Monday, 13 October 2014

NHS and the Mansion Tax diversion

Michael Gove, Parliamentary Secretary to the Treasury and Chief Whip, appeared on Radio 4's Question Time recently.  He said he was outraged and insulted at allegations by another panellist that the Coalition Government is privatising the National Health Service.

Who is he kidding?

Some of my work is in the NHS is in primary care.  The NHS is being privatised by stealth.  Here's how it works:  a particular service, such as Physiotherapy, is put out to tender.  The chosen provider is a private company.  As the NHS physiotherapy service loses market share, it withers on the vine.  When the contract comes up for renewal, there is no longer any NHS physiotherapy to make a bid for it.  True to form, the contracted out service proves to be more expensive than the NHS equivalent.  In the county I work, mental health services were under pressure.  The area health authority contracted a private company to provide low level Cognititive Behavioural Therapy paid for centrally.  As financial pressure mounted on GP surgeries, they looked around for cuts to make.  Locally funded counselling services were an easy target.  Patients now have CBT or nothing (a service which costs the NHS more than the locally funded counselling.)

Salaries have been flatlining for several years and many services typically provided by GPs have been contracted out, reducing income.  GP surgeries run as businesses, a legacy of arrangements made when the NHS was first founded.  The more that income shrinks, the greater the pressure.

The ambulance service is in crisis as the population has increased massively in the last 2 decades, but funding has not kept pace.  Trivial and prank calls contribute to expansion of demand, but not completely.  Paramedics report that they get no breaks on shifts, because the pressure is constant.  Staff are leaving.  People are dying because ambulances take too long to reach high risk cases.

What does this have to do with the Mansion Tax?

The Liberal Democrats promoted this idea, but failed to get it through the Coalition.  Labour are now advocating this policy and promising that funds raised will be spent on the NHS.  This plays well with many regions outside of London and the South East.

If you live in Pontefract, an impoverished part of West Yorkshire, you can buy a 5 bedroom, detached 5 bedroom house built in 1894 (with attic and cellar rooms and extensive grounds) for £595,000.

In Clapham, South London, you can buy a small 3 bedroom terraced house for the same price.

These are neither the cheapest regional area or the most expensive zone of London and the South East.

The Mansion Tax will hit lots of ordinary people, who will pay a premium on top of inflated housing prices.  It will not hit the non-domiciled Russians, Chinese or Middle Eastern multi-millionaires who are buying up properties all over the South East.  These are for investment, a bolt hole insurance in case the regime changes and many are left empty and crumbling over time.  These people tend to buy through companies and are often not subject to Stamp Duty and other taxes.  Nothing has been suggested to deal with this development that skews the property market.  Properties that are bought to let will have rental prices increased to absorb the Mansion Tax.  There are no rent controls, so accommodation costs are pushing people to the margins.

Why is this a diversion from the state of the NHS?

The biggest single threat to our state run National Health Service is the current move to join the TTIP.

The Transatlantic Trade & Investment Partnership is a bi-lateral tade agreement quietly being negotiated with the USA.  This has already been agreed between North and South America to devastating effect.  Private Eye describes it as a deal which opens the door for US corporate lawyers to challenge any service that is state run in the UK, demanding access for private companies.

If you watch/listen to BBC news and analysis you might imagine this does not exist, as TTIP is so rarely reported.  Negotiations are held in secret and nothing is being reported to the public.  TTIP did not feature in any of the political party conferences in the past month.  It is left to charities and pressure groups to gather support to block the deal.

Political parties are all careful to say that the NHS will remain free at the point of use under their stewardship.  They do NOT guarantee that it will be state run.

The mansion tax is a diversion from wholesale corporate sell off of the NHS.

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