It was the Labour party that decided to involve private finance in the NHS. It must pick up the pieces. Photo: Getty
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To save the NHS, Labour must face the ugly truth of PFI debts

Labour is right to focus on rescuing the NHS from the harm done by this government, but must face the truth that it was the party that introduced private finance into the health service in the first place.

Ed Miliband has said that this is going to be an “NHS summer”. He has sensed, rightly, that there’s something in the air, a tension over the precarious health service.

Strain on services is rising, the number of hospitals in the red is surging up, patient concern is growing and doctors are quitting in disgust at the ominous developments from the top. As much as the coalition would love to suppress them, the figures point towards a potential full-blown crisis before the parliamentary term is through. In August, campaigners will march for 300 miles, through 23 towns from Jarrow to London to press home these fears, and there are activists up and down the country straining just to get the same message across to the public: the NHS is in danger.

Labour has already made some firm commitments to undoing some of the harm done by the coalition. Andy Burnham has said in public, and behind closed doors to NHS activists, that he will repeal the Health and Social Care Act, and work to “scrap Cameron’s NHS market”. And the party has brought forward Clive Efford’s private member’s bill to rewrite rules forcing NHS contracts onto the market.

Labour should be commended for this. But if Miliband is serious about rescuing the NHS, there is an ugly truth to face. The NHS is riddled with extortionate debt from decades of misguided PFI deals. NHS hospitals owe £80bn in PFI loan unitary charges – in other words, the ongoing costs of maintaining PFI hospitals and paying back the loans. Next year alone, trusts will make some £2bn in repayments. Trusts like Peterborough and Stamford Hospitals NHS Trust, which is locked into making £40m in repayments a year on the PFI it took for Peterborough City Hospital, or Sherwood Forest NHS Trust, which is spending 15 per cent of its annual budget on the annual repayments on a PFI loan it took to expand the King’s Mill Hospital, and so on.

But there are plenty who do gain. The initial investment made by PFI companies is paid back in spades. As Joel Benjamin of Move Your Money points out: “Typically the unitary charge is three to five times the capital cost, and on more egregious PFI projects as high as seven times”.

The even uglier reality for Miliband is that the New Labour era was a golden age for the PFI. The modern PFI is the child of John Major’s Conservative government, but it was adopted and thrived under Tony Blair and Gordon Brown. Between 1997 and 2008, 90 per cent of all hospital construction funding was under PFI agreements, which paid for 75 per cent of all hospitals built.

The only positive, of course, is that 101 new hospitals were delivered in this time. New Labour invested heavily in the NHS, even if it did bring in some marketisation at the same time. Unlike this government, which has replaced marketisation with full-blown privatisation, and effectively cut budgets, especially for those with PFI debts, whose repayment rates are tacked to inflation.

Yet through a sustained campaign of attrition, the coalition has managed to shift the blame for “shortfalls” onto beleaguered health service staff and the principle of public care, and totally ignored the devastating role of the private finance cancer at the heart of it all. The next step is to present that same finance as the cure, and drive trusts that have been forced to cut back services just to balance the books straight into the waiting arms of private providers.

Figures published by the Nuffield Trust out today reveal the true extent of austerity’s toll on the NHS. In its report, Into the Red, the Nuffield Trust spells out how hospitals and trusts faced with austerity were just keeping their heads above water until last year, when “cracks” began to show. In 2013/14, a further 21 trusts had sunk into the red from the previous year, and overall trusts recorded a deficit of £100m. And the report reveals another sobering figure: of the health and social care leaders surveyed, 70 per cent said that they think more providers will be forced into the red to continue to provide high-quality care, if current levels continue.

Miliband has a real opportunity now: to rescue the NHS from another five years of this, and make huge political gains in the process. He could pledge to reform the PFI system, renegotiate the terms of existing loans agreed under duress to get payments down to “fair value”, which could even lead to a refund for some hospitals, or as has happened in selected cases, use public money to bail out hospitals crippled by debt. After all, it was good enough for the banks.

Not only would it free dozens of trusts like Peterborough and Sherwood Forest from the abject spiral of debt they’re in – and the negative impact that debt is having on healthcare – it would undermine the odious and transparently ideological argument that cuts to frontline services are needed to reduce the deficit. But that will involve facing up to the fact that it was his party, albeit under a very different leadership, that was so keen to get private finance involved in the first place. It would be a gutsy move, but a potential high earner. And it might just save the NHS.

Benedict Cooper is a freelance journalist who covers medical politics and the NHS. He tweets @Ben_JS_Cooper.

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The SATs strike: why parents are taking their children out of school to protest against exams

Parents are keeping their children away from school to highlight the dangers of “over testing” young pupils.

My heart is beating fast and I feel sick. I force myself to eat some chocolate because someone said it might help. I take a deep breath and open the door…

The hall is silent except for the occasional cough and the shuffling of chairs. The stench of nervous sweat lingers in the air.

“Turn over your papers, you may begin.”

I look at the clock and I am filled with panic. I feel like I might pass out. I pick up my pen but my palms are so sweaty it is hard to grip it properly. I want to cry. I want to scream, and I really need the toilet.

This was how I felt before every GCSE exam I took. I was 16. This was also how I felt before taking my driving test, aged 22, and my journalism training (NCTJ) exams when I was 24.

Being tested makes most of us feel anxious. After all, we have just one chance to get stuff right. To remember everything we have learned in a short space of time. To recall facts and figures under pressure; to avoid failure.

Even the most academic of adults can find being in an exam situation stressful, so it’s not hard to imagine how a young child about to sit their Year 2 SATs must feel.

Today thousands of parents are keeping their kids off school in protest at these tough new national tests. They are risking fines, prosecution and possible jail time for breach of government rules. By yesterday morning, more than 37,000 people had signed a petition backing the Let Our Kids Be Kids campaign and I was one of them.

I have a daughter in reception class who will be just six years old when she sits her SATs. These little ones are barely out of pull-up pants and now they are expected to take formal exams! What next? Babies taught while they are in the womb? Toddlers sitting spelling tests?

Infants have fragile self-esteem. A blow to their confidence at such an impressionable age can affect them way into adulthood. We need to build them up not tear them down. We need to ensure they enjoy school, not dread it. Anxiety and fear are not conducive to learning. It is like throwing books at their heads as a way of teaching them to read. It will not work. They are not machines. They need to want to learn.

When did we stop treating children like children? Maybe David Cameron would be happier if we just stopped reproducing all together. After all, what use to the economy are these pesky kids with their tiny brains and individual emotional needs? Running around all happy and carefree, selfishly enjoying their childhood without any regard to government statistics or national targets.

Year 2 SATs, along with proposals for a longer school day and calls for baseline reception assessments (thankfully now dropped) are just further proof that the government do not have our children’s best interests at heart. It also shows a distinct lack of common sense. It doesn’t take a PhD in education to comprehend that a child is far more likely to thrive in a calm, supportive and enjoyable environment. Learning should be fun. The value in learning through play seems to be largely underestimated.

The UK already has a far lower school starting age than many other countries, and in my opinion, we are already forcing them into a formal learning environment way too soon.

With mental health illness rates among British children already on the rise, it is about time our kids were put first. The government needs to stop “throwing books at heads” and start listening to teachers and parents about what is best for the children.

Emily-Jane Clark is a freelance journalist, mother-of-two and creator of stolensleep.com, a humorous antithesis to baby advice.