Even as the bill dismantling the health service completes its journey into law, older people in care homes have already been abandoned in a foretaste of what’s to come.
There are 376,250 older people living in 10,331 care homes in England and many are frail and vulnerable, with more health needs than most of the population. Around 40% have dementia, many are on cocktails of medication, and the average lifespan in a care home is one to two years.
The residents needed a whole range of medical services, including mental health teams, dietetics, occupational therapy, physiotherapy, podiatry, continence, falls and tissue viability (dealing with wounds, pressure sores and ulcers). Yet only four out of ten soon-to-be abolished primary care trusts (PCTs) make these available to care home residents.
In place of the ineffective PCTs is, however, a new system of commissioning that will put price competition with the corporate sector at the heart of deciding what patients will get. This will tear the heart out of an NHS already ravaged by budget cuts, dodgy “private-finance initiative” deals and the conversion of hospitals into business trusts by New Labour.
Opposition to the ConDems bill even forced its way into the discussion at the Bath Festival of Literature, when leading health academics Colin Leys and Allyson Pollock issued a rallying call to everyone who wants to save the NHS.
"This Bill will destroy the NHS," said Pollock, London University professor of Health Policy and Health Services Research. "If you care for the future, you need to focus now on stopping the Bill. This is a terrifying, Big-Bang moment, because Lansley and his team are moving us to a mixed-financing system similar to that in the US."
Leys forecast that "it will be the end of free care for all". The future he foresaw would be one in which "community care will contract and decline, everyone who can afford to will go private and all we'll be left with is a much-reduced service for the poor".
Today sees two separate rallies in Central Hall Westminster organised by the union Unite and the TUC. But you’d hardly know it. The TUC clearly doesn’t want and isn’t expecting many to turn up. It’s webpage for the event says “Places at the London event will be limited due to seating capacity”. The TUC and Unite and clearly of one mind. Unite’s transport details list consists of one coach each from Southampton, Oxford and Bristol. And that’s it.
Why is the organised opposition so muted? Answer? They simply don’t have an alternative. The not-so-stirring right-to-know demand to publish the Department of Health’s risk register into the impact of the health Bill on services, from Len McCluskey, Unite’s general secretary is about as far as it goes.
Just as on the pensions fight, the continuing wage freeze, public sector job and services cuts and every other reactionary ConDems policy, the union leaders have led one retreat after another. McCluskey’s call for civil disobedience and strikes during the London Olympics is just bluff and bluster to disguise the rout.
There is absolutely overwhelming opposition to the NHS bill, even among Tory supporters. A mass campaign of strikes, sit-ins, marches and rallies should have been organised with the aim of bringing down the government. But compromised by years of watching Labour governments undermine the NHS, and warned off confrontation by Ed Miliband, the TUC has organised a rally just as the bill is about to become law.
The fight to defend the NHS will take something quite different from the approach of the hardly-organised ranks of the opposition. Taking profit-hungry corporations into social ownership will be high on the list of tasks for a new democratic network of Peoples’ Assemblies.