Focus on cuts 4: NHS – creeping privatisation, spending cuts, media storms and a simple lack of understanding
Professor Raymond Tallis, served as a doctor and clinical scientist. He has worked as an adviser to the Chief Medical Officer and served as with the National Institute for Clinical Excellence.
A Fellow of the Academy of Medical Sciences and the Royal College of Physicians, he minces no words: “Jeremy Hunt has blood on his hands”.
In a scathing essay, Professor Raymond Tallis explained why he believes the Health Secretary, Jeremy Hunt, is destroying the NHS – through creeping privatisation, spending cuts, media storms and a simple lack of understanding. He quotes from a pamphlet co-authored by Hunt in 2005, “Our ambition should be to break down the barriers between private and public provision, in effect denationalising the provision of healthcare in Britain.” In 2005, and again in 2008, he called for the de-nationalisation of the NHS and for a US-style insurance scheme.
Hunt: “an existential featherweight”
In the light of Jeremy Hunt’s CV, Tallis finds it easier to understand his approach: “After leaving university, Mr Hunt established a marmalade exporting business that failed. He then moved to something less sticky and established, first of all, an IT PR company and then Hotcourses, an agency that lists courses for people who want to improve their work prospects or to follow a hobby. It made Mr Hunt a wealthy man and so freed him to enter politics. Though being a millionaire did not discourage him from over-claiming on his parliamentary expenses or from avoiding £100,000 tax in a way that shocked even The Daily Telegraph”. He cites Hunt’s preference for the private sector, expressed in his disastrous decision (when he was Culture, Media, and Sport Secretary) to hire G4S to oversee security at the London Olympics, with the result that the Army had to be called in.
The NHS is effectively being defunded by 3% annually and this is set to continue until 2020
Tallis reminds us that the Coalition agreement guaranteed an increase in NHS funding in each year of the Parliament. There was a dip in health expenditure in the first two years of the Coalition and then a 0.8% annual growth. He continues: “Due, however, to the increase and ageing of the population served, developments in medicine, and government-set targets for increasing staffing levels and the provision of treatments, the demand on the NHS has risen by 4% per annum.
We spend 25% less as a percentage of GDP compared with the EU average
The proportion of GDP spent on healthcare fell by nearly 1% in five years after 2010 to 7.3% – contrasted with 11% for Germany and France. It is due to fall to 6.6% by 2020”. Unsurprisingly, hospitals had racked up a £2bn deficit by the end of 2015 and are heading for a financial crash. They have now been instructed to cut staffing levels and this will ensure that care will deteriorate further”.
Tallis notes that Mr Hunt’s PR training has served him well: “He has played a blinder in denigrating the NHS and discrediting those who work in it – for the most part individuals whose laces he is not worthy to unloose”. Hunt has handled this unfolding catastrophe ‘masterfully’, blaming the growing deficit in the NHS
- on the service itself,
- on the staff,
- on patients who do not use it properly,
- and on the failure of local authorities to provide those services that will prevent patients being trapped in hospital with nowhere to go.
The Care Quality Commission is headed by Lord Prior, formerly deputy chair of the Conservative Party. Its expensive, time-consuming inspections of GP surgeries and hospitals, have been of enormous benefit to Hunt’s mission. Prior cited Circle’s spectacular success with Hinchingbrooke – though shortly after the arrangement collapsed and Circle ditched the Huntingdon hospital and though scandals have been emphasised, Tallis believes that there is still much work needed to undermine confidence in the NHS, “because the vast majority of the population (especially those who owe their lives and limbs to it) still think very highly”.
Hunt’s use of studies reporting that death rates are higher in patients admitted at weekends than on weekdays is then criticised: “As the authors of the studies repeatedly emphasised, it is not easy to be sure of the reason for the excess mortality. An obvious contributory factor is that weekend admissions tended to be emergencies of more acutely ill patients. Subsequent studies showed the “weekend effect” to be largely illusory. The headline data provided a political opportunity too good to miss . . .”. Mr Hunt’s solution: a 24/7 NHS, as an urgent clinical necessity and moral imperative, but without specifying any additional resources, though the Department of Health estimated that it would cost just under £1bn annually and require 11,000 extra staff, none of which was forthcoming).
Doctors pointed out that the NHS was open 24/7 already
Open, but not yet sufficiently resourced (in particular staffed). Financially challenged trusts had no money to hire extra staff, even if they were available – and this despite a virtual pay freeze for six years. As of 2016, 40% of hospital consultant posts are vacant and increasing medical staff would not be enough: nurses, lab staff, radiographers, porters, would all be a vital part of a full 24/7 service.
There was, however, one result of Hunt’s campaign that was even more serious than his failed attempt to discredit NHS staff. The care of ill people, Tallis stresses, unlike Hotcourses or failing to sell marmalade, really is a matter of life and death. He ends:
“Alarmed by Mr Hunt’s self-serving emphasis on how dangerous hospitals were at weekends, some patients postponed presenting themselves or their children until Monday. Patients with strokes and even one or two individuals awaiting transplant, for whom a compatible organ had become available, also held back. This was called “The Hunt Effect”. Spin has real consequences that cannot be spun away. Mr Hunt’s wagging index finger has blood on it”.