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Contrary to the British government’s framing of the STPs, they will further the process of marketization of health services, leading to cuts and closures. This will undermine health professionals to patients staffing ratios, with adverse consequences for health outcomes. The research based on data collected from NHS London bolsters the consistent argument of PSI and its affiliates that a better future for all requires adequately funded public health care delivery and reversal of privatisation or marketisation of health and social services in all forms.
Using “big data” techniques in a pioneering manner for health research, physiological data computed comprised over 120 million patient entries over six years. Bespoke hospital database for the study conducted by researchers at the Birmingham City University (United Kingdom) and London South Bank University (LSBU) also covered nine years of daily data on staffing levels and safety factors.
The results established 40 correlations between staffing levels, safety and physiological factors. The inter-related elements of this correlations demonstrate the critical impact of trained nurses’ availability on patient outcomes.
In analysing several scenarios with the mined data, the replacement of six healthcare support staff (who more often than not are employed on fixed term, precarious bases) with six registered nurses, for example, was shown to reduce the total number of falls per month by 15%. This is enough reason for adequate nurses staffing levels to be considered a top priority.
But this is not the case. Since the enactment of the National Health Service and Community Care Act by Margaret Thatcher in 1990, the NHS which was a pride of the welfare state in post-World War II Britain has faced a series of reforms aimed at marketizing health care delivery. The most significant of these was the Health and Social Care Act 2012, which had the “inevitable consequence” of privatisation.
PSI affiliates in the UK and several civic organisations opposed the reforms five years back. But the government was intractable, going ahead to implement them. It claimed that the reforms would put patients at the centre of the NHS. On the contrary, they have led to further marketisation, damaging top-down reorganisation and confusing systems of governance and accountability.
It is within this context that the Sustainability and Transformation Plans being rolled out by NHS England and local councils in 44 areas can be best situated. The STPs were presented as attempts to roll back the marketization promoted by the 2012 Act. This was despite the fact that they were drafted in utter secrecy. But, insight from the 17 STPs which have been made public shows that they represent an attempt to get around “local objections to closures and downgrading of services”.
This will undermine health employment, leading to unsafe and ineffective staffing levels and care delivery. Health care is a fundamental human right. PSI and its affiliates stand firmly against the commodification of health, and for quality public health care for all.
So much has been said by the government about challenges in funding the NHS. In 2015, with a deficit of 2bn GBP, it was described as the NHS’ “worst financial crisis in a generation”. NHS England has also raised the spectre of a 22bn GBP affordability gap by 2020.
But what is not mentioned is how a few persons and corporate bodies make away with vast sums of money which make the amounts required to fund the NHS pale into insignificance. For example, “the UK’s tax gap may now be £122bn a year”. This is almost six times the much touted affordability gap by 2020.
And it is not only about such shadowy movements of resources. Social inequality is fast rising in the UK. “The accumulated wealth of Britain’s richest 1% is more than 20 times the total of the poorest fifth, making the county one of the most unequal in the developed world”, according to Oxfam in September 2016. It is poor working class people and other vulnerable segments of the population that bear the brunt of attacks on public health care, including the impact of these on staffing levels.
The challenge is thus to put people over profit. This requires campaigning together to defend the NHS in the UK, and for public health care for all. PSI thus welcomes the “It’s Our NHS” demonstration in London on March 4 and all efforts to resist cuts and closures in NHS England.