Youssef El-Gingihy - How to Dismantle the NHS in 10 Easy Steps

First published by Zero Books, 2015

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Text copyright: Youssef El-Gingihy 2014

ISBN: 978 1 78535 045 0

Library of Congress Control Number: 2015931661

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Dedicated to all those who have fought for the NHS and to a future

NHS for all time.

I would like to thank those, who showed the way and illuminated my understanding of what has been happening to our NHS. It is only through their contribution that I have been able to write this book. All those years ago, they were lone voices. More people are now becoming aware of the marketisation and privatisation of the NHS and are determined to fight against vested interests to preserve it.

Introduction

I am a doctor. I work as a GP in London. Like most of you, I was born in a National Health Service hospital. I studied medicine and worked as a junior doctor in the NHS. I wrote this book because I fear that there will not be an NHS as our generation grows old and certainly not for our children. Yet the British public remains largely unawares of this and the media, with few exceptions, have failed in their duty to inform them. The remit of my book is charting how the NHS has been insidiously converted into a market-based healthcare system over the past 25 years. This process is accelerating under the Coalition government and the very existence of a National Health Service is in danger. This matters to all who use the NHS or are concerned by the privatisation of public services and the dismantling of equitable healthcare and welfare. The NHSlong the envy of the worldis being broken up into a universal insurance system based on the US model. Multinationals are opening the NHS oyster following on from the Health & Social Care Act 2012 and in preparation for the forthcoming Transatlantic Trade & Investment Partnership (TTIP EU-US trade agreement). This is about much more than the NHS; it is about turbo-charged neoliberalismthe ideological doctrine that encompasses privatisation, deregulation and shrinking the state.

We are on the eve of an epoch-defining general election in 2015. Put simply, this election is likely to define whether the NHS continues to exist as a cherished institution or whether it is gradually dismantled into a privatised, insurance-based system. The election, in the context of the financial crisis and austerity, would seem to be as significant as 1979. The issues at stake extend to the current neoliberal political and economic model and the kind of society we want to live in. It is likely to have huge ramifications for the direction Britain is heading in, at a time of great change, turmoil and chaos across the world.

NHS politics is an area that can be dry and foreboding to the public. The concept of this book is to make it accessible and to communicate clearly what is happening to our NHS. I want to shine a light on the deliberate destruction of the nations most sacred institution whilst the majority of the British public have been kept in the dark by a neoliberal agenda pursued by the main political parties and the media. I only became aware of what was happening in 2011 at the time that the Health & Social Care Bill was making its way through Parliament. Incredibly, they dont really teach you much at medical school or as a junior doctor about how the NHS works and the history of its evolution. Maybe they shouldtheres certainly enough time in five years of studying.

Healthcare affects us and our loved ones arguably more than anything else in our lives. It would be a tragedy if the NHS were to be dismantled by vested intereststo great detriment to all of uswithout the British public even having a say in the matter. People often feel impotent in the face of powerful interests. Yet the NHS belongs to us and we are the only ones who can fight for and save it.

Lots of questions are being asked of the NHS by politicians, the media and the public, such as:

Can the NHS survive the current crisis?

Is the NHS affordable?

Where will the money come from?

Would we be better off with universal private insurance?

I will try to answer them in this book. But what if these are the wrong questions diverting us from the real issues?

The National Health Service was created in 1948. It is one of the pillars of the welfare state. It was created as part of a planned

The founder of the NHS, Aneurin Bevan, officially opened the first NHS hospitalPark Hospital in Manchesteron 5 July 1948. He met a 13-year-old girl with a liver condition by the name of Sylvia Diggory (ne Beckingham), who became the first patient to be treated under the NHS. Ironically, the birthplace of the NHS, now renamed Trafford General, is one of many hospitals facing cuts and closures.

Aneurin Bevana coal miners son who fought hard against bitter opposition to establish the NHStold her that it was a milestone in historythe most civilised step any country has ever taken. So, one day there was no such thing as the NHS and the next day it had come into existence. 1 April 2013the day the Health & Social Care Act came into effectrepresents the reversal of that process.

The Health & Social Care Act is virtually impenetrable, but the main thrust of it is: Primary Care Trusts and Strategic Health Authorities will be disbanded. In their place, Clinical Commissioning Groups (CCGs) will control about 60-80 billion of the NHS budget and commission local services. Commissioning will take place through competitive tendering of NHS contracts open to the voluntary and private sectors. But these recent events are the final stages in a journey that started over 25 years ago

Although nobody has told you this, the NHS has been effectively abolished. The national in National Health Service has been removed. It is fast becoming more of a notional health service subject to the whims of commissioners, cuts and rationing.

Now that may seem like a strange thing to say, seeing as you can still go to your local GP or hospital and receive free healthcare. On the surface, nothing seems to have changed. But, as you read on, you will discover that everything has. It will take many years for this to become apparent. The NHS lives on as a logo, which has helped to keep the public in the dark.

Our story really starts in the 1980s with Margaret Thatcher. Speaking at the 60th anniversary of the NHS in 2008, Kenneth Clarke remarked that: In the late 1980s I would have said it is politically impossible to do what we are now doing.

Ken Clarke was talking about how the NHS has been gradually converted into a market-based healthcare system. After 30 years of neoliberalism, what was once impossible has become possible. Ken Clarke, of course, was there at the beginning. As Health Secretary under Thatcher, he got the ball rolling by introducing the internal market into the NHS in 1990.