While Labour made some positive manifesto commitments to the NHS after almost a year there are now serious concerns about whether these will ever amount to a restoration of the service based on its founding principles.
Fears for campaigners include:
◼︎the failure to acknowledge that the huge and growing waiting lists, together with difficulty accessing care, causally relate to underfunding
◼︎investment in the private sector at the expense of the NHS. Labour Lord Prem Sikka for example has talked of his party’s general election victory being built on corporate patronage
◼︎ a new period of austerity with cuts to public services , disability and welfare payments
WHAT YOU CAN DO
Write a letter to your local constituency MP and ask them to tell Wes Streeting to change course on the NHS.
Please feel free to use your own words to adapt the following letter:
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If you don’t know who your local MP is you can find out here.
NEW 2 PAGE LEAFLET
Underfunding, re-disorganisation and privatisation will not save the NHS
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Labour’s current approach to the NHS is failing to address problems with urgent care, has only a marginal impact on waiting lists, and is falling far short of what it promised. Labour is embracing the private sector, with no mandate from the public or NHS staff. The collapse of the NHS model is a real possibility, unless those who use it and those who work in it, stand up and fight for it.
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The series of articles below from KONP, JOhn Puntis, Greg Dropkin, and the KONP Integrated Care System Working Group look at what is happening in the NHS under the guiding hands of Secretary of State, Wes Streeting, and Chancellor, Rachel Reeves.
Underfunding, re-disorganisation and privatisation will not save the NHS – time for Labour to rethink
John Puntis
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In this article originally written for Doctors in Unite KONP Co-Chair John Puntis discusses how Labour In its manifesto, promised to recover services and ‘transform’ the NHS to make it ‘fit for the future’. A 10-year plan (to be informed by Lord Darzi’s report) is under preparation to tell us how this could be achieved, including shifts in services towards more community-based care, prevention of ill health and use of digital technology. Labour now claims to be making progress with restoring the NHS, yet after almost one year in office, improvements to date suggest much more needs to be done. Furthermore, a far-reaching reorganisation including the abolition of NHS England is being carried out in advance of the 10-year plan even being published. There is little so far to reassure the public that Labour has a grip on the crisis in health care, and some are speculating that the 10-year plan when eventually it does appear will ignore the system failures requiring urgent attention.
‘ACOs’: a taboo term is back on the NHS agenda
Greg Dropkin
In this article Greg Dropkin writes that seven years ago NHS England (NHSE) made a sudden about turn in its march towards the US system of healthcare finance, known as “Accountable Care”. Sustainability and Transformation Partnerships, the 42 semi-autonomous bodies introduced by NHSE in its first attempt to fragment the national NHS, were intended to evolve into Accountable Care Organisations (ACOs). Some campaigners and unions spotted the dangers in moving towards the US model, and in response in January 2018 NHSE declared that “Accountable Care Systems” would now be called “Integrated Care Systems”, with no change to the concept, policy, or implementation.
Accountable Care dropped out of sight. The Health and Care Act 2022 finally gave a legal basis for “Integrated Care Systems”. During the lengthy Parliamentary debate on the Bill, countless speeches praised “integrated care”. Accountable care was mentioned just twice, and only Margaret Greenwood MP connected the phrase with America.
Now, just as NHSE is facing abolition, its transitional CEO Jim Mackey has openly declared he supports the concept of ACOs. By reviving a taboo term, Streeting’s team is showing confidence that its long-term strategy for NHS privatisation, harking back to the Blair-Brown era with many former ministers and advisors now back in post, can be implemented without disguise. But what are ACOs, what happened the first time round, why is the concept back again now, and how does this relate to Labour’s agenda?
NHS England abolished as Starmer and Streeting take ‘control’
Only days after Wes Streeting announced there would be massive cuts in NHS England’s (NHSE) workforce – halved from 13,000 to 6,500 to avoid ‘duplication’ of work by officials at the Department of Health and Social Care (DHSC) – the prime minister Keir Starmer declared on 13 March that NHSE will be entirely abolished.
This was justified on the spurious grounds of a ‘cut to bureaucracy’ and bringing management of the health service ‘back into democratic control’. But what does this mean for the future of the NHS, and is it anything other than more disruptive restructuring (albeit with a populist spin), in the middle of a major NHS crisis?
NHS Consultation: KONP’s response December 2024
KONP’s response to the Public Consultation on the NHS and ‘The 10-Year Health Plan for England’ submitted 2 December 2024
We were founded in 2005 with the aim of preserving the National Health Service in England and campaigning against privatisation of the NHS estate and equipment and clinical and NHS support services.
Darzi Report – will the Government write the wrong prescription
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KONP responded immediately when, following nine weeks of reviewing data, Lord Darzi published his report ‘Independent Investigation of the National Health Service in England’. His conclusions focused on patient access, quality of care and the overall performance of the health system. Not surprisingly, his findings on the state of the NHS (summarised in our response) reflect those of health campaigners that have persistently highlighted the deteriorating state of the NHS for many years.
Darzi report – a fig leaf for Labour
Greg Dropkin
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In this article Greg Dropkin takes a deeper look at Lord Darzi’s ‘Independent Investigation of the National Health Service in England’, calling it ‘a double- edged sword’. Yes, it is a no-holds-barred look at how the NHS is failing to deliver in line with what the public rightly expects from their health service. Darzi’s report provides uncompromising evidence that these problems cannot be resolved without ending Austerity and refunding the NHS to the level required. KONP summarised those aspects, which echo other recent analyses of a NHS under severe stress, when Darzi’s report was published on 11 September.
At the same time, Darzi rewrites NHS history, omits a key founding principle of the NHS, does not oppose privatisation, is silent on a major current controversy, and sets the stage for Labour’s intended “reforms”. For those reasons, Darzi’s approach is both deficient and dangerous.
What do we know about Wes Streeting?
This article explores possible influences on Streeting’s thinking by referencing his background in politics and focusing on his registered interests. This includes an investigation into where his donations (mainly, but not exclusively, ‘towards costs of office staff’ – are these not paid by Parliament? – come from.
Under the banner of the Fourth Industrial Revolution (cloud technology, artificial intelligence, automation, advanced engineering, etc.), his enthusiasm for innovation and technology as an answer to the problems of the NHS are also touched upon. One of Streeting’s mentors, Patricia Hewitt, quickly asserted that his claim the NHS is broken was an acknowledgement that both the model of care is broken, and a change to the model of funding is needed. Since he plans to prescribe treatment on the basis of Lord Darzi delivering a diagnosis for the ills of the service, can we expect this to be evidence-based?
Using the private sector to help the NHS – is Labour intent on repeating the mistakes of the past
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This article examines Labour’s past experience with using the private sector to support the NHS, to see what lessons should have been learned. Through his ‘concordat’, Alan Milburn first encouraged referral of simple NHS non-urgent cases to the private sector, but went on to oversee outsourcing of diagnostics together with interventions performed in Independent Sector Treatment Centres (ISTC). It was claimed that the latter would increase NHS non-urgent capacity and reduce waiting lists and times, reduce charges in the private sector, increase patient choice within the NHS, encourage best practice and innovation, and stimulate reform within the NHS through competition. In fact, ISTC proved to be expensive, and a subsequent investigation by the Commons Health Select Committee showed little evidence of increased capacity or of overall benefit to patients or the NHS. They did, however, succeed in embedding a number of private companies within the NHS where they remain to this day. Rather than learning from this experience, Streeting seems bent on repeating such mistakes, despite being alerted that growing the private sector might bring about the very thing he has warned against – the NHS becoming ‘a poor service for poor people’.
Alan Milburn and the Labour agenda for the NHS
This paper deals with the re-emergence of Alan Milburn on the health policy scene. Milburn was central to New Labour’s reform of the NHS and now appears to be an influential voice once again. When Secretary of State for Health in the Blair government, Milburn argued that the founding model of the NHS was out of date. He extended the scope of outsourcing and sought to establish a market in health care. The Private Finance Initiative was promoted on the basis it would offer savings and deliver value for money. Foundation Trusts were introduced to give greater independence to hospitals, exposing them to the risk of bankruptcy. After resigning in 2003, Milburn took a post with Bridgepoint Capital before joining the accountancy firm PricewaterhouseCoopers (PwC). He chaired Steering Groups and wrote introductions for PwC reports foreshadowing Integrated Care Systems, redesigning funding flows to benefit “the system”, and increasing reliance on big data and digital techniques provided by US corporations. He continued to advocate for reform of the NHS and shares an enthusiasm with Streeting for technology and innovation, envisaging and welcoming greater reliance on big business.
Judging by the words of their chosen advisors and the Secretary of State, Labour’s agenda for the NHS is to continue the privatisation programme begun by Thatcher and developed further by Blair, and successive Tory governments. All this calls into question whether Labour has the right advisors and the right (evidence-based) policies for the NHS. As John Lister has pointed out: “Rather than repeating the errors of 20 years ago, Labour should show real courage, and follow the examples of Attlee and Bevan who built the NHS – and raised the money to pay for it – rather than Alan Milburn, and Paul Corrigan who wasted millions trying to turn the NHS into a market”.
The Tony Blair Institute, AI and the future of the NHS
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Tony Blair has frequent talks with the new Prime Minister, although he says he is not directly advising him. Others claim that Starmer is increasingly turning to Blair as an unofficial source of advice. Blair’s stance (arguably New Labour on steroids) may be gleaned from the policy unit of the Tony Blair Institute (TBI). This article examines the Tony Blair Institute in greater depth.