KONP Statement: To tackle Coronavirus we need an NHS for all

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Keep Our NHS Public believes that the damaging impact on the NHS of failed policies for the last ten years is a damning indictment of the decade of Conservative Government. This has undermined the ability of the NHS to respond to COVID-19 at the threshold of pandemic. A return to the founding principles of an NHS for all - embodied in the vision laid out by Nye Bevan in ‘In Place of Fear’ - would immediately strengthen our response to the COVID-19 threat.

As fear sets in about the spread of this coronavirus, the weakest points in the protection that the NHS and other public services offer exactly mirror the most ignorant, vindictive and ideological of the policies of our political leaders. These include the slashing of social care and - how irresponsible? - the severe cuts to the very public health services the country are now relying on. And it is a certainty as coronavirus spreads in Britain that the hardest hit will be among the working class, the poorest, the most vulnerable sections of society - including migrants excluded from free NHS care, the elderly, the disadvantaged and disabled.

The principles of a national health service - free at the point of use, available according to need, publicly funded and provided - are not only morally correct: they enable society to respect the universal right to healthcare, to share risks, to protect everyone without exception against contagious diseases - and by doing so they protect society as a whole. Those principles have never been needed more as we face the potential consequences of COVID-19.

End the charging of undocumented residents, including migrants, now and we take a giant step forward both for public health and humanity. This would restore universal access to the NHS. End outsourcing of NHS contracts, zero hours and insecurity for those staff placed outside the NHS and we enable the NHS to re-prioritise public service and publicly provided care. Commit to real funding increases to allow full staffing and restoration of bed losses and we will restore morale amongst our 1.5 million NHS staff.

A return to these principles, alongside a restoration of real-terms full funding plus funding to repair deficit damage, will guarantee that the NHS is the most efficient and effective health service once again. The people served by the NHS will then be the safest and best cared for - be they faced with coronavirus, giving birth or coping with any other health challenge.

Health and social care face severe challenges

Writing in the Independent, our co-chair of KONP and retired doctor, John Puntis said:

The UK appears woefully unprepared for coronavirus. The NHS is already in bad shape, with the worst ever A&E waiting times, over 95% bed occupancy, 100,000 staff vacancies … the worst-case scenario [would forecast] up to 50 million infections and up to 250,000 deaths in the UK alone ... [There] can be little doubt that both health and social care services will be severely challenged by even a modest intensification of the outbreak.

Senior NHS bosses are warning that the service will struggle if COVID-19 takes hold in Britain, while the Government’s strategy to deal with the catastrophic staff shortage it has created includes the ill-thought-through suggestion that a ‘Dad’s Army’ of retired health workers are being prepped to step into the breach if the virus breaks. Unsurprisingly, the BMA have questioned the wisdom of drafting in older people to tackle a virus to which older people are far more vulnerable.

Currently, there has been no underwriting with added funding from Government or NHS England for CCGs, ambulance, hospital and community trusts facing inevitable spiralling of costs for drugs and other treatments - when grossly underfunded trusts are already held to be £14 billion 'in debt'.

It is the Government's existing policies that have done the most harm in undermining the robustness of the public health system, NHS and social care services that the country rely on more than ever at this time.

Government’s ‘Hostile Environment’ threatens the safety of excluded individuals and the whole population

If Boris Johnson and Matt Hancock were serious about taking every measure to contain COVID-19 and to minimise the deaths and damage from serious illness, they would reverse the Government’s legislation of 2015 and 2017 NOW. This threatens the undocumented patient with not only unaffordable bills but, crucially, fear of deportation - prohibitively dangerous barriers for those needing to make a choice whether they can safely access the NHS. The coronavirus makes it essential that everyone with possible exposure can access the NHS promptly. However, it is well reported that fears about status and charges on patients unable to prove their entitlement to free NHS care have a known deterrent effect. Undocumented patients may avoid contact with the healthcare system for fear of debt or adverse impact on their immigration status, even where GP advice and A&E urgent care treatment are in fact free.

The Academy of Medical Royal Colleges agreed last year when they said:

Research from Doctors of the World demonstrates that 1 in 5 of their service users were affected by healthcare charging, and 1 in 3 of those were deterred from seeking timely healthcare. Maternity Action also demonstrates the detrimental effects of charging on mothers and children during and after pregnancy in a recent report.

The shocking reality is that 600,000 people - including 120,000 children - are denied free NHS treatment because of their immigration status.

A ‘lost decade’ of austerity policies will mean working people are more vulnerable than ever

Professor Michael Marmot has recently highlighted once again how the 'social determinants of health' are a vital part of inequality. As we enter the stage of a large-scale coronavirus outbreak, it is the poorest paid workers who will be hit hardest. Boris Johnson has been forced to concede that workers who take sick leave will be paid statutory sick pay from the first day of that leave, rather than Day 4 (this is a mere £94.25 per week). But this does not address the problem faced by nearly 2 million people who do not earn enough to receive statutory sick pay.

In addition, there are millions who simplify don’t qualify regardless of how much they earn: by 2020, the gig economy has seen a doubling to 4.7 million of workers without pension protection, a living wage or rights to statutory sick pay.

Added to this, 320,000 people are homeless in the UK with no secure access to safe cooking, heating or clean water.

Trades Union Congress General Secretary Frances O’Grady has called for sick pay for all workers:

Employers have a duty of care to support workers affected by coronavirus. No one should have to worry about making ends meet if they have to self-isolate or if they fall ill. They should be able to focus on getting better. The threat of coronavirus shows why sick pay should be a day one right for everybody. It’s unacceptable that millions of UK workers miss out on this protection. The Government must ensure everyone gets statutory sick pay, however much they earn.

KONP also support the Socialist Health Association’s statement on the right to sick pay:

The SHA strongly supports the view of the TUC and urges that this scheme is extended to those on ‘self-employment’ contracts – part of the 3 million plus 'Gig economy'. We would argue further that employers should make up SSP to the average pay of workers to ensure they are under absolutely no financial pressure to attend work while they are unwell and may inadvertently pass on the disease.

Should the coronavirus outbreak spread significantly everyone will be expected to respond putting the interests of the community first. Undoubtedly workers will volunteer long hours and take on exceptional responsibilities. This will increase the risk of errors which will need to be balanced against the risk of failure to treat patients in a mass outbreak. We urge professional bodies to be aware of this.

The SHA congratulates trade union and Labour leaders for engaging with the government and employers and instructs our incoming leadership to move very rapidly to promote this position through forceful lobbying, online petitions and other appropriate means.

In place of fear - we need an NHS for all now

In contrast to the callousness of our present Government, Nye Bevan argued for compassionate state investment in the fight against contagious diseases. In his 1952 ‘In Place of Fear’ pamphlet he said:

[Contagious diseases] are kept at bay by the constant war society is waging in the form of collective action conducted by men and women who are paid fixed salaries. Neither payment by results nor the profit motive are relevant. It would be a fanatical supporter of the competitive society who asserted that the work done in the field of preventive medicine shows the enslavement of the individual to what has come to be described in the United States as ‘statism’ and is therefore to be deplored.

We call for an ‘NHS without fear -an NHS for all.’

Our demands

These are fundamental demands that would immediately and materially protect millions of our population and would instantly aid the NHS in controlling the spread of Covid-19 in the UK. The measures would also deliver a safer, more just society.

End NHS charging of migrants – end this injustice and restore faith in the NHS
Give legal rights to paid sick leave from Day 1 (beyond statutory £94 per week sick pay)
End enforced ‘self-employment’ in the gig economy – restore right to paid sick leave, annual leave and work pensions
Provide emergency accommodation for all street sleepers and access to health care

When crisis hits, it will predictably be community activists, trade unions and campaigners, not our current political leaders who will step up and help those most in need. Make sure you join your union if you can.