With the introduction of bills like Health and Care 2021 and Integrated Care Systems (ICS) programs, the Healthcare system has been changing for a long time. When it comes to Healthcare, the political dispensation in Britain has had only one thing in mind: Imitate the United States of America in every sense of the word. But this can have a cost. Like the United States, medical errors may be the third biggest killer in Britain. As its primary health program, the National Health Service has undergone a series of orchestrated erosions.
System Was Compromised Long Before Corona Virus Arrived
Even long before the arrival of Covid-19, the Service was in a terrible mess. The reports of people already dying while waiting for a bed at the hospital or for an ambulance to arrive. The alarm had already been sounded, and then when the Covid-19 came, it only became worse. The risk to lives increased, and hospitals were overburdened. Before Covid-19, the NHS suffered from something called Winter Crises, an annual occurrence where there would be more patients than the system could handle. NHS was consistently failing to deal with a predictable patient flow during the flu season, making it clear that the British Health Care system was in itself under an ailment.
The main driver of Britain’s National Health Service is primary care. But though it accounts for 90% of all patient contacts with NHS, primary care gets less than a tenth of total funding. Since Britain provides free health care to its citizens, people have not gathered the nerve to complain about it. Arguably, the data and the evidence point towards severe lacunae in the Health care system. Unfortunately, the Pandemic has somewhat helped sway the sentiment favouring the NHS. Due to outpourings of support and opinion during the Pandemic, the NHS was able to capitalise on the hard work of the health care workers and the doctors. The reports suggest that the doctors and health workers in Britain are psychologically stretched, and it’s the handlers of the system who have done injustice to both the British populace and the health staff.
Where does Britain’s Healthcare Stand?
By international comparisons, the performance of Britain’s health care system ranks in the bottom third, along with the Czech Republic and Slovenia. Though Britain spends almost the same percentage of its GDP on Healthcare as other developed European economies like Belgium and Switzerland, its Healthcare is nowhere as good. According to experts, if patients from Britain with common cancers like lung, breast, and prostate cancer were treated in the Netherlands, more than 9,000 lives would be saved every year. Similarly, if they were treated in Germany or Belgium, the saved lives would be 12,000 and 14,000, respectively.
No Longer the Same NHS
Introduced in 1948, Britain’s National Health Service was the first to provide free and comprehensive medical assistance to Britain’s residents. The NHS distributed Britain’s medical resources previously restricted to the affluent areas only, more evenly across the state. The NHS helped improve the quality of life of the British working class in the post-world war era. It made Britain a welfare state.
When the NHS was inducted, the General Practitioners were compelled to join the social advance in exchange for secure funding. The NHS was heavily regulated and made the General Practitioners somewhat independent contractors whom the government paid following the number of patients that they attended to. Unfortunately, many government actions have overhauled Britain’s NHS into a corporate cash cow like the American Medicare— publicly funded, privately controlled, and personally delivered. The Pandemic has given a cover for a fundamental overhaul of the NHS. The General Practitioners are reduced to corporate functionaries that benefit the all expanding medical-industrial complex of the United States.
The Health and Care Bill 2021, which created Integrated Care Systems (ICS) in the fashion of the American Medicare, has been a total disaster. The Pandemic made the evidence of its devastation when the beds appeared to be shrunk, and the emergency departments seemed to have gone.
Many experts have ringed the alarm bells and pointed out the failures of ICS. Still, the British government is adamant about replacing the NHS with a dystopian American system, where, according to many studies, medical error is the third leading cause of death.
The Historical Turning Point
The disenfranchisement of the NHS started in 1979 when the government of Margaret Thatcher paved the way for the free market economy and privatisation of public utilities and natural resources. Although the privatisation of the NHS was heavily disguised to avoid political suicide, it received an equally neoliberal treatment as the other sectors of the British Economy.
Before the market reforms affected by the government of Margaret Thatcher, administration costs were less than 4% of the total NHS budget. The rest was spent on staff, buildings, and medicines, resulting in cost-effective Healthcare. Better Healthcare led to improved life expectancy and brought down infant and maternal mortality rates. With General Practitioners spread evenly through the communities, the preventative health programs and continuous care contributed to further health and cost gains. Then, its downgrading was orchestrated in the guise of improvement.
New Labour, shielded by the reputation of being the party that created the NHS, did more damage to it during their time in power from 1997–to 2010. The motive was always clear: benefit the corporations. To fund the building of new hospitals, Tony Blair’s government used Private Finance Initiative (PFI) schemes. As a result, the British National Health Service was pegged to £11 billion of private debt, which eventually cost £88 billion in repayments. Such huge debt destabilised the finances, created a funding problem, and led to a contraction in NHS operations.
But that is not all. The scam of Blair’s Private Finance Initiative was so blatantly shameful that even when the loans to private investors were duly paid off, the ownership remained with them. It’s as if somebody lends you money to build your house, and even then, when you have repaid it five times more, he will still own your home. Stupendous! Right? But that is how the bonhomie between the corporations and the politicians worked in Britain regarding Healthcare.
The Current State
Britain spends 12.8 per cent of its GDP on Health, about £269 Billion of it in 2020, but where is all that money going every year? Of course, in the pockets of the private investors, because Britain, unfortunately, has chosen to privatise Healthcare. The statistics show that in the past 30 years, the number of available consultant-led beds in England has reduced to half. Proportionally, the most detrimental reduction has been seen in the number of beds for people with learning disabilities, people with mental illness, and long-term beds for older people. And all thanks to Britain’s Privatisation Push.
One of the chief drawbacks of private Healthcare is that it always seeks to reduce costs. And the most effective way of reducing the cost is by down-skilling the workforce. Doctors are seen as financial sinkholes in privatised Healthcare; therefore, the less they are, the better it is. However, it, in turn, erodes the quality and safety of health care and puts the 67 Million citizens of Britain at a heightened risk.
No Lessons Learnt from Pandemic
The British government‘s pandemic response was to squander billions of pounds on private companies with no experience in Healthcare and often without due probity. It has been one of the most expensive, privatised, and least effective public-funded health programs globally. Government instruction limited access to doctors, leading to significant unmet needs, delayed treatment and diagnosis, and damage to trust in primary care services. The right-wing press scapegoated GPs, blaming them for growing patient dissatisfaction and diverting attention from the government’s catastrophic performance. This was capped with the forced discharge from hospitals of infected patients into nursing homes leading to over 20,000 preventable deaths.
A year into the Pandemic, with Medicare demoralised and exhausted beyond its limits, Johnson’s Government moved the Health and Care Bill, 2021, into the parliament. Endorsed by the British Medical Association (BMA) the Health and Care Bill 2021 aimed to rework the National Health Mission with programs like Integrated Care Systems (ICS). This leads to an incredible amount of implications. Due to its privatisation, the decentralisation of Health Care led to increased workload, generated by growing waiting lists and overstretched hospitals beyond their capacity. The result was an immense number of preventable deaths during the Pandemic.
BMA Supporting the Demise
Representing all the health and medical professionals in Britain, the British Medical Association (BMA) deserves condemnation for its silence and for providing cover to the market reforms in the Health sector. The BMA has repeatedly failed to resist the series of legislations that have continuously eroded the standards of Health Care in Britain and gnawed at the interests of the Doctors and medical professionals. In February 2021, BMA actively endorsed the Health and Care White Paper, which preceded the bill before parliament. The bill will complete the transition of Britain’s NHS into American-style Healthcare. The new system works by hoarding cheaper labour with fewer protections, and it has already begun to lead to a recruitment and retention crisis in NHS and primary care at large.
Due to recurrent press attacks, loss of public trust, and increased workload, the morale of the General Practitioners in Britain is at the rock-bottom. While the patient waiting lists have grown exponentially, the number of GPs has decreased. As the standards of Health continue to erode in Britain, more and more services are stripped of NHS provisions, a system that was once somewhat pure and good. The Britons need to recognise the threat and realise that the government and media of the country have long aligned themselves with the corporates. The Britons need to wake up to the fact that the country’s successive governments have pulled the whole population onto a landmine, and the life and well-being of every citizen are at stake. The citizens and the medical professionals in the country need to launch peaceful movements and win back the old, pure and good NHS.
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