Workers' Weekly Health Group Bulletin

NHS News In Brief
NHS Crisis to Intensify this Winter
Plans to Cut Back NHS to "Life Critical" Service
Dramatic Rise in Cost of Generic Drugs
Shortage of Beds in East Kent Causing Concern

We actively encourage enquiries, contributions, e-mails and letters.
To Contact the Workers' Weekly Health Group e-mail: [email protected]

Now Is the Time to Seriously Discuss How to Safeguard the Future of the NHS

At this time when the struggle against the cut-backs in the NHS and the widescale introduction of PFI is growing, it is essential that serious discussion should also be organised on how to safeguard the future of the NHS.

The issue really is to make sure that this struggle which is growing in power is not diverted but is broadened and strengthened. This can be done if people are drawn into discussing this crucial question – how the future of the NHS can be safeguarded.

Such a discussion must seriously question and examine the parameters which are being put forward by the government in the NHS Plan, the White Paper Saving Lives: Our Healthier Nation, and generally in the direction that the government is taking the NHS. At the same time, the discussion must involve health workers and staff, professionals, and the masses of the people in discussing on what principles a modern health service should be based, and what kind of a society would guarantee that such principles are realised in practice.

For example, the Prime Minister in his speech to the Royal College of Surgeons on October 17 identified that much of the problem of the NHS "is down to a poorly organised and managed system". He asserted that the NHS Plan addresses this problem in such ways as popularising "best practice", using staff "more flexibly", giving more power to "front line staff", and so on. All of these steps, he said, are "designed to deliver a patient centred service". So let it be discussed and we can see, is this the problem in the NHS, and how Tony Blair’s plan relates to reality. If a patient-centred service is the aim, how is it that the patients are totally peripheral to how the NHS is run, and how is it that the direction that the NHS is moving in, which is to gear it to the sealing of Private Finance Initiatives, is meaning that the patients are more and more up in arms about their treatment? How are these facts related to the direction that society itself is moving in? These are serious questions for discussion.

If an NHS were "patient-centred", could it not be said that it must be based on the principle that health care is a right? Should not the movement to safeguard the future of the NHS begin from this principle? In words, the government talks about improving the health of the worst-off in society and narrowing the health gap. Is this anything more than a policy objective? Should it not be that the "health gap" should actually be eliminated rather than narrowed. Should not health care be available to all at the highest level society is capable of, and not be made dependent on whether one is worse off or better off? Should it not be addressed how the gap between the worse off and the better off is constantly widening in society?

People should get together to discuss these questions with the perspective of strengthening the pro-social programme, that programme which stands on the bed-rock that society itself must recognise and meet the claims on it of all the individuals for health care and their other needs.

Specifically, WWHG gives the call for health workers and all concerned people to get together and build the bulletin of WWHG, by discussing the articles at the workplace and in their communities, making contributions to the content and by furthering the whole discussion on safeguarding the future of the NHS.

Health Workers Defend their Interests by Defending the Interests of Society

A demonstration of the Dudley hospital workers’ campaign against Private Finance Initiative (PFI) in the NHS will take place on November 4. It will assemble at Stourbridge Town Hall from 12.30 pm. A conference on PFI called by UNISON West Midlands Region will take place before the demonstration. (Details and application on www.labournet.net). There will be a rally at the Town Hall following the march at approximately 2.00 pm.

The health workers at the Dudley Trust are fighting against plans to transfer staff to Summit Healthcare in an £88m PFI scheme. In a recent letter to all UNISON branches, Rodney Bickerstaffe, General Secretary of UNISON, has called on branches to organise support for the demonstration and give financial support to the strikers.

These actions of the Dudley hospital workers against the PFI, along with other actions launched by other health and other workers against the PFI, are a very significant development. These struggles are being waged not only in defence of the interests of the health workers affected by the transfer from the public to the private sector but the whole struggle against the PFI is a struggle which is in the general interest of society. The monopoly media ignores this struggle precisely because of the issues it raises. The issue that it presents is fundamental to the society we live in and its future. Should spending on social programmes and public services be transformed into arrangements that provide profits for big business and finance capital a path which is intensifying the political and economic crisis in Britain, or should society be organised to meet the claims of the people who live and work in it and a path that will lead society out of the crisis?

The answer that the Labour government gives is that it is proud of its record of removing the obstacles to the PFI arrangement in order to serve the interests of finance capital. It continually congratulates itself on what it sees as an achievement that the previous government was unable to accomplish. Andrew Smith, Chief Secretary to the Treasury, is one of many who boast about the government achievements. In his report on PFI at the end of last year he said: "We have already had one step change in the delivery of public service infrastructure since this Government came into power. Over the last two and a half years, we have fundamentally reformed PFI. By prioritising projects, ending universal testing, offering a fairer deal to staff and standardising contracts, we have streamlined PFI and put it on a more sustainable and successful basis." He continued: "The flow of deals has risen rapidly as a result. In less than two years contracts with a combined value approaching £5 billion have been signed compared with £4 billion over the whole of the previous Parliament. PFI will generate some £11 billion worth of new investment over the period 1999/00 to 2001/02." Using this logic he goes on to point out that the "next step" is "expanding the PFI and applying it in sectors where it has not been extensively used before and enabling smaller projects to combine so PFI is a more cost- effective option".

Of course, what the government fails to point out is the amount of debt servicing and profit making that such "investment" will cost society. It is signing contracts of up to 30 years guaranteeing billions of pounds to the private sector whilst it at the same time it does not guarantee the future of the NHS. It is already estimated under the present projections of the PFI that in 20 years time £140 billion will be paid from the Treasury to big companies each year. Such a sum is over five times the present amount paid in interest on the National Debt and indicates the scale on which the ruling circles are planning to take their pay the rich system.

It is important that health workers along with the working class as a whole grasp the significance of what the PFI represents. It is one of the centrepieces of the anti-social offensive which New Labour, as present champion of the bourgeoisie, is trying to put in place. It wants to ensure that the monopoly and finance capitalists counter the falling rate of profit and receive handouts, contracts and are paid in every conceivable way through the operation of the anti-social offensive throughout society. The defeat of the PFI by the working class would represent a serious blow to the bourgeoisie and their plans. It means for the health workers that they should not only defend their interests but defend these interests by defending the general interests of society and by uniting people around this programme is their most powerful weapon.

Dudley UNISON NHS Strike

Dudley Hospital Workers Hold Successful Conference on Fighting PFI

What Was Said at the Conference of Dudley Hospital Workers

At the conference, held on Saturday, October 7, in Dudley on fighting PFI and privatisation, Mark New, UNISON branch secretary and chief strike organiser said:

"The conference comes at a critical period of the strike. We should be proud of what we have done so far. It is not only against a management that refuses to listen, but we know that in the background there is a government that refuses to listen as well. This is one of the longest and biggest strikes in the history of the NHS. The strikers can be rightly proud. We have had support from the West Midlands, Britain and across the world from Russia, Australia, Philippines, California and so on. We have even had support from delegates to the Labour Party Conference but we need support from the whole of the labour movement.

"We have a letter from the Regional Department of Health, which says that 78 percent of the current PFI in Dudley is concerned with staff, 20 percent only is concerned with the buildings and that is why they are pushing this so much. The government has now nailed its colours to the mast in support of the NHS trust. They are no longer in the background, therefore we need to mobilise the whole community, the rank and file workers and public."

A trades unionist from the RMT, representing London Underground workers, said:

"In 1998, the government announced its plans for the London Underground. It covered the backlog of the investment, which everyone knows was needed. We find ourselves in the absurd position of being told that the New Labour government would ‘tax the rich’ for the investment, which they were elected to do. The New Labour government announced its plans to partially privatise the engineering and maintenance and the infrastructure. In other words, sell us off to the private sector. This would be a three-year strategy to recognise the privatisation to take effect next year. Within three months we had everyone on the streets and balloted everyone. Although it did not directly affect everyone, in 1998 we had a strike. We went back to the negotiating table to see if there was any more sense, which resulted in another ballot and we had another strike on New Year’s Eve 1998. Anti-trade-union laws, brought in by the Tories, were used against us in December ’98 in the High Court in London by the government (which still owns the underground), to stop us from taking industrial action (even though we had been through all of the ballots). They used specific legislation saying that it was a political strike. This came from the mouth of John Prescott, the Minister of Transport. Secondly, the Lord Chief Justice said that he had to take into consideration public order and safety on New Year’s Eve. We re-balloted our members on another issue to do with privatisation in the February of ’99.

"They were quite astute in what they had done; they have not immediately privatised the operations side. One group is privatised and one isn’t – this is to divide the workforce. We decided then to make it a political issue. Why did we stop the strike at that stage? Other unions went down another road, which left us in an invidious position. The majority of workers were being privatised and two campaigns were set up in London: one was called the ‘Listen to London Campaign’ and the other, the ‘Campaign against Tube Privatisation’ for workers and commuters. The workers lobbied the Greater London Authority – we should keep Ken Livingstone to the promise to stop the PPP. He said legal action was in the offing by the London Mayor against the PPP and there is going to be demonstration on October 23. Later we will be back on the picket lines for the industrial campaign. We must engage the people as well as the workers."

Ron Dorman from CAEF said:

"The EU wants privatisation and wants to limit the percentage of GDP to 39 percent for public spending. £3bn is the target for the Euro and also they are going to use the money saved for the changeover for the Euro (tills, slot machines, etc.)." He went to say that all campaigns against cuts in public spending have a common thread and that is why we should support the Charter for Social Justice launched this year. He hoped that everyone would sponsor the Charter and help bring together all organised groups.

The 378 Branch secretary from South Wales spoke. He said:

"People in South Wales are beginning to understand the importance of the strike and the struggle against PFI." He went on to say that their branch officers had decided to recommend to donate £1,500 to the dispute in Dudley because they recognised that if we do not defeat PFI then it would be the end of the NHS as we know it.

The speaker from 433 Branch said:

"What they are interested in, that is the PFI company, is whether you are profitable enough. At UCLH what we did was to generate as much support as possible outside UCLH. This was not just trade union branch meetings of health workers, but every aspect of the community. We got invited to address pensioners and fire fighters. They said that they could not afford fire stations but spent millions on Canary Wharf. We spoke to small community groups. What people started to realise was that we are up against the system, which says profit first and people second. What you must realise about Dudley is that you must have a political understanding of the world in order to understand the issues.

"The most interesting thing is that when we marched at lunchtime, people were clapping on the pavement. What this showed was that people of this country know who provides the NHS and this is not a tired and sterile debate. Politicians should stand up for public services financed by the public sector and provided by public servants."

The speaker went on to say, " It’s all right to criticise the Tories, but New Labour is carrying on the tired policies. What do we do if the alternative to the Tories is only Labour? We have been looking at regaining old methods of organisation and the idea that has come to the front is Socialism. A word is used a lot at UCLH and that is ‘capitalism’ and ‘anti-capitalism’, and in fact we took a delegation to Prague. People realise that Balfour Beatty is building a dam in Turkey on Kurdish Land and building hospitals in London at UCLH making £600m profit. We must articulate that there is an alternative to the ‘market’ system and that is Socialism."

A floor speaker said:

"What was said about making the dispute national, having national demonstrations and things like that, I agree with. Also the fact that UNISON has not agreed yet to make it national. People obviously want this, but in the meantime we could possibly have a West Midlands demonstration. We have as well as Dudley a dispute about privatisation in Coventry at the Walgrave, and also we have the dispute in Selly Oak and Birmingham at the Queen Elizabeth."

A speaker who is on strike from 464 Branch said:

"If Tony Blair had turned up today I would like to have asked him what is happening to our money, where has it gone?

"The money we pay, as taxes, should be used for hospitals and fighting crime and things like that. Where is it going? We are being told that the limits on public spending are such and such a percent but there is no limit to the government spending on their own luxuries. It’s our money; we should have a say on where it is going. It should be going to where it is needed."

An activist of RCPB(ML) said:

"What has actually happened in this strike is to focus my mind – and I have no doubt others too – on the real question and that is, ‘What kind of health service do we want?’ What we have to take to the community is about the future of our health service. By its very nature the health service strike has to be political because of the very fact that you are involved in an area that is automatically linked to a pro-social programme. It is different from Rover and the narrowing of the argument to Phoenix or Alchemy. Even in that dispute we are trying to raise the issue of what kind of system can guarantee a livelihood for car producers. The strike in the health service raises the question of why ancillary workers should be put in this position just because the government wants to privatise them. Why should there be a struggle to find nurses, doctors, equipment, and so on? The health service should be seen as being there as a basic human right and shouldn’t be dependent on a private company putting in money or not, or whether we can afford this or that in the service. It should be guaranteed with the supply of all its requirements and free at the point of delivery to all."

Amongst other things concerned with the transnational companies’ interests in privatisation, the speaker said:

"It is important to develop the arguments and consciousness around the crucial question of the health service where those that are inside and outside of the health service take part. It is important to open up the debate and call upon the vast experience that people have in order to defend and even develop the discussion centred around this particular social programme. The question of ‘What kind of health service do we want?’ raises the political profile of the issue and raises the question of the system that supplies that service. Only in this way can the whole country and working class engage in changing the direction of society and develop the whole struggle against PFI."

Another striker spoke, saying:

"The support from around the country and abroad has been brilliant. We must take a leaf from the Hillingdon workers and fight until we win. This government is not going to change anything with Tony Blair. We deserve better, we know we are not going to get that. The workers need to stay united and stick together until we win."

Another strike from UNISON Branch 521 spoke, saying:

"I’m not used to stranding up front, but I think it’s about time we all did. You don’t need to be nervous. We need to go outside the union and get the public involved. They hear of privatisation, but do they really know what it is? Do they really know what is happening at their local hospital? Do they know what is going to happen next? The public are the ones who vote them into power, but once they get in they don’t do what they should. We now have to go out to other union branches and community centres wherever there are people, whether they are going to be involved now, next year or five years’ time. The government is going to reduce everything until there is nothing in the public sector any more. The workers must create a network like a spider web. On our own we cannot do anything but together we can get what we need."

An ex-miner, who is now on the NEC of UNISON, spoke after the lunch break. He said:

"Listening to the Bolivian miner who spoke earlier in his solidarity message, I thought back to the miners’ strike of ‘84-’85. I don’t want to harp back to it because it was nearly 20 years ago. But I remember during those dark days of winter that the miners felt really downhearted because if the deputies had had a national meeting and a mandate to come out on strike the pits would have stopped completely. The national leaders had sold them out, no doubt about it. This was well recorded.

"The miners in Bolivia had nothing, they had to live on everything from the employers, yet they were sending us money. We were getting support all across the world. This makes you realise what worker solidarity is. I am proud to be on the NEC and a fighting rank and file member who has been put there to do a specific job and intends to do it.

"In Scotland in local government, Blair and the employers have offered two and a half percent where others have been offered three. There have been massive actions – they all got strike pay. Just because of bureaucracy and rules they don’t get it in Dudley. Why? Why don’t they make it a national action? The reason for PFI is profit. What someone said before is right, we are the people with the social conscience, we are the people who make the public services work, we should be the people who are supported in that. "

Dr Kay Phillips from Manchester spoke, saying:

"I apologise, as I am also not used to public speaking. We are not here to congratulate Dudley strikers. I am going to tell you about my experiences about going around wards and clinics and branches. This week was inspirational and everyone was saying, ‘Thank god that someone is giving some resistance!’ I am a GP in Manchester and work with the homeless. The sense of anger and despair I have felt when these cuts have gone through on a daily basis, first Conservative and now ‘New Labour’! Orthopaedic beds cut by half – after five days people sent home after a hip replacement; three days after hysterectomy. Private companies now deal with dermatology where they take a picture of a rash and send it via the internet to a private consultant who sends the results by fax. This is a second rate service. Private companies are making a profit out of it. Every day I get furious about this and a sense of frustration. I can’t do anything on my own and what has happened here is that people are standing up with resistance. We need to shout about it widely. We went round clinics, and so on. Although the branches passed resolutions and collected money they didn’t know what was going on. When we told people of it they said, ‘What strike?’ and, ‘Why hasn’t the press told us about it?’ The longest strike in the history of the NHS and ‘Thank god someone has done something!’

"Every single health worker and public service worker has got to take an interest – we all use the NHS! What do we mean by talking to the rank and file? I think it is by what we were doing last week, going to the wards. Automatically people are putting their hands in their pockets and ask, ‘Are you coming back next week?’

"People look at what the government has decided to do: they don’t care about the people who voted them in, this is their flagship – privatising public services. I like the fact that they look a bit weak, firstly the fuel crisis and then the problems with the pensions, because there was mass public support for those things and they were scared of national demonstrations taken by pensioners. They all know that the mass of the population will support them."

The next speaker was the UNISON 367 Branch, Selly Oak, steward, who said:

"The discussion at our hospital is really about fighting back. We have PFI coming up on us before one hospital is built. We see ancillary work and records being sold down the river. This means we have to do something now. I think the resolution is really good as it takes things up a notch. The best things at Selly Oak have been lunchtime protests about staffing levels and pay. People have been fantastic."

The next speaker from UCLH said:

"At UCLH we balloted our nurses to take industrial action and they went on strike in support of ancillary workers. You need to be constantly raising the anti. You are 600 and it’s not your job just to be collecting money for the strike but to politically educate people why you are fighting here. What will PFI mean to them? People have to understand why politically the union leadership is not giving the steel of leadership. When you are fighting PFI, ask them why they had expelled the branch chairman and branch secretary from UCLH allegedly for breaking some anti-trade-union laws. You have a big strike compared to what we had – we had 250 on strike. In London, we had two demonstrations outside Frank Dobson’s house and a group of nurses slept outside to show the implications of the sell-off of the nurses’ home as part of the PFI bid."

NHS Concordat’s Broadening Scope

The Concordat with the private sector, signed by Health Secretary Alan Milburn on Tuesday, also commits the Independent Healthcare Association and the government to work together to "broaden the aims of the concordat".

When asked if that meant the private sector could be brought in to manage NHS hospitals or provide a complete hospital service for the NHS, the Health Secretary said: "For now, we have a clear focus on the three areas I have described [waiting list operations, intensive care, and rehabilitative care for the elderly]. But the concordat also says that we will seek to build on this."

Alan Milburn went on to say that the government was already bringing more private finance into NHS hospitals through the PFI, and it would be looking at other forms of partnership with the private sector, refusing to rule out any ideas.

In other words, the trend is becoming very clear. More private finance is going to be tied up in the NHS, which means that the trend is intensifying whereby the health service becomes a channel by which the government pays the rich. Furthermore, it becomes ever more exposed that the government is simply paying lip service to the policy of closing the "health gap" between the better off and the worse off. The policy objective of "the delivery of high quality healthcare free at the point of delivery to those who need it, when they need it," is a cover for removing every obstacle to the health service becoming a pool of money-making for the financiers. At the same time, the government is further enticing private sector companies by pointing out that low productivity caused by illness can be reversed. Meanwhile the stress on health staff and the deterioration in health care provided to the majority of the people are spiralling out of all proportion.

At the heart of the incoherence of the NHS Plan is the move by the government to consolidate new arrangements with the financial oligarchy in the health service. Under these arrangements, the financial oligarchy not only get the opportunity of making the maximum profit, but will increasingly be the actual ones who plan directly how the health service will be run.

For example, at the same time as the Concordat is being signed and immediately projected to be broadened in scope, the Institute of Public Policy Research, the think-tank that is said to be close to the Downing Street policy unit, is running a study on the future of public/private partnerships. One of its working groups has suggested a pilot in which the private sector would provide an entire hospital – doctors and nurses as well as the buildings – under PFI.

The NHS spends at present around £1.25 billion on purchasing health care and specialist services from the private sector, £130 million of it buying 40,000 waiting list operations from private hospitals. Any expansion in that would benefit such big private groups as Bupa, Nuffield, General Healthcare and the Community Hospitals Group, which is quoted on the Stock Exchange. The NHS Plan also envisages that £7 billion of capital investment will be provided under PFI by 2010.

The government is making clear that the Concordat is merely the start of its stepped up partnership with the private sector. This "Third Way" of public-private partnerships represents an intensification of the neo-liberal agenda of the financiers, and is a stepping up of the anti-social offensive under present conditions. The Concordat is a further example of this trend, which is demanding of the people that the opposition to the government’s programme be centred around safeguarding the future of the NHS by developing a pro-social agenda and programme, connected with the political renewal of the whole society.