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An exposé of the back-door deals and negligence that threaten to destroy the NHS – and a 10-step manifesto for saving it The Coalition Government passed into law an unprecedented assault on the NHS. Doctors, unions, the media, even politicians who claimed to be stalwart defenders failed to protect it. Now the effect of those devastating reforms are beginning to be felt by patients – but we can still save our country’s most valued institution if we take lessons from this terrible betrayal and act on them. Contributors to this eye-opening dissection include Dr Jacky Davis, Oliver Huitson, Dr John Lister, Stewart Player, Prof. Allyson Pollock, David Price, Prof. Raymond Tallis, Dr Charled West and Dr David Wrigley. Proceeds from the profits of this book will go to Keep Our NHS Public (www.keepournhspublic.com).
Universal, comprehensive health care, equally available to all and disconnected from income and the ability to pay, was the goal of the founders of the National Health Service. This book, by one of the NHS's most eloquent and passionate defenders, tells the story of how that ideal has been progressively eroded, and how the clock is being turned back to pre-NHS days, when health care was a commodity, fully available only to those with money. How this has come about-to the point where even the shrinking core of free NHS hospital services is being handed over to private providers at the taxpayers' expense-is still not widely understood, hidden behind slogans like "care in the community," "diversity" and "local ownership." Allyson Pollock demystifies these terms, and in doing so presents a clear and powerful analysis of the transition from a comprehensive and universal service to New Labour's "mixed economy of health care," in which hospitals with foundation status, loosely supervised by an independent regulator, will be run on largely market principles. The NHS remains popular, Pollock argues, precisely because it created the "freedom from fear" that its founders promised, and because its integrated, non-commercial character meant low costs and good medical practice. Restoring these values in today's health service has become an urgent necessity, and this book will be a key resource for everyone wishing to to bring this about.
Revealing the British coalition government's plans, this examination demonstrates how a small "policy community" inside and outside the department of health have schemed for 10 years to replace the National Health Service (NHS) with a U.S.-style health care market without informing parliament or the public. While ex-ministers, officials, and the like profit from lucrative positions in private health companies, the population must cope with the increasing health care costs and the diminishing quality of care. With accounts from NHS patients and doctors, the key strategies of implementation are uncovered and the companies involved--their lobby, their businesses, their fortunes, and, in some cases, their crimes--exposed.
A transformative approach to public health, political economy and social care in the wake of Covid-19
What kind of state emerges from the pandemic? The pandemic caused two crises, in biosecurity and in the economy. The state was forced to tackle both; but subduing one inevitably exacerbated the other. Emerging from the impossible task of handling two conflicting crises is a new form of state, the state to come. To outline the emerging state, this book offers an in-depth critical account of the state's responses to the biosecurity and the economic crises. It is thus the first study to address both crises ensuing from the pandemic, and to synthesise the responses to them in a comprehensive account of political power. Addressing biosecurity, the book deciphers its key modalities, epistemic premises, its law, the threat it aims to oppose and the ways in which it relates to public health and society — especially its extraordinary power to suspend society. Addressing the economic crisis, the book deciphers the actuality and prospects of both the economy and the state's economic policy. It claims that economic policy is now dual: it adopts countercyclical measures to serve and entrench a neoliberal economy. The responses to the twin crises inform the outline of the emerging state: its structure, logic and legality; its power and its relation to society. This is a state of extraordinary power; but its only purpose is to preserve the social order intact. It is a despotic state: powerful, and set to impose social stasis. This work offers ground-breaking analysis based on our pandemic experience. It is indispensable for critical scholars and students in Politics, Security Studies, Sociology, Law, Political Economy and Public Health.
This book explains what has been happening to the NHS since the 2012 Act. It challenges myths: that the NHS was broke, that we can't afford the NHS, that doctors and GPs would be in the driving seat; that patients would have more choice, that there would be less bureaucracy and that communities would have greater control.
The global response to the COVID-19 pandemic is the greatest science policy failure in a generation. We knew this was coming. Warnings about the threat of a new pandemic have been made repeatedly since the 1980s and it was clear in January that a dangerous new virus was causing a devastating human tragedy in China. And yet the world ignored the warnings. Why? In this short and hard-hitting book, Richard Horton, editor of the medical journal The Lancet, scrutinizes the actions that governments around the world took – and failed to take – as the virus spread from its origins in Wuhan to the global pandemic that it is today. He shows that many Western governments and their scientific advisors made assumptions about the virus and its lethality that turned out to be mistaken. Valuable time was lost while the virus spread unchecked, leaving health systems unprepared for the avalanche of infections that followed. Drawing on his own scientific and medical expertise, Horton outlines the measures that need to be put in place, at both national and international levels, to prevent this kind of catastrophe from happening again. Were supposed to be living in an era where human beings have become the dominant influence on the environment, but COVID-19 has revealed the fragility of our societies and the speed with which our systems can come crashing down. We need to learn the lessons of this pandemic and we need to learn them fast because the next pandemic may arrive sooner than we think.
This timely analysis sets out the full impacts of policy reform, austerity and marketisation on our country's mental health services.
This new edition of this bestselling book argues that patients need to develop as active citizens and co-producers of health. This second edition has been entirely rewritten with two new chapters, and includes new material on resistance to that world-wide process.
Who are NHS middle managers? What do they do, and why and how do they do it’? This book explores the daily realities of working life for middle managers in the UK’s National Health Service during a time of radical change and disruption to the entire edifice of publicly-funded healthcare. It is an empirical critique of the movement towards a healthcare model based around HMO-type providers such as Kaiser Permanente and United Health. Although this model is well-known internationally, many believe it to be financially and ethically questionable, and often far from 'best practice' when it comes to patient care. Drawing on immersive ethnographic research based on four case studies – an Acute Hospital Trust, an Ambulance Trust, a Mental Health Trust, and a Primary Care Trust – this book provides an in-depth critical appraisal of the everyday experiences of a range of managers working in the NHS. It describes exactly what NHS managers do and explains how their roles are changing and the types of challenges they face. The analysis explains how many NHS junior and middle managers are themselves clinicians to some extent, with hybrid roles as simultaneously nurse and manager, midwife and manager, or paramedic and manager. While commonly working in ‘back office’ functions, NHS middle managers are also just as likely to be working very close to or actually on the front lines of patient care. Despite the problems they regularly face from organizational restructuring, cost control and demands for accountability, the authors demonstrate that NHS managers – in their various guises – play critical, yet undervalued, institutional roles. Depicting the darker sides of organizational change, this text is a sociological exploration of the daily struggle for work dignity of a complex, widely denigrated, and largely misunderstood group of public servants trying to do their best under extremely trying circumstances. It is essential reading for academics, students, and practitioners interested in health management and policy, organisational change, public sector management, and the NHS more broadly.