Socialist Resistance

An archive of socialistresistance.org, 2002–2022

Why Hewitt's 'surplus" is bad for our health

by John Lister  |  Socialist Resistance no43  |  page 4

This is scanned newsprint, not web text. The original PDFs carried no text layer at all, so every word here was read off the page by OCR. Expect dropped opening letters, run-together words and wrong characters. There was no contents page to cut the paper up by, so the articles were found from the size of their headlines: a headline may carry its kicker, and where an article ran beside a boxed panel a few lines of the neighbour can appear. The scanned issue is the authority; this text is here so the words can be found at all.

Patricia Hewitt has proudly announced that the NHS will end the current financial year with a "surplus" of £13 million.

Of course her sums are a fiddle. A closer look at the accounts published for the third quarter of a traumatic year for many Trusts and Primary care Trusts showed six of the ten Strategic Health Authorities facing net deficits totalling £463m, with East of England leading the debtors at £175m, London notching up £125m and South East Coast £103m.

One SHA (West Midlands) is hilariously predicting an exact break-even on a budget of billions; and just three SHAs are predicting a combined surplus of just £27.8m.

Even these figures excessively optimistic: many Trusts and Primary Care Trusts facing huge and worsening financial problems, and for them it is no consolation to know that neighbouring Trusts and PCTs may be predict- The whole ing a healthy crisis has been surplus.

So how have artificially Hewitt's bureau- created to force crats managed to

the pace of conjure up claimed overall reorganisation. surplus? It's simple: ministers are now planning to pay back to Primary Care Trusts some of the money they took from them earlier in the year in a controversial "top-slicing" of budgets... to keep as a reserve against deficits!

In other words the whole crisis has been artificially created to force the pace of rationalisation and reorganisation. Ministers call it "creative destruction"

Local cash crises have been the force driving the relentless process of bed closures, job losses, service cuts and plans for closures of whole hospitals and departments that have triggered angry protests across much of England.

Since NHS funds are allocated on the basis of a complex formula that is supposed

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TRUST. Which lag vould you like us to to be related to health needs it IS alarming that Strategic

Authorities and Primary Care Trusts expect to sit on any unspent surpluses while waiting times are pushed up and services cut back elsewhere to balance the books.

But the cash problems that have caused such chaos also flow from a new system of financing NHS Trusts, called "payment by results". This is designed to open up a competitive 'market' in health care, with the NHS reduced to the role of a fund for the purchase

of services from a range of private and not for profit companies and Foundation Trusts. Every pound spent with a private sector provider means pound less to finance local NHS services.

This is Blair's new "vision" for the NHS - the end product of all the relentless process of "modernisation".

Such is the manic commitment to switching services to the private sector that a brand new private sector is being built, entirely dependent upon New Labour patronage: and for those services that the private sector regards as less attractive and unprofitable, ministers are urging a new type of private sector organisation so-called "social enterprises".

Hewitt's team have also nodded through another clutch of ruinously expensive new hospitals to be built under the Private Finance Initiative (PFI) - again maximizing the flow of public funds to private shareholders.