The government can’t hide behind grateful applause: they must now fund the NHS properly

The solidarity expressed through weekly applause for the NHS, carers and key workers has been truly inspiring, and a great source of support for all staff. 

But we need those in power to do more than just clap for us. The NHS and local authorities have been starved of resources for the last ten years. The current crisis has been worsened by a decade of government hostility towards a publicly funded health service. Low staffing levels are a direct result of budget cuts and limits on pay.

We cannot go back to an NHS that lurches from winter crisis to winter crisis. The government should admit that their past approach to health and social care was wrong. There should be a review of pay for NHS and social care workers, which at minimum adds back money denied, compared to inflation, as a result of pay rises that have been capped for years at 1%. Below inflation pay rises are a cut in spending power. The public sector has been ‘awarded’ 1% for ten consecutive years; their wages have shrunk below pay growth in the private sector.

An apology and pay correction would be a starting gesture for people who are now accepted to be courageous, brave and essential to all of us. It turns the admiration shown on our streets every week into a tangible benefit, which would boost the morale of the people now working in dangerous and difficult circumstances.

We, the undersigned, acknowledge the supreme importance of NHS and social care staff. We recognise that they are indispensable.

We call on the government to:

Publicly and formally apologise to NHS and social care staff for past policies that led to a 1% limit on pay rises and cuts to the services in which they work.

Begin a review of wages and salaries for these workers that, at minimum, restores pay lost compared to inflation from 2010 to 2020, and sets above-inflation pay rises for 2021 and thereafter.

Fully fund the NHS and social care.

The only future for the NHS after COVID-19 is a return to its founding principles

The COVID-19 pandemic illustrates the vital importance of a comprehensive, publicly funded and universal health service. The choices we make during this crisis will shape the future of the NHS and our wider society.

We are already limited by poor decisions made before the virus struck. The Conservative’s ‘hostile environment’ policy, where people with a precarious immigration status risk deportation or destitution if they seek NHS services, means there may now be considerable apprehension to access necessary care. Though coronavirus treatment is exempt from charging for those without documentation, this message is likely to be lost.

When more beds were needed, rather than requisition private hospitals the government struck a deal where beds are rented for £300 each, per day. This amounts to a public sector bail out of private hospitals that the NHS should never have to pay. These beds could be utilised in the public interest; instead they are rented at public expense.

The government then wrote off £13.4bn of NHS debt. It is disingenuous to call this debt. It represents money that has been rightly spent on patient care, and the government’s actions acknowledge this with a trick of accounting. It is also only a fraction of the shortfall in NHS funding over the last ten years of austerity.

A sincere approach to the NHS’ debt would be to cancel Private Finance Initiative payments. £2bn was paid in 2016/17 in PFI debts, and repayments will continue every year until 2050. This lost wealth represents around 2% of the annual NHS budget. It could be reinvested to improve the nation’s health but instead vanishes into private hands. The same is true for private buildings used for NHS services. There is an opportunity to return these to the ownership of the public they serve.

Fragmentation, cuts and creeping privatisation have all contributed to the difficulties in our response the pandemic. More than 17,000 beds have been cut from the 144,455 that existed in 2010. The UK has a lower number of critical care beds per person than Italy, France, Spain, Germany, the USA, Japan, or South Korea. Years of underfunding led us to this moment. The PPE distribution fiasco shows the inability of the private sector to provide the service needed. Cutting warehouse capacity in order to prioritise profit means private distribution companies cannot now supply health and social care workers with the person protective equipment they need.

The hundreds of billions of pounds made instantaneously available in response to coronavirus shows the transformative power of the state to provide a crucial safety net for all of us. We can afford a far fairer society than the one we became accustomed to. Rapid changes to manufacturing capacity to produce ventilators, dialysis machines, PPE and other socially useful products demonstrates that an economy based on public ownership, planning and democratic control could meet the needs of people across the world, unlike the chaotic response of the free market.When this crisis eventually subsides, the public must not be made to pay. We must not return to more austerity.

We also cannot emerge from this pandemic and continue to ignore the harm caused by environmental destruction. The delayed, incomplete initial response to coronavirus echoes our apprehension to face the challenge presented by climate change. We should confront the runaway economic expansion that created the conditions for previous, current, and perhaps future outbreaks. We have an opportunity to live within our planetary means.

We could recreate our health and social care systems based on need not profit. We could choose to reduce inequality permanently. The reset button on society has been pushed – what happens next is up to all of us.