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THE current Health and Care Bill represents a grave threat to the NHS and the health of the nation. Presently at committee stage it has the potential to take the health of the UK population back to the beginning of the 20th Century.

The UK is already facing a health crisis with the re-emergence of diseases such as scurvy, and the rise in malnutrition is leading to rickets amongst children.  

The threat is real. There is a Conservative majority of 80 and many MPs and influential people around them have links to private healthcare companies.

The government’s Health and Care Bill represents a major threat to the future of the NHS.  It will fundamentally change it from a national public service, delivered by public sector workers, to around 42 local, integrated care ‘systems’, each based on a business model. The implications for patients and staff are extremely serious. If enacted, the bill will worsen a postcode lottery, as each system will be required to develop a plan to meet the health needs of the local population, deciding which treatments to prioritise and which not to prioritise in their given areas.

I believe it will also lead to increased rationing of services, as the Integrated Care Boards (ICBs) running the care systems will have far stricter financial limits each year, and, once they have spent the money they have been allocated, patients may have to wait longer or go without treatment. That is a frightening prospect. 

A tale from the past about UK health and the NHS

“The Boer War (1899-1902), World War One (1914-1918), as well as World War Two (1939-1945) could be said to have acted as catalysts in the creation of the NHS. As the Boer war commenced it was only too evident to the government how ill and unfit the British men were. Recruitment agents had to turn away the majority of men who came forward for the army as they were too unwell for the demands that the army would have put on them…rejecting about 60 per cent of military volunteers on grounds of stunted growth, rickets, poor eyesight, deformities and weight. The conditions outlined were the result of malnourishment and were preventable. Fresh air, exercise and diet were seen as the best ways to eliminate such conditions. The government realised they had to take measures to ensure that the health of Britain improved, as the country would not be able to perform well in war, especially as Britain was a leading power in the world.

“Before the National Health Service (NHS) came into being, Britain’s healthcare – and the health of its people – left much to be desired. Pre-Second World War, infectious diseases, including diphtheria and tuberculosis, were rife, and infant mortality rates were high. Healthcare was something of a postcode lottery, with those who lived near to what were then considered to be good hospitals most likely receiving a higher standard of care than people whose closest port of call was a cottage hospital with few beds. And, of course, people had to pay for their healthcare: in the 1930s, one doctor’s visit was approximately three shillings and sixpence – an eye-watering cost that even the middle classes struggled with.” (three shillings and sixpence is 37.5 pence & a quick google search reveals that the annual salary for a working class man in the 1930s was 40 shillings per week or £2 per week).

Now all of this ultimately led to the creation of the NHS in 1948. The NHS when it was launched was based on three core principles: 

1. That it meet the needs of everyone. 

2. That it be free at the point of delivery. 

3. That it be based on clinical need, not ability to pay.

If we do not fight to keep this basic service for all, we as a nation will suffer, as the toll of poor health and untreated injuries and inability to work, will in the long term impact on the economy and some unfortunate individuals within our society will suffer the most.

A parallel future?

Now this story is about my dog Ellie, a rescue greyhound, and she is fully recovered. Luckily, I did not have to go to the vet more than once as the diagnosis and treatment were correct and here she is in one of her favourite places Pembrey Park.

My girl and I went for a walk along the lanes. The local farmer had been cutting the hedges and the debris was strewn across the road. Our local hedges are stock proof, as farming here in West Wales is mainly sheep, dairy and beef fattening, so consist of blackthorn, hazel, holly and hawthorn, a prickly mix.

I did not notice at the time but she must have trodden on something sharp. That Saturday afternoon we went for a walk in the park. Everything was normal; my girl was her usual happy self, bounding around enjoying the freedom of space. She came home and had tea and went to bed.

The next morning she got up but was in obvious pain. Her foot was swollen, she had difficulty walking and could not bear to put any weight on it. My wife and I were in a panic; what could we do? We had not been able to afford pet insurance and therefore were not registered at a surgery.

It was Sunday; we phoned a surgery where we had once been registered and explained the situation. They checked their computer records – yes we were still on their books and they offered us an emergency appointment. We would have to pay a Sunday premium of an extra £20, and no transport or home visit was available so we would have to make our own way to the surgery 10 miles away. We managed to lift her into our car and made it to the surgery.

It was obvious the pain in her leg was intense and we sat in the waiting room. Eventually a medic was free and took her into the consulting room. After about 15 minutes, the medic and my girl reappeared. The medic gave the verdict: A thorn had gone into her foot and become infected. She had a temperature of forty degrees; she could give her an antibiotic and painkiller injection and a course of antibiotics and send her home. If it got any worse, we were to bring her back in 48 hrs.

“Yes! Yes! Please do whatever is necessary.” And so it was.

“Please pay at reception and collect your course of treatment.”

How much was this going to cost? What would happen if it got worse?

A fifteen minute consultation including our £20 Sunday premium and a course of antibiotics was £225.

Well you can say it was my choice to have a pet, but imagine for a moment if this had been a human member of your family.

The true cost of a privatised NHS

Now, had we been registered and had fully paid up insurance, all of this would have been free of charge. Wouldn’t it? 

We all know how insurance works:

First there is an excess which you must pay before the insurance company dips into its pocket. Secondly there is the threat of increased premiums if you make a claim, and then, common to many health insurance policies, there are exclusions for pre-existing conditions.

Then, if the insurance company pays out a large amount, they will look for a third party to recoup their costs from. Can we prove that the farmer’s debris on the road caused the injury? Can they then sue him to recover the money?

This is the threat we face

Anyone runs the risk of accidental damage and the risk of suffering and only being treated if they can afford it. Imagine the cost of more severe health problems: broken bones, heart attack, serious long term conditions.

We cannot allow this government to privatise our NHS.


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