An estimated 60,000 people marched for the NHS thr
An estimated 60,000 people marched for the NHS through the streets of London on 3 February 2018. This winter, hospital corridors have at times been crammed with trolleys and ambulances have queued outside. It is hard to estimate how many will have suffered and died unnecessarily before spring, in a crisis driven by deadly ideology.
Health and social care have been starved of funds year after year, services disrupted by repeated reorganisations and privatisation and health-damaging policies pursued. This has created fertile soil for prejudice against foreigners and minorities, which the UK government has helped to cultivate, further harming the NHS.
These changes have been largely driven by neoliberalism, which has been pursued with near-religious zeal by the powers-that-be, even when this makes little economic and political sense. Yet this has been increasingly questioned, especially since the collapse of the firm Carillion, a major contractor in health and other public services.
There has been strong opposition to NHS cuts and privatisation from the public. Yet, while politicians and private contractors should be held to account, wider failures have paved the way for the crisis. To reverse the situation, faith communities and other people of goodwill may need to ask ourselves difficult questions about what is often seen as acceptable or inevitable.
A crisis that could have been avoided
The National Health Service has been facing its worst crisis for decades, maybe in living memory. Even at the beginning of February 2018, when it had been hoped that non-urgent operations could resume, the situation remains dire . Indeed urgent operations are sometimes being delayed .
This is largely the result of savage cuts. In England the total number of NHS hospital beds has more than halved over the past 30 years, plunging from 300,000 in 1987 to 142,000 in 2017. Accident and emergency targets have been suspended .
“The most galling aspect of this shameful picture is that it was entirely predictable. The BMA warned in the summer that talk of a ‘winter crisis’ was a misnomer when it was clear the NHS was already struggling to cope during what was meant to be the quiet season,” wrote Chaand Nagpaul of the British Medical Association in January. They “highlighted that other leading EU nations spend about £10 billion more annually than the UK on health.”
Meanwhile billions of pounds were being given away in tax cuts and loopholes to rich people and large corporations. At one time it was widely accepted that the state should fund essential public services, not only benefiting ordinary people but also assisting the smooth running of business and government. Companies could profit from a healthy, reasonably contented workforce with access to transport and homes.
However the neoliberal ideology which has taken hold in recent decades has favoured shrinkage of the public sector and privatisation of common assets. Schemes such as the Private Finance Initiative and outsourcing of NHS services have caused further expense and disruption.
“It is not just public sector outsourcing but the entire neoliberal policy – religion almost – of privatisation that has been exposed”, wrote Iain McWhirter, the political editor of the Herald Scotland, in a powerful piece after the fall of Carillion. It reflected an era when “corporate capitalism’s thirst for profit became insatiable.” Yet similar contractors may soon get even greater power over the NHS
This winter’s crisis also reflects the interconnectedness of the health and social care system, including public health. Sometimes as the wealthy get an increasing share of the cake, sections of the public have come to see others as competitors for the crumbs. And minorities’ experiences may be little known to others. Yet harm to vulnerable groups which may go largely unnoticed, or even approved of, by the majority may in the end damage them too.
NHS continuing care and adult social care have been starved of funds year after year and increasingly refused to those who need them. Frail older and other disabled people have often suffered terribly as a result. In addition some may have needed hospitalisation because of accidents or flare-ups of illness which could have been avoided. Others have had their discharge delayed because of inadequate home support. So hospital beds have been tied up, affecting other patients too.
Social security cuts and sanctions, policies stoking up housing costs and reduced access to legal aid have caused stress, and sometimes physical harm, to many on low incomes. If even a small proportion have landed up in hospital, this will have worsened the crisis.
So will the surge of hostility to ‘foreigners’ resulting from politicians’ power games. Hospitals have been pressured in many instances to check eligibility for treatment, not only affecting patients but also tying up precious staff time. And non-British or minority ethnic staff have been left demoralised, driven away or even refused visas , however desperately needed.
Saving lives and rebuilding the NHS
Tackling the immediate crisis may require the building of cross-party alliances among those opposed to the most damaging policies and seeking to win over the uncommitted. Anger at the state of the NHS is understandable but directing this against ordinary people with the ‘wrong’ views will not help.
At the same time, if the health service is to be rebuilt, challenging harmful ideology is also important. This includes the notion that practically everything in the world should be for profit and the rich deserve even greater rewards. In reality health gains are often dependent on the generosity of nature or God for raw materials and collective human effort. Solidarity and mutual care matter too, which may involve questioning prejudice such as the notion that some chronically ill people are ‘unproductive’ and should be written off.
Faith-based and other community organisations and networks may offer valuable opportunities for sharing information and talking about values. The NHS crisis is a reminder of the need to put protecting humanity above profit and power for a few.
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© Savitri Hensman is an Ekklesia associate and respected commentator on welfare and other issues. She is author of the book Sexuality, struggle and saintliness: same-sex love and the church (Ekklesia, 2016): http://www.ekklesia.co.uk/node/22613 and has been involved in seeking greater inclusion. She wrote on ‘Health or Wealth?’ in Feast or Famine? (http://dltbooks.com/titles/2195-9780232532616-feast-or-famine)