David Owen's NHS bill offers a final chance to save our health service

Labour and the Lib Dems must support a bill that restores the right of all citizens to comprehensive care.

David Owen has today published in full a bill in the House of Lords to reinstate the NHS and the secretary of state’s legal duty to provide a national health service throughout England. This duty has been in force since 1948 and is the legal foundation of the NHS and our rights and entitlements to health care, a duty the coalition’s Health and Social Care Act 2012 is abolishing.

Owen’s 'reinstatement' bill puts into reverse the monstrous 473 H&SC Act, which from April this year abolishes the NHS throughout England, reducing it to a stream of taxpayer funds and a brand or logo for the public bodies and private companies which will receive them. The bill does not entail yet more disruptive reorganisation, it simply restores the democratic basis of the NHS and the rights and entitlements of all citizens to comprehensive care; rights which were shredded by the 2012 Act.

As Owen has warned: "the NHS has remained by far and away the most popular public service because people sense rationing and restrictions are inevitable, and resources limited but that they value and recognise the fairness of those decisions being taken not by market forces or quangos but by some overall democratic, open, transparent decision-making."

This bill comes at an important moment. Next week, Health Secretary, Jeremy Hunt will determine the fate of Lewisham hospital and very soon the fate of many more hospitals as cuts and shareholders' profits bite deep into NHS budgets. By putting power into the hands of quangos, the government hopes to protect itself from the full force of public anger at the implementation of a four-year 'efficiency' plan expected to generate £20bn savings by 2014.

The plan, drawn up by US management consultants McKinsey on PowerPoint slides, the electronic equivalent of the back of a cigarette packet, has already led to the sacking of thousands of nurses and loss of services.

David Nicholson, the chief executive of the new NHS Commissioning Board, who appeared before the public accounts committee last week, warned of worse to come: "We are just going into a phase now where quite a lot of fairly contentious service change issues are surfacing." "Fairly contentious" makes a mockery of the scale of proposed losses and closures.

In north west London the government plans to cut 25 per cent of beds, and throughout London at least seven accident and emergency departments will close; 5,600 jobs in North West London will be lost by 2015, 4,000 in Merseyside, and thousands more in Rotherham, Devon and Cornwall, Bolton, and Portsmouth. Hospital closure and downgrading will take place in several major cities. Meanwhile, payments to private contactors continue to escalate, from those to management consultancies that have taken over from public officials, through expensive PFI deals involving payments that are contracted to rise each year, to outsourced services from which shareholders are seeking returns ranging from 15-25 per cent.

And yet the NHS returned over £2bn to the Treasury last year. Hospitals have deficits because the government chooses to load them with these costs, not because they are badly run. The government is manufacturing a financial crisis which is not of hospitals' own making.

The Health and Social Care Act legalises the break-up of the NHS under the efficiency plan. Some services will become the responsibility of local authorities and others will be the responsibility of private, for-profit firms; many services may no longer be provided free. For instance, mental health, immunisation and sexual health are being transferred to local authorities. Services for pregnant or breast-feeding women, for younger and older children, for the prevention of illness, even for the care of persons suffering from illness or needing after-care may no longer be mandatory parts of the free health service. In fact, pretty much everything is up for grabs.

MPs and the public have yet to realise that the Act will abolish the NHS by splitting up services in this way and removing the secretary of state’s control over provision. Unfairness has already been creeping in under existing rules. Two weeks ago the medical director of the NHS, Sir Bruce Keogh, admitted to the public accounts committee that for the last two years he has been "deluged by letters from people saying, 'This PCT isn’t paying for that', or that one PCT takes a different view on (entitlement of patients to) hip surgery or cataracts to another." We are outraged by the unnecessary pain this causes and authorities must be held to account for the denial of care. After April, when the Act is implemented, that will no longer be possible. Instead, a range of bodies not accountable to parliament, including for-profit companies, will decide which services will be freely available and who will receive them. That is no longer a national health service and people must understand that.

The coalition has deceived the public over the NHS. The Health and Social Care Act is not about making the service GP or patient-led, it is about abolishing the national service and transferring public funds and services to the private sector through a process of closure and the manufacture of a financial crisis. Loss of services coupled with new discretionary powers mean that people will be forced to pay out of their own pocket for more of their care. Owen’s bill exposes the truth behind the Act. For sixty years, the public , unlike their US cousins, had no fear of health care bills; this freedom from fear and commitment to the NHS model has stood the test of time. Will Labour and the Liberal Democrats support a Bill that restores the democratic and legal basis of the NHS and the principle of health care for all on the basis of need and not ability to pay?

Allyson Pollock is professor of public health policy and research at Queen Mary, University of London, and the author of NHS PLC

David Price is a senior research fellow at Queen Mary, University of London

Demonstrators protest against the proposed closure of the Accident and Emergency and maternity units at Lewisham hospital. Photograph: Getty Images.

 

Allyson Pollock is professor of public health policy and research at Queen Mary, University of London, and author of NHS PLC

David Price is a senior research fellow at Queen Mary, University of London

 

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White supremacists are embracing genetic testing - but they aren't always that keen on the results

Users of far-right site Stormfront are resorting to pseudo science and conspiracy theories when DNA tests show they aren't as "pure" as they hoped.

The field of genomics and genetics have undergone almost exponential growth in recent years. Ventures like the Human Genome Project have enabled t humanity to get a closer look at our building blocks. This has led to an explosion in genetic ancestry testingand as of 6 April 2017 23AndMe, one of the most popular commercial DNA testing websites, has genotyped roughly 2 million customers.

It is perhaps unsurprising that one of the markets for genetic testing can be found among white suprmacists desperate to prove their racial purity. But it turns out that many they may not be getting the results they want. 

Stormfront, the most prominent white nationalist website, has its own definition of those who are allowed to count themselves as white - “non-Jewish people of 100 per cent European ancestry.” But many supremacists who take genetic tests are finding out that rather than bearing "not a drop" of non-white blood, they are - like most of us a conglomerate of various kinds of DNA from all over the world including percentages from places such as sub Saharan Africa and Asia. Few are taking it well.

Dr. Aaron Panofsky and Joan Donovan, of UCLA’s Institute for Society and Genetics and the research institute Data and Society respectively, presented a research study (currently under peer review for publication) at the American Sociological Association a week ago, analysing discussion of GAT on Stormfront forums. Panofsky, Donovan and a team of researchers narrowed down the relevant threads to about 700, with 153 users who had chosen to publish their results online. While Panofsky emphasised that it is not possible to draw many quantitative inferences, the findings of their study offer a glimpse into the white nationalist movement's response to science that doesn't their self perception. 

“The bulk of the discussion was repair talk”, says Panofsky. “Though sometimes folks who posted a problematic result were told to leave Stormfront or “drink cyanide” or whatever else, 'don’t breed', most of the talk was discussion about how to interpret the results to make the bad news go away”.

Overwhelmingly, there were two main categories of reinterpretation. Many responses dismissed GAT as flimsy science – with statements such as a “person with true white nationalist consciousness can 'see race', even if their tests indicate 'impurity'".

Other commentators employed pseudo-scientific arguments. “They often resemble the critiques that professional geneticists, biological anthropologists and social scientists, make of GAT, but through a white nationalist lens", says Panofsky. 

For instance, some commentators would look at percentages of non-European DNA and put it down to the rape of white women by non-white men in the past, or a result of conquests by Vikings of savage lands (what the rest of us might call colonialism). Panofsky likens this to the responses from “many science opponents like climate deniers or anti-vaxxers, who are actually very informed about the science, even if they interpret and critique it in idiosyncratic and motivated ways".

Some white nationalists even looked at the GAT results and suggested that discussion of 100 per cent racial purity and the "one drop" rule might even be outdated – that it might be better to look for specific genetic markets that are “reliably European”, even though geneticists might call them by a different name.

Of course, in another not totally surprising development, many of the Stormfront commentators also insisted that GAT is part of a Jewish conspiracy, “to confuse whites by sprinkling false diversity into test results".

Many of the experts in the field have admitted to queasiness about the test themselves; both how they come to their results and what they imply. There are several technical issues with GAT, such as its use of contemporary populations to make inferences about those who previously lived in different places around the world, and concerns that the diversity of reference samples used to make inferences is not fully representative of the real world. 

There are other specific complications when it comes to the supramacist enthusiasm for GAT. Some already make a tortous argument that white people are the “true people of color" by dint of greater variation in hair and eye color. By breaking up DNA into percentages (e.g. 30 per cent Danish, 20 per cent German), Panofsky says GAT can provide a further opportunity to “appropriate and colonise the discourse of diversity and multiculturalism for their own purposes". There's is also, says Panofsky, the simple issue that “we can’t rely on genetic information to turn white nationalists away from their views."

“While I think it would be nice if the lesson people would take from GAT is that white nationalism is incoherent and wrong. I think white nationalists themselves often take the exact opposite conclusion."