Defence of the NHS: An issue for all trade unionists

I had the pleasure of speaking last week at a Unite branch meeting in South London. This is a new branch, rather belatedly bringing together former MSF and AEEU members.

I was asked to introduce the ‘Healthcare for London’ proposals – supposedly written by Lord Ara ‘I’m a doctor not a politician’ Darzi. Except, of course, Darzi is now a Health Minister in Brown’s Government, and the shoddy proposals for London’s healthcare were written by private consultancy McKinsey.

I ran through the nastier elements of the proposals. Obviously this included the plans to close down GP surgeries and replace them with polyclinics – reducing access to primary care for the most vulnerable users, destroying the doctor-patient relationship that is central to the family doctor service, and introducing the widespread privatisation of community NHS services.

I also talked about the plans to run down District General Hospitals, with a majority of these set to become ‘local hospitals’ without intensive care beds, and losing their A&E departments and maternity provision.

I talked about the loss of paediatric hospital provision, and the grubby proposals to privatise end of life care.

The discussion was brilliant – thoughtful, and sometimes challenging, but above all reflecting a passionate desire to defend our health service. People thought very carefully about polyclinics – understanding the convenience of getting all your services under one roof, but very clear that we don’t want this if it means closing down existing GP surgeries, and letting big business take over. We discussed how changes to end of life care should build on what we already had – GPs and district nurses, obviously, but with most people also accepting a role for the voluntary sector through MacMillan nurses, for example. We talked about the impact of ‘marketisation’ on the voluntary sector, though. If MacMillan nurses win a contract against United Health, they end up forced to compete on a cost basis and will compromise on the quality of care. ‘Competition’ is as destructive for voluntary agencies as it is for the public sector.

One Unite member in the meeting I knew well – but I’d had no idea that she was a member of my union! I’d met her before at Keep Our NHS Public meetings, and when she invited me to speak to a 500-strong meeting of older people organised by the National Pensioners Convention. Decades of activity as a trade unionist flowed quite naturally for her into defence of the NHS and a fierce fight to defend health services for older people.

I came away from the meeting feeling genuinely inspired. I had expected a ten minute slot in the meeting, but we talked about the NHS for over an hour before the Chair insisted we move on. Everyone in that meeting understood the importance of a publicly owned and publicly accountable NHS. Everyone in the meeting was committed to defence of the NHS.

It’s easy as a health worker to feel a bit beleaguered sometimes, given that every week seems to bring another loopy ‘reform’ as a failing Government digs itself deeper and deeper into a hole. It’s well worth talking to trade unionists who aren’t health workers. If we fight on pay, we’ll have their support. If we fight to defend the NHS, we will also have their support. There’s real potential for a fight here. One of the tasks for the trade union movement is mobilising that mood for resistance.


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