We are facing a momentous upheaval. Many of us have worked for decades in the NHS, but the landscape we know, love and are rightly proud of is about to be bulldozed beyond recognition.
But why? What is the reason? Is it really about clearing national debt and efficiency? I do not believe so. Do we need to economise? Yes, but is a total restructure of the NHS the way to achieve this? No. And is the NHS really so expensive and inefficient?
Compared with other developed nations as a percentage of GDP, the cost of UK healthcare is actually at the lower end of the spectrum.
No – the forces about to be unleashed are at the vanguard of a brave new corporate world. One by one our institutions will be eviscerated. And the speed is astonishing. Our current Government is unlikely to last beyond one term due to the anger that will be created. So, to impose its ideology, it has to act very fast, while we are all too shocked to react.
Large public institutions represent a lost opportunity for corporate profit.
By and large these public institutions, like health and education, are valued and loved, so simply privatising them in a transparent way is political suicide.
So we have a new model. The public institution apparently remains intact but actually becomes an empty shell that commissions services from private corporations.
At a stroke the tough issues of working conditions, salaries and public-sector pensions are solved by handing it all over to private corporations. Global healthcare corporations maximise profit by lowering quality and reducing the workforce expense (at the cost of pay and conditions). This is the current worldwide model.
We are told that competition will reduce costs and increase quality, but this is not true. Bigger and bigger multi-national corporations will take over our services and the monopoly of the public sector will be replaced by a monopoly of huge private corporations that exist for only one reason – profit, which they have a legal obligation to maximise.
Corporations are protected by competition law. They are less accountable. And once they are in, we can't get rid of them. Profits will be sent to offshore tax havens, not used for services. We've seen it before.
GPs are being hoodwinked by the apparent offer of power, but it's now clear we don't believe it. The phrase ‘poisoned chalice' is being used often. And be warned, even if amendments to the health bill are introduced, they will be overridden in the future. We must reject it. The principles on which it is based are wrong.
And don't rely on the Liberal Democrats doing a U-turn and voting against the Government. If they did, it would probably precipitate an early general election in which they would disappear.
There is growing awareness and opposition to what is happening. The governor of the Bank of England, Mervyn King, is calling for changes in banking law. Military leaders have asked David Cameron to reopen the strategic defence and security review.
We need all bodies like the BMA to express their unequivocal opposition to the health bill. We need a show of social democracy. Predictably, there are laws making it illegal to co-ordinate industrial action between public-sector employees, but we can demonstrate our opposition peacefully. I dream of one million people marching through London together.
Look at the recent by-election in Barnsley.
From Dr Simon Moore
Crouch End, north London
Will private corporations cut quality in order to boost profits?