Election fever: what it means for your health

Gordon Brown has fired the starting gun for a race that was already in full flow. In four weeks we will know who has won the 2010 general election.

Many angry activists, frustrated at new Labour's adherence to Thatcher's anti-union laws and continuation of her privatisation offensive, have argued that there is "no choice" between the main parties. But one area this is clearly not true is the NHS.

While 18 years of Tory rule saw the NHS face cuts, the privatisation of hospital support services, Thatcher's mad, costly and wasteful "internal market" reforms, more cuts, soaring waiting lists and a growing gulf between the quality of British health care and much of Europe, 13 years of Labour rule has brought a real transformation.

Huge new resources have been pumped in to the NHS. Spending has risen at the fastest rate in 60 years, with the health budget almost trebled since 1997, with generous above-inflation year-on-year increases since 2001, and the share of national wealth spent on health has increased towards the European average.

Waiting times are down and with the 18-week maximum wait they are now among the best in Europe. And staff numbers are up - even if too many of these are managers.

There are new hospitals, too, far more than since the late 1960s - although almost all of these have been funded through the controversial private finance initiative, the most expensive possible way to secure the money. PFI is just one of many weaknesses in Labour's record, of which we are all aware.

Another fundamental problem is that instead of sticking to his promise to sweep away Thatcher's costly and wasteful market system, Blair, and now Brown, have hung on to it, made it more complex and bureaucratic and brought in far more private-sector involvement than the Tories ever dreamed of.

Overhead costs have mushroomed, while the talk of "efficiency" has never been louder.

With the market has come today's indecipherable and pointless jargon of "world-class commissioning," swarms of private-sector management consultants, and the relentless drive to draw in private providers to deliver clinical services and even community and mental health services through the Transforming Community Services policy.

With the market has come the establishment of a biased Co-operation and Competition Panel as a platform for whingeing private entrepreneurs to complain at their failure to win contracts, the positioning of Richard Branson's Virgin group and Care UK to exploit the current fad for expensive new "polyclinics" and privatisation of primary care, and the expensive irrelevance of independent-sector treatment centres creaming off the simplest and most profitable elective services at higher cost - and often delivering far fewer than the contracted numbers of operations.

The market system has also brought the "patient's choice" initiative encouraging NHS patients to seek simple elective treatment in private hospitals, leaving their local NHS hospitals facing financial losses and, of course, the costly folly of the billions squandered on a complex computer system that still doesn't work.

But while Labour could obviously have spent much of the extra money more wisely - and even now could save billions painlessly by changing course on some of these policies - we know from their previous 18 years in office that the Tories wouldn't have spent the extra money at all.

Left to them, the waiting list would still be with us, with tens of thousands of people still waiting 18 months or more for treatment in crumbling and poorly cleaned hospitals. And while Labour has stupidly rolled out the red carpet for private providers, the Tories would be even more eager to please any of their big business friends, like Sir Peter Gershon, who fancy a slice of the NHS £105 billion budget.

So let's use the election period to keep the pressure on all the main parties to halt the £20 billion of cuts in the next few years, which threaten to devastate many local services, close hospitals, axe tens of thousands of beds and NHS jobs, and throw more qualified staff on the dole queue.

Both parties threaten that, and these cuts must be fought, no matter what the result of the election.

But let's not forget that in 62 years of the NHS only one party has had the courage to pump much-needed resources into health care and create a service that gives us so much to defend.

Ignore that difference and we could have years to regret a Cameron government.

Top of the health cutters

The pace and scale of planned cutbacks in health care and hospital services has been gathering pace up to the "purdah" period between now and May 6.

Top of the cutters seems to be Southampton University Hospital Trust, which is seeking to axe a staggering £100m and 1,400 jobs over four years. Salford Royal - once known as Hope Hospital - is to axe 750 jobs over three years, cutting its budget by 15 per cent.

The most hurried cuts seem to be in Leicestershire, where the hospitals trust announced plans to cut £58m of spending in just one year with the loss of 700 jobs.

But jobs and spending are being hacked back in Oxford, Cambridge, Leeds, Nottingham, Derby, Gateshead, Wirral, Portsmouth, Gloucester, Basildon and Slough.

The NHS is Europe's biggest employer. The loss of these jobs, with a knock-on impact on local suppliers and businesses in each area, seems certain to contribute much more to a double-dip recession than Labour's plan to add 1 per cent to national insurance.

As soon as "normal" politics resumes on May 7, each of these and many more cuts will need to be challenged by local campaigners and health unions.

The vultures are circling

Private-sector hawks and vultures are circling hungrily above the NHS, scenting the prospect of rich pickings to come if damaging policies are not reversed.

An alarming report in the GP magazine Pulse concludes that PCT bosses "are gearing up for a huge shift of services to alternative providers as a means to drive efficiencies." Two-thirds of PCTs admitted plans to further increase use of the private sector.

More GP out-of-hours and home visit contracts are also expected to be put out to tender if ministers press ahead with their plans to abolish GP boundaries and allow patients to sign on with GPs in the area where they work rather than near where they live.

Sir Richard Branson invested almost £300m a few weeks ago to take a controlling stake in Assura, the company leading the pack scooping up contracts to build polyclinics and bidding for out-of-hours and other contracts to deliver primary care.

Such a substantial gamble must surely be based on a nod and a wink suggesting that the company stands to win more profitable contracts.

This will be further encouraged by the clear statement from Tory shadow health ministers that they would scrap Andy Burnham's policy of making the NHS the "preferred provider" and instead invite "any willing provider" to bid for contracts.

Meanwhile another big player, Care UK, has reported a 54 per cent increase in revenue from its health-care activities and a hefty 25 per cent jump in profits in the last year. It expects to do even better from whichever government wins on May 6, and its chief executive Mike Parish has told the Financial Times he is confident that government will deliver "structural reforms to facilitate a move in our favour."

But there is mounting evidence that Care UK, like other private-sector providers, is less than popular with patients. Ten PCTs in Greater Manchester have resorted to bullying GPs into sending all patients to the controversial Independent Sector Clinical Assessment and Treatment Service (ISCATS) run by Care UK, which has been seeing less than a third of the contracted numbers of referrals.

Now all local GPs are required, unless they have "compelling reasons," to advise their patients to go to ISCATS. So much for "patient choice."

It seems that these decisions have been taken for Manchester patients by the faceless Department of Health bureaucrats who imposed the contract on local PCTs.