Francis ⤗ Fish

In their recent book "NHS for Sale" the Keep Our NHS Public campaign point out that getting rid of the the internal market in the NHS will save between £5bn an £10bn a year. Given that the paltry promises from the mainstream parties are only an extra £2bn a year to plug some of the gap this would easily resolve the funding crisis quite quickly. For comparison, before the market was introduced the NHS admin costs was around 6% of the overall budget, now they are rising to 15%. The NHS budget is huge, the estimated figure for 2015/16 is £115bn, so 15% gives us the astonishing figure of £17.25bn, 6% would be £6.9bn, which leaves around the £10bn figure they quote.

For reference in the USA there is an unregulated market controlled by a small cartel of "providers" who work together to fix prices. 30-40% of health budgets are wasted on administering claims instead of patient care. These are the companies that are buying up UK health care.

A second way of saving large amounts of money is to abolish the use of the Public Finance Initiative (PFI). This was an accounting trick used by Labour and Tory governments to make it look like they needed to borrow less money by giving away public assets like hospitals to private companies and getting them to rebuild and refurbish them. Then they rent them back from these companies, hiding the costs as expenditure instead of borrowing. As an example a hospital in Peterborough that cost about £235 million will end up costing over £1bn in total over the next 20 years. The other problem is that the staffing of the hospitals still has to be paid for and the PFI payments have to be taken out of the budget first. This is why Accident and Emergency services are being closed down up and down the country, and it's also why there has been such powerful downward pressure on NHS staff salaries. It's also why NHS trusts up and down the country are struggling to keep themselves afloat, the system is built to fail catastrophically as these charges mount up over the years.

When you see the promises about billions going into what you think is NHS care, remember that a big chunk of this will be going straight to the banks and hedge funds as "rent" on what used to be publicly owned and financed hospitals and schools because of a cynical accounting trick by heartless airheads (and Tories).

In the previous parliament there was the NHS Reform Bill, which was going to abolish the internal market, PFI and reestablish the principle that the government had a statutory responsibility to provide health services free at the point of delivery for all - we would of course fight for this. Interestingly very few MPs voted for it, even the ones that are now saying they will save the NHS.

PFI has been used extensively in education as well. The same arguments about paying the banks first and driving down salaries apply, as do the ones about what you think is education funding paying rent to the banks instead of going on our children and education in general.

We promise to build 100,000 social homes. It sounds like this is impossible because it will cost so much. 

Firstly, there are huge number of empty houses up and down the country that we could probably refurbish relatively cheaply. 

Secondly, we can perform an accounting trick of our own.

Building social housing saves money, very large sums of money. At the recent Left Unity Raise the Roof for Housing conference one of the delegates pointed out that state spending on housing for the working poor is done through housing benefit. Because we have a chronic shortage of decent social housing the rents are very high and billions of pounds are going straight into the pockets of landlords. The rents on social housing are typically much lower than so-called market value. This means that people living in those houses don't need billions of pounds worth of rent paying that goes out of the system. He estimated that spending a billion on decent social housing would easily save two or three in housing benefit. This will also defuse the ticking time bomb in places like London where it is impossible for anyone under 25 to ever dream of living in a house or flat of their own, rather than a crappy room in a shared one where you pay an extra £100 a month because you have the en suite bathroom.

We will also bring in rent controls that will keep the housing benefits bill down, which will help everybody who isn't a profiteer landlord.

PFI is being used for everything now, including projects like the second Mersey bridge at Runcorn. The bridge will cost around £600 million to build, but the associated long-term costs of the project will be around the £2bn mark. Originally the toll to cross the bridge was going to be around the same as the Mersey tunnels, £1.70, because of PFI it will be at least £3 to start with. Also the original bridge will become a toll bridge to support this lunacy - stealing a publicly owned asset to finance private profit, again.

We will stop using PFI - if we need to borrow money from the markets for public projects then we will, but we won't hide it in secret unaccountable schemes where the returns are inflated to make huge secret profits for racketeers and their political friends. We stand for complete transparency in public finances, and the renegotiation and abolition of this millstone around the necks of honest tax paying people.

When we ask the richest people to pay more back into the system, there is no point in giving it straight back to them as "rent" on things we already own!