Screenshot from Michael Moore’s film Sicko where Rick is left choosing which finger to save

Secret diary of a NHS nurse

In the first of a new series that looks at what it’s like on the ground for NHS workers facing cuts and privatisation, our correspondent under the pseudonym “the secret nurse”, describes her experience applying for NHS funding and her shock at the entrance of Richard Branson into healthcare

I have been a healthcare assistant and medical secretary for almost two years in the National Health Service. Naturally I have a lot of positive things to say about our NHS and even my own job. I have just returned to university to become a qualified nurse.

It is comforting that 65 years on, the NHS is still one of the most popular and well-known institutions this country has. We saw it in the Olympic opening ceremony and we still see programmes like Casualty playing across millions of homes in Britain every Saturday night.

However, sadly that is not the only story. The significant changes that have been implemented in the NHS have changed it fundamentally.

The popular images we see on TV are missing the sneakiness of the privatisation that is slowly taking over. We may still see that famous blue and white logo depicted across our health service, but more and more the logo is masking evil actors in private companies that are taking away the service bit by bit.

Whether you are an elderly individual who is interested only in knowing that your prescriptions will be dealt with or you are a young person seeking an x-ray after falling off your cool new skateboard, perhaps you feel the privatisation is not really a problem as long as you still receive your treatment at the end.

Let’s be clear that this will no longer be the case in 10 years time if the privatisation that is currently occurring continues apace. All of us must take action and educate others if we are to still receive the free treatment for all that was demanded when the NHS was founded in 1948.

Virgin healthcare

But the NHS is a public institution funded by our taxes? How can it be privatised? Admittedly, I also find this difficult to get my head around. I go into work some days and I am still shocked by the level of privatisation that is already occurring.

Most worrying, however, is that most patients I see are oblivious. Not because they don’t watch the news or because they are stupid, but because they still receive the treatment they were expecting and they still see that blue and white logo each time they go into a GP surgery or hospital.

Let’s begin by putting this privatisation into some perspective. If your local GP decided one day to become a pilot for the day, with no experience of flying planes, would you get on board knowing they had no co-pilot or anybody experienced with them? I am hoping you have said no to that question. And yet one of the biggest private companies invested in the NHS is VirginCare. Yes, that’s correct, Richard Branson’s Virgin. Now I am all for career changes but something smells fishy to me when one of the richest companies in the world that have an airline, a television station, mobile phone contracts to name but a few, want a piece of the care cake.

Virgincare state on their website “Just because NHS services are universally available doesn’t mean they can’t be outstanding”. This is a very interestingly worded quote with many reasons to have it picked apart but taking it at face value, we all agree with it right?
So welcome aboard Mr Branson…. oh wait…. hold it…. why has £11 billion worth of NHS gone up for sale yet we have seen 10 percent of A&E departments close, ambulance stations on the brink of being shut down and near on 35,000 jobs cut including nearly 6000 nurses. If this is all part of VirginCares “outstanding care” I’m terrified of their definition. Moreover, we all know what the shortened version of Richard is…

Not just blaming Branson
Don’t get me wrong, I am not blaming this all on Dick. Please pardon the not-so-pun. I definitely have a lot to say about the “Tory Vermin”, as Bevan called them, who are the engineers of the privatisation. It is also important to emphasise that privatisation of the NHS is not new, with companies and charities taking over services since the 1980’s, especially within mental health services and elderly care. But what frightens me is the concord speed at which this has happened in the past 2 years. Nearly 200 contracts, worth over £2 billion, have gone out to tender since April 2013 many of which have been taken up by private companies.

With the new “any qualified provider” rule in place since 2012, every corner of the NHS is being opened up to private companies who fit this description. All it means is that these companies must be assessed and fit the criteria for the care or service they are offering following the same guidelines and protocols that NHS services but offering the patient more “choice”. Across the NHS, from pathology and imaging to ambulance services and maternity care, private companies have taken on contracts worth billions of pounds. You can even visit Specsavers now for an NHS hearing test. What will it be next, nipping into Sainsburys to get a filling?

Maybe, I hear you ask, this isn’t such a big problem if we still receive the standard of care that we have always received, if not better as claimed by VirginCare. But can competition between shareholders and companies really drive up standards of care for all? My opinion is that competition makes revenue not excellent care.

We have seen what competition, using league tables, has done for our education system: it is no coincidence that we see a postcode lottery where the poorest areas of the UK use the schools which are at the bottom of the league tables. Do we really want to see this happen with our health service but with the addition of a tax code lottery? As noted quite clearly in the excellent book 2NHS SOS” (I recommend that everybody reads this book) Sweden put “competition at the heart” of their NHS. “Choice” grew in affluent urban areas where privately-owned clinics pushing unnecessary care now abound. Of the 196 new clinics that opened in Sweden, all privately-owned, 195 were in wealthy areas.

Since 2012’s Health and Social Care Act scrapped the government’s duty to secure a comprehensive health service, the health secretary is now legally able to wash their hands of the entire mess. So what happens now? While the US are desperately striving to create a similar public health service like ours, should we all be calling Direct Line to sort out our health insurance? Will we start to see scenes like in Michael Moore’s documentary ‘Sicko’ where a man had to choose which finger he had sewn back on because his insurance wouldn’t cover both?

How would my grandad who has lung cancer, hypertension, gastro-enteritis, arthritis, cataracts, hearing aids and 24hr oxygen get cover? I doubt even compare the meerkat, I mean market, could find him something.

Compare the market
At work I have to fill out forms on behalf of GPs to apply for funding for “less important” procedures such as cataract extractions and hip replacements. The forms go through, just like all referrals now, to a contracted body called the Referral Facilitation System who decide first of all whether or not referrals are warranted, without even meeting or assessing the patient.

The procedures that require funding then go to a second independent body who decide on the urgency of the procedure. This usually goes back and forth until I am as blurry eyed as the poor patient with cataracts and often results in the treatment not being funded. How can this happen in our NHS in 2014? This is only one small example of the damage bureaucracy and privatisation creates for our NHS.

In this series of articles I intend to introduce a few topics surrounding the NHS, from what it is like to work for in the NHS today to what the future holds for staff and patients. “But, there can’t be more!”, I hear you cry. I agree and I wish there wasn’t but I really feel that this is so important right now.

With campaigns like Save Lewisham A&E we have seen how much people are willing to fight for this NHS but sadly that was only the beginning. If we continue to ignore what is happening to our NHS then we really will lose the best of it within the next 5 to 10 years but if we all now wake up and smell the coffee I truly believe that this could be our poll tax.

There is a lot to fight against at the moment, with climate change, education upheaval and attacks on the working class left right and centre, but without our health we are nothing. As I said to a friend very recently regarding the Facebook “No make-up selfies” in order to raise money for cancer research, it’s wonderful to see so much money raised, albeit through in my opinion a self-indulgent means, but what is the point in having new machines and cancer treatments if nobody but the rich can afford to use them, the rich who probably didn’t take part in cancer fundraising in the first place. Will this be the new beginning of alienation from our health where we raise the money for the treatment and equipment but cannot actually afford to use it?

This was written by the secret nurse but what is happening in our NHS is no secret. Let’s act now – before it is too late.