THE historic and welcome launch on September 26 of Health Campaigns Together comes at a time of a pressing need for united and massive resistance to Tory attacks. It is an alliance of health unions and campaigners fighting to defend and restore the NHS.

The ready response of thousands of junior doctors and medical students to Health Secretary Jeremy Hunt’s attempt to cut their wages has given a focus for the anger of another one million NHS staff who have seen the value of their pay slashed by years of Tory freezes and below-inflation increases.

But the underlying problem behind this and the growing crisis in the hospitals and front-line services has been the unprecedented five-year freeze in health spending, resulting in the meanest-ever levels of increase in the NHS budget, leaving two-thirds of hospital trusts facing deficits averaging £22 million this year. The NHS as a whole is facing a deficit of £2 billion.

More and more trusts — including most recently Addenbrooke’s Hospital (Cambridge University Hospitals) — are being subjected to “special measures” or Simon Stevens’ obscure “success regime.”

By contrast the Mid Staffordshire Hospitals Trust triggered its disastrous crisis of care by trying to make cuts of “just” £10m in a year.

Many trusts have only survived up to now as a result of hefty handouts from the Department of Health and the slush funds given out by the Independent Trust Financing Facility — but much of this money to prop up trusts until after the election is effectively an advance payment of “winter pressures” money for the coming season.

While their income is being eroded in real terms, not least by relentless efforts from irresponsible clinical commissioning groups (CCGs) to siphon funding out of hospital services to build as-yet imaginary services outside hospitals, trusts face the costs and quality problems of having to fill growing numbers of staff vacancies with costly agency staff. This problem has been compounded by short-sighted “cost-cutting” efforts to downband more qualified and experienced staff to save money, and using unfilled vacancies as a way to minimise spending.

But the Tory government is adding more problems with its crackpot racist plan to force overseas staff from outside the EU who are earning less that £35,000 a year — in other words almost all non-EU nursing and professional staff, many of whom have been expensively recruited by trusts combing the world for trained staff — to leave the country.

The financial squeeze on the NHS is also forcing trusts and CCGs to dust off plans for “reconfiguration” (cuts and closures of hospitals and mental health services) and once more press through unpopular plans for closures.

Already the NHS has been made even more complex, bureaucratic and fragmented by half-baked efforts by CCGs to “contract out” services, as required by the Tory Health and Social Care Act. In parts of west London, services in the geographical area of one trust have been contracted out to another, which has chosen not to provide it directly, but to bring in a third, even more remote trust to do the work.

All over England there has been a wacky races contest by CCGs to carry through the daftest contracting exercise, from NHS Kernow trying to undermine the only acute hospital trust in Cornwall by contracting out most of its elective services, to the Sussex CCG which was determined to privatise elective musculoskeletal services, despite BUPA refusing to take the contract for fear it would bankrupt two local A&E services, or the CCGs exposed by Pulse magazine as offering cash bonuses of up to £11,000 to GPs who refer fewer patients to hospital — raising huge concerns about the effect on doctor-patient trust.

However the stark example of Circle’s abysmal failure to meet any of its targets or make anything but losses at Hinchingbrooke before finally pulling out just two years into a 10-year contract is a reminder that despite the privatising frenzy of some CCGs, it’s not so easy for private operators to guarantee any profits from the NHS.

Another big name, Serco, has famously withdrawn from bidding for healthcare contracts after a series of high-profile failures and mounting losses. Virgin is losing money on most of its NHS contracts. In west London Care UK has admitted long-term losses running an urgent care centre at Ealing Hospital.

This has not stopped the onward march of privatisation: private firms won £3.54bn of £9.628bn worth of deals awarded in England last year — almost 40 per cent. It’s useful to remember that these big figures are the total payable for the whole contract over five or more years, and not by any means the profit firms can make from each deal. Now the cash squeeze is forcing down the amounts of money on the table and therefore how much the private sector can scoop in profits. So some are pulling away from what seem like the choicest opportunities.

That’s why all private bids but Interserve pulled out from the controversial contracts for cancer services in Staffordshire — the deal was so underfunded that the local NHS trust also pulled out of the proposed £600m five-year contract, saying they could not guarantee to provide services on this funding, leaving the prospect of no local services for Staffordshire cancer patients.

In Cambridgeshire too, the private sector realised the apparent £700m five-year contract for older people’s services was nowhere near as generous as it seemed, and the contract went to a consortium of local trusts.

One bright star on the horizon for the private sector has been the fact that despite the ruinously expensive cost of disastrous PFI schemes in various parts of the country, Tory ministers are still pressing trusts in Birmingham and elsewhere to sign up for costly “PF2” schemes in which a larger share of the upfront funding comes from the public sector, while the private sector still makes good, guaranteed profits on the rest.

But of course the real boom sector for private operators has been in the new bureaucracy of the NHS, with high-priced management consultants crawling all over flagging NHS trusts, steering CCG decision-making through commissioning support units and developing fancy graphics and neat PR spin for CCG “reconfiguration” projects.

McKinsey alone has been picking up tens of millions from dozens of projects like “Shaping a Healthier Future” — the plan to axe for A&E units and two whole hospitals, Ealing and Charing Cross, in west London.

Now another big firm Capita — whose past service failures have led to it being tellingly referred to as Crapita in Private Eye — has emerged on the scene, grabbing a £1bn contract to supply support services to GPs.

It’s all a far cry from the NHS as set up by Bevan with a simple structure, minimal overhead admin costs and public-sector provision of services ensuring that every penny of NHS spending was delivering patient care, not profits to vulture capitalists. To rescue the NHS from complete fragmentation and the grasping private sector we need an end to the cash freeze, and an end to the crazy, costly market system that has triggered this frenzy of contracting.

Many campaigners support the NHS Bill drawn up by Allyson Pollock and Peter Roderick to sweep away not only the Health and Social Care Act but the whole expensive apparatus of the market, and “reinstate” the NHS as it was before Thatcher, Blair and Cameron. But there is common cause to be made even with those that have a different approach but share a commitment to repeal the Act, bring privatised services back in house — and stop the cuts and closures which are reducing NHS trusts to little more than an emergencies-only safety net.

More funding is needed to rescue general practice and primary care from the disastrous neglect and relieve the intolerable pressures on GPs. More funding is also needed to restore NHS pay levels, improve staffing levels and quality of care and meet the needs of a growing population with growing numbers of older people. It’s high time corporate scroungers were forced to pay their share to support this vital service.

Health Campaigns Together is an important start, with health unions, the TUC and a wide range of campaigners establishing a committee to plan future initiatives such as a conference in the new year, amid what seems set to be a major winter crisis. With a Corbyn-led Labour Party and the main health unions affiliated to Labour joining together to campaign, we should now expect support from local Labour parties and MPs for every challenge to Tory cuts and privatisation.

Cameron’s majority is just 12. If we can now hope to mobilise a united campaign effort targeting key cuts and privatisation, we can shake this reactionary government and build a movement that can seriously fight to defend and restore our NHS.

• Dr John Lister is director of Health Emergency www.healthemergency.org.uk. Health Campaigns Together can be contacted at healthcampaignstogether@gmail.com.