07.11.1996

Fiddling the health books

The government has proudly let it be known that health secretary Stephen Dorrell has won his ‘battle’ in the cabinet for extra funding for the National Health Service. And for good measure it triumphantly claims to have met John Major’s pledge to the Conservative Party conference to increase health spending in real terms year on year.

The forecast outturn for 1995-96 is £34.4 billion, while in 1996-97 £35.4 billion has been budgeted. After allowing for inflation that represents an increase of just 0.1%. Yet even this minuscule ‘increase’ is an illusion. It has been achieved not by raising this year’s spending, but by reducing last year’s estimates by £100 million. ‘Better’ healthcare at the stroke of a pen.

The reality is that already, just halfway through the financial year, 36 hospital trusts have a projected deficit of £34 million, despite a legal requirement for them to break even. Why not demand extra payments from the health authorities, government ministers helpfully suggest. Unfortunately 63 of the 99 districts are also heading for a deficit, totalling £118 million.

These figures are not just meaningless statistics. They represent real attacks on the health of working people. Hospitals are already planning to cut back on operations, extending waiting lists even further, while leaving beds and even whole wards unoccupied. Between 1990 and 1994, there has already been a two percent reduction in available beds. Perversely, the government proudly claims that this is due to greater hospital ‘efficiency’ - in other words churning patients in and out conveyor-belt style, often discharging them prematurely.

But surely all will be well when Tony Blair takes over? Like the Tories, New Labour is full of pledges of commitment to the NHS. But what do they amount to? The Labour Party will not spend a penny more on health, but it promises to save £100 million through cuts in bureaucracy - as if the Tories would not do the same if it was possible. That sum would build one small hospital. But 350 have been closed down over the last seven years.

Instead of promising to cut, let alone abolish, waiting lists, Labour merely promises to juggle them so that patients in the most pain get priority. Those who are ‘merely’ suffering discomfort can wait longer.

Another Labour stroke of genius is its plan to reform NHS “information technology organisation”, without of course providing the necessary funding. But the coup de grâce undoubtedly is the proposal to appoint a Minister for Public Health, who, according to Labour’s health spokesperson, Chris Smith, would be “working across government departments, looking at everything from the banning of tobacco advertising to the establishment of nutritional standards for school meals” (The Independent November 4). What was that about bureaucracy?

Totally in tune with the Tory-inspired hospital bed cuts is Labour’s notion of a ‘recuperation service’ “in a supported environment near to their home”.

Just as in all the other capitalist states, the ruling class is no longer prepared to ‘waste’ profit-seeking capital on the health and welfare of the working class. Labour or Tory, you can be sure the party of government will talk sweet and act mean.

Alan Fox