Dr Philippa Whitford October 2019

My Vision for the NHS – Why Healthcare should be free from markets, outsourcing and austerity

Healthcare should be free from markets, outsourcing and austerity

Health policy has been devolved to the Scottish Parliament since 1999 with the exception of a few areas such as drug licensing. Since then, there has been a significant divergence in the direction of travel between the different National Health Services across the UK, particularly between NHS Scotland and NHS England. Scotland currently spends 9% more per head on health and social care than any other UK nation and, while funding is not always the answer to NHS pressures, underfunding can create inefficiencies. The most significant difference is that NHS Scotland has maintained its unified, public structure, having abandoned the ‘internal market’ after devolution. Hospital and community services are run by area Health Boards which are now working with Local Authorities on the challenge of integrating health and social care.

In contrast, outsourcing under the Health and Social Care Act 2012 (HSCA) has fragmented the English system, replacing collaboration with competition. The contracting and transactional costs of this market waste billions of pounds every year and, along with Labour’s PFI legacy, have sucked funding from frontline services and driven NHS Trusts into debt: leading to the closure of beds, A&E departments and even hospitals. This has caused a marked decline in Emergency Care, with performance against the 4-hour A&E target consistently lagging 9-10% behind that of NHS Scotland. Similarly, the drastic reduction in hospital beds in England has led to patients lying on trolleys in corridors for many hours.

Due to financial pressures, common operations such as joint replacements and cataract surgery are being rationed by setting, what the Royal Colleges consider to be, unjustifiably high symptom thresholds. However, patients who are refused, can pay for treatment through the NHS ‘My Choice’ system as the HSCA now allows NHS hospitals to make up to 49% of their income from paying patients. Not only is this creating a two-tier health system in England but undermining the basic premise of the NHS which is based on NEED. If the patient needs an operation, the NHS should provide it without charge: if they do not, it should not be sold to them simply to generate hospital income! This is why I, and my SNP colleagues, support reform of the Health and Social Care Act.

To read the article in full go to http://bright-green.org/…/healthcare-should-be-free-from-m…/