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TOPIC: Coming to the defence of the NHS

Coming to the defence of the NHS
15 Feb 2017 20:00 #2748

Basil Clarke Basil Clarke's Avatar Topic Author

Defend Enfield NHS public meetingIn recent weeks scarcely a day has gone by without new and very disturbing information about the crisis in the National Health Service.  Ever longer waiting times in A&E departments, postponement of non-emergency operations, skilled surgeons having to waste their precious time waiting for beds to become available, hospital doctors buckling under stress, and so on - it seems that the tremendous improvements that we saw in the first decade of this century have all been overturned.

All around the country people are coming together to form local NHS defence groups.  Here in Enfield a group calling itself Defend Enfield NHS (DeNHS) was set up last year.  This weekend it will be holding its first public meeting (10am on Saturday 18th February at the New Crown in Southgate).

Ahead of the meeting DeNHS has issued a document setting out its concerns and the steps it is taking to defend the NHS in Enfield.

Defend Enfield NHS logo
Defend Enfield NHS: Our talking points

We are a group of local people from the London Borough of Enfield who got together originally as a local 38 Degrees group.

These are some of the points that we will be making at our first public meeting on 18th February.

People support the NHS

The National Health Service (NHS) is a key part of British life.  We pay for it through general taxation so that we can get the care we need, when we need it, free at the point of delivery. The NHS treats on average one million people every 36 hours. An overwhelming 84% of us  believe it should be in public ownership.

The NHS is cost-effective

nhs how uk compares to europeFar from being a ‘money pit’, NHS funding is now reduced to 8.5% of Gross Domestic Product (GDP) compared with France’s 10.9% and Germany’s 11% GDP health spends. They face the same challenges as the UK - ageing populations, obesity, smoking and long term conditions like diabetes.

NHS privatisation is increasing – but is wasteful

nhs contracts graphicEvery year more services are contracted out, with 40% of contracts going to the private sector in 2015. £250 billionhas been spent on using the private sector to build new hospitals, often locking the NHS into long-term loan repayments at high rates of interest, instead of spending the money on patient care. Far from boosting efficiency, the requirement for NHS commissioners to buy in services on a competitive basis adds in an extra layer of bureaucracy and is very expensive for both purchaser and provider.  It is estimated that every year  £4.5 billion is wasted in this way - enough to pay for either ten specialist hospitals; 174,798 extra nurses; 42,413 extra GPs. Meanwhile there are 25,000 nursing vacancies and the pay freeze has seen the value of NHS salaries reduce by 14%.

There are several examples of privatisation going seriously wrong; in 2014 a private company handed back the running of a Cambridgeshire hospital (after only three years of a ten year contract) after it was found to be  neglecting patients.  Our NHS has to step in and pick up the pieces when this happens

The NHS in Enfield is under threat again

hospital bed supplyLocal people still remember how Highlands Hospital was closed in 1993 and the closure of the accident and emergency department at Chase Farm Hospital in 2013 without providing suitably enhanced services to compensate.

The number of hospital beds in England has fallen by 40,000 in the last 20 years. Commissioners will have to reduce the work done by providers (making waiting lists longer), change referral criteria (reducing our access to treatments), centralise services (making us travel further for treatment) and try to manage more patients outside hospital.

We are holding the local NHS to account

Enfield Clinical Commissioning Group (CCG) meets in public and publishes its papers online - 524 pages for the most recent meeting, full of abbreviations and terminology that make it difficult for the general public to understand. We read those papers carefully and put questions to the officers. We have drawn up a detailed response outlining our concerns about the STP.

We have teamed up with health campaigns across England

hctbannerWe have joined Health Campaigns Together to share information and to work together with the many groups campaigning against closures and privatisations right across the country.

We support the NHS Bill

The Bill, which has cross-party support, proposes to fully restore the NHS as an accountable public service, by abolishing the purchaser-provider split, ending contracting and re-establishing public bodies and public services accountable to local communities.

We are calling for

  • No service closures (or ‘reconfigurations’) through STPs or any other process without full proper local consultation and consent.
  • A publicly funded, provided, managed and staffed NHS which can comprehensively identify, prevent, manage and treat ill health
  • Integration of our NHS with a properly publicly funded social care system
  • The re-nationalisation of our NHS to exclude profit-orientated private providers and to return service accountability to government and the public.

We are marching for the NHS

On Saturday 4th March 2017, we will be joining campaigners from all over England to march in central London in support of our NHS. We warmly encourage you to join us. If you would like information on joining up with us to travel in with us, please sign up to our mailing list


If you would like know more or are interested in joining us for our regular meetings, please sign up to our mailing list or:

Email us on:

Like us on Facebook:

Download our Talking Points leaflet

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Coming to the defence of the NHS
15 Feb 2017 20:41 #2749

Basil Clarke Basil Clarke's Avatar Topic Author
If you're not convinced that the NHS is in mortal danger, here are some links from reliable, non-radical sources that might make you change your mind.

First off, an hour-long expert debate on the Radio 4 programme Inside Health, entitled NHS Special: What needs to give? The programme entitled Why hernias, hands and varicose veins might not be treated on the NHS is also a must-listen.

Then some of the articles from the first two days of a week-long investigation into the state of the NHS in the i newspaper. There are another three days to go yet...

The Great NHS Gamble: What we have investigated and why it is important to you

STPs: How they will shake up the NHS and what they mean for you

NHS crisis: 19 hospitals face axe as doctors accuse Government of deliberate underfunding

A&E doctor writes: I don’t have the capacity to be caring – it’s soul -destroying

I gave away a kidney because I love the NHS – now I fear privatisation

How £18m of taxpayers’ money was spent on private consultants to plan NHS cuts

The full list of the 24 A&E units marked for closure

NHS crisis revealed: 24 A&E units marked for closure or downgrading

How to speak NHS manager: Decoding the jargon that obscures the cuts

The cuts and changes planned for your local NHS

The Great NHS Gamble: What we have investigated and why it is important to you

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The NHS crisis - facts and figures
15 Feb 2017 22:24 #2751

Basil Clarke Basil Clarke's Avatar Topic Author
More evidence of the NHS crisis. "STPs", referred to below, are the sustainability and transformation plans that are currently being drawn up, with the twin aims of improving NHS services while simultaneously cutting costs significantly.

As chair of the BMA London Regional Council, Gary Marlowe recently presented a synopsis on the variants creating the current situation in the health and social care environment:

  • 2014/15 spend on NHS £135 billion = 7.3% GDP. By 2020/21 this will decrease to 6.6% amongst lowest of any OECD country
  • We have fewer beds, 2.8 per 1000 pop than almost all OECD (Germany 8.3, Poland 6.6) in 2011 and STP plans are to decrease this between 5 and 20%
  • We have fewer doctors, around 2.8 per 1000 than most of Europe (only Slovenia, Romania and Poland have less)
  • Current spend per head per year in England = £ 20657, lower than other European country
  • The Five Year Forward View estimates a funding gap of £30 billion per annum by 2020/21. To close the gap the government have proposed £10 billion extra funds and £22 billion efficiency savings. However, when the Health Select Committee (Chaired by a Conservative MP) examined the figures, for current year its actually £4.5 billion
  • The important fact to hold on to is the eye watering £22 billion “efficiency” savings = cuts.
  • Hospital deficits grew form £859 million in 14/15 to £2.54 billion in 15/16. PFI is a significant contributor to the deficits (eg Barts Hospitals Trusts, the biggest PFI in the UK, pays approx. £2 million a week in interest payments)
  • The 4 hour A&E target is now only 88.4% (target was 95%)
  • Delayed discharges are >25% up from last year
  • Number of emergency admissions have gone up by 2.9% (this at a time when all efforts are being made to keep people out of hospital) suggesting that it’s the truly ill who are attending A&E
  • STPs in theory are an excellent idea but a “must do” is to operate within the “system control total” i.e. they have to save money. They appear to be completely subservient to the financial imperatives
  • Public Health and preventative policies will only show dividends decades down the road.
  • Much of the STPs are predicated on shifting work out of hospital to primary care. However, primary care is on its knees with low morale, high vacancies and a retirement time-bomb. NHS spend on primary care in 05/06 was 10.4% of the total, decreased to 8.1% in 14/15 and now around 6%. This is while providing 90% of patient contacts.
  • A solution that is often touted is increasing skill mix using Health Care Assistants, Pharmacists and Physician Assistants. The evidence is that this improves quality of care but does not save money or replace medical professionals. It in fact might turn out to be more expensive.
  • In the 2015 Spending Review there was a 20% cut to non-ring-fenced Health spend. This included education with a loss of nursing bursaries just when we are desperately short of nurses (vacancies have increased by 60% and applications for training posts have fallen by 20%)
  • Last year £13 billion of health care was purchased from private providers, an increase of 76% from 2010. On the other hand NHS receipts from private earnings increased by 30% to £558 million (the beginning of a truly 2 tiered system within our own NHS hospitals)

Dr Marlowe's concluding remarks:

Amongst all this gloom remember the NHS was declared the best healthcare system in 2014, by an international panel of experts and led by an American charity, who rated its care superior to countries which spend far more on health. The same study castigated healthcare provision in the US as the worst of the 11 countries it looked at, despite spending the most, as many patients in need are denied care because they do not have health insurance, it is also the poorest at saving the lives of people who fall ill. Published in 2014 this report was produced by the Commonwealth Fund, an internationally respected Washington-based foundation. They examined an array of evidence about performance in 11 countries, including detailed data from patients, doctors and the World Health Organisation. "The United Kingdom ranked first overall, scoring highest on quality, access and efficiency"

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Coming to the defence of the NHS
16 Feb 2017 16:23 #2761

Its very upsetting to know that the NHS is being badly treated, human life is just not valued. Politicians publicly praise the NHS and privately they deprive it of necessary funds. Cruel.

It not the country that is rich but the Government, to me its not the same thing.

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Coming to the defence of the NHS
16 Feb 2017 18:16 #2766

Basil Clarke Basil Clarke's Avatar Topic Author

The Sustainability & Transformation Plans (STPs) have some very good ideas for improving health and social care - but transformation can't be done on the cheap. Trying to transform and simultaneously make big savings is either madness or the whole thing is designed to fail, at which point the government can say "We tried to fix the NHS, but couldn't, which proves that universal health care free at the point of delivery is no longer viable."

For more, from the people who understand the NHS - the doctors, see

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Coming to the defence of the NHS
17 Feb 2017 19:02 #2769

I fear everything points to the latter conclusion. This government is heading hell-for-leather towards the privatisation of the NHS. They keep saying they're not, but actions speak louder than words. Services are cherry-picked and sold off - I think I heard that 10% of the NHS budget is spent on the bidding process for all that! Private providers would have to be incredibly more efficient than the nationalised service to make up for that, as well as provide a return to their shareholders. What results in practice is money-saving by staff cuts, and hence a worse service. No wonder the staff are in despair.

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Coming to the defence of the NHS
02 Mar 2017 12:31 #2844

The NHS is thoroughly abused and will eventually die unless free POS is removed (even partially).

Almost lost part of my leg last summer due to Dr incompetence at North Mids, main reason I'm healthy & walking now is being able to get treatment under my private medical insurance cover.

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Coming to the defence of the NHS
02 Mar 2017 14:05 #2848

You may have just been unlucky in your doctor, David. Every profession has its share of incompetents, and also competents who have off days. The general impression people seem to have of the NHS is of dedicated and caring professionals doing a good job, but snowed under with mounting volumes of work to be done on a shrinking (or not expanding fast enough) budget.

If we lose 'free at the point of provision' we're heading for the American model where only the rich can afford to get ill. I saw a tweet the other day with a hospital bill for a 6 days stay (with op) coming to more than $50,000:

Likewise when the NHS started in 1948, doctors' surgeries were packed out with people with diseases and injuries they'd suffered from for years and could only now afford to get treated. Let's not go back to that pre-1948 situation.
The following user(s) said Thank You: Julia Mountain

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