Based on his experiences of helping to fight cuts and closures in Suffolk, Michael Mandelstam delivers a damning verdict on the mismanagement of the NHS at national, regional and local level. He charts the widespread cutbacks and closures, both rural and urban, to clinics, A&E services, beds, wards and scores of community hospitals. He outlines how humane care, particularly for older people, is compromised by the ruthless determination of NHS management to increase patient throughput and hit government-set targets. The author highlights how the chaotic change to the NHS is being driven by concealed agendas - including privatisation of the NHS, obsessive interference from central government and well as selective use, if not abandonment, of evidence-based practice. Seriously flawed and damaging decisions are the result, affecting the population at large as well as those most vulnerable - older people with chronic and complex needs, people with physical or learning disabilities and people with mental health problems. Above all, he exposes the scandalous lack of transparency and accountability behind changes that threaten to destroy the NHS.
1. Introduction. 2. Summary. 3. Comprehensive, universal and free. 4. Sowing financial seeds: the great investment. 5. Declaring the health harvest and concealing ruined crops. 6. Uprooting the traditional health fields. 7. Cultivation of local health services. 8. Choosing the method of cultivation: patient choice. 9. Alienating and spreading fear in the community. 10. Combing the landscape for a decision-maker. 11. Rushing into decisions and reaping the consequences. 12. Discarding the chaff: the shedding of NHS responsibilities. 13. The great hospital and health service clearout. 14. From hospital to homestead: the great go-between of intermediate care. 15. Thresholds and fending: erecting the social care barriers. 16. The uprooting of real care. 17. Suffolk health services: gathering storm over the land. 18. Rural conflagrations and early hostilities. 19. Setting the wheels in motion: the timetable of war. 20. The campaign in full flux. 21. Other fights in a changing landscape. 22. Decision-making day. 23. Conclusions. Index.