{"id":70552,"date":"2023-06-25T14:07:34","date_gmt":"2023-06-25T13:07:34","guid":{"rendered":"https:\/\/www.taxresearch.org.uk\/Blog\/?p=70552"},"modified":"2023-06-25T14:07:34","modified_gmt":"2023-06-25T13:07:34","slug":"critical-why-the-nhs-is-being-betrayed-and-how-we-can-fight-for-it","status":"publish","type":"post","link":"https:\/\/www.taxresearch.org.uk\/Blog\/2023\/06\/25\/critical-why-the-nhs-is-being-betrayed-and-how-we-can-fight-for-it\/","title":{"rendered":"Critical: Why the NHS is being betrayed and how we can fight for it"},"content":{"rendered":"

Some readers of this blog will be familiar with the work of Dr Julia Grace Patterson<\/a> and the Every Doctor UK<\/a> organisation she leads. It has had a strong campaigning presence on Twitter for some time. \u00a0 I have supported her campaigning work that seeks to restore the NHS as we once knew it not so long ago. Now, Julia has written a book about that campaign entitled \u2018Critical: Why the NHS is being betrayed and how we can fight for it.<\/p>\n

\"\"<\/p>\n

The book is well-written, flows well, and is a good read. I have to stress the importance of that: I am struggling to read far too many turgid books at the moment, however worthy their authors and the issues that they espouse. This book does not suffer in that way.<\/p>\n

That said, if you are familiar with the failings of the NHS (and I am) you will not learn much that is new from this book. Although it is clearly researched and referenced, I am not sure it breaks new ground with any of the information that it has to tell.<\/p>\n

However, I am not sure that is the purpose of the book. That purpose is to deliver a narrative in five parts. The first deals with the promise of the NHS, which few doubted was being honoured by politicians until 2010, although Labour\u2019s disastrous flirtation with the Private Finance Initiative and its consequences are rightly addressed, as was its failure to create a single IT system for the NHS.<\/p>\n

Patterson then tells of the political betrayal of the NHS by the Tories since 2010. She has the data. She has researched the changing narratives of successive health secretaries, and what she says are three things. The first is that the Tories do not believe in the NHS. They evidence that by, secondly, denying it funds. And third, they have organised effectively to support this active undermining of the NHS.<\/p>\n

The method that they have used to achieve their aim has been the ever-greater fragmentation of the NHS. This has undermined its effectiveness whilst opening it up to progressive privatisation by ever more outsourcing, even though there is strong evidence that this does not result in better clinical outcomes, even when the outsourcers can (and do) cherry-pick the easiest cases.<\/p>\n

The impact is obvious, and has got progressively worse. The NHS was not ring-fenced sufficiently during austerity to provide it with the funds it needs. Excess funds have flowed from it to the private sector, including via PFI. Real pay has been cut. Required investment has not taken place. Morale and service quality have crumbled. Staff have left and are not being replaced. The refusal to pay wages appropriate to the tasks demanded has resulted in ten per cent understaffing. A vicious downward cycle has resulted. The private healthcare sector is far too small to pick up the slack in any meaningful way. And so we have 7.4 million people waiting for care right now, although the delays they are suffering, like everything else in this approach to healthcare management, is just a statistic and not a tale of human stress, pain and suffering in the eyes of Tory politicians.<\/p>\n

So, Julia Patterson argues that we need a better NHS. Or rather, she argues that we need the NHS we were promised. That would be state run, properly staffed by personnel on fair pay and with manageable stress levels, working systematically to provide universal healthcare at lowest possible cost. It\u2019s hard to disagree.<\/p>\n

But then the problem is encountered. There is no description as to how this will be delivered. The absence of an economic argument is the weakness in the book. What needs to change in the structures of power, the thinking of politicians in all leading parties, and the economy at large so that we can actually attribute value to something as fundamental as healthcare for all are issues that are not addressed. I am left feeling this is a campaign without a solution to offer as a result, and I have only ever worked on solution focussed campaigns in my career.<\/p>\n

I also note that it leaves the arguments in the book open to attack. Former Labour health secretary Alan Johnson reviewed the book<\/a> recently for the Guardian alongside one by pro-Tor Isobel Hardman. He praised pro-privatisation (or perhaps more correctly, privatisation denier) Hardman and damned the pro-state line Patterson promotes. His suggestion was Patterson \u2018better go to Specsavers\u2019 to understand the value of private care.<\/p>\n

Johnson accurately reflects the modern Labour Party and the mountain that those who believe in the NHS have to climb when that party is now part of the problem that the NHS faces and appears to offer no solution to its issues. An economic argument would make the difference. Maybe that should come next, but despite that I still recommend this book to those interested in saving the NHS: it is an invaluable sourcebook and call to arms.<\/p>\n","protected":false},"excerpt":{"rendered":"

Some readers of this blog will be familiar with the work of Dr Julia Grace Patterson and the Every Doctor UK organisation she leads. It
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