A new report from Audit Scotland on the finances of NHS Scotland has outlined the significant pressures being placed on the health budget.
Politicians from the Westminster and Holyrood governments always like to boast about the increased spending they have provided for the NHS. Workers and service users have, over a prolonged period of time, had to endure attacks on terms and conditions in the workplace and a gradual erosion in the quality of service provided. There are also reports from health workers across Scotland of a lack of staff available to cover shifts on a regular basis.
While the health budget has continued to grow in cash terms, in reality, when you take into account inflation, the real terms increase has practically ground to a halt. There has been an increase of just over 1% in 2013/14 on the previous year, which will decrease further over the coming years. These figures only represent the revenue budgets for NHS boards. When you take into consideration that the capital budget for the NHS is due to decrease by 53.6%, then the overall health expenditure of the SNP led Scottish Government is due to fall by 0.9% over the next two years.
But even if you don’t take the capital budget cuts into account the greater increase in population compared to the paltry rise in the revenue budget means that health spending per head of population is already falling. And not only to we get less spent on us per head, but the money is no longer going as far. This isn’t because of any pay rises for staff but rather due to the increased prices that private pharmaceutical companies are charging for drugs. New technologies being used in the NHS are also taking up a larger share of the budget, forcing greater cuts to be found elsewhere.
When you add this to the other pressures being placed on the health service such as an ageing population, which has lead to a higher number of people with long term health conditions, then it is quite clear that there needs to be a drastic change in direction.
This report from Audit Scotland provides clear evidence that despite the claims of politicians, many savings are having to be made in the NHS – and savings invariably mean cuts somewhere. It’s workers and service users that are facing the brunt of the cuts that are being forced on them by consecutive governments and their agenda of creeping privatisation.
More departments are being outsourced to the private sector. And while at the moment in Scotland these are non medical services, the heart and soul of the NHS is now being privatised in England. The drive for profit that is the raison d’etre of private companies inevitable leads to more cash for the capitalists at the expense of terms and condition for staff and the level of service provided.
In order to rejuvenate the NHS we need to kick out the profiteers. This means an end to all PPP/PFI projects whose cost allows private companies to extract massive profits from the public purse on their initial investments.
It also requires the nationalisation of the pharmaceutical companies. The UK Government has agreed a deal to cap the NHS drugs bill at £12 billion. Instead of capping the drugs bill, brining these companies into public ownership would allow billions of pounds to be reinvested in the NHS.
In the mean time it is essential that trade unions mount a mass campaign to defend pay, conditions and services.The future of the NHS in this age of capitalist austerity is of continuing cuts. Coordinated action by the main health unions Unison, Unite and GMB could begin to turn the tide if an effective lead was given. There is massive anger within the NHS at the attacks on staff by management but there is also rising discontent at the lack of a fightback being provided by the unions.
The NHS took centre stage during the Scottish independence referendum because it is largely seen as one of the biggest achievements of the labour movement over the last century. If the NHS is to be maintained as a service people can be proud of then the fight against cuts in the NHS needs to step up a gear and be linked to a wider campaign lead by the trade unions against all austerity.