Storm clouds are gathering over our National Health Service

Felicity Dowling writes

Storm clouds are gathering over our National Health Service. Yet when campaigning on the streets, there is overwhelming support for the NHS. It is the issue that most concerns people at present according to this survey.

https://www.theguardian.com/uk-news/2016/oct/09/nhs-is-most-widely-held-concern-of-uk-adults-survey-finds

This is a new era for campaigning. Once if there were demonstrations marches, pickets, petitions and public meetings the powers that be, would be taking notice and perhaps adjusting their plans. Even Thatcher bowed to public opinion on the NHS. This is a different kind of politics. The Government and their allies in the privatisation project feel immune to pressure, shored up behind walls of power that make our campaigns impotent.

Like the decision to plough ahead with war despite huge anti- war activity, those in power will push on towards their disastrous ends unless our campaign out matches Stop the War, No Poll Tax and even the suffragettes

But when the going gets tough, the tough get going. All our campaigns must link up, strengthen and spawn even more campaign groups, and those campaign groups must put pressure on the unions and those parts of Labour that want to fight this to produce a campaign like no other since 1945.

Many different aspects of care are in serious danger. The whole National Health Service is in the gunsights of the big game privatisers

If you have a physical illness that allows a planned appointment, by and large you still get good service from the NHS, thanks to the efforts of cleaners, health care assistants, receptionists, admin staff, nurses, midwives and doctors of every level.

But if you have mental health issues, it is far worse.

if you go into the system via Accident and Emergency you face long, long waits and actual crisis

A psychiatric nurse described sending a patient in psychosis all the way from Plymouth to Liverpool with “a driver and a pot to piss in” because Liverpool was the nearest available bed. Patients are often sent out of the home region. Mental health trusts are in the best financial states because they have cut most.

Accident and Emergency Services across the country are facing closure or major cuts. Chorley’s campaign is very powerful.  Maternity services are also in the firing line.

The situation is complex. The storm clouds are gathering from different directions.

The forces in the storm

• Marketization and the markets model in health care
• For profit providers
• The commissioning model of providing health care
• Deliberate rationing of funds to force “reform” on organisation
• The Sustainability and Transformation Plans
• Shortage of doctors, nurses and midwives
• Admin support for doctors is being cut with medical secretaries being pooled and down graded to medical typists. One hospital is intending to cuts it pay roll by 10%
• The cost of PFI (private finance initiative) projects. These are like overpriced mortgages hospitals have to pay to developers. Previously the government paid for such projects.
• The drive for large specialist hospitals
• Remodelling the NHS on geographical basis akin to the US model, to lay the ground works for large scale privatisation.
• The use of “ninja” privatisers who are allowed to experiment with health care whatever the outcome.

This is a constructed crisis.

Private for profit providers are rife within the NHS. The problems are reported and ignored.

What’s the problem with private companies getting mixed up with the idea of choice in childbirth?

There is a concerted attempt to restructure the NHS as a for profit health care system using the geographical organisational model of the USA. This is shown most clearly in the Sustainability and transformation documents, leaking our now. Cuts and reorganisation for privatisation are clear within them.

This large scale model will be created by merging hospital trusts across sub regional areas. There are 44 such areas.

The secretary of state no longer has legal responsibility to provide universal health care to everyone, thanks to the 2012 act.

The Government policies have resulted in rationing funds, so much need services are not in use and shortages are created. This is all part of preparing the population for this reality. There is some indication that these plans will be announced in full on December 23^rd for public consultation. The Government is planning a Christmas present for us all.

Workers in the health service report shortages of staff, long hours and enduring crises cheap equipment. The Junior Doctors dispute showed the potential power and impact of NHS workers standing up and making their case, but we cannot leave such struggles to those on the front line.

If we are to defeat these plans then the response must be huge, as large as the Poll tax response or larger. Our opponents, representing huge companies from the US and their cronies in this government, expect and are ready for local opposition. It is important to spread opposition nationally and to make it huge.

The NHS was the most efficient health care system in the world even in 2014.

All of the same mind moulding tricks that let the government blame the financial crisis of 2008 on the poor, blame those with disabilities and the unemployed, for. Now the propaganda says that we are too old, we smoke, we are overweight, we don’t exercise enough, we insist in pain control in childbirth. We, the people, cause the problems it seems

The language of these documents is deliberate. It appears kind and caring and hides its malice. Look at Jeremy Hunt’s line on the Junior doctors’ contract pretending a seven-day full service could be delivered with the same number of staff with no additional resources. If all the focus is on the convenience of the seven day backed up by false statistics about weekend deaths, his lies become plausible

There is now a small army of NHS campaigners to oppose these plans and its growing by the day. Where once there were meetings of 7 or 8, now meetings of hundreds of people, where once were demonstrations of hundreds now it is thousands. Serious attempts are being made to link up across England. The recent national meeting against the Sustainability and transformation Plans is one example.

Scotland and Wales also have huge issues but the main assault on the NHS from this government is in England

There are myriad organisations across the county campaigning locally Keep Our NHS Public. Save our NHS, The National Health Action Party, Defend our NHS, Save our NHs, 999 for the NHS, and more. Health Campaigns Together tries to coordinate this work.

Trades councils ( local TUCs) also are doing good work on this issue. Unite’s community branches are working hard on it. Trade Union branches provide much of the funding for  individual campaigns like Save Liverpool Women’s Hospital.

However, in a quick check through union websites looking for Sustainability and Transformation plans no major general union had this as an issue, yet it presents huge threats to workers’ conditions of service and to the NHS which they treasure. The RCN, though, had a bit in praise of the SSTPs.

 Maternity services are in their firing line too. The Maternity Tariff (the money paid to hospitals for supporting women in delivering babies) is not enough to pay for the midwives that we need.

The largest cause for admission to hospital is maternity. The government wants to reduce the numbers of  patients in hospital and the numbers of women who  have their babies in hospital.

The language of the maternity review is sweetness and light but hides appalling ideas about

• reducing obstetricians’ roles
• a major move to home births and
• more midwife lead units
• introducing “other providers”

This is all without research and theoretical back up.

Maternity units run by midwives are  themselves are under threat. Major hospitals, like Liverpool Women’s Hospital also face closure. Its cuts, but not as we know it. Cuts of a new order of magnitude.

Maternity services are to be judged by how few interventions are required, including how few anaesthetists are used, how few C-sections and more. New indicators of success in the outcomes of maternity services are being introduced. They are proposing that the main indicators are the non use of interventions. This is ridiculous. The life and health of mother and child, as well as levels of interventions, should be measured.

Interventions are also used more in over stretched over worked maternity provision than in those where calmness and confidence prevails. The UK does not do as well as it should on maternal or child mortality. This is probably due to poverty and inequality but not entirely, Shortages of midwives is also a factor. Maternity care will always struggle in a society that disrespects women but current policy is far beyond a joke.

The Maternity Review is a blueprint for privatisation with talk of £3000 vouchers for mothers to spend with any provider they choose. One report we have heard said that the model will be home births or small, for profit units, like the old Nursing Homes used for births.

More on all of the maternity issues in saveliverpoolwomenshospital.com.

Labour were complicit in bringing the US model and for profit providers into the NHS. The departure of Heidi Alexander did seem to signal an end to such complicity and Diane Abbot, MP spoke well as shadow secretary and stood firmly with the junior doctors. We hope the new shadow secretary follows Diane’s lead.

This though is not a campaign we can leave to the Labour Party and to 2020. We have to fight it now before it becomes further embedded into the system

Provision for the elderly and infirm is in crisis.

We also should be campaigning for a fully funded National Care Service to upgrade and improve care for our elders and for people requiring help with day to day living. Thousands of people are in hospital just because the care system is broken. Others are alone at home neglected and denied the respect their age  deserves.

Remember the model used in care for our elders is the one they want to use in the NHS and maternity. For profit providers, making money out of poor standards and dangerous conditions.
The benefit cap is attacking sheltered housing for the elderly as the same time

Building the campaign

Trade Unions and trades Councils need joint meetings to plan action.

Resolutions calling for national action on the Sustainability and Transformation Plans and on systematic closures of services should go through all trade unions

Councillors need to raise serious objection, informing their populations, and organising meetings on the procedures of the Sustainability and Transformation Plans. The legality of both the process and of the suggestions need to be challenged by the full weight of the Councils legal resources. The Health Scrutiny Committee on the councils should be called into emergency sessions.

The many people who sit on heath boards of different kinds must step up. We need conferences to pool their knowledge and to brief them.

Campaigners need to get out and campaign with petitions, leaflets, and street and community meetings.

Campaigners can go to hospitals early in the morning to leaflet staff, discussing with staff going into work or coming off shift, making sure that the Sustainability and Transformation plans become as notorious as TTIP.  Done sensitively such community support lifts the spirits of the staff. NHS management practices keep staff working very hard and convinces some that there is no alternative. We need to shout the alternative from the roof tops.

Shop stewards and Union reps, both those who work in the NHS and those whose members use the NHS must get the message out at work.

Community groups need to make sure their members know what’s happening.

Campaigners in Labour must campaign within and outside the party

Councillors could  be using the Health Care scrutiny committees to expose the situation

National links between all the campaigns should be strengthened.

We need to campaign for a fully funded NHS, publicly provided, a universal service paid for from taxation, the best available treatments and services. The NHS reinstatement bill needs full support

Organise our self defence of the NHS, including Mental Health, maternity services and of care for the elderly