Starmer wants your vote to save the NHS. Can he be trusted?
In his speech on Monday Sir Keir Starmer promised to “conserve, cherish and protect” the NHS as “a public and universal health system, free at the point of use, paid for by general taxation”. Though, as Starmer should know, health is a devolved area of responsibility. So, rightly, it is now four universal health systems with four different ministers, one for each country of the UK, and four different budgets. Though the one thing that is universal in all four systems is that they are under-funded and poorly managed.
The next Labour government will restore the targets of the previous Labour government for things like ambulance response times, time spent in A&E and waiting lists. They want the NHS to meet existing targets for cancer diagnosis and treatment and reduce the rate of suicide, presently one of the biggest killers of people under 25. And there is a ten-year plan to reduce heart disease, and to reform social care and “build towards a locally delivered National Care Service”.
This will need more and better paid health workers. Labour says it will expand the NHS workforce with 7,500 more medical school places and 10,000 more nursing and midwifery clinical placements per year, along with a pledge to train 700 more district nurses each year, 5,000 more health visitors and recruit 8,500 more mental health staff. There is also a promise to institute fair pay for health and care workers.
The plan is to move more health care into the community, to integrate health and social care and to prioritise healthy living and preventative measures like banning junk food advertising that targets young people. There is also a commitment to new technology, specifically AI, to increase efficiency, improve access and reduce workload.
“And with artificial intelligence, with personalised medicine, with new vaccines, we stand on the cusp of a revolution that could transform healthcare for the better. My message today is this – science and technology are the game-changers.”
There is no promise to alter the commissioning structure that invites private contractors into the NHS. Hence the commitment to employ salaried GPs is contingent on there being no successful private contractor like Virgin Care (now rebranded as HCRG Care Group) running GP services. So, when private contractors fail the Government will step in, a bit like the rail franchises. But missing your train is not usually as drastic as losing your primary health care, and there is no mention of the present crisis in dentistry.
The promise of fair pay must be set against Starmer’s statement that restoring pay levels to their pre- austerity levels is ‘unaffordable.’ And, while they plan to fund the training of additional health and care staff by changes to non-dom tax status, there is no mention of increasing taxes for the rich to fund the cost of employment for these additional workers. At Critical Mass we suspect that the, as yet unspecified, implementation of new technology will be expected to deliver ‘efficiency’ savings to cover wage costs.
Starmer said nothing about investment to improve working conditions and end the turnover of health workers forced to quit because of the mental health pressures of the job and the sheer poverty after years of below inflation pay settlements.
And, when Starmer said he wanted to improve healthy life expectancy for all, he looked to technocratic solutions like tackling specific diseases rather than the role of capitalism in creating ill health among the ‘hard-working people and families’ that he claims to represent.
“It’s not all about money,” he said. Only it is. And he gave the game away in a radio interview on Monday morning when he admitted that the funding for his health reforms depended not on the redistribution of wealth, but on sustaining the capitalist system that creates and exacerbates the crisis in health care. We suffer work-related illness when we go to work and poverty-related illness when we become too sick or old to work. Not much has changed since 1964 when Ron Angel sang about his experience as a chemical worker with ICI.
And it’s go, boys, go
They’ll time your every breath
And every day you’re in this place
You’re two days nearer death
But you go…
If we are to ever to enjoy a sustainable National Health Service, we have to follow the money and create a National Wealth Service called Socialism.