“Our NHS, Our Future”

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Professor Darzi’s Review of the NHS:
“Our NHS, Our Future”

Gordon Brown’s government has ordered another review of the NHS. Review after review has been ordered, a so-called Citizens Jury has met to discuss the health service, yet the direction in which the government is taking the health service is not presented for the people to discuss and take control of.

In this latest move, Alan Johnson, Secretary of State for Health, announced in July that Professor Sir Ara Darzi would carry out a wide ranging review of the NHS titled Our NHS, Our Future. Professor Darzi will complete an initial assessment in October "to inform the Comprehensive Spending Review" and will produce his full report in January 2008. "At the end of the review, consideration will be given to the case for a new NHS constitution."

Before considering this review, it is worth reflecting on the governments 10-year NHS Plan published on July 1, 2000. This plan promised by 2010 investment in the NHS to create

• 7,000 extra beds in hospitals and intermediate care
• over 100 new hospitals by 2010 and 500 new one-stop primary care centres
• over 3,000 GP premises modernised and 250 new scanners
• clean wards – overseen by "modern matrons" – and better hospital food
• modern IT systems in every hospital and GP surgery…and investment in staff:
• 7,500 more consultants and 2,000 more GPs
• 20,000 extra nurses and 6,500 extra therapists
• 1,000 more medical school places childcare support for NHS staff with 100 on-site nurseries.

One could be forgiven for at least hoping that the government had called in Professor Darzi to ensure that the 10-year NHS plan that was supposed to be the centrepiece of its health policy was being implemented. As all over the country NHS organisations are shedding thousands of nurses, doctors and other health workers either through direct redundancies, or through not replacing vacancies as the government imposes its "deficit" financing on the NHS to force the NHS to "balance its books". A plan by the NHS Health Authorities to close around 50 District General Hospitals is also being vigorously opposed by the people up and down the country.

Yet the main theme of the government Darzi review Our NHS, Our Future is "improving quality and safety, extending access and reducing inequalities", creating "clinical pathway groups", "patient and public consultation" and "staff engagement" and at the end of the review a "new constitution"! What is the aim? The opposition to the anti-social offensive in health and the privatisation of health care is growing into a powerful movement. This is so amongst health workers, as well as amongst professionals and the public who have a right to the health care they require. In the review government is trying to create the impression that its "listening events" and "staff engagement meetings" and feed back on its website demonstrates that it is not " top down" driven. But the review is a closed book and regional events are carefully screened and by invitation only.

Neither is there any doubt that the review is a fraud and that its conclusions have already been decided. In fact, this is why Professor Darzi was picked to do the review in the first place. He has already set out his blueprint for London’s future healthcare in a report A Framework for Action which continues with the government’s agenda of claiming to provide more care in community services as an excuse to close many London hospitals. This has led to huge anger and opposition from the people of London, yet the government is pressing ahead with these closures as if they were being sanctioned by the people via Professor Darzi’s report.

All over the country these attacks on the NHS are meeting with resistance in one way or another. But it is extremely difficult to respond when caring for patients and when constant changes are being made that attack jobs, terms and conditions. A situation which is made worse by the reviews and "consultations" designed to give the appearance of involvement of the staff in decisions.

Whose is the "Our" in the title of the review? Under Gordon Brown the identification of the government with the people as a whole is being stepped up, a rosy picture is being painted of government and people working joyfully together. This cannot be allowed to go unchallenged, and the struggles of the people to defend what is in the public good is evidence that the people do not accept this parcelling together of government and people into "Our". There are very serious issues which demand being addressed in a plan designed to produce a "new constitution" for the NHS. It is not a matter of some "deep clean" of hospitals, or of consultation when some other force on high has already decided on the agenda and the parameters for discussion. Why should the parameters of the NHS being "based less on central direction" be accepted? What is the issue with patients being offered "choices"? Is it even true that the direction of the NHS is one of being based less on "central direction"? Is not the government determining the NHS budget and forcing trusts and health authorities to jump through hoops to ensure that the budget is adhered to? If the people are deciding that the health service should not be handed over to private capital, where is the "choice" if the government declares the opposite? The issue of the right to health care is not one of being more "discerning as consumers", as Alan Johnson declares. It is that health is a most precious asset to the individual and society. It is a mark of a humane society that it not only cares for the ill and vulnerable but that the well-being of all is guaranteed, that health care is part of the very fabric of society. That is why people are so outraged by the monopolies and private capital benefiting from the provision of health care, where equality of treatment is just a mealy-mouthed phrase and not a reality.

Health workers should not become overwhelmed by this present situation but put their energy into discussing, planning and organising to take hold of the decision-making power so that they can shape the type of health care service that they require. In answering the question of whose NHS? the working class and people declare that it does not belong to the monopolies and businessmen but to health workers and the working class and people. It is our NHS and it is we who should decide and we should step up this fight to safeguard the future of the NHS.

Whose NHS? Our NHS!

Who Decides? We Decide!