A glimmer of hope for the NHS

October 1, 2009

“The NHS is our preferred provider”.

These are the words of Andy Burnham, Secretary of State for Health. A speech to the King’s Fund has been followed by a letter to TUC General Secretary Brendan Barber, and an agreement of the Social Partnership Forum (representing NHS unions and employers). The documents are here.

This is extraordinary. After years of a deliberate and wilful assault on a public NHS,  this looks like being a real policy shift. Yes, all of us would have written a harder and sharper document, without the prevarications and the loopholes – but nevertheless there are requirements here that make it far harder for NHS ‘commissioners’ to hand over services to big business.

The  furious response from former Secretary of State Alan Milburn highlights the extent to which this is a break with the past. Milburn did his damndest to smash up the NHS when he ran it – and now makes a pile of money as an advisor to the private sector firms muscling in on healthcare. If Burnham was just coming out with the usual New Labour drivel, Milburn wouldn’t be so angry.

Trade unionists and campaigners have a responsibility to seize this opportunity. We’re on the brink of losing primary care now – all those vital community health services that make up over 80% of our NHS. Burnham claims he doesn’t want it to happen. Fine – let’s hold him to account. Let’s hold to account, too, the army of eager privateers in the Department of Health and the Strategic Health Authorities, and the scummy little bureaucrats and empire builders who hold so many senior management positions in the NHS, and the Labour councillors on Health Scrutiny Committees who have been unwilling to defend local services. Let’s get the message out to the army of MPs who are terrified of losing their seats: “Stop the break-up of the NHS”.

Why is Labour doing this? Unison’s Mike Jackson claims it’s ‘partnership’. I think it’s a desperate government flailing around for votes. Actually it doesn’t matter. We’ve got a window of opportunity to save the NHS. Cynicism is understandable – but a mistake if it gets in the way of a fight. Now’s the time to throw every effort into building the biggest, boldest and loudest campaign we can deliver.


McKinsey Madness

September 3, 2009

Apologies for a quiet few months. I’ve been seeing the NHS from another angle, having acquired myself a diagnosis of ‘syringomyelia’. This is a rather obscure spinal condition – relatively common in spaniels, apparently, but quite rare in people. You know you’ve got something a bit unusual when you go and see your GP to discuss treatment options, and she says, ‘Now tell me what that is’.

So how has the NHS been, so far? Not perfect, but not bad either. I’ve met some highly skilled health professionals. I’ve had access to MRI scans when I’ve needed them. I’ve had onward referrals to appropriate specialists – so far, as and when required. I’ve been treated with respect and courtesy by virtually every NHS worker I’ve encountered.

The problems, predictably enough, are around privatisation, and the drive towards cost-cutting that you get when you ‘marketise’ the NHS. I’ve had appointments at one hospital that is struggling with a massive PFI debt and pushing through savage cuts as a direct result. It shows. I’ve also talked to clinicians (at the same hospital) who have told me of the growing clinical risks as managers set targets that cannot be met without compromising patient care.

These are not failures of the NHS. This is an important point. The NHS works, saves lives, and transforms the quality of peoples’ lives, and does this as a matter of routine, every single day. The failures here are of Government policy, which continues to be one of dismantling the NHS and destroying the values and ethos that make the NHS work.

The latest bit of madness is, of course, the Government-commissioned McKinsey report – out since March, but our pals in New Labour have been sitting on it. McKinsey is a particularly vile management consultancy that has made a mint out of the public sector. The HSJ summary is here. McKinsey recommend axing 10% of NHS jobs to achieve £20 billion savings.

Coincidentally, £20 billion is the estimated cost of the Government’s loopy privatisation schemes. If there are savings to be made, perhaps stopping the dash for privatisation might be a better bet than imposing massive cuts in clinical care. Even better, maybe we could just invest the £20 billion in patient care, and have an NHS we can all be proud of.

There’s one NHS cut I would welcome. Around £350 million of our money was spent last year on management consultants – the greedy parasites who feed off the NHS. The result? Reports that aren’t fit to be used as toilet paper.

Dial-a-Ride: Right to strike

May 25, 2009

I had the pleasant surprise last Friday of bumping into a picket line on my way to work. The strikers were Unite members at London Dial-a-Ride – the service that offers door-to-door transport for very elderly people and for people with disabilities who cannot access public transport easily.

I stopped and had a chat with the workers on the picket line. Nobody goes on strike (and loses money) for fun – people are generally pushed to breaking point before they even consider strike action, and are typically absolutely right to use the strongest weapon that workers have.

That was certainly the case at London Dial-a-Ride. The Unite convenor told me about the background to the dispute. The booking and scheduling system was centralised a couple of years ago, with a new computer system doing the work that used to be done at local level. The system simply doesn’t work. Users are left hanging on the phone trying to book a call, can’t book rides for the times they need them, or can’t book rides at all.

This isn’t about minor inconvenience; this is about quality of life. I was told about the real distress of service users.  It might be the highlight of someone’s week to go to the shops with a friend, or to go to a social club at a regular time, with people they know, knowing that they can rely on a ride there and back. ‘Flexibility’ isn’t an option when it comes to the things that are keeping you sane and making life worth living – or, for very practical reasons, when a journey is to a medical apointment, or fitted in around other health care  and social care arrangements.

It isn’t just the service users who are distressed. It’s the drivers who take on responsibility for a failing system and who swap rides when they can in a desperate effort to meet peoples’ needs. The convenor told me about the drivers who are in tears when they let down Maisie who always does her shopping with her neighbour on Wednesday mornings, or Bill who always goes to his club on a Thursday afternoon.

There’s a human cost to systems that don’t work. It’s astonishing that a new system can be put in without proper testing to ensure it will work, and downright bizarre that problems persist a couple of years after the thing went live. The grotesque mismanagement increasingly leaves the future of the whole service in jeopardy.

Not content with mismanaging the service to users, senior managers seem to have decided that it’s the workforce who are the enemy. There’s a headlong gallop towards a bullying, top-down and intimidatory style of management. Existing agreements are simply being torn up. Grievances are stalled, because managers don’t want to progress them. People aren’t allowed union representation until disciplinary actions become formal – a grudging compliance with the bare legal minimum, and an approach that is punitive and anti-union. There’s no evidence at all of very committed and hard-working drivers abusing sick leave arrangements – but that hasn’t stopped managers imposing a ‘get tough’ approach to absolutely legitimate sickness and to time off for hospital appointments. There’s also a very direct attack on Unite, with facility time for stewards being slashed. All of this is a massive attack on collective bargaining in Dial-a-Ride. Workers are much easier to push around if they’re isolated individuals, without the protection of a union that negotiates for everyone.

Were London Dial-a-Ride workers right to go on strike last Friday? Of course they were. Will they be right to take the dispute forward, if members back this? Again, of course they will be. The needs of Dial-a-Ride users and Dial-a-Ride workers seem pretty much the same here: a right to be treated with respect and decency.

Victory at Visteon

May 4, 2009

News emerged at the end of last week of what looks like a significant victory for the Visteon workers. I’ve written about this dispute  before.  Around 600 workers were sacked at the end of March with a few minutes notice – and the employer then denied them even the pensions and the redundancy pay they were due.

Visteon workers used to be employed by Ford until 2000, and were on Ford contracts. When it came to the sackings, though, Ford managers simply said, ‘Nothing to do with us’.

The workers quite rightly fought back, with occupations and pickets of their plants to prevent the bosses moving machinery out. What really swung it was the threat of secondary action by Ford workers. There was a serious and growing mood amongst the Visteon workforce to take the fight to Ford, and picket out Ford plants. This could have cost Ford millions.

The outcome? Ford has been forced to acknowledge its responsibilities to the workers. They’ve been offered redundancy payments totalling hundreds of thousands of pounds, with some workers likely to receive as much as £40,000. They haven’t saved their jobs – but they have won a significant victory nevertheless.

There are lessons to be learned from this. When the Visteon workers occupied their workplaces, this was of course against the law. The threatened solidarity action by Ford workers would have course have been against the law. It is very, very difficult – in the context of Thatcher’s anti-union laws, perpetuated by Blair and Brown – to win an industrial dispute and stay within the law. The economic crisis means that workers are likely to face an absolute onslaught of pay cuts, axed pensions, and mass job loss. Our unions can either meekly obey Tory law – or can put their members first.

The Visteon workers didn’t win by asking nicely, or by waiting in the vain hope that a Labour Government might start treating ordinary workers with respect. They fought back, and they were right to do so. Their victory sends an important message to other workers as redundancies soar. When they come for our jobs, we can fight back and we can win.

Labour may be toast – let’s make sure we’re not!

April 24, 2009

At least two papers carried the same joke as commentary on Wednesday’s budget. They captioned the ubiquitous picture of Alistair Darling and his wife having breakfast together before he heads off to make his budget speech. Mrs Darling says, ‘Toast, dear?‘. Our Al looks up from the Financial Times and replies, ‘Yes, we are’. It made me laugh – but only briefly.

The reality is that Labour is finished. ‘Snowball’s chance in hell’ is the phrase that springs to mind. Labour will get smashed at the next election for the simple reason it has betrayed its core voters, again and again and again. The UK’s biggest trade unions have allowed the Labour Party to betray workers (and pensioners, and children, and single parents, and the unemployed, and people who need affordable housing, and so on and so forth) on the basis that however bad the Labour Government gets, they’re not quite as bad as the Tories. By letting Blair and Brown off the hook, our union leaders may have effectively signed Labour’s death warrant.

The miserable political bankruptcy of Labour has been matched by the rising tide of sleaze. The last few months have been extraordinarily reminiscent of the dying days of John Major’s Tory Government, before Labour swept to victory in 1997.

A few days ago I warned of the likelihood of massive cuts in public spending lying just ahead. Analysis of the budget is starting to confirm this. Today’s Guardian carries genuinely frightening predictions, with two articles outlining the crisis into which our public services will plunge. The Institute for Fiscal Studies has picked up on a £45 billion gap in Darling’s plans, and predicts the deepest cuts since the 1970s. The IFS analysis is of an average 2.3% a year cut across government departments from 2011/12 onwards.

The second article reports on responses to the budget.  The Lib Dems’ analysis is of a fall in NHS spending of £2.3 billion from 2010/11 onwards, with a further £600 million to be taken from the Department for Children, Schools and Families. I don’t for one second trust the Lib Dems, but commentators with considerably more integrity make the same warnings. The Trade Union Co-ordinating Group, representing nine unions that are independent of Labour, believes that the Government intends disastrous public spending cuts that will dwarf anything ever attempted by Margaret Thatcher. John McDonnell MP says, ‘These cuts are catastrophic. People are worried by the combination of cuts and asset sales and privatisation… there will be massive cuts in public expenditure. If you combine the cuts with privatisation this is on a scale that has never been seen before’. 

This is a warning that has to be taken seriously.

There are two ways forward. One is a descent into savage attacks on workers that are not met with resistance – and bitterness and despair can provide a fertile breeding ground for the Nazi BNP. The other way forward for us is that workers organise and fight back – black and white, gay and straight, women and men, public and private sector – all of us standing together and demanding that we do not pay the price for the bosses’ crisis.

There are obvious stepping stones towards this. The Visteon dispute shows that closures and redundancies can be fought. We have to do everything we can to ensure that this very winnable dispute ends in a clear victory for the workers. The key to winning this one is practical solidarity. We also have the Unite Demonstration for Jobs in Birmingham on 16th May – an opportunity for a massive show of strength by rank and file trade unionists. We should aim to have victorious Visteon workers heading up the march!

And crucially, we need to demand that trade union leaders do their job and lead.  If we don’t have a serious, organised defence of jobs, pay and public services, the consequences for workers are close to unthinkable.

Got five minutes spare before 30th April?

April 20, 2009

There’s an important leaflet here from Keep Our NHS Public.

This is about the ‘Co-operation and Competition Panel’ – a fancy name for a body that will allow the private sector to overturn local decisions to keep NHS services publicly provided and publicly accountable.

It’s astonishing that a Government that is so discredited and so unpopular remains determined to destroy the welfare state and the NHS. Brown’s ambition is seemingly to go down in history as the man who succeeded where Margaret Thatcher failed.

There’s a consultation exercise going on now around the Co-operation and Competition Panel. It’s not intended to be a real exercise in democracy, as this might actually mean asking people if they want their NHS to be sold off to the profiteers. However, it does no harm at all to respond along the lines suggested by KONP. If you have a spare five minutes before 30th April, give it a go.

The consultation documents are here  if you can’t access them from the KONP leaflet.

Massive public spending cuts just around the corner?

April 19, 2009

I can’t keep track of the number of media reports I’ve seen in the last few weeks calling for public spending cuts. This is rapidly becoming the new orthodoxy, with well-paid journalists, right-wing think tanks and neo-liberal politicians all joining together in reactionary chorus.

A quote here from Reform, a grubby little outfit that claims to be “an independent think-tank whose mission is to set out a better way to deliver public services and economic prosperity”. That’s prosperity for a handful of the super-rich then, I guess. Reform says that “in order to put Britain’s economy on the right path, public spending cuts must be considered and traditionally ‘unthinkable’ areas such as the NHS and defence cannot be exempt from the discussion”.  Anyone who’s naïve enough to think that the Lib-Dems offer a progressive alternative to Labour or the Tories might like to note that Reform is launching its pre-Budget report with Vince Cable as the keynote speaker.

An even less subtle but equally grubby little outfit, the Taxpayers’ Alliance, is also calling for public spending cuts. The Taxpayers’ Alliance claims that there is “a very severe divide” opening up between public and private sectors, with state employees enjoying better pay, pensions and job security.

The bosses’ paper the Financial Times and the right-wing  Daily Telegraph are going out of their way to promote this view, as are many other newspapers. Tory Shadow Chancellor George Osborne is happy to provide the politics these rags are looking for. Osborne told the FT that the 1.1% a year expansion in public spending planned by Labour is not sustainable. He has threatened to renege on the (very poor) three year pay restraint deals forced through by Labour, and says the issue of ‘gold-plated’ public sector pensions will be swiftly addressed by a Tory Government. Eton and Oxford wasn’t it, George? Good to know you’re in touch with the concerns of ordinary people.

And what about Labour? Subdued murmurs of massive public spending cuts have been going on for a long while now – way before the multi-billion bail-out of the banks, even. However, the Government’s got so few people left who actually support them, they don’t necessarily want to drive away the few voters who doggedly cling on hoping for something better. The BBC suggests that spending cuts will be announced in a future comprehensive spending review, rather than in the forthcoming budget – and any spending review will presumably be delayed until after the European elections in June.

We’re already seeing the softening up attacks from Labour, though. When Brown calls for reform of MPs’  ‘gold plated pensions’ this sounds remarkably like step one towards Osborne’s wider attack on ‘gold plated pensions’ in the public sector. Brown’s hatred of decent public sector pensions is an open secret. And the budget may well include other attacks – an increase in National Insurance contributions, an increase in VAT, the reduction of tax relief on pension contributions and so on. Who gets clobbered by these things? Ordinary workers, obviously.

We’re left with a bit of a dilemma then. One way forward for trade unionists is to accept that all we can do is tail Labour. That means doing as little as possible while the Labour Government desperately flails about in its death throes, with union leaders trying hard to look the other way while the NHS gets privatised, the public sector as a whole is decimated, and all workers are made to pay the price for the bosses’ crisis. My belief is that our big unions like Unison and Unite have made far too many concessions so as not to embarrass Labour.

The other way is to fight back. The claimed divide between public and private sector workers is a completely false one – a fake argument designed to divide and rule. It’s in the interests of ALL workers that we have decent public services. It’s very obviously in the interests of all workers that all of us have jobs, fair pay, and a pension that won’t leave us destitute in old age. Workers have never got anything for free – the lesson of history is that we get what we fight for. We’re now facing the deepest recession since the 1930s. If we allow the ruling class to get away with it, our side will pay a very heavy price. The need for militant trade union organisation has never been clearer.