Support Laurence Faircloth

We’ve got a Government that remains determined to break up the NHS and hand over anything profitable to the private sector. For patients – particularly older people, people with disabilities, and people with chronic conditions – this will be an absolute disaster. For health workers, too, this is about attacking our pay, our conditions, and our ability to offer high quality patient care. We have to resist this in any way we can.

The leadership of our Union matters in this context. We need a General Secretary who will stand up to the Labour Government – not just at the level of huffing and puffing a bit, but prepared to make Unite funding contingent on the Government giving something back in return.

I’m backing Laurence Faircloth because – of all the candidates – I believe that he is best placed to do this. Laurence’s leaflet for Health Sector reps is here. Every rep in Unite’s Health Sector should be nominating Laurence Faircloth.

Baby P

I work with children with disabilities. Part of my job, as someone who works with children, is to be on the look out for children who are at risk – and to take every possible action to ensure that they’re protected when something goes wrong, or could go wrong.

The death of ‘Baby P’ is tragic and upsetting, and I’ve done what many health and social care professionals will have done – I’ve gone through the timeline and tried to work out who made a mistake and when. Having done that, I’m still not sure what happened. It may be that individuals did make mistakes; I’m not certain, and it’ll take a detailed independent enquiry to know.  When individuals get it wrong, though, there’s almost always a bigger picture. The tabloids are shrieking for individual social workers to be sacked. That’s just pointless and stupid.

The sense of responsibility and the understanding of what can happen to a child when you make a mistake are really difficult sometimes. I’m lucky – I deal with child protection cases occasionally. For social workers, they make incredibly complex and difficult judgement calls on pretty much a daily basis. This isn’t a job I’d want to do.

A senior social worker in Haringey has complained about huge caseloads and a culture of bullying. That isn’t the best work environment to be making life and death decisions on behalf of vulnerable children. If we want to stop tragedies like this happening, we have to make sure that social workers get the resources and the support they need.

Haringey isn’t alone in this. I’ve worked with social workers in a few London boroughs now, and they have genuinely shocking stories to tell. Caseloads way too big to allow social workers to do a careful and safe job are now the norm. A lot of social workers – maybe including the best people – get out because they hate not being able to safeguard children in the way they want to.

There are other problems. I know of at least one area that’s gone down a ‘skill mix’ route, so a lot of the frontline work is done by unqualified staff. Qualified social workers are employed mainly in a supervisory role. Sensible? Not really. The pressure on all staff in this situation is sky high. The risks to children are increased. Senior managers claim it’s a high quality service. They must know that isn’t true.

A social worker told me once of the constant pressure that she and colleagues were under to get children off the child protection register. I couldn’t understand this, and asked why. She explained that if a child died or was seriously injured while they were on the register, the Social Services Department would be considered more culpable than if they could show they’d assessed, intervened, sorted everything out – and got the child off the register. In a target driven system, the illusion had become more important than the reality. It’s senior managers who determine the culture of a social work department. Downplaying risk and managing budgets can co-exist quite nicely.

Health visitors have always played an incredibly important role in child protection work, too. This used to be a supportive ‘public health’ role – giving the ongoing universal support that prevents neglect and abuse. We can’t afford that in a modern NHS, apparently. Numbers of health visitors are at a record low, and services are directed only at the families where things have already gone wrong – but typically with completely inadequate resources to do a decent job. The health visitors I work with tell me routinely of the massive caseloads and the stress levels that are now routine in the profession. This is about Government policy and the decisions made by strategic managers in the NHS – but it’s individual children who pay the price when the modernisation and ‘reforms’ let them down.

There’s other stuff that’s just plain daft. In April this year, the Government imposed a 32-fold increase (yes, 32-fold) in the court fees charged for care proceedings. It used to cost £150. It now costs £4,825. Cafcass, the children’s legal charity, has found that 600 fewer applications have been made by local authorities to take children into care compared with the equivalent six month period last year. It may be coincidence – or it may be that Government policy has placed an additional 600 children at risk.

And it’s genuinely appalling that one in three children in the UK lives in poverty. The Government had promised to halve child poverty by 2010 and end it altogether by 2020. Without a fundamental policy change, this is now an impossibility. The thing that was unusual about the Baby P tragedy was the apparent sadism and deliberate violence from the adults involved. In the abuse and neglect cases I’ve known, children have been harmed when families are under pressure, not coping, and needing support. Poverty and rotten housing are big, big factors in this. I was disgusted to see Labour careerists Ed Balls and Yvette Cooper attacking the concept of a London living wage earlier this month. Apparently paying Londoners £7.45 an hour is not “necessary or appropriate”. It’s hard to know if this is stupidity or ignorance – but these people aren’t going to safeguard the interests of small children any time soon.

Is it all bad news? No – and this needs saying too. The Laming enquiry into the death of Victoria Climbié changed things for the better. Communication between teachers, a range of health workers, and social workers has improved out of all recognition. Training and support and systems to give backup to professionals who are worried about a child – all of these things are significantly better than they used to be. Laming’s recommendations have almost certainly saved lives.

Laming didn’t fix everything, though. His 2003 report was powerful because of its breadth and its honesty. He argued that you can’t separate the protection of children and support for their families, and that the best protection for children is often achieved by the timely intervention of family support services. That means adequate resources and enough skilled staff. My experience is that often it’s still very, very hard to get the right support put in place.

Laming also fiercely attacked the senior managers and strategic decision makers who leave children at risk by passing the buck. His comment five years ago was, ‘…the greatest failure rests with the managers and senior members of the authorities whose task it was to ensure that services for children, like Victoria, were properly financed, staffed, and able to deliver good quality support to children and families’.

Some lessons were learned after Victoria Climbié died – but there’s a long way to go yet.

A morally bankrupt government divides the NHS

An excellent Editorial piece here from the Lancet of 15th November. No further comment is necessary.

The UK’s National Health Service (NHS) is one to be proud of: free care for all at the point of delivery. But a proposal last week by the Department of Health to allow NHS patients in England who can afford to buy treatments that are not approved for NHS use to top-up their treatment heralds a truly two-tier system.

The existing system allows patients to pay for extra treatment (top-ups) but then they lose all NHS care. The new proposal, which is out for consultation until January, will allow top ups, with the rider that the extra treatment cannot be given on an NHS ward but will need to be administered in a private ward or hospital. The UK Government is clearly embarrassed, not wanting patients in adjacent NHS beds to be receiving different care.

Welfare spending (and health-service spending can be seen as part of that) affects the health of citizens. In a paper in The Lancet last week, the NEWS Nordic Expert Group showed that generosity in family policies is linked with lower infant mortality and that generosity in pensions is linked with lower old-age excess mortality. “Social policies are of major importance for how we can tackle the social determinants of health”, the authors concluded. A Comment added: “At least in the Nordic countries, such policies have been as much about dignity and solidarity.”

Dignity and solidarity are key concepts that must be applied to NHS funding. The decision to allow a two-tier NHS is undignified and divisive. The National Institute for Health and Clinical Excellence, battered this year for its decisions about high-profile drugs for renal and lung cancer, and dementia, is to review how it calculates whether a treatment is cost effective. But the funding of a national health service reaches higher, to the heart of government. This summer saw the UK Government use £400 billion of taxpayers’ money to rescue ailing financial institutions. Vast sums of money can be made available when needed. The government needs to re-align its priorities, or face accusations of moral bankruptcy.

Unite Health Sector Pay Fight: One step forward, one step back

Two important meetings of Unite lay activists took place this week to decide the way forward in our fight for fair pay for health workers. The meetings follow our very good campaign on pay, delivering ‘Yes’ votes for strike action and for industrial action short of strike action.

A meeting of senior union officials took place before these meetings. The position decided by officials seems to have been to discourage strike action, even though we have a mandate for it. In both the lay meetings, the emphasis of the key National Officer was very much on the problems, difficulties and reasons why strike action was not the way to go. The alternative suggested to us was a one day work to rule/ day of action on 3^rd December, with further action to be decided after this.

Many of our senior lay activists are well aware that we will need strike action in order to win this fight – although there are real disagreements on whether we should go for strike action now or later.  After much debate, the joint national committees of Amicus and TGWU Health members agreed a resolution supporting the day of action on 3^rd December, to be followed by further action ‘up to and including strike action’ in January if the Government has not made necessary concessions.

A longer report on the meetings is here.

So where are we now? It’s a mixed picture. Unite’s stance on pay has been a principled one, in terms of rejecting the truly rotten three year package negotiated by other unions and imposed by the Government. We’ve run a strong campaign, and delivered ‘Yes’ votes for strike action and for industrial action short of strike action as a direct result of this. We’re going for the one day of work to rule – fine, but the chances of this forcing the Government to make concessions are minimal. If we’re serious about delivering fair pay for our members in Health, we have to be prepared to take strike action; strike action with any other public sector union we can make common cause with, or strike action on our own if we have to. If our senior officials block this, they need to be challenged. It’s our pay that’s at stake here, not theirs.

The other thing we might want to do, of course, is to review how sensible it is to have donated £15 million to the Labour Party since the 2005 general election, and to have received so little in return. The money poured into the Labour Party’s coffers is a growing source of dismay amongst our members in Health.

The money’s there for bankers. The money’s there for war. Why can we not pay our health workers a decent wage?

Unite: Health members vote for industrial action

The results of the Unite Health Sector ballot were released yesterday afternoon. Members voted in favour of strike action, and in favour of industrial action short of strike action. Unite’s press release is here.

The vote is an important one. A significant group of public sector workers has stood up to Gordon Brown’s pay restraint and said, ‘No, we deserve better than this’. The NHS can’t function without NHS workers – and many of our members in Unite carry out particularly crucial professional, scientific and technical, and support roles.

Health workers are, quite rightly, disgusted by the Government’s plans for year on year pay cuts. The money’s there to bail out the bankers – why isn’t it there for fair pay for health workers? The contempt for us goes alongside contempt for a publicly funded and publicly accountable NHS, as the Government continues its privatisation plans. It’s time to make a stand against this nonsense.

Important meetings of senior lay reps will take place today and tomorrow to decide the next steps in this fight.

General Secretary Election: Support Laurence Faircloth

This may be an election few of us want – but the outcome matters. Unite is the UK’s biggest union. We have the potential to be a powerful union that rebuilds and reinvigorates the trade union movement. It’s time to challenge the mindset that all we can do is donate millions to Labour, cross our fingers, and hope that – somehow – everything will turn out all right.

Laurence Faircloth is the left candidate for General Secretary – endorsed by ‘Amicus Unity Gazette’, the union’s Broad Left organisation.

Like others on the left, I’ll be working for branches and workplace reps to make their nominations in support of Laurence. The nomination period runs through November and December.

Workplace reps have to contact regional offices to get nomination forms. The union website has information about the election, including contact details to obtain nomination forms in each region.

Laurence’s details are as follows:

Branch: Plymouth 0738

Membership No: 30835343

Address: 36 Burnham Road, High Bridge, Somerset TA9 3JH

Laurence also has a website and a Facebook page.

The election few of us want

The Amicus section of Unite is now plunged into a General Secretary election that most activists regard as unnecessary and downright damaging.

Our members are facing the consequences of deep economic recession. This union should be fighting for jobs, and fighting on pay and pensions. So what are we doing? Spending at least six months worrying about whether one of our Joint General Secretaries stays in office until 2009 or 2010. This is just plain daft.

The background to all this is complex, and is worth a brief summary. Part of the arrangements for merging Amicus and TGWU were that Derek Simpson would stay on an extra year, standing down in December 2010. Back in May this year, this was challenged by Jerry Hicks, a former Amicus National Executive Council member. Jerry made a complaint to the Certification Officer that this was illegal. At the same time, he announced himself as candidate for General Secretary.

In October the Executive Council of Unite agreed rule changes that would allow an election for General Secretary of the Amicus section. This could only be done by delaying implementation of the new rule book, and therefore delaying the integration of the two sections of the union. Derek Simpson’s intention was that this would under-cut Jerry Hicks’ legal challenge. There is, of course, now a risk of further legal challenges around whether or not the Executive could do this.

I argued strongly against this, although this was a minority position. My view was – and is – that our priority must be building a strong united union that backs our members. Let’s challenge redundancies and pay cuts and repossesions of our members’ homes – that’s a lot more relevant than a completely unnecessary election. Building a strong union means getting on with merging the TGWU and Amicus sections, so our members can work together and support one another. I’m also appalled by the suggestions that the TGWU might be so sick and tired of all the shenanigans that they walk away from the merger altogether. This would be extraordinarily damaging to our own union and to the union movement as a whole.

So where are we now?

At this stage, we’re on course for an election whether we want one or not. I don’t! However, the task for union activists now has to be working hard to get a decent candidate elected.

I’ll be backing Laurence Faircloth, the left candidate in this election. Laurence was the only candidate to attend the left’s selection meeting held in Preston last week, and he was endorsed by the meeting. He talked about his support for lay control in the union; support for an end to our current practice of handing over millions of pounds to Labour and getting nothing back; support for an organising model of trade unionism but with priorities set by lay members; support for strong equalities work within our union and so on. Quite rightly, Laurence wants to move as quickly as can to a fully merged union, as that’s the only route to a strong union that can deliver for members.

There are, of course, other candidates.

We have Derek Simpson, elected as a left General Secretary back in 2003. Derek has moved a long way away from his origins. Derek’s approach has been characterised by a systematic attack on lay control and democracy in the union, by hostility to the left, by a strongly expressed view that organising is a waste of time, strikes and demonstrations are out of date, and that running a union is about managing decline. Derek set up a new centre right group in the union a few weeks ago, in clear opposition to Unity Gazette (the organised left group in Amicus).  There are many reports of Derek and his supporters obstructing the merger, and attacking the T&G. It’s Derek’s personal ambition that’s causing this unnecessary election. He does members a disservice.

I think one of the other candidates is doing members a disservice. Jerry Hicks has triggered this unwanted and unnecessary election through his legal challenge. He acted alone, without reference to the left in the union. He announced he was standing for General Secretary – again, acting alone, and without reference to the left. He chose not to attend the selection meeting for the left candidate, so he presumably doesn’t regard himself as being bound by the collective decision of the meeting. Jerry used to be a good trade unionist, and was savagely victimised by his employer back in 2005. Since then, though, Jerry’s played no part at all in the union at any level. It’s a bit of a mystery why Jerry has suddenly decided he wants to be General Secretary – but I firmly believe that being on the left is about seeking to build collective organisation, not playing your own individual games. Sadly, I think Jerry’s forgotten that.

A fourth candidate is Kevin Coyne, former National Officer for Health and now Regional Secretary of the North West. Kevin Coyne was a leading figure in ‘ MSF for Labour’ – a right wing group within the old MSF union that seemed to believe that slavish support for Blair’s Labour Party was a priority for trade unionists. Subsequently Kevin Coyne was a founder member of ‘ATU Network’ widely seen as an attempt to unite Blairites in Amicus. Does this union need more support for the right-wing of the Labour Party? Like we need a hole in the head!

Laurence Faircloth is the only credible candidate for those of us who want to build the left in the union, and those of us who are committed to building a fighting, campaigning union that backs its members.

NHS Pay: There’s no Government goodwill

Well, what a surprise. The Government submitted evidence to the Pay Review Body yesterday against increasing NHS pay. The Nursing Times article is here. Apparently recruitment is buoyant, and the NHS is a really good place to work. All that bullying and stress and overwork must be a figment of our collective imagination.

When two NHS unions negotiated a three year pay award back in April, their negotiators placed great faith in something called a ‘re-opener clause’.

Unite’s view – I think rightly – was that the re-opener clause wasn’t worth the paper it was written on. What the re-opener clause actually says is, ‘In the event that the NHS PRB receive and identify new evidence of a significant and material change in recruitment and retention and wider economic and labour market conditions, they may request a remit from the Secretary of State to review the increases set out in this agreement for 2009/10 and/or 2010/11′.

In other words, we’re allowed to say ‘Please’ to the Pay Review Body, the Pay Review Body is allowed to say ‘Please’ to Alan Johnson, and Alan Johnson might – if he’s in a good mood and the wind’s in the right direction and Gordon Brown gives him the nod – might just possibly consider asking the Pay Review Body to look at the possibility of recommending a higher increase – which the Government might or might not accept.

We can’t, of course, rely on any of this happening. Why should Gordon Brown worry about us being underpaid? He cuts our pay; our unions hand over the money anyway.

There are two fights to be had here. One is to stop handing over blank cheques to Labour. If the Labour Party wants our money, it’s high time we got something in return.

The more immediate fight is for a ‘Yes’ vote in the Unite pay ballot. We’re not going to get a pay increase on the basis of Government good will – that’s quite clear. We’ll get what we fight for.

The Unite ballot matters. Every member in our Health Sector should be voting ‘YES’ for action.

Latest Government Plan: The rich get treatment, the poor die

On 5^th July 1948, the day the NHS was launched, Nye Bevan made a speech in Preston. The Socialist Health Association has a fascinating collection of Bevan’s speeches. Reading them is a valuable reminder of the savagery of current attacks on the NHS.

Bevan, at the birth of the NHS, mentioned drug treatments in passing. He was fiercely critical of the notion that patients should have to pay for drugs or any other part of their care. The press report at the time said, ‘Mr. Bevan had a sharp reproof for general practitioners, who told applicants they were prepared to keep them as paying but not public patients. This was a “wicked thing”. There was no limit to the cost or quality of drugs which might be prescribed‘ (my emphasis).

What a contrast to 2008, where we now see the introduction of top up fees in the NHS. The review on ‘top-up fees’ has ruled in favour of patients paying privately for drugs that are unavailable on the NHS – no great surprises there, but the consequences will be vile.

The option selected by Professor Mike Richards, the author of the report, is ‘separate care’. Patients will be entitled to receive NHS treatment and to pay for private care in another setting – a private hospital, or a private facility within an NHS hospital.

This is fantastically dangerous. In 1948, a fundamental principle behind the NHS was that the NHS would pay for all the care that patients need. That principle has been central to the NHS for most of the last 60 years. Quite rightly, there has been outrage when we hear of patients denied the treatment they need.

Suddenly, the argument has shifted. Suddenly, it’s common sense that the NHS can’t afford to meet everybody’s needs. Suddenly, the priority is that we defend the right of patients to go private – as an alternative to defending their right to publicly funded healthcare.

Richards acknowledges the arguments ‘for’ and ‘against’ his preferred option.

In favour, we have ‘Patients will have the choice to buy additional private drugs from the private sector’.

Against, there is the rather important point, ‘Many patients will be unable to afford additional private treatment’.

So what are we left with? The intention is to establish a new norm where the NHS provides whatever level of care is deemed ‘cost effective’ – subject to Richard’s comments that ‘there is a general recognition that there is a limit to the level of services that the NHS can deliver and that this will inevitably lead to difficult decisions having to be made about the availability of treatments’.

Clinical care is therefore determined immediately and directly by ability to pay. There is nothing positive or progressive about this at all.

The last time I wrote on this, I quoted from Bevan’s ‘In Place of Fear’. The quote bears repetition: ‘The collective principle asserts that… no society can legitimately call itself civilized if a sick person is denied medical aid because of lack of means’.

What a tragedy that New Labour has forgotten this. One of our priorities going forward must be not just to fight the overt privatisation of the NHS – but also to fight hard for a genuinely comprehensive NHS, where care is not based on ability to pay.

NHS Pay: I’m voting ‘Yes’ for action

I’ve just got my ballot paper. I’ve had few opportunities in my life to have my say on how much I get paid. This morning I was happy to have the chance to vote ‘Yes’ for a decent pay rise.

‘Toxic debt’ is a phrase that’s been thrown around a lot in the last few weeks. I think a more immediate problem for a lot of us is ‘toxic government’.

This is a government that has imposed public sector pay cuts as a matter of policy – it’s a choice made by Gordon Brown that we’re to get paid less each year.

This is, of course, the same government that bails out the banks and big business – but lets home repossessions spiral, leaves pensioners to freeze while energy companies make obscene profits, and that allows the pensions of millions of workers to be put at risk.

The same government, too, that attacks our civil liberties,  scapegoats asylum seekers, conducts brutal war in Iraq and Afghanistan, presides over shocking levels of child poverty, glories in anti-union legislation, dismantles the NHS and attacks the welfare state…

Their crisis; they want to make us pay. I’m voting ‘Yes’ for action to protect our pay and our pensions.