype.

Rights groups estimated the two-week assault on Homs has killed almost 400 people, and a medic reached on Skype said 1,800 have been wounded.

So what next? How much longer must this go on? As George Irvin wrote on Left Foot Forward, there is, regrettably, “no simple solution” to end the bloodshed and force Assad out. It appears, shamefully, sickeningly, that for the time being, Syrians will continue to die, and die, and die, at the hands of Assad and his brutal, murderous regime.

Progressive of the week:

Business secretary Vince Cable, who this week urged David Cameron and Nick Clegg to adopt a more strategic approach to industrial policy.

In a letter to the PM and his deputy seen by the FT (£), Cable writes:

“There is something important missing: a compelling vision of where the country is heading beyond sorting out the fiscal mess; a clear and confident message about how we will earn our living in future…

“We can’t predict the economic cycles and market-driven competitive forces of the future. But we can think a decade or two ahead.”

As Will Straw explained on Left Foot Forward:

Cable has looked out countries such as Germany, South Korea, Japan and Singapore for models of a modern industrial policy.

The approach mirrors that taken by IPPR in our recent report (pdf), “The Third Wave of Globalisation”, which looks at how Britain can make a living in the global economy.

The report includes this chart (jpg) which maps a selection of sectors on a matrix showing the extent of Britain’s comparative advantage against expected global demand, each measured on a scale from 1 (low) to 5 (high). Drawing on evidence from a number of academic and industry sources, it highlights some of the opportunities currently available to the UK…

There may also be government failures where reform is needed, such as unnecessary or outdated regulations, poor procurement rules, or incentives that are keeping people away from work. In some cases, government and business may both have to do better such as the provision of a skilled workforce which is properly utilised by firms.

Government has many more levers to push and pull than it often realises, but taking a sectoral approach is critical to get Britain growing again.

Regressive of the week:

Edwina Currie, the former Tory MP and minister, who took to the airwaves this week to spew bile at the poorest, most vulnerable people in society, people living in poverty, blaming them for their predicament and reducing some of those she harangued to tears.

Alex Hern described the horror show on Left Foot Forward:

Edwina Currie has returned, triumphantly, to what she does best: attacking people living in poverty for having the temerity to do things like watch TV, smoke cigarettes, or own pets.

In a phone-in show on Radio 5, Currie spoke with Hayley, a mother from Derbyshire, who’d been explaining that her and her husband sometimes have to skip meals to feed their children.

The first thing Currie said in the discussion was to quiz Hayley on her lifestyle, asking:

“Have you by any chance got any animals? Dogs or anything like that? … Do you feed the dog everyday? … How many animals and pets have you got in the house? … Have you got Satellite TV? … Have you got clubs, are you paying through catalogues for clothes? …

“So where’s all the money going, Hayley?”

Currie’s implication is that answering yes to any of these questions – having a pet, buying clothes through mail order, paying the equivalent of two cinema tickets a month for TV – renders one ineligible for sympathy. And her incredulity at the difficulty of Hayley’s life despite not committing these ‘sins’ belies her ignorance at life below the poverty line in the UK.

When Currie hears something she thinks she can blame Hayley for, she jumps to conclusions almost instantly.

As Hern adds, it is, of course, not the first time Currie has appeared on Radio Five to lambast the poor:

Currie simply can’t believe that people who have hard lives aren’t personally to blame.

It’s the point she made in November, when she said:

“I don’t think people in this country go hungry. But are these people at the same time maybe buying the odd lottery ticket? Do they just occasionally have the odd cigarette?

“Somewhere along the line does food come as the first priority?”

And it’s the point she’s making now. She is a walking embodiment of the just-world fallacy, she appears to be impervious to reason or evidence, and she makes people cry on the radio.

As Mark Ferguson tweeted:

“I bet Tory HQ wish they could keep Edwina Currie off the air. She’s like a one person re-toxification machine http://labli.st/ztyTvt

Evidence of the week:

SOS NHS’s new report, “Breaking the NHS: Stealing England’s health through reckless reform” (pdf), which outlines the risk to the health of people in England and the dangers to the British economy of the proposals contained within the health and social care bill.

The paper demonstrates how, if the proposals are not stopped, “the NHS will cease to be a public service, free for all at the point of use”, with the health of the nation being placed “at great risk”.

Citing “the voices and knowledge of the people who understand how the NHS should work and how it has significantly improved the health of the country and supported the economy as a result”, the five key areas it explores are:

1. The threat to patients;

2. Privatisation and EU competition law;

3. The lack of evidence;

4. The economy and the wasting of funds;

5. The ignoring of moral obligations.

As Alex Hern wrote on Left Foot Forward:

The government argues it’s too late to reverse the process – but as well as demonstrating how withdrawal of the Bill would, at the very least, prevent the full scale destruction of the NHS and the full impact of marketisation, the report (pdf) also shows that dropping it now will save at least £1 billion and put a stop to the most dangerous elements of these reforms.

On the day when Dr Kailesh Chand’s petition soars to almost 120,000 signatures, accumulating an extraordinary 40,000 in 24 hours, the contents of this report show exactly why everyone who knows about the urgent need to safeguard the NHS is speaking out.

The report shows that a critical mass is now emerging to say one thing: Drop the bill.

Everyone who cares about the NHS should continue to sign the petition, and help spread the report (pdf) showing the damage the changes will cause to Britain.

This weekend on Left Foot Forward:

Saturday:

• Tony Burke reports on the German super-union’s negotiations for a 6.5 per cent wage increase.

• The Week Outside Westminster – sign up to receive it by email here.

Sunday:

• Carl Packman reviews Stewart Lansley’s new book, “The Cost of Inequality: Three Decades of the Super-Rich and the Economy”.

• The World Outside Westminster – sign up to receive it by email here.

This week’s most read:

1. The Left has to raise its voice on the FalklandsJames Hallwood, The Fabian Society

2. Tesco’s unpaid labour shows the flaw at the heart of workfareAlex Hern

3. Leaked documents expose multi-million dollar climate disinformation campaignJoss Garman

4. Youth unemployment, Job Centres, and meHarriet Williams

5. Edwina Currie is good at making people cryAlex Hern

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