The following speech was delivered on September 26 in Bristol by Mel Simpson to a Socialist Equality Party meeting “For Action Committees to defend the NHS”
Over the last two years, there has been an unprecedented attack on the National Health Service. Sweeping cuts to jobs, wages and services have been carried out.The NHS, the jewel in the crown of the welfare state created in 1948, is being dismantled so that health care can be handed over to the private sector. Hardly a week goes by without the announcement of the closure of a critical service or specialist institution that provides life-saving treatment and operations, or the needless death of someone as a consequence of cuts.
Here in the south west of England, another front in this social counter-revolution has been launched. Earlier this year 19 NHS Trusts, covering 60,000 workers, formed a Pay, Terms and Conditions Consortium. Among the key objectives of the pay cartel, which was revealed in the leaked Project Initiation Document, is reducing the pay bill of the South West region NHS trusts by nearly 10 percent. It wants to cut wages and introduce a performance-based pay system, increase working hours, reduce unsocial-hours payments, remove sickness absence enhancements and cut annual leave. Anyone who resists the plans risks having his or her existing contract terminated.
The Project Initiation Document states that it wants to create a “flexible workforce able to respond to any qualified provider”—that is, any private company that is looking to make profits from patient care. The pay cartel intends to implement these changes by April next year and then extend them to Mental Health/Community and Social Enterprise Trusts across the region. Trust managements have started to intimidate workers who voice opposition.
NHS workers have already suffered a two-year wage freeze. They are paying much more into the pension scheme at the same time as the retirement age has been increased. Those with families have seen child tax credits reduced and child care fees increased. Many have been forced to work extra hours in the “bank” or with agencies to keep their heads above water.
There is evidence, despite denials, that the Conservative-Liberal Democrat coalition government was involved at least 6 months before the cartel was formed, and possibly even earlier. It is clear that the pay cartel plans are a test case for the 1.5 million NHS workers across the country. Nobody should be surprised. The government has imposed cuts on the NHS of £20 billion—almost one fifth of its total annual budget—as part of its austerity drive to pay for the multi-billion-pound bailout of the banks.
The NHS has been deliberately driven into near bankruptcy—a situation then utilised to justify further steps towards privatisation!
The Health and Social Care Act effectively ends free and comprehensive health care and hands huge swathes of the NHS over to the private sector. Hospitals will be able to use 49 percent of their hospital beds and operating theatre time to generate private income. Commissioning groups will see doctors and other health care professionals take control of their budgets and be able to outsource services to other providers.Dozens of health trusts are in financial trouble as a result of the Private Finance Initiative (PFI) whereby the private sector builds, finances and operates roads, prisons, schools and hospitals in return for an annual fee with ever increasing and crippling interest payments.
It was the Conservatives who introduced PFI in 1993, but it was the incoming Labour government in 1997 and their financial advisors from the City, who famously boasted that they had got it up and running. The PFI always disguised the real cost of building and running a hospital with subsidies diverted from other services, land sales, cuts in bed numbers, and increased funding that went straight into the pockets of the contractors and their bankers. But the austerity cuts, initiated by Labour and vastly expanded under the Tory-Liberal Democrat coalition, have pushed the Trusts, particularly those with new PFI hospitals, over the edge. The only part of the NHS budget that is ring-fenced from cuts is the part that goes to the private sector.
Earlier this year the first privatised hospital since the creation of the NHS began operating under Circle Healthcare Limited in Hinchingbrooke, Cambridgeshire. Circle Health is a subsidiary ultimately controlled by Circle Holdings and almost 95 percent of its shares are in the hands of six investors. The tendering process begun under the last Labour government was described as the only way to solve Hinchingbrooke’s £40 million debts. But both Labour and the Tories systematically closed down all alternatives to privatisation, rejecting the popular demand for the government to clear the debt using public money.
The government is seeking to use Hinchingbrooke as a model to expand the involvement of the banks and private capital in health care, with at least 20 potential hospitals having been identified as candidates to be handed over to similar outfits. Politicians from all the major parties are set to make a fortune from further privatisation of the NHS. According to the news blog Social Investigations, over 200 MPs and members of the House of Lords hold financial interests in businesses involved in private healthcare. Here are just a few examples.
Back in 2009 the “personal office” of former Health Secretary Andrew Lansley received a donation of £21,000 from hedge fund boss John Nash. Over the past five years Nash has donated £203,500 to the Conservative Party. Nash is chairman of Care UK, which relies almost totally on the NHS for its £400 million a year business and is founder of city firm Sovereign Capital, which runs a string of private healthcare firms.
The private company Interserve chaired by Conservative Peer Lord Blackwell looks likely to be awarded a staggering £300 million contract to run and maintain more than 550 National Health Service buildings housing nearly 3,100 beds in Leicestershire.
Since 2004 the Liberal Democrats’ have received donations to the tune of £440,000 from Alpha Healthcare Ltd. In 2010, the year they entered into coalition with the Conservatives, the company donated £125,000.
The Labour Party has its own ties to private health care.
McKinsey & Co, who drew up many of the proposals finally accepted into the Health and Social Care Bill, has paid David Miliband, Labour MP for South Shields and brother of the current Labour leader Ed Miliband, over £20,000.
Alan Milburn, the former Health Secretary under Labour, was a consultant for the parent company of Alliance Medical, which runs diagnostic services for the NHS. In 2008 his registered parliamentary interests highlight that he was a member of Lloyds pharmacy’s Healthcare Advisory panel and he was paid in the region of £30,000.
The disastrous fate awaiting Britain’s most popular and most vital institution could not have happened without the trade unions, which have played a crucial role in implementing the cuts against their own members. All the NHS unions have agreed to the government’s increase in the retirement age and attack on pensions, and have also indicated their willingness to take part in further discussions on the latest plans. None of the unions, whether the Royal College of Nursing , Unite, Unison, or any other, has made any attempt to lead a struggle by workers against the attacks of the government. They have worked consistently to isolate and keep each section of workers in the dark about what is taking place, while blocking the emergence of any struggle by workers that challenges the privatisation of public health care.
The unions sold the Agenda for Change in 2004 claiming that the radical reorganisation of job descriptions and work patterns would protect wages and conditions. At the core of the Agenda for Change were provisions for the end of national pay scales and an increased dependency on discretionary pay based on productivity gains. The actions now being taken by the South West pay cartel are a predictable outcome of the agreements previously made. The unions kept workers in the dark on the pay cartel proposals for months. Now that workers are starting to take matters into their own hands, the unions have started fruitless petition campaigns pleading with individual trust managements to withdraw from the cartel or urging letters to be written to MPs—the very people who voted for the health care “reforms”.
One nurse we met while campaigning at the Victoria Hospital, Wimborne was scathing of the Royal College of Nursing saying, “My union is asking us to write to our local MPs in order to change their minds about these attacks.” Showing a copy of a reply she had had from her MP she exclaimed, “Look at the bullshit I have got in the reply from my MP. There is no point of writing to them.” The MP’s letter justifies the attacks on the ground of the economic crisis and endorses the NHS employers collaborating together locally to slash budgets.
The Socialist Equality Party rejects the claim that there is no money to provide decent health care and public services.
Hundreds of billions have been handed over to the banks, without any strings or even the pretence of going through the banks’ books, much less any public consultation or accountability. Likewise, billions are made available to kill and maim people for military interventions in the oil and mineral-rich regions—from Afghanistan, Iraq and Libya to the next targets, Syria and Iran. The ruling class did not graciously bestow the NHS to us after World War 2. It was forced to cede it after bitter struggles and as the necessary price to stave off further social unrest.
The right to health care can only be defended and extended by working people and their families mobilising once again as a class, independent of and in opposition to the corporate-controlled political parties, the trade unions and their so-called left supporters that seek to tie workers to the Labour Party and the institutions of the capitalist state. That is why last month we launched a campaign South West NHS Fightback and set up a website.
We insist that to be successful in their struggle, workers must form action committees independent of and in opposition to the trade unions. These committees must be made the means through which strikes and other protest actions are organised, to undermine the control exerted by the union bureaucracy and challenge the plans of the pay cartel. But such action cannot remain confined to the South West alone. Behind the cartel stand the government and the entire political establishment. The events in the South West region are being used as a test case for wider cuts in the NHS across Britain as well as in other public services.
Similar strategies are being implemented internationally, with governments across Europe and in North America fully committed to the preservation of the wealth of the financial elite at the expense of working people. The struggle confronting NHS workers requires a revolutionary and international perspective. The building of action committees to lead a struggle in defence of public health care must be guided by a socialist political programme.
In opposition to the dictates of management and the corporate elite, workers must take up the fight to realise the social rights of the working class, including the right to a secure and decent paying job, and the right to well-funded and accessible public services, of which health care is a critical part.
The Southwest NHS Fightback website has had thousands of hits since its launch a month ago. Workers are sharing their experiences of how working conditions in the NHS are being eroded and patient care jeopardised due to so-called efficiency savings. A growing number of people are also following the Tweets of the Southwest NHS Fightback and on Facebook. We have distributed thousands of leaflets at most of the main hospitals in the south west. Workers have welcomed them very enthusiastically. Several have grabbed bundles of the leaflet to share with their colleagues and display in staff rooms and departments.
We think there is a huge appetite to fight back. I ask you to help us with the campaign, take up our call for action committees and to join the SEP.