Money for the banks, cuts for the NHS

Unite organises workers in the finance sector. They’re not all ‘greedy bankers’ – in fact they earn, on average, around £15,000 a year. One of the real industrial problems they are now facing is that members of the public come into banks and abuse staff, somehow believing that they’re all greedy fat cats, and that they’re all responsible for the catastrophic recession.

At the Unite Executive Council last week, Rob McGregor, National Officer for Finance, reported on the massive job losses now taking place in the sector. He also gave us a reminder of just how much of our money has been poured into bailing out the banks (with a view to nationalising the debt and re-privatising the profit). The real City fat cats want to get back to ‘business as usual’ as soon as they can, and the Government is happy to support them. There is, of course, no trade union representation in the FSA, the agency that pretends to regulate financial services in the UK.

The public money spent on ‘capitalising’ the banks now stands at an astonishing £900 billion. This compares with only £82 billion in total spent on education – schools, colleges and universities.

Pouring this kind of money into banks has serious implications for public sector spending. The Government is pretty cagey about this, but reports are now emerging about the deep spending cuts that are planned for the NHS.

Monitor, the regulator of Foundation Trusts, has warned that NHS Trusts applying for foundation status will be required in the future to demonstrate that they can survive if their income grows by only 0.7 per cent a year from 2011-12 onwards, compared with 2.2 per cent next year. The Monitor estimate for ‘efficiency savings’ (the Government’s euphemism for cuts) stands at 4 to 4.5 per cent in 2011-12.

What does this mean? Real cuts of up to 3.8 per cent a year. The HSJ story on all this is here .

It may well be even worse than this. Sue Slipman, the Foundation Trust Network Director, says, ‘We all know it’s going to be infinitely more grim than the Monitor figures suggest’.

And Price Waterhouse Cooper – a company that knows nothing about healthcare but a good deal about money – says that Primary Care Trusts should reckon on cutting their spending by up to £6 billion between 2011-12 and 2012-13.

We have a Government that bails out banks but shows utter contempt for workers. We have a system – capitalism – that looks ever more corrupt.

Transforming Community Services: An attack that has to be stopped

I’ve posted before on the ‘Transforming Community Services’ guidance now being implemented across England. A detailed analysis of what’s happening is here. We have to understand what’s happening in order to resist it.

‘Transforming Community Services’ would be more accurately described as ‘Transferring Community Services’ - transferring them out of the NHS. The clear intention is to strip community healthcare out of the NHS altogether. This has been an ambition of this reactionary Government since 2005. Then, we forced them to back down. Now, they are counting on unions falling into line as a general election looms.

This is an ideological attack, from a Government that has an increasingly open contempt for workers and trade unionists. The NHS was one of the greatest achievements of the last century. If our unions don’t wake up to the scale of the threat here, the loss of the NHS will be one of the greatest defeats of this one.

Community Healthcare: Opportunities for big business to make big profits

Many of us think of the NHS in terms of hospitals, cancer, cardiac arrests and blue light emergencies. Actually most NHS care is a lot less exciting than this. Around 80% of NHS appointments are in ‘primary care’ – the unglamorous community services offered by GPs, health visitors, district nurses, speech and language therapists and so on.

This is the ‘bread and butter’ work of the NHS. It doesn’t make for good TV, so we don’t have the primary care equivalent of Casualty or Holby City. But primary care is about ensuring quality of life for elderly people, people with disabilities, people with terminal illnesses, children.

The Government, through a vicious set of proposals called ‘Transforming Community Services’, is now trying to strip community healthcare out of the NHS. Short term, we’ll see a return to the 1930s – healthcare provided by a ragbag of charities, social enterprise companies and private companies. Longer term, it is a virtual certainty that big business will dominate the NHS ‘market’.

A brief commentary on the proposals is here. This was prepared for a Unite meeting tomorrow. I’m working at the moment on a much more detailed analysis of this. I regard ‘Transforming Community Services’ as the most serious threat the NHS has faced yet. The damage that will be done to the NHS (and to NHS workers) is immense.

It is essential that our trade unions oppose this nonsense at national level. We cannot possibly have the level of fightback we need if it is left to trade union activists to resist a national attack at local level.

Ivan Cameron – and the loss of expert care

I was genuinely saddened by the death of Ivan Cameron. The death of any child is a tragedy – no less so when they have profound disabilities. It’s clear from media coverage that Ivan was a much-loved child who had the very best care available. It’s also clear that he had informed, hands-on parents who worked phenomenally hard to ensure he had the best quality of life that was achievable.

For several years, Ivan Cameron attended the Cheyne Day Centre five days a week. I used to know the Cheyne Centre well a few years ago  – I worked sometimes with Cheyne staff, and visited the Centre regularly.  Cheyne was an absolute centre of excellence. It offered superb integrated care and intensive support for children with the most severe disabilities. Classroom and therapy staff worked together extraordinarily well, and the expertise and commitment of all staff were impressive. I have never seen care of this standard offered anywhere else.

The Cheyne Day Centre has gone now. It was closed down in 2007, essentially for financial reasons. Places like Cheyne cost a great deal of money to run. Over the last few years of its existence, it was increasingly clear that Cheyne was in trouble. Local authorities across London refused to pay for children to attend, hiding behind the pretence that mainstream schools or other special schools could offer the same provision. This was, of course, not true. The Primary Care Trust with overall responsibility for Cheyne waited until Ivan Cameron left before announcing the decision to close the centre. One might speculate that this was for political reasons. Just think of the adverse publicity that might have ensued otherwise.

In 2004, when Cheyne was initially under threat, the local Overview and Scrutiny Committee held its own hearing into the proposal. The report is here  – and it still makes moving reading.

David Cameron, then a prospective Cheyne parent, is reported to have reported the closure of the Centre as ‘a matter of life or death’ for his child.

A staff member commented that ‘Cheyne was a small, nurturing, calm, quiet environment where intensive and early intervention work could be undertaken, offering these severely disadvantaged children a chance to make sense of their world’.

The parent of a child at Cheyne said that the ‘Cheyne Day Centre offered a unique quality service, a model of excellence in the treatment of these kinds of severely disabled children. These children and their families had for too long been hidden and beaten down, but it was important that their needs were not ignored’.

Children like Ivan Cameron, with these profound disabilities, very often have short lives. There are choices to be made here. We can offer these children basic medical care and education that doesn’t meet their needs, and wait for them to die. Alternatively we can understand that they are human beings with real intrinsic worth, and we can value them and nurture them for who they are. I know which of these I want to see.

Public services are under attack. The overall direction of travel in the NHS is for cheap (and not very cheerful) care. ‘Inclusion’ in mainstream education can be an excuse for not spending the money on highly specialist provision. The death of Ivan Cameron is a tragedy. The loss of the superb specialist services that Ivan accessed is an ongoing  tragedy for other disabled children.

United Left: The launch of a vibrant left in Unite

I attended a brilliant meeting yesterday – the sort of meeting that gives you the energy and enthusiasm to carry on slogging away with the hard grind that’s built into trade unionism.

The meeting was the launch meeting of United Left – the new broad left organisation in Unite. The predecessor organisations of Amicus Unity Gazette and the T&G Broad Left have now been formally closed down.

There is a real sense of urgency now in building a left in Unite. We desperately need a union that does more than lobby a rotten and reactionary Labour Government. We have a virtual meltdown in many of the key areas where our members work – in the car industry, most sharply, but also in manufacturing generally, in finance, in construction. In the public sector, market madness continues to prevail – the Government may have been forced to pretty much nationalise the banks, but they’re desperate to break up and privatise local government and the NHS.

We need a union that fights for us – a union that uses its political and industrial muscle to fight for every job and to stop every attack on our conditions. A strong left can be at the heart of building that union.

The meeting was in Birmingham, with over 200 activists cramming into the hall. I’m not going to attempt a verbatim report of a detailed and fast moving meeting, but rather to give my own impressions of what took place.

Tony Woodley, Joint General Secretary of Unite, spoke first. He was very supportive of the new left organisation, and talked about the need for an open, progressive and democratic left. He also spoke very well about the real problems our members face – about the 6000 automobile workers at immediate risk of losing their jobs, the 850 agency worker who were sacked with no notice at Cowley, and the attacks faced by so many of our members. He attacked Gordon Brown and his predecessor ‘warmongering Blair’ for thinking that it was OK to let the market decide, and for looking after the filthy rich. He talked about the need for leadership, and said our union had to put members first, not ministers.

I didn’t disagree with a word Tony Woodley said. The challenge is, of course, that we need real action now.  Our members are being wiped out. Waterford Crystals stands out as a brilliant example of how to defend jobs – but in the UK we have not yet seen any comparable fight. If we’re going to save jobs, we must fight for them – and Tony Woodley has a responsibility to move heaven and earth to make sure that fight happens.

The other guest speaker was Unite member John McDonnell MP. John is an enormously well-respected figure on the left (which means, of course, that he is savagely disliked by many in the Labour Party, and by the Parliamentary Labour Party most of all). John launched a savage attack on the neo-liberal policies of the Government, and the ‘toxic mix’ of free market policies, the denial of trade union rights, privatisation, and the way people have been forced into debt. He was scathing about Labour’s ‘talking out’ of the Trade Union Freedom Bill – even this minimal protection for trade unionists was impossible for this Government to contemplate. He commented that negotiations with this Government aren’t working – it’s like having a ‘conversation with the deaf’ trying to talk to them.

John also quite rightly condemned the slogan of ‘British jobs for British workers’, saying that we needed jobs for all workers. He condemned Labour’s attacks on civil liberties, the replacement of Trident, and the ‘money laundering’ of privatisation that simply transfers public money to private sector pockets.

John gave a vision of an alternative society – a socialist society where we can end recession now and forever, a planned and managed economy, trade union rights, decent public services and so on.  He talked about the launch of the new ‘People’s Charter’ – potentially an important initiative in building the fightback we need. He talked about the importance of Unite as the biggest UK union, and of the left in Unite, in fighting for the sort of world we want to see.

John is a passionate and hardworking socialist. His contribution set the positive, upbeat and radical mood in which the rest of the meeting took place.

There was a strong mood for left unity amongst virtually all of us in the meeting – essential in breaking with regarding ourselves as ‘T&G’ or ‘Amicus’ and getting on with the job of building a left in Unite. People grappled with the very real problems that can emerge in a general union – for example, the questionable policies of supporting nuclear power, and supporting the third runway at Heathrow, when so many of our members are opposed to these things.

People talked about the need to fight for jobs, and the need to break the law – Tory law and bosses law – when it doesn’t allow us to defend our members. We made a commitment to supporting the mobilisation against the BNP in Liverpool (10 am onwards, 14^th March, Church Street, for a rally at noon). We pledged to build for the G20 demonstration, and in principle to support the People’s Charter.

Importantly, we also talked about the recent oil refinery dispute and the issues around ‘British jobs for British workers’. The overwhelming mood of the meeting was that we must defend jobs and national agreements – but not by making concessions to nationalism, xenophobia and racism. A large majority of those at the meeting felt that the ‘British jobs for British workers’ is divisive and dangerous – a complete dead end for our movement. (An aside – but it’s worth noting that the BNP has taken up this slogan enthusiastically, and that a BNP candidate won a supposedly safe Labour council seat in Kent last week. Trade unionists and socialists play a very dangerous game when they flirt with crude nationalism).

The meeting went on to endorse a decent set of ‘aims and principles’, and to elect a national steering committee. The work of building United Left in Unite is well underway. Yesterday’s meeting gave a glimpse of the possibilities that are there for socialists, and the role we can play in building unions that deliver for our members.

Finally, many of those in the meeting signed a statement on the need for unity to defend jobs and to build union organisation – but also to reject the ‘British jobs for British workers’ slogan as being divisive. Over a thousand trade unionists have now put their names to this, including 15 Unite Executive Council members, and Joint General Secretary Tony Woodley. The statement can be signed online here.

Social Enterprises: No, not the best thing since sliced bread

There’s a completely bizarre supplement in today’s Guardian, all about social enterprise companies. There’s no analysis here at all – the eight page insert is devoted to telling us how wonderful social enterprises are. The headlines are along the lines of ‘How to build a better future’, ‘Onwards and upwards’, ‘The NHS should seek advice from social entrepreneurs’ and so on. We’re told that ‘in future a millionaire will not just be someone who has made a million pounds but also someone who has helped change a million lives’.

I read this garbage on the train home feeling a bit mystified. The Guardian’s coverage of the Government’s systematic dismantling of the NHS is nothing to write home about – but I expected more than this grovelling praise for some vicious and reactionary policies. I would put in a link to the supplement, but it doesn’t seem to be available online.

As I read the supplement, I felt it had the feel of an advertising feature. All hype, no honesty. I looked more closely – and realised that this really was an advertising feature. The supplement has a Department of Health logo on the front. A full page Department of Health ad on the back proclaims, ‘Social Enterprise: Making a difference to communities; More choice for better health’. In very, very small print, we’re told the paper is produced ‘In association with the Department of Health’.

I assume, then, that this was written by Department of Health civil servants – many with a private sector background, and all of them seemingly committed to the break-up of the NHS. I also assume the Department of Health paid for this promotional material. If so, it’s a shame the Guardian didn’t make this a little bit clearer. Perhaps some slightly more robust coverage of what’s actually happening to the NHS would help to make amends.

Social enterprises are one strand of a multi-faceted attack on the NHS – but this is serious stuff. Last week, Cabinet Officer Liam Byrne announced to the ‘Voice 09 Social Enterprise Conference’ that 25,000 jobs will be shifted to social enterprises companies over the next few months – many coming from the NHS and local government. The Cabinet Office press release is here.

The Guardian’s DOH advertising puff boasts of the ‘Right to Request’ plan. The intention here is to encourage NHS staff to set up small businesses to provide healthcare, with NHS commissioners forced to accept the proposals whether they meet local health needs or not. The scale of this is intended to be huge – a quarter of a million staff, and £10 billion of public money. We’re told “We are the first state in Europe to go down this route”. One might wonder why.

We should have no illusions about the merits of social enterprise companies. The agenda here is the breaking up of the NHS, the large scale transfer of NHS services and NHS staff to non-NHS organisations, and the destruction of the public sector ethos of the NHS. And how on earth can we maintain high standards of clinical care when care is provided by a miscellaneous ragbag of companies competing – on the basis of cutting costs – to grab contracts? Clinical governance is off the agenda these days, while professionalism is a dirty word.

Social enterprise companies themselves are simply a stepping stone towards out and out privatisation. As we move rapidly towards a free market system for the provision of health care, social enterprises run by clinicians will be very quickly wiped out by loss leader bids submitted by multinational companies.

The risks of losing the NHS are escalating sharply. We need a serious fight by the unions to defend the most valued institution we have in this country. It would help if the media alerted the public to the scale of the attack we’re facing. Campaigning journalism might be, short term, less lucrative than printing Department of Health puff – but could be of far greater long term value.

Want a spot of prayer with your district nursing?

A few years ago I came across a forum on the internet that I found genuinely offensive. It was a discussion group for NHS workers who belonged to an evangelical Christian network. Participants in the forum boasted about their attempts to convert their patients. One post was from an Allied Health Professional working in a school for children with severe learning disabilities. She was thrilled to bits that a Muslim child at the school had asked her about Jesus, and she regarded this as a major victory for Christianity.

The contributions that I looked at were characterised by an astonishing arrogance, and – although this would, of course, never be admitted – a real contempt for anyone who did not share these evangelical beliefs.

I have little sympathy with Caroline Petrie, the evangelical nurse who was suspended for asking a patient whether she would like to be prayed for. Petrie has now been reinstated following a high profile media campaign. The Telegraph, for example, alleges that ‘individuals… have faced aggressively punitive action from the authorities merely for demonstrating their Christian convictions’. Melanie Phillips, writing in the Mail, pontificates, ‘This is the way a society dies’. How dare we defend the rights of people who don’t want to be prayed for!

There’s an interesting interview with Petrie, in the Mail On Sunday. The incident for which she faced disciplinary action was not in any way a one-off. Petrie has designed a prayer card, which she gave to over 50 of her patients as she went from home to home changing dressings and measuring blood pressure. This is OK, though – ‘if they just threw them in the bin, she did not mind’. Tremendously magnanimous of her.

I can understand why patients might be angry or upset to be offered this. I certainly would be. The prayer card is here:

Last October, the carer of one patient complained about the prayer card distribution, and Petrie received a formal warning from her employer. A second patient triggered the more recent suspension. The patient turned down the unwanted offer of a prayer, commenting ‘It could perhaps be upsetting for some other people if they have different beliefs or thought that she meant they looked in such a bad way that they needed praying for.’

The patient’s common-sense view is not shared by Petrie. Asked if she will do it again, she says “Yes”.

Personally I’m an atheist. I have been since I was five years old. My own belief in atheism is as profoundly held as Petrie’s belief in Christianity. Do I bang on about this in my professional role as a speech and language therapist? No – and it would be grotesquely inappropriate if I did. My job is to work with children with disabilities, and to support the parents of children with disabilities. I seek to give respectful, equal, sensitive care to ALL those I work with. I’ve worked for eight years in a part of London where very many families are either Muslim or Orthodox Jewish. It’s not my job to tell them why I’m an atheist. It’s my job to provide culturally appropriate care.

This seems pretty self-evident to me. My take on this is shared by my colleagues (across several faiths and none). It’s also shared by the Hospital Chaplains I’ve worked with. For most health workers, there is a straightforward understanding that our starting point has to be one of respect for other people, and respect for their beliefs. The overwhelming majority of health workers understand that it’s not our job to proselytise. Thankfully, most of us also understand that it’s unacceptable to try to ‘cure’ gays, or to stop women from accessing abortion or contraceptive services.

This stuff actually matters. It’s not about ‘political correctness gone mad’ or ‘discrimination against Christians’ or any of the other fanciful claims we’ve seen over the last few days. It’s about providing high quality health care for everyone.

Oil Refinery Disputes: A fundamental problem

Last week’s Unite Executive saw brief reports on the Lindsey Oil Refinery strike, and the support strikes that were unfolding as we met. Since the Executive, I’ve had the opportunity to talk to people who’ve visited the picket line, to read websites run by strikers, and to look at the media coverage in more detail.

It frightens me that so many socialists and trade unionists are giving uncritical support to this dispute. The slogan at the heart of the strikes is ‘British jobs for British workers’. Since when has this been a progressive demand? The BNP is organising around the dispute – and isn’t being chased away as filth like this should be. And since when has the Tory press given such positive and detailed coverage to illegal strike action? The Daily Mail and the Sun are no friends of trade unionists.

There’s a problem here that can’t be ducked.

Yes, construction workers are being treated like dirt. Yes, Europe is about maximising profits for the bosses and screwing workers – across the whole of Europe, not just in the UK. Yes, sub-contracting is being used to undermine trade union organisation and erode national agreements. Does any of this mean that Italian workers are the enemy? Of course not.

There are principled class demands to be put in this dispute – defence of the NAECI agreement, unionised labour at every site, an end to sub-contracting, the rate for the job for every worker irrespective of their country of origin. These are the issues we should be organising around.

It’s simply wrong to make concessions to racism. Trade unionism and socialism must be about internationalism. ‘British jobs for British workers’ is not a demand that socialists can support.

Unite: Strong support for Gaza

I’m writing this as news breaks that Israel is again bombing Gaza. There are already close to 1000 dead, including hundreds of children. Thousands of homes are in ruins. Reliable reports are of 400,000 people without clean water supplies. The prospect of even more slaughter is horrific.

I’m attaching the Unite statement on Gaza - a good document, unanimously supported by Executive Council members on Thursday.  Joint General Secretary Derek Simpson moved the proposal.

The statement is a powerful one. It demands that the British government unequivocally condemns the Israeli aggression, for example, and demands that the British government ends arms sales to Israel.

Importantly, the statement also encourages branches to affiliate to the Stop the War Coalition  and the Palestine Solidarity Campaign.

Members are urged to make donations to relevant causes such as the TUC Gaza Appeal and Medical Aid for Palestinians.

Unite members are also encouraged to attend demonstrations against Israel’s attack on Gaza.

It’s great to see Unite responding in a very principled way to the nightmare situation in Gaza. Unite activists should make sure that the statement is circulated as widely as possible inside the Union.

The renewed attacks by Israel lend a real urgency to this. Our money can save lives. If we succeed in forcing a principled response out of our own Government, this could save a great many more.

Polyclinics: Not needed, not wanted

Apologies for a lack of recent posts – I’ve had some health problems.

Last year the BMA launched a petition against the Government’s assault on primary care – the community health services that are vital in ensuring a decent quality of life for millions of people. In a matter of weeks, 1.3 million people signed the petition against polyclinics – the new ’super surgeries’ that are about handing over the NHS to the private sector and reducing access to primary care for the most vulnerable people in our society.

Our caring sharing Government listened carefully. Having totally lost the argument on polyclinics, they renamed them ‘GP-led Health Centres’. GPs are of course overwhelmingly opposed to these daft proposals, but this is not a Government that lets truth get in the way of privatisation plans. The Government instructed every Primary Care Trust to open a polyclinic, irrespective of whether there was a local need for this or not.

We’re now starting to see the results of this massive privatisation scheme. Cuddly junior Health Minister Ben Bradshaw said, “Don’t worry, we haven’t privatised all of the NHS yet – we’re just working on it”. Actually, I paraphrase. What he really said was, “This rather demolishes the scare spread by some that all these contracts would go to private companies”. He’s right that not all contracts have gone to the private sector – only 25% of them  have. It would have been more, but the slide of the economy into absolute chaos has deterred many of the likely bidders, as they no longer believe they can make enough easy money out of our NHS. Virgin Healthcare, for example, has pulled out of bidding for polyclinics. Branson has decided there’s more dosh to be made elsewhere. Also the viability of the private companies that have won contracts is highly questionable. For example, Assura has won four contracts to run polyclinics – but its shares plummeted by 90% by November last year, and they were predicting end-of-year losses of £6 million. So first we privatise the NHS, and then we watch it go bankrupt? That seems to be the plan.

So are polyclinics needed? Of course not. The House of Commons Health Select Committee reported earlier this month on its own findings that the plans were seriously flawed, not adequately evaluated, and that polyclinics should have been piloted before widespread introduction. The story is here.

It’s downright extraordinary to see a Government so determined to smash up the NHS that it will force through privatisation at precisely the time that the failure of the market is clearer than ever. A priority for 2009 is to build the broad-based campaign of trade unionists and community campaigners that can stop this absolute madness.