The Negation of Democracy: Demise of Britain’s National Health Service (NHS)

In 2004 Comrade Brownski sold off for around £17 Billion NHS Logistics…politicians knew then where that would lead.
2011 complaints pour in re nurses and general staff being unable to communicate with patients-it’s gotten so bad that instead of a written label stating the contents of cuboards- pictures are now drawn…And this isn’t because Brits don’t want te jobs- ty getting one!
Staff recruitment has been outsourced to other nations…..akin to America…some areas white males are excluded from certain jobs.
Tax payers ought to say to Government sorry but I’m outsourcing my taxes…to some holiday area-Spain, Greece etc

Taking the piss seems to be the reason Politicians get up on a morning- they need reminding BRITAIN and NOT ISRAEL is where they get THEIR salary from….do the job they get paid for or move out!!

Here to deconstruct BRITAIN has they’ve been doing over decades.


The Negation of Democracy: Demise of Britain’s National Health Service (NHS)

by Prof. Colin Leys

September 15th 2011

In voting, in the British House of Commons, for the third reading of Andrew Lansley’s Health and Social Care Bill last week MPs voted to replace the National Health Service (NHS) as a public service with a system of competing businesses – foundation trusts, social enterprises and for-profit corporations. The government’s claim that the Bill does not mean privatization is plainly specious: the truth of the matter is to be found in what Lansley’s health minister, Lord Howe, told a meeting of private health businessmen on the day the Bill was approved. He said it presented ‘huge opportunities’ for the private sector, and noted that commissioners of health care would be barred from favouring NHS providers. The truth is also to be found in the government’s leaked plans to hand over the management of NHS hospitals to private companies, and in the current and promised large-scale opening up of NHS work to ‘any qualified provider.’

Lord Howe reiterated Tony Blair’s dictum that it doesn’t matter who provides care, so long as it is free to the patient. What this does is to treat as irrelevant everything that follows from introducing market dynamics. The basic fact about health care is that high quality care depends on a sufficient ratio of skilled staff to patients, whereas in the long run profits can only be made by reducing the skill-mix (to lower the wage bill) and cutting staff ratios. The resulting decline in care quality is already evident in privatized long term care and home care, and is now beginning to be seen in community health services and GP services. Once NHS trusts have to compete with for-profit companies they will be forced to follow suit.

The erosion of quality will be reinforced by two other powerful factors: a) the cuts being imposed in the NHS budget, leading to the withdrawal of some services and the scaling back of others; and b) rising costs due to marketization. The costs of market-based health care – from making and monitoring multiple and complex contracts, to advertising, billing, auditing, legal disputes, multi-million pound executive salaries, dividends, fraud, and numerous layers of regulation – will eventually consume 20 per cent or more of the health budget, as they do in the United States. Neither the Care Quality Commission nor NHS Protect (the former NHS Counter-Fraud Unit) is remotely resourced enough, or empowered enough, to prevent the decline of care quality or the scale of financial fraud that the Bill will introduce.

Declining Quality, and Lengthening Wait Time
The effect will be that people with limited means will be offered a narrowing range of free services of declining quality, and will once again face lengthening waits for elective care. To get high quality and more comprehensive care people will have to pay for private insurance and private care, if they can afford to. More and more NHS hospital beds will be occupied by private patients, further reducing the resources available for free care. Fixed personal budgets, like those already given to people for social care, are to be introduced for a growing range of chronic conditions, allowing those with resources to top up their allocations while leaving the rest to make do with ‘basic’ NHS provision.

None of this is wild speculation. It is either already happening or announced or readily foreseeable on the basis of current policy. To deny that the Bill means privatization and the end of the NHS as a comprehensive service equally available to all is like denying that the earth is round.

The fact that MPs have nonetheless endorsed the Bill reveals something more serious than an ideological blind spot. It shows that they don’t really care that they are flouting the wishes of the electorate. David Cameron promised categorically that there would be no further top-down reorganization of the NHS, but is pushing through a reorganization that amounts to a destruction of it, against the known wishes of a large majority of voters. Governments, we are told, must often take unpopular decisions. But this is not some incidental measure. We are talking about something fundamental to what, for more than half a century, has played a key part in making Britons equal citizens, and Britain a civilized and humane country. If democracy doesn’t mean that governments have to respect public opinion on something as important as this, what does it mean?

It is no less depressing that the Department of Health has been reduced to peddling more and more brazen lies, such as its ‘Department of Health Myth Buster’ document, published to coincide with the Third Reading debate. The principle seems to be that that if an official lie – such as that the Health Bill does not mean privatization – is repeated often enough, most people will feel it must be true. Democracy depends on voters having trustworthy information. If we cannot trust departments of state, run by public servants, to tell the truth, who can we trust?

Defence of the NHS?
But most depressing of all is the failure of any organization to mount a serious defence of the NHS. To call Labour’s opposition to the Bill weak is to give it too much credit. The NHS was Labour’s greatest social achievement. To have made no serious effort to defend it now ranks as one of the greatest, and at first sight one of the most puzzling, political betrayals in modern British history. The immediate reason evidently lies in the fact that New Labour prepared the NHS for privatization, as Conservatives like to point out, and failed to be honest about it. But Ed Miliband was elected leader of the Labour Party on a promise to break with the legacy of Blair and Mandelson. Why would he not then break with the legacy of Milburn, Reid and Hewitt, their faithful water-carriers in relation to the NHS? And why have the unions, and the medical and nursing professions, not mounted a sustained and serious campaign to defend the NHS?

The reason lies, I think, in a broader pathology. At every level we see an anxiety to conform – not to be dubbed ‘unrealistic,’ ‘out of touch,’ ‘difficult,’ ‘radical,’ ‘ideological,’ ‘leftist,’ ‘Old Labour,’; a prevailing unwillingness to challenge the dominant discourse and the forces that underpin it. I don’t know about MPs, but so many professional leaders and managers, and many ordinary rank and file too, seem more afraid of being seen as out of step with the establishment than as having failed to stand up for what they believe in, or what their constituents want. There is a profound lack of confidence and independence.

Any attempt to account for this must include two obvious factors. One is the power of market forces, strongly felt but most of the time unacknowledged. People know, without wanting to think about it too closely, that the power of the financial markets, which lies behind the power of corporations like United Health and McKinsey, is ultimately driving policy. They feel that when all is said and done it is, really, just quixotic to stand up for any policy that may be said to be at odds with what Blair and Mandelson liked to call the ‘new reality.’ The other factor is the near-disappearance of collective organization and action. People feel alone. If we take a stand, who will support us? Certainly not our party leadership, or our department head, and possibly not even our union. Instead we are all too liable to be marginalized and even punished. And so no clear, principled challenge is made to the tightening grip of market forces by those in a position to do so.

The one encouraging qualification to this is the impact of the new social media: 38 Degrees, Facebook, expert bloggers and tweeters. Along with the million-plus people who work for the NHS a steadily growing portion of, especially, younger voters, have been exposed to a different narrative on the destruction of our social infrastructure, and not least the NHS. They see through the spin. At the moment most of them may be more cynical than politically active. But if the Bill becomes law and the reality begins to be felt in people’s daily lives it is this counter-narrative that will take hold, and cynicism will give way to anger.

Eleven years ago, in the autumn of 2000, I summed up the prospects for the NHS as follows:

“It is not difficult to foresee that [the NHS] is destined to reach a point when resistance to privatization has been sufficiently weakened and disheartened, and the market forces surrounding it [have been] sufficiently strengthened and emboldened, that further, more radical measures will become practicable. The conjuncture of a pro-market government and an economic downturn… would provide the context. The link between medicine and science… would be displaced by the link between medicine and profit.” (Market-Driven Politics: neoliberal democracy and the public interest, p. 207)

It’s usually nice to be proved prescient. On this occasion I just feel angry, and not only about the impending loss of the NHS. But I don’t believe the electorate will remain pacified indefinitely. Events will force a change.

Colin Leys is an honorary professor of politics at Goldsmiths College London, and former Professor of Politics at Queen’s University in Kingston, Canada. This article first appeared on the website.

Colin Leys is a frequent contributor to Global Research. Global Research Articles by Colin Leys




One response to “The Negation of Democracy: Demise of Britain’s National Health Service (NHS)




    Department of Health Myth Buster 06 September 2011 09:31 Department of Health (National)
    MYTH: The Health Secretary will wash his hands of the NHS

    The Bill does not change the Secretary of State’s duty to promote a comprehensive health service.

    MYTH: Bureaucracy will increase significantly

    We are abolishing needless bureaucracy, and our plans will save one third of all administration costs during this Parliament.

    MYTH: You are introducing competition in the NHS

    Competition will not be pursued as an end in itself. We have said that competition will be used to drive up quality, and not be based on price. Nor will we allow competition to be a barrier to collaboration and integration.

    MYTH: You are privatising the NHS

    Claims that we aim to privatise the NHS amount to nothing more than ludicrous scaremongering. We have made it crystal clear, time and again, that we will never, ever, privatise the NHS.

    MYTH: Private patients will take priority over other patients

    The NHS will always be available to all, free at the point of use and based on need and not the ability to pay. Nothing in our proposals will enable private patients to “leapfrog” to the front of NHS waiting lists.

    MYTH: NHS hospitals will be managed by foreign companies

    Even if independent sector management is used, NHS assets will continue to be wholly owned by the NHS. And there would be rigorous checks to ensure that any such independent provider is reputable and fit for purpose.

    MYTH: The Bill hasn’t had proper scrutiny

    The Bill has so far spent longer being scrutinised than any Public Bill between 1997 and 2010 – 40 Committee sittings, and over 100 hours of debate. Even Opposition MPs acknowledged that every inch of the Bill has been looked at.

    MYTH: The NHS doesn’t need to change

    The NHS does need to change to meet future challenges of an ageing population and rising costs of treatment. The independent NHS Future Forum confirmed the NHS must change to safeguard it for the future.

    MYTH: You are introducing EU competition law in the NHS

    The Bill does not change current UK or EU competition legislation or procurement legislation or the areas to which they apply.

    MYTH: These plans were not in the Coalition Agreement

    The Coalition Agreement clearly said doctors, nurses and health professionals will be handed freedom to decide what is right for their patients; that we will establish an independent NHS board; that patients will be in charge over their care; and that we will cut the cost of NHS administration by a third to reinvest into the front line.
    NDS Enquiries
    Phone: For enquiries please contact the issuing dept

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