The nations health service - safe in the government's hands?
submitted by Gerry Ramsden.

"Total privatisation of the NHS is not on the cards", words to placate the massed ranks of the public and trade unionists alike that support a NHS, free at the point of use.

It would make me smile, if the situation wasn't so serious. The National Health Service is now facing a threat, which I couldn't have envisioned from a Labour government.

Moving one of the original anti-privatisation resolutions at MSF conference all those years back, I think I have a little grasp on the situation which has arose in the present day. Each year it became necessary to re-iterate the same stance, strengthening and re-defining the arguments which led trade unions to their present position. Reflecting on privatisation of the NHS which has gone on apace with building projects, Estate service contracts, Clinical service contracts and now the proposed Logistics contracts.

I came to the conclusion that out and out privatisation of services whilst having some threats to the workforce are a lot less dangerous then the insidious mal-administration of PFI schemes and contracts in addition to the bad financial accounting that is rife throughout the system. Whilst the vast profits that are made concern me, they don't concern me unduly. Waste, repetition of paperwork, financial mismanagement and administrative incompetence loose more value of the NHS than even the amount profit gained by PFI companies and consortia. Illustrating this incompetence are the services that have been paid for but not provided and a system that allows contractors to defraud resources with what seems like impunity of detection.

Throughout all the re-organisations of the NHS, finance has been and remains as the prime driver for change, not primarily as a rationing of services, but a requirement to obtain "value for money", "positive outcomes" and "win/win situations".

Presently financial control of the NHS is like a corrupt computer programme, you know the feeling, expert salespeople tell you it works, it looks like it works, but then fails at the last hurdle so you have to go back to the beginning, loosing everything in the process. Then a realisation, it is the Department of Health's accountants that control financial planning to the trusts therefore the whole system needs to be re-examined. Since managers of the NHS keep praising the concerted efforts made throughout the NHS to curb costs, against the background increasing accumulated debts, only one conclusion can be made: With a widespread growing accumulated debt across the system, £1.4 billion pounds in the present year I argue that the accepted financial management systems are not up to the job.

At each re-organisation management structures change but the individuals who occupy these important posts do not. Further, generally the present incumbents of posts that control and plan the financial systems for the NHS are also not fit for purpose.

The reasoning is they are wedded to a system that has failed and continues to fail again and again.

In conclusion, what I propose is a re-birth of the financial system of the NHS. If the money used for killing Iraqis, innocent civilians and military personnel had been used for saving lives rather then ending them, the accumulated debt could have been paid four times over. Canceling this debt for all trust is a pre-requisite for re-taking financial control of the NHS.

Private company finance ethic must be imported into democratically accountable public services. Import the financial skills nationally into the system, re-train and implement locally but refuse to pay the extortionate consultant fees that are endemic across the financial sector.

Democratic local accountability of the health services within a geographical area must also be established, to make local services accountable to local communities, one size fits all NHS services do not work, and is fraught with complications.

The beginning of this process is to campaign for cancellation of the NHS within the trade unions and also in the external political communities.