Boris Johnson together with his leading ministers and officials is urging the British people to “support the NHS”. But hold on a minute. Isn’t the National Health Service supposed to be supporting the people who finance it through the taxes we pay? There is a perverse logic at work here. This slogan is designed to deflect attention away from the fact that the NHS already was struggling because of the impact of a decade of underfunding by Coalition and Tory governments. There have been increasing demands on the NHS because of a growing, ageing population and the development of new treatments. In order to maintain health services at the level they were in 2010 expenditure on it in real terms should have risen by 4% a year but in reality it has only increased by 1% a year. Even before the corona virus crisis there was a shortage of many tens of thousands of doctors, nurses and other personnel. Also there was not enough equipment such as beds, ventilators and protective clothing.
We are being urged to avoid seeking medical help so as to free up doctors and nurses to treat corona virus victims. Even before the outbreak Government ministers were telling us that people were wasting the time of doctors and nurses by seeking treatment for trivial illnesses. In reality there is little evidence that this was the case. Indeed there is a lot of evidence that some people experiencing symptoms, especially men, delay seeking medical help until serious illnesses have reached advanced stages and thus are more difficult and expensive to cure. The line of British governments has been that the people are a burden on our NHS because we actually use it when we are ill!
Just as happened with British soldiers serving in Iraq and Afghanistan, the media and politicians are hailing doctors and nurses as “heroes”. A hero is a person who does outstanding and exceptional things. British military personnel oppressing and killing Iraqis and Afghanis trying to defend their homelands from foreign invaders were not heroes. Some of these soldiers might have been quite brave but what they were being paid to do was quite unexceptional. Attacking innocent people in foreign countries is business as usual for imperialist armies.
If we consider the NHS then emotions are easily aroused because it deals with matters of life or death. We feel very grateful when medical attention is given to ourselves and those close to us. Unless we are the victims of inadequate and incompetent treatment we are predisposed to regard those providing it as “angels”. But are they? The reality is that people following medical careers do so for a variety of reasons. Some do so because they do have a genuine humanitarian desire to help the sick. Others enter medicine because it is a family tradition to do so. Some people who become doctors do so because it is possible to earn very high salaries. Many consultants supposedly employed on a full-time basis by the NHS are moonlighting in the private sector simply to increase their already excessive salaries. Very often they are treating patients who are being paid for by the NHS. The enormous pay differentials in the NHS between on the one hand consultants and senior managers and ordinary nurses and paramedics are obscene. Some of the lower paid personnel in the NHS have had to resort to using food banks.
People employed in the NHS are much like other occupations in terms of their commitment and competence. Let us consider car mechanics. Some are very good at servicing and repairing motor vehicles, doing their best to ensure that drivers are safe and making reasonable charges. Other auto mechanics are less competent and scrupulous, not carrying out maintenance properly and even charging for work not necessary or not done. This can endanger the lives of drivers and other people. So it is in the NHS. There have been plenty of cases in recent years where doctors and nurses have provided inadequate care to patients and these are the ones we know about because they have been publicly exposed. There must be plenty of other cases of medical malpractice which have not come to public light. As for commitment to serving patients, if we consider hospital nurses then many of them work three twelve hour shifts a week thus giving them four days a week off work. They do this because it personally suits them. But what sort of shape are nurses in towards the end of a twelve hour shift, especially under the pressures that understaffing has brought about? What impact does this have on the quality of treatment patients receive?
DEFENDERS OF THE NHS?
There has been much public campaigning, e.g. by Keep Our NHS Public, to try to maintain the quality of of NHS care ever since serious privatisation of its services began under the Blair-led Labour Governments. Such campaigning has intensified since the Coalition Government started the financial squeeze on the NHS in 2011 and introduced a major reorganisation with the Health and Social Care Act 2012. But it has to be said that the response of NHS personnel to these adverse developments has not been very strong.
The British Medical Association – the doctors’ trade union – and the medical Royal Colleges have made some criticisms of these negative changes but have not taken any effective action against them and have obediently implemented them. Some doctors have enthusiastically joined in the privatisation drive by becoming involved in and setting up private health care companies such as Circle. Others have taken senior, highly-paid positions in hospital administrations and healthcare trusts where they willingly implement measures which they know will provide inferior services for patients. It is also true that there are some doctors who have publicly spoken out against negative changes in the NHS but they are a very small minority.
As for the nurses, paramedics and other NHS employees, they have done little to defend their own pay and conditions let alone taking action to defend the quality of the health services they provide. At the same time many nurses and other personnel have been leaving NHS employment because of their dissatisfaction with their employment situation. The trade unions with health service members, such as UNISON and UNITE, have shown themselves to be pretty useless at defending their own people. The well-paid full-time officials and national leaders of these organisations want to avoid any serious confrontation with the NHS employers and governments.
I write as someone whose life has been saved by the NHS on two separate occasions. At present I am receiving treatment for a serious coronary condition and I have personally witnessed the pressures doctors and nurses were under even before the corona virus outbreak. For this health care I am truly grateful. But I am also very grateful for the efforts of mostly low-paid employees in supermarkets and food distribution in keeping us supplied with necessary food stuffs despite the high risk of infection they have because of close contact with many thousands of customers. This doesn’t make them “heroes” but simply people who are conscientiously doing their best to provide a necessary service in difficult circumstances.
Also I am aware of two cases of people I know who have received bad treatment in a private hospital but at NHS expense. One was sent to this hospital to have a hernia operation but it went wrong and he had to be taken to the A & E department at the local general hospital. The other person was sent by the NHS to the same hospital for a routine cataract operation. The surgeon carrying it out admitted that he was in a hurry. The result was some unnecessary damage to the patient’s eye. The private hospital companies have been doing very well out of dealing with the overspill of patients from an inadequately supported NHS. The time has come for them to be nationalised and incorporated into the NHS.
REVIVING THE NHS
The corona virus pandemic has exposed some of the unnecessary shortcomings of the NHS brought about by years of underfunding and mismanagement. We should not allow the Government to revert to providing an inadequately resourced NHS after the corona crisis has been overcome. We should demand that the NHS is adequately funded and first and foremost it is the people employed in the NHS who should be making this demand.