A depressing milestone was reached last week in the unravelling of the NHS. The regulator of Foundation Trusts announced that over a half of hospitals in England now have ‘foundation status’. The Guardian report is here.
We now have 112 hospitals that are still part of the NHS, subject to planning, control and regulation. We have 113 hospitals that are run as small businesses, that – so long as they are financially viable – can do whatever the hell they like. A majority of the remaining NHS hospitals are likely to follow in their footsteps. William Moyes, in charge of regulating Foundation Trusts, boasted that by 2011 or 2012, the whole hospital system could be outside ministerial control.
Is this sensible? No, of course not. Simple commonsense dictates that the provision of healthcare should be on a planned basis. We should work out how many people are likely to need, for example, hip replacements; ensure resources are allocated to the right geographical areas; plan the workforce to ensure we have enough surgeons, nurses, physiotherapists and so on – and do the same for across the whole health and public health agenda. Alternatively, we close our eyes, cross our fingers, and hope that the market will provide.
A concrete example of the absolute idiocy of deregulating the hospital system came last year. The Department of Health, sensibly enough, decided that every hospital should undertake a ‘deep clean’ to reduce the incidence of hospital acquired infections. Even better if they’d insisted on hospital cleaning being taken back in house, and provided the resources to enable a reduction in bed occupancy rates – but still a deep clean exercise was the right thing to do. Monitor, on behalf of Foundation Trusts, reacted with fury. Apparently it is now against the law for an elected Government, or for the Department of Health on behalf of an elected Government, to tell Foundation Trust hospitals what to do! Where’s the accountability in that? The priority for Foundation Trusts is their financial viability – that, and only that, will dictate the care available to patients. Stark, raving bonkers.
Aneurin Bevan, the driving force behind the NHS 60 years ago, once said, “A free health service is pure socialism”. There was a large element of truth in this. The NHS was created only in order to meet the needs of human beings. Profit and competition and market forces didn’t come into the equation. That’s why the Tories were so hostile to the NHS back in 1948. Sadly, that’s maybe also why Brown’s Labour Government is intent on dismantling the NHS in 2008.