Fear is growing as the COVID-19 coronavirus spreads across the planet. As the media ramps up the anxiety with its daily reporting, people are crazily sweeping supermarket shelves of toilet roll, hand sanitiser, face masks, pasta and anything else they can stockpile – just in case. Worse, it has been reported that in a UK hospital people have ripped hand sanitisers off hospital walls, stolen bedside hand gels used by health professionals as a preventative measure against MRSA and in France, 2000 face masks were stolen from a hospital in Marseille. Induced by an irresponsible media, the calm and sensible response of taking the recommended precautions against infection has been abandoned; replaced by panic and alarm which is spreading like the disease itself. It reflects the promotion of the individual over collective wellbeing which has been driven by the decades-old ideological agenda of the market and the primacy of the individual.
Clearly, we should be concerned about the spread of the virus, in particular for those at real risk because of age or medical conditions. However, while supermarket shelves are ransacked, people fight over toilet rolls, and the media focuses on the numbers of infections and deaths, the role of government in austerity and its consequences have almost become background news. The real stories about the effects of government cuts to public spending; about human beings who have borne the significant costs of government policies. The real stories about the consequences of public service sector cuts and privatisations. These will surely come to bite the government where it hurts as the public, in the light of the spread of COVID-19, wakes up to the recognition of the important role such public and social infrastructure plays in keeping a society in good health and an economy functioning. Indeed, in this case, society being able to respond to potential emergency situations. It will become ever clearer that government policies have been not just harmful, but positively destructive. The message will be reinforced that it is not the state of the public accounts that determine the health of the nation and its economy, but the policy decisions taken by government to deliver it.
GIMMS has covered the events with comment week in week out since its launch 18 months ago and we have built a chilling picture of people’s lives; the ongoing demolition of our public services and local government, cruel reforms to our social security system and their consequences. We have aimed to demonstrate that these policies were not linked to repairing the state of the public accounts, as has been endlessly repeated, but to delivering a political agenda.
We have also aimed to show that, whilst there is no shortage of money, what constrains government spending are the real resources with which to deliver its policy agenda. In effect, that its role is not to balance the budget, but to balance the economy. In short, this means that a government which issues its own currency must match its spending to the resources it has available and, should it desire to do so, use mechanisms like taxation to free up those resources being used by the private sector to deliver its public policy agenda.
In this regard, it also has an important role in planning to ensure a well-educated workforce and training of essential public sector personnel such as nurses, doctors and other health professionals, not to mention teachers and social care workers – not just for this current generation but for future ones to come. In other words, it has a role to serve the people, even though it has to be said that in recent decades it has been more about serving other masters. It has instead actively sought, through its pursuit of market-led ideology based on monetary stability, increased competition and the primacy of the individual over the collective and thus created a monster.
This week, the evidence piles up about the consequences of cuts – in the health service, in social care and in local government – all sectors which not only have a role to play in the good functioning of society but also when a crisis or an emergency strikes. However, public spending cuts over ten years have left those services in a state of decay. Doctors responding to the COVID-19 threat are already expressing their concerns about the lack of Intensive Care Units, they are pointing out the lack of beds, isolation areas, huge shortages in nursing staff, and equipment. The fact is that hospitals have been running at 100% capacity for some time, A&Es are full, and patients wait for hours to be seen or for a bed if they are to be admitted. Government has created through its health reforms and lack of funding a ‘just in time’ health service with no spare capacity. These facts highlight the realities of a service that has been starved of funds and facing a bleak future without a change of government policy. And that was before the threat of COVID-19.
We have a severe shortage of nurses. Last year a report by leading think tanks predicted that in the next five years that would double and GP gaps nearly treble unless radical action was taken. The BBC also reported last year that according to official figures there were just over 28,000 fully qualified full-time equivalent GPS in England as of September 2019, which was a drop of 3.7% since September 2015. Increasing stress and poor working conditions, combined with the pay cap have forced medical staff to vote with their feet; retire or leave the profession.
Figures released at the beginning of last year also showed that the number of people applying to study nursing in England had fallen by more than 13,000 since 2016 which was the last year that students received the bursary. The Royal College of Nursing said that with over 40,000 nursing vacancies in England that the fall in student numbers would jeopardise future supply of nurses and would put safe patient care at risk.
Last November it was reported that the number of hospital beds had fallen to its lowest ever level with 17,230 beds cut from the 144,455 that existed in 2010. Figures showed that the 127,225 beds available in acute hospitals, maternity centres and units treating and caring for patients with mental health problems was the smallest since records began in 1987/88. The decrease has occurred despite an increase in population and means that from four beds per thousand people in 2000 there are now only two and a half beds per thousand people.
However, it is important to note that bed closures have not just been a feature of the last 10 years of austerity – it has been the policy of successive governments including New Labour to reduce dependence on hospitals and health services in favour of pushing care into the community through the voluntary sector, private provision and public goodwill. Indeed, that has been the objective of the NHS England Five Year Forward Plan despite the current parlous state of our failing social care system and a deterioration in local government services due to public spending cuts.
The government is keen to reassure us that all is in hand and Matt Hancock the Secretary of State for Health said: ‘Public safety is my top priority’. If that is the case, why has this government and its coalition predecessors spent the last 10 years decimating services through cuts to public spending, when those services form the bedrock of a stable and healthy society and economy? It would instead show that public safety and wellbeing has been at the bottom of the list of their priorities.
Their solutions to the potential crisis, which added to the current global economic slowdown caused by the addiction to austerity policies will likely and finally push our economy and others into the recession that we have been on the cusp of for some time, are equally wacky. They seem to have resulted from a meeting at the back of the bins at number 10 and noted on the back of a fag packet. Opening up mothballed beds, forcing retired nurses and doctors to come back to service (those very people who might be at risk), amassing a volunteer army (the Big Society in action), doing the shopping for elderly neighbours and advice to self-isolate.
As Aidan Harper from the New Economics Foundation pointed out, self-isolation is a luxury that gig economy workers can ill afford and for low paid and zero-hour workers advice that would leave them struggling. As he pointed out in a recent article Britain’s gig economy has more than doubled in three years and accounts for 4.7million workers; research has shown that one in six UK workers are now in low-paid, insecure jobs where many lack protections such as sick pay. He cites JD Wetherspoon which has said that workers that are quarantined under government orders will be treated the same as those off sick, meaning they won’t be paid for the first three days of absence and will only receive statutory pay. In such circumstances, people will have a choice – work and spread the disease or lose pay. Once again it is clear that it would be the poorest with the least financial resources that will suffer. As Harper points out, the social reformer Edwin Chadwick’s ideas were grounded on the clear basis that ‘the conditions of the worst-off in society affect the health of everyone – and even the wealthiest aren’t immune to the threat of disease’. As, no doubt, the wealthy discovered in another era when the Great Plague killed an estimated 100,000 people —almost a quarter of London’s population in 18 months.
Government has lost sight of its responsibility to its citizens. It has served other masters in the form of global corporations and the excessively wealthy. When it promises £46 million (a mere drop in the ocean) to fight the coronavirus it has chosen to ignore the consequences of its own policies. Where will the extra nurses, beds and ICU facilities come from should the situation worsen? The government has spent the last 10 years depriving our health service and other essential public services of the funding they needed, leaving our public and social infrastructure in a state of decay. And now it thinks that throwing money at the problem will make all the difference.
It’s time for us all to understand that it’s never a question of monetary resources or financial unaffordability, it’s always a question of having the real resources to deliver your emergency plans or indeed your policy agenda. And the government has stripped that infrastructure down to its bare bones. That cannot be resurrected in an instant no matter how much politicians spout their rhetoric at the despatch box.
There is a solution, albeit one that will take time. And it starts with understanding four things:
- that the role of government should be to serve the public purpose rather than the interests of a small section of society
- that the public finances do not operate like a household budget and government does not need an income in the form of tax before it can spend
- that the only balancing a government needs to do is balancing its spending against available resources – asking questions like “Do we have enough construction workers, nurses, doctors, teachers and other real resources to deliver our plans and if not, what can we do about it?”
- and finally, that government spending choices have nothing to do with whether there’s money in the tax kitty but are politically motivated. The question to ask is not “Did the government balance the budget?” but “Did it ensure a fairer and more equitable distribution of wealth and did it provide adequate public and social infrastructure to meet the needs of citizens and the economy?”
If you want to know more, GIMMS has a website where you can find out more about how money really works and get started on questioning the economic orthodoxy which prevails and has done so much damage. You don’t have to be an economist or any sort of expert to learn that there is an alternative!