Workers' Weekly On-Line
Volume 53 Number 25, August 19, 2023 ARCHIVE HOME JBCENTRE SUBSCRIBE

The Integrated Care System and the Elective Recovery Taskforce

Further Distancing Decisions from the People on Health Care Intensifies the Crisis

Keep Our NHS Public (KONP) Protest in Birmingham

Mass opposition to the Health and Care Act 2022 [1] which was imposed by the government and given the Royal Assent in April 2022 continues to this day. The Act applies to England, but regulations made by Welsh Ministers bring the Act into force in Wales also. Scotland's NHS remains a separate body from the other public health systems in the UK.

The so-called Integrated Care System (ICS), which was heralded by the Westminster government, further distanced decision-making from local communities. It was seen then and now by community campaigns as a desperate attempt by government to push the interests of a US-style dominated privatised health care system even further in England by making decisions far away from their communities by unelected and remote Integrated Care Boards (ICBs) and sub-committees under government control. Yet 18 months later, the publication on August 4 of the long-awaited report of Rishi Sunak's 17-strong "Elective recovery taskforce: implementation plan" [2] is another example of the government's complete failure with this corporate-led ICS system to solve the deepening crisis in the NHS. It does not bode well for yet another dangerous escalation of the crisis this coming winter.

There is no surprise that the focus of the report is on ways of maximising the use of private hospitals and of getting private providers to run new Community and Hospital Diagnostic Centres. This is the whole direction that the ICS was set up to increasingly implement. The taskforce plan is backed by no extra funding at all for the NHS and is simply diverting more existing NHS funds into contracts with the "independent sector". Yet this sector's accomplishments are small scale and of little scope viewed in terms of what is needed to resolve the crisis in the NHS.

The main headlines on the report were grabbed by the announcement of 13 new "community diagnostic centres" (CDCs), eight of which are to be run by the private sector. Five of these in the South West (on permanent sites in Redruth, Bristol, Torbay, Yeovil and Weston-Super-Mare) are to be run by one company, In Health, which hit headlines back in 2019 when they landed a controversial 7-year contract to provider PET scan services in Oxfordshire. They also run a CT scanner in Sunderland. Alliance Medical runs a PET scanner and other scanners in South Tyneside in rivalry to the NHS scanning service. However, disgraceful and scandalous that it is that NHS funds get diverted to make profits for these private companies, unless the government invests in the state sector this can never be a solution to the crisis in the NHS.

The new CDCs announced case studies which show that "currently over 200 Independent Sector Providers (ISPs) provide over 10,000 diagnostic procedures per week to the NHS". Yet this is a tiny figure when compared to the "479,000 diagnostic tests and procedures the NHS delivers every day". And, on the recommendation to use private beds, the data so far underlines what a minor and insignificant role the private sector has played in delivering such patient care. This while they make huge profits and charge more with payments diverted from public health care. In fact, the data shows that in the year to April 4, 2023, private hospitals treated just 105,000 NHS-funded elective in-patients and 650,000 day cases, and delivered 665,000 diagnostic tests and procedures. By contrast England's NHS in the most recent statistics (2021-22) treated 7.9 million elective in-patients, 6.8 million day cases, 6.2 million in-patient emergencies and 17 million diagnostic tests.

Protest outside South Tyneside Hospital against the closure of the midwife-led birthing unit in 2022

One of the 17 members of the "taskforce" was Independent Healthcare Provider Network (IHPN) boss David Hare. The Lowdown, a publication linked to Health Campaigns Together, and written by HCT campaigner John Lister comments; "In an article on the 75th Anniversary of the NHS [IHPN boss David Hare] tried to justify a greater role for the private sector. But he admitted (as the Lowdown has shown from ICB Board papers) many NHS managers, facing tight financial constraints, have been looking for ways to reduce rather than increase their reliance on the private sector".

John Lister quotes Hare where he complains that; "IHPN recently conducted a survey among our members, looking at engagement with the NHS planning process for 2023/24. 60% of respondents reported being asked by their local NHS to do the same or less activity as in 2022/23."

Hare goes on: "I understand the reasons. Of course it's understandable that NHS trusts - themselves under extraordinary financial pressures - want to retain work. However, we also need to ask - with 7.4m people on the waiting list - and with more than 300,000 people having waited more than a year - are we pulling out all the stops? Are we doing everything we possibly can?"

John Lister comments that; "Mr Hare, of course, wants us to ignore the costs and consequences of NHS reliance on private hospitals:

"In other words using apparently "empty" or "spare" capacity from the private sector not only lines the pockets of their shareholders, but comes at a heavy price to the NHS."

He concludes; "The most logical and efficient way to expand capacity in health care in England is to expand the NHS, not divert vital resources, staff and funding, into small-scale, profit-seeking private businesses." [emphasis in original]

Thus the opposition of health workers, their trade unions and health campaigns is about speaking out and continuing to expose this fraudulent direction for the NHS and social care in Britain, which is only aimed at paying the rich. The call of the times is for people to speak out everywhere for the new. Everyone must gain the confidence to speak out and take a stand against their own unethical governments on health matters as well as on everything to do with the health and well-being of the people. People must empower themselves, especially health workers when it comes to the NHS, and recognise that to do so is part of bringing about a new situation.

Emphasising this point, in an interview with Nursing Times on August 1 [4], the chief nursing officer of the World Health Organisation (WHO), Dr Amelia Latu Afuhaamango Tuipulotu, called on national governments to listen to the voice of nurses, amid the pay disputes that are currently taking place across the globe. She explained that now was the right time "for empowerment, recognition, value and respect for nurses and midwives". She spoke about WHO's warnings that many high-income countries, including the UK, continue to fill vacancies with nurses from countries on the red listwhere active recruitment should not be used. Currently, the WHO has a red list comprising 55 countries that have been identified as facing the most pressing workforce shortages and should, therefore, not be targeted for systematic recruitment by international employers. She added: "If our actions are unethical, which may solve a short-term problem for now, it will not be the best solution for us in the long term."

The government's further distancing of decisions from the people on health care is only intensifying the crisis. People require new public health authorities which are human-centred. These must be new democratic authorities that involve health staff and the people in the communities that they serve in speaking directly about their requirements for health and social care services and participate in making the decisions. Such a direction for society must be to fully fund a public health and social care system that is free to all humans as of right regardless of any other consideration. For example, the latest inhuman treatment of charging immigrants and visitors to England must stop, as all residents in the country should have access regardless of their citizenship status. Health and social care is a human right in a modern society and must be upheld by all.

1. "Health Care Bill: Imposing the Path of Privatisation and Cronyism in the NHS" Workers' Weekly, April 16, 2022
2. Elective recovery taskforce: implementation plan. The Task force was set up with great fanfare by the Prime Minister, Rishi Sunak at Downing Street in December 2022 to solve the backlog of operations. The report itself has been delayed and only published on August 9, 2023.
3. "Task force packed with privateers backs outsourcing plan for NHS recovery" The Lowdown August 9, 2023
4. "WHO chief nurse urges governments to 'listen to nurses'" Nursing Times, August 1, 2023


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