Party Point – January 2014

John Clark writes…

First published: January 2014

What is happening to our NHS? The Prime Minister promised ‘No top down reorganisation of the NHS’ and then launched the biggest top down reorganisation of the NHS in its 60 year history. The ConDem government then promised ‘no cuts’ to the NHS budget. However the costs in health provision are rising due to the cost of new drugs and hospital procedures. As a result savings have to be made in the NHS just so as to stand still. This was not the time to spend £2billion on reorganisation.

We are now seeing waiting times at A & E rising dramatically. In Belfast last week there was a ‘major incident’. One of the seeds of the A & E crisis was sown in 2004 when the Labour government negotiated a new GP contract. GP’s took a 6% reduction in salary in exchange for not supplying evening, week end and bank holiday cover. Livestock farmers and vets have no such luxury. It is hardly surprising that the vast majority of GPs grabbed this offer. People now go to A & E rather than use the out of hours replacement for GPs.

As part of the same 2004 negotiations the government introduced the Minimum Practice Income Guarantee (MPIG). This was an arrangement to ensure that GP practices would have their income topped up so that they would not have a reduction in income to the practice as a result of the changed contract.

In the current re-negotiations of GP contracts the government is phasing out the MPIG. Some North Yorkshire practices complained bitterly. The NYCC Overview and Scrutiny Committee were asked to investigate. The committee was concerned that this could impact on the services (and even existence) of some rural practices. We asked for a breakdown of the MPIG practice by practice. The NHS replied that to provide this at practice level was not possible because it ‘could be considered commercially sensitive’. In times when people on average or below average incomes are having a year after year cut in living standards I have little sympathy or support for a loss of income for the higher paid. GPs are paid with public money. It should be open and transparent.

The ‘commercially sensitive’ phrase should set off alarm bells. It is a phrase from the corporate greed hand book. We are being kept in the dark for GPs benefit. It is a powerful sign that the NHS is moving further away from public ownership towards the private sector. The private sector is already doing many routine operations and creaming off profit for shareholders. Now private health companies are taking over the management of some GP practices.

There are two good changes coming out of the NHS reorganisation.

  • The return of Public Health responsibility to local government. NYCC has made an impressive start.
  • The recognition that Social Services and Health must work much closer together. People should not be taking up a hospital bed when they could be cared for in the community.

The rest of the NHS is creeping into private hands. It is going away from this democratic, community approach. The NHS cannot afford to pay shareholders dividends whilst the quality of services is being reduced.

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