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By ProgBlog, Jul 9 2018 04:58PM

Britain’s National Health Service celebrated its 70th anniversary last week, having come into effect on July 5th 1948. Despite a relatively limited personal use of the Service with only one hospital stay for overnight observation following a head injury sustained during a mountaineering accident in the Lake District in 1976, and continued checks in the ophthalmology department to monitor for trauma-induced glaucoma after being hit by a squash ball in the eye in 2007, it’s good to know that a comprehensive health service, free at the point of delivery for everyone, exists in the UK. Sadly, free universal and comprehensive healthcare in the UK has been under attack for much of the last 40 years, even when Blair’s New Labour was increasing health spending by an average 5.4% per year, selling the public the idea of new hospitals (and other major projects) but actually committing the coffers in the public purse to fatally flawed PPI ventures from which hospitals in particular continue to suffer.

It’s widely remarked that the NHS has a special place in the hearts of British citizens although it’s always been highly politicised. Conceived by health minister Aneurin Bevan and introduced by Clement Attlee’s post-war Labour government, there was considerable opposition to the scheme amongst those with vested interests. Many doctors did not want to become employees of the government; hospital consultants wanted to continue to charge private patients for treatment and 64% of GPs opposed the NHS, preferring to treat patients privately, leading to the BMA to organise a campaign to ‘boot out Bevan’. Even nurses were against the plan, as it threatened their income from private family visits. Bevan finally won round doctors with the promise of new hospitals and badly needed equipment but significantly also agreed to allow doctors to continue to treat private patients in addition to their NHS work.


NHS 60th anniversary edition of Bevan's In Place of Fear
NHS 60th anniversary edition of Bevan's In Place of Fear

The Principles of the NHS:

Universal Access: The NHS was for all

Comprehensive: The NHS would treat all medical conditions. Doctors, dentists, opticians and hospital treatments would all form part of the service

Free at the point of need: Patients would not pay for treatment

The new NHS was to be paid for out of National Insurance contributions and would provide free medical services for all

Ambulance services were set up to cope with emergencies


I’ve been involved the service since 1981, one of the behind-the-scenes staff in a laboratory. Initially employed by the National Blood Transfusion Service immediately after graduation, within five years I’d expressed a few hundred litres of plasma from whole blood, pooled platelets, washed blood, made clotting factors VIII and IX, provided reagents derived from blood donations to hospitals in the South East, screened ante natal blood for antibodies to prevent haemolytic disease of the newborn and selected and crossmatched units of blood for patients requiring transfusion. I was working there in 1983 the virus responsible for AIDS was independently discovered by Gallo in the US and Barré-Sinoussi/Montagnier in France, naming the novel retrovirus HTLV-III and LAV respectively, before it became known as HIV in 1986 and, to reflect the importance of that discovery, changed the name of the band I was in at that time to HTLV-III.

In 1984 I moved to the section that covered bone marrow transplantation but after a successful two years in that post, I was told I was to be moved to a different department. Fortunately my predecessor, who had left to join the kidney transplant team at Charing Cross Hospital, was moving on again to Scotland; I applied for and was appointed to fill that vacancy, delivering a leaving party speech that criticised the management of the Transfusion Centre for virtually forcing me out. It’s satisfying but disappointing that things got much worse there after I left, all due to poor strategic decisions, in search of ‘efficiencies’.

The lab at Charing Cross was small and friendly and though much of the work was for renal transplants, we were actually part of Rheumatology. It’s good to have a different perspective and meeting professionals from other disciplines helped me see healthcare from a holistic point of view. With rumours of a pathology reorganisation circulating in 1988, a post at Guy’s Hospital offering research potential and an annual international conference proved too good to resist.


The Guy’s lab had something of a mixed reputation when I joined but within a couple of years we started to make some astute personnel changes and began to build up one of the most successful renal transplant teams in the UK, no longer treated as just a laboratory but sharing expertise with the medical and nursing teams.

The Conservatives introduced the National Health Service and Community Care Act 1990 which created an ‘internal market’ for the supply of healthcare so that the state would no longer be the main provider, but act more as an enabler, forcing local authorities to assess people for social care and support to determine a patient’s requirements and to purchase the care from providers – the new NHS Trusts. Guy’s and Lewisham joined forces and became the Tories’ flagship Trust but hospital reorganisation in London, to make the service yet more efficient, meant that the Guy’s – Lewisham partnership was dissolved and Guy’s & St Thomas’ NHS Foundation Trust, complete with a level of autonomy from the Department of Health, was created in 1993. A few years before, Guy’s had been singled out for major improvement, what was to have been the £140m Philip Harris House, a state-of-the-art seven storey wing designed to be conducive to effective healthcare. However, the inexplicable transfer of acute services to St Thomas’ Hospital, considered by many to have been a political move disguised by that reorganisation (Tommies was in a parlous state before the formation of the Foundation Trust) led to Philip Harris, a carpet magnate and Conservative Party donor withholding his £6 million from the project; the building sat empty for some time before being reassigned for outpatient services and some research facilities under the name of Thomas Guy House.


The creation of NHS Trusts immediately increased the running costs of a hospital because of the number of managers required to oversee the internal market and to control budgets. Cutting waste and making efficiencies has long been the mantra of officials but they failed to see the hypocrisy of paying management consultancies huge sums of money to produce reports to validate decisions made by hospital boards to circumvent discussion. This continued after Blair replaced John Major as PM in an attempt to show the public that New Labour was both a prudent manager of the public purse and that it was business-friendly. The machinations of GSTT managers or ministers in the Department of Health didn’t impact on me directly until 2008 when, encouraged by a government which delighted in ‘a third way’ but based on poor data collected pre-2006 for the Carter Report, it was proposed that pathology at Guy’s and St Thomas’ (also to include Bedford Hospital) should be part-privatised in a joint venture between the hospitals and outsourcing darlings Serco. Despite opposition from staff throughout the hospital and sympathy from the chair of the board of governors, the Joint Venture commenced operating under the title of GSTS Pathology on January 1st 2009 so, to ensure I couldn’t be singled out for my outspoken opposition to this development, I became a union representative and campaigned vigorously to stop all forms of NHS privatisation and the unfair treatment of staff.


Protesting against the privatisation of Pharmacy by Sainsbury's
Protesting against the privatisation of Pharmacy by Sainsbury's

GSTT was at the forefront of removing staff from its books through a series of privatisations; Pathology, the Post Room, Pharmacy, seemingly simultaneously oblivious to the wishes of staff and mounting evidence to show that in fact, privatisation was a contributory factor in declining standards of delivery of care. When the coalition government was formed in 2010 they quickly revealed a major shake-up in the provision of healthcare, Andrew Lansley’s Health and Social Care Bill (enacted in 2012), despite a Conservative manifesto pledge that there would be no NHS reorganisation. Now largely scrapped though still adversely affecting the NHS, other changes to public sector pensions and terms and conditions of work introduced by the coalition shortly after they came to power were part of a strategy to entice private sector providers to take over services; unfortunately the strategy worked, but not without seriously affecting provision of comprehensive, universal healthcare (according to a report by the NHS Support Federation, £7.1bn worth of NHS clinical contracts were awarded through an NHS tendering process in the year up to April 2017.) The changes were sold to the public as being necessary in an age of austerity but the government was defending its friends and the failed ideology that caused the collapse of the global financial system in 2008; George Osborne’s imposition of austerity measures to eradicate the budget deficit was really another strategy to break up any power remaining in the hands of the state and politicians and economists alike have criticised the approach, which is responsible for a continuing weak, low-growth economy.



On the occasion of the NHS’s 63rd birthday, I predicted that unless there was a change in administration, it would barely make it to 68. Fortunately I was wrong, though how it managed to survive the last three winter crises and a lengthy doctor’s strike is a miracle. It appears that the cuts to NHS funding have now been stopped but there’s still insufficient movement on the investment required for integrating health and social services. However much money we put into health is never going to be enough but it’s pleasing to see that the British public would accept a tax rise for the NHS. Bevan’s guiding principles for the service illustrate a willingness to eradicate inequality and what he founded may stand as the highest achievement for social democracy. To ensure his legacy continues to have a future we need to recognise the value of everyone who plays a role in healthcare provision, from the cleaners and the porters and post room staff and catering staff upwards. Jeremy Corbyn’s recent call to end the NHS internal market is also a key move, as competition between providers is likely to lead to unrealistic tenders, an uneven provision of care or a diminution of quality; the Lansley Act had the detrimental effect of splitting effective care pathways and raising costs through inefficiency.



I left Viapath (the re-branded GSTS Pathology) in 2015 to restart as an NHS employee in a different NHS Trust. Despite a national celebration of the service on its 70th birthday, I didn’t join in because the cheerleaders for the day, the higher managers who sanction privatisation of services and impose punitive sickness policies were handing out free muffins to all staff... The passion that many millions share for the NHS, despite its shortcomings, is the reason it’s still going and anyone who cares to can check that it ranks very highly on efficiency and social equity; the US with its private insurance-based system favoured by some of the more right-wing members of the Conservative party, spends far more on health per person with poorer and dreadfully inequitable outcomes.



So what’s the NHS got to do with progressive rock? Apart from the excellent band National Health (see ProgBlog’s February 2014 post National Health), it’s about the prevailing social conditions in the late 60s and the notion of equity of access; the founding of the NHS is one of the defining features of advanced social democracy, along with the provision of decent social housing, and opened the door for further democratising movements like access to higher education for students from all backgrounds. The prime movers in progressive rock appealed to the burgeoning student groups but also envisioned a better world and even attempted to challenge accepted norms through bridging the two worlds of high- and popular culture; I don’t believe that progressive rock would have developed in Britain in the same way if we’d not already made moves to make society more equal.


So the next challenge is to see how the NHS fares post-Brexit, but I agree with the words attributed to Bevan: the NHS will last as long as there’s folk with faith left to fight for it.








By ProgBlog, Jun 11 2017 05:59PM

The UK has been gripped by the general election over the last week, somewhat surprisingly when it appeared that the electorate was completely battered by a spate of recent polls: The Scottish Independence referendum; the 2015 general election; the EU referendum; then the somewhat unnecessary call for a stronger mandate to bolster Theresa May’s negotiating hand for our exit from the EU. Yet, on Friday as I prepared to go for work, there was an indication that the world of politics may never be the same again as the results indicated a hung parliament and a good number of seats gained by the Labour Party, including mine in Croydon Central. Seven weeks ago there was a tacit understanding, promoted by almost all mainstream media, that Labour faced annihilation and that Jeremy Corbyn would be personally responsible for the wipe-out at the ballot box. However, on that morning commentators and a large proportion of the Parliamentary Labour Party had to admit just how wrong they’d been; though Labour didn’t get more seats than the Tories it was widely recognised that in overseeing a net gain of 32 seats, including positive results in Conservative heartlands such as Canterbury and Kensington, Corbyn had emerged as the biggest winner of the previous night.


Croydon Central. Photo: Chris Gorman www.standard.co.uk
Croydon Central. Photo: Chris Gorman www.standard.co.uk

At the start of the campaign, the contradictory behaviour of May, parroting that she was ‘strong and stable’ while embarking on a series of damaging U-turns seemed to be sufficient to dispel any vestiges of interest in politics in all but the politicians themselves, numbed as we were by the inane slogans of a political class which frequently put itself before the constituents. The gap in the polls between the two main parties was running at over 20 points, leading to the conclusion that May was calling the election, already with a working majority, for simple political gain. Despite the backing of media moguls and big business, however much money was thrown at the Tory campaign it was insufficient to hide May’s innate deficiencies. Badly advised and playing to vested interests, and projecting many of the damning qualities she accused the Labour leadership of possessing, her presidential-style campaign came unstuck with her refusal to debate head-to-head, the catalogue of changes in policy, a lack of empathy towards struggling working people, plus her dismal record as Home Secretary as she sought to pin the blame for the murderous attacks in Manchester and London on ‘terrorist sympathisers’ leading the opposition.

Meanwhile, Corbyn did what he does best; take his campaigning style out around the UK. Helped by the most socialist manifesto for a generation, one which had been agreed by the PLP, he sent out a message of hope and a rejection of seven years of failed neo-liberal economics. If anything, the manifesto was a little too cautious for me but I understood that the Labour document would undergo more forensic scrutiny than anything produced by the incumbents; fortunately for Labour, the Tories relied on their (entirely unwarranted) reputation for sensible fiscal management and didn’t bother to properly cost their programme, thus revealing a deep disdain for the voting public. The trend for the poll gap to close in some surveys, attributed to Corbyn’s message of hope to the young, was also dismissed as being of little concern because of the perceived notion that young people wouldn’t bother to turn out to vote.

The other misplaced presumption was that UKIP votes, even those from former Labour supporters would end up with Conservative candidates. This worried many prospective Labour MPs in the north, in Wales and the Midlands where they believed that Corbyn was responsible for alienating voters. What I already knew and what people saw following the announcement of the election, was that when seen outside of the bear-pit of the House of Commons with its turn-off adversarial politics, a game Corbyn was unhappy playing, he went down very well with thousands of people all around the country and, when reported on the news outside the prism of normal parliamentary coverage, millions more could hear his message of hope and positivity and witness his inclusivity. It became obvious, rather quickly, that he wasn’t a monster with fringe ideas dedicated to destroying the UK but quite the opposite; he wanted a fairer system where those who could afford to, paid a bit more tax and through investment, wealth was better distributed and services were resumed for the benefit of all.


I became politically active when Andrew Lansley proposed his Health and Social Care Bill after the formation of the coalition government in 2010. This was something that didn’t even feature in the Conservative manifesto at the time but, because of its swift introduction, it had evidently been pre-planned and I could see that it spelt out the certain break-up of the NHS. Over the following years I marched, sat down in the middle of Westminster Bridge for an hour or two and made connections with like-minded individuals. The highlight of this time was giving a short address to a crowded Central Hall, Westminster, about the threat of privatisation in the NHS. I’d just organised a ‘Hands Around St Thomas’ Hospital’ event, held opposite Parliament during some of the most dreadful spring weather imaginable and Jeremy Corbyn was one of the only MPs to attend; then, when I’d given my speech, John McDonnell approached me to say how much he enjoyed what I’d said.


The drift towards an acceptance that austerity was the only possible answer to the global crash of 2008 was simply the will of large corporations who wanted to carry on as normal. Politicians, possibly fearing the wrath of vested interests, went along with this because the alternative narrative required a shift to economics proposed by the left and a refutation of centrist social democracy so ironically, it was Labour who saved neo-liberalism. The coalition inherited an economy that had begun to shows signs of recovery but, following the dogma that decried the requirement for any form of state control, they imposed a wage cap on the public sector and began a series of cuts to services which hit the poor, the ill and the young while cementing the lifestyle of the top earners. The downward pressure on wages of already low-earners in an economy dominated by the service industries provided one of the sources of anti-immigrant sentiment; another was a chronic shortage of appropriate housing stock. No one in a position of power had the will to challenge the causes of this tension because this too would have upset the orthodoxy. Instead, we witnessed the return of slum landlords and an increase in top-end properties bought by foreign investors who never set foot in their purchases; the divide between haves and have nots got ever wider and resentment simmered in former industrial heartlands, stoked by the multimillionaire proprietors of The Sun, The Daily Mail, The Daily Express and The DailyTelegraph and the people ignored by Westminster.


This election result changed all that. Originally deeply despairing of the Labour leadership, fuelled by the difference in opinion of the members and the PLP, The Guardian came round to supporting Labour following the publication of their manifesto. The contrast between Labour and Conservative became quite stark: positivity vs. fear and negativity; concern for social justice vs. conceited indifference and, crucially; discipline vs. chaos. Even after the exit poll at 10pm on Thursday there were still some Labour MPs who doubted. Of the imagined carnage, they only lost five seats but gained 37; the Conservatives lost 33 seats and gained 20, losing the parliamentary majority they held before the election. May’s Brexit-election gamble backfired spectacularly. Winner? Hardly!


Jeremy Corbyn may be an unorthodox leader but his sincerity and willingness to listen in a world where shouting loudest (including electronically) and acting strong were formerly seen as important traits, has enabled him to rewrite the rules. Brexit may have been a tussle between the Conservatives and an irrelevant UKIP but 40% of the voting public had much more to worry about and Labour has the best answers to their problems. I’m looking forward to the Conservative-DUP deal coming unstuck – bring on the next general election!






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