“Crumbling to the point of crisis”: so reads the headline from the Irish News of 16th April 2024, referring to the dire state of our GP medical services and the NHS in general. What should have been added to the headline were the words “by design”.
Those of us who live here; and are activists here, know all about it. It doesn’t matter now if you are seriously ill, it doesn’t matter if you have a sick screaming child and it doesn’t matter if you are old and ill, you will wait for days phoning for an appointment to hopefully see a doctor, which will end up being a nurse practitioner.
“No society can legitimately call itself civilised if a sick person is denied medical aid because of lack of means.” – Aneuran Bevin
Last year (2023) approximately 10% of NHS operations were carried out by private
companies. That’s up from a 3% figure in 2011, according to the Irish News. That excludes all the private companies now employed to do cleaning, repairs and maintenance and now, increasingly, ambulance services. This is not to mention the privatisation of hospital buildings themselves.
Doctors are scarce, very scarce, in the north of Ireland, and deliberately so. Phoning the local Health Centre two hundred times just to get an appointment, is not uncommon. But even before you are granted the “honour” of an appointment or a visit to the practitioner, you will first be thoroughly screened by a receptionist – yes, a receptionist – to establish if you are really ill or meet some unspecified criteria. Yes, this is a supposedly “developed” part of the world, and yet the north of Ireland and Britain are now experiencing the consequences of the same “tactically devastated” health service, which really began under Thatcher.
This was under the so-called private finance initiative (PFI) “ponzi schemes”, that rack up billions in interest and lease payments to faceless financiers. All the signs are there of the development of a largely privatised NHS and that the plans for this are already well advanced. It is accepted too, that multi-national healthcare companies have been waiting patiently for the total collapse of the NHS, to really move in and snap up the most profitable parts. The result will be a two-tier health service: a world class health service for those who can pay and a rather more basic one for those who simply cannot. And guess which class in our population that will affect the worst?
The central question is, why has this all been allowed to happen now? Well, according to the Irish News there has been an increase of 200,000 registered GP patients in nine years. That approximates to over 22,000 per year. With 350 GPs in the North at the time of writing, that’s an increase of about 64 extra patients per GP Service per year. That’s not exactly a serious increase. And allowing for the deaths of patients of a given GP practice, it could well mean an even smaller increase. Yet we are told that there is an increasing demand on GPs because we are living longer. Yet the figures do not support this.
The origins of the problems within the NHS are rooted in a planned attack on it via neoliberal policies, driving the creeping privatisation of our health Service. Only about 65 GPs were trained in the North in 2015-2016, with similar numbers in subsequent years, while this year 121 GPs are being trained.1
However, just to keep pace with retiring doctors, a minimum of 160 new doctors per
annum are needed. This results in a doctor to patient ratio of one doctor per 1,450
patients, on average, here. Also in hospitals, hundreds of thousands of places lie empty at all medical levels. And yet, a “third world” country like Cuba, has thousands of extra doctors, and 9 doctors per 1,000 patients. They also can send thirty or forty thousand doctors all over the world as well.
Wages and conditions at all levels of our health system are being deliberately run down so that the “knights in shinning armour”, in the shape of multi-national “healthcare” companies and health insurance vultures, will appear over the horizon to “rescue” the NHS. In reality, they will pillage, plunder and carry away all the profits they can manage for their CEOs and shareholders, with not the least care for the patients. If you cannot pay, you will die. It is happening already all over Ireland and the UK. Profits from health and death are alive and well.