The economy and Maastricht are not the only questions on which the Tories are vulnerable and the Labour opposition bankrupt.
As hospital wards close and health workers lose their jobs in a wave of cuts and crisis measures across the country, HARRY SLOAN looks at the crisis the Tories have created for themselves in the health service.
In our next issue, a special feature 'What is to be Done THE TORIES' ideological Insistence upon creating an anarchic internal markel in the NS is turning into a bureaucratic nightmare.
By separating purchasers of health care -the lund holding District Health Authortes and GP lund holders - from the providers - hospi tals and units delivering fiont-line care Thatcher's reforms spawmed a monster.
Each side of the split has now developed li own bureaucracy with the biggest expansion coming among the provider unis, sub- dviding Into competing optad out Trusts, each of which cares the tappings and overhead costs of a Board of Direciors, new tiers of servor manage ment, and mushrooming finance and personnal departments in place of productive nursing, medical and support staff, hospllds are clooging up with parasitic platoons of highly pald senier managers and accountants, while thousands more clerical stall are requited to administer the cumbersome pricing and billing structure which now dominates the new system.
With no overall Increase in resources, the Tory reforms have diverted cash fom patiest care into bureaucracy.
Planning abolished By abelishing any pretence of plenning and lotcing hospital units into competition for refer. rais in which crice is the key factor, thay have also inggared a war of alinion agamet staff 70 percent of NIS spending is on pay, so the only way to rebuce prices is to cut the numbers and qunity of stall Icarrying out skill mix reviews designed lo reducs the numbers of mare expensiva qualilled stall employed while pushing patients out of hospital beds even faster, whether of not they are teady to go Certain losers in this new market are contes of excallence, in which qualialive care has been provided at slightly higher than average cost Already the victims of this include London's Elzabeth Garret Anderson Hospital for Women and Shelbeld's King Edward's orthopaedie 10 Oct. 1992 No. 29 Yorkshire's Klingbeck Hoepital, In the battle to compete by cutling costs and asset stripping surplus siles, big cities such as Bamingham, Manchester, Liverpool Sheffield and esewhere face massive tationalisation plans involving the loss of beds and walk loved hospitals The biggestof these shake-ups is in Landon, where inflated property values and the cost pressures of the capital routinely add 29 percent to the cost of services.
anding their prices under cut by hoggies i uter London and in the Home Counties, the inner London teaching hospitals ate being driven towards bankrupicy, revealing mutt-mil Ion pound delicits. Every altempt to tackle these shorffalls by cutting services simply pushes up the unit cost ol treatment, Hit list The Tory response to the London onsis hass been to set up the Tomison Inquiry with a brief to draw up a hi list of planned dosures Eaget to win perfotmance related pat benuses managers from all tou Themes healt regions have rushed to volunteer draconian culs in beds: their combined proposals would ax: anything up lo 9,000 London beds in the next live years. This is almost 50% of acute hospilal capacily in the capital but there are no proposals on where the 450,000 displaced in patients could hope to find treatmen.
A camonion against Taminson and the Regional closure plans is being aroposed bu pressure group tondon Health emersons An early and unexpected victory was notched up when tha stidently Tary London Evening Stand ard abruptly switched course from all out sup port for Tominson to declare iselt commited b campaign in defence of Barts and olher teach ing hospitals A London-wide meeting on November 10 al Camden Town Hal will launch the LHE campaign, which is horing to link health and other Nade unions, Labour Partles pensloners groups and community organisitions around a S point plan or resistance Battling against market forces: protestors oppose Mile End hospital closure MIl
Andrew Wiard hospital, Others are threatened Including