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.

Karen Reissmann: A leading activist needs our support

Karen Reissmann is one of the best respected trade unionists in the NHS, with 25 years experience as a workplace rep. She’s a good nurse, too. Back in June 2007, she got a promotion in her job as a mental health nurse – a clear recognition of her skills and professionalism.

One problem, though – on the same day she was promoted – senior managers at Manchester Mental Health Trust suspended her for alleged gross misconduct and bringing the Trust into disrepute. She was later sacked.

Karen’s crime? She had fought hard against the cuts and semi-privatisation that were devastating the service she worked for. It’s a disgrace that NHS bosses think its OK to sack someone for defending patient care and defending the NHS. It’s a disgrace that a Labour Government glories in anti-union laws that let bosses behave this way.

Karen now has an Employment Tribunal case coming up, and urgently needs to raise £10,000 to fund it. There’s been a massive campaign in support of Karen. She’s been re-elected to Unison’s National Executive – an indication of the respect that Unison activists have for her. She needs financial solidarity now to make sure that her case wins.

This isn’t just an issue for Unison members. The NHS is under attack on an unprecedented scale. If NHS staff are too frightened to speak out, it will be that much easier for savage cuts and wholesale privatisation to go through unopposed. Karen’s fight is one that must be supported by everyone who cares about defending our NHS.

 A letter from Karen and a  collection sheet are attached. A victory for Karen will be a victory for all of us.

Solidarity with Gaza: Two events to support

At least 195 children have died (photo from BBC)

There are two important events this week that socialists and trade unionists should support:

Rally: Stop The Gaza Massacre, Thursday 8 January 7.30pm Speakers Include Tony Benn, Tariq Ali, George Galloway MP Friends Meeting House, Euston Rd, London NW1 2BJ. Nearest tube: Euston.
Organised by Stop the War Coalition and Palestine Solidarity Campaign.

National Demonstration: Saturday 10 January Stop the Massacre : Israel Out of Gaza
Assemble 12.30pm Speakers Corner, Hyde Park March to Israeli Embassy, High St Kensington, London

And a quick round-up of the news from today’s BBC website shows why:

At least 30 people were killed and 55 injured when Israeli artillery shells landed outside a United Nations-run school in Gaza, UN officials have said.

Palestinian health ministry officials say 595 people have been killed since the attacks began, 195 of them children.

Earlier, the International Committee of the Red Cross (ICRC) warned of a “full-blown humanitarian crisis” in Gaza.

The BBC also carries the diary of an aid worker, who reports on a visit (earlier today) to a UN school. I don’t know if it was the one that was bombed. His report:

What I saw was heartbreaking. Before me were families who have had their homes destroyed and have lost everything. Gaza is a very poor place and many people didn’t have much before the bombing started. Many more are left with even less now.

The people I met told me that they had found themselves in the firing line and had no choice but to leave their homes.

I met a mother who was burning paper in order to boil water for her child. She was doing this because she had no milk – maybe she could fool her hungry baby with the warm water?

I was surprised at the amount of women and children I saw in the school – and worried too.

People are exhausted, traumatised and they are surviving on a limited amount of food – there simply isn’t enough.

Solidarity with Gaza

Many trade unionists will be sickened by Israel’s brutal attack on Palestinians living in the Gaza strip. There are now over 500 dead, including many children.

The charity Medical Aid for Palestinians describes the horror of a situation where the number of hospital beds is far outstripped by the number of injured, and where people are now left to die on hospital floors.

Paramedics risk their lives when they go out to pick up the injured (with reports of at least one paramedic being killed). News reports today are also of hospitals with power only from backup generators, set to fail in the next day or two, and of doctors struggling desperately to save lives with an acute shortage of drugs and other essential medical supplies. A situation that is already a catastrophe is set to get far worse.

The Palestine Solidarity Campaign  gives some of the background to this conflict, and to the 60 years of oppression experienced by the Palestinian people.

An important demonstration against the attack on Gaza will take place in Central London on Saturday 10^th January; I’ll post details here when they are available. There are likely also to be demonstrations in other areas of the UK.

Either of the organisations mentioned above would make good use of any collections that trade union members can make at work.

Can we have a website to rate Ben Bradshaw please?

Harold Shipman was a remarkably popular GP. Older patients loved him to bits because of the interest he showed in them. A lot of relatives loved him too, and valued the time he spent with his patients and that he even bothered to sit with them when they were dying.

Is this true? I don’t know. It’s an account that’s entered modern folklore, anyway. I tell the story only to highlight that there can be a world of difference between a popular GP and a good GP – not in any way to downplay the horrific crimes of Shipman.

A really daft proposal from Health Minister Ben Bradshaw was covered in last week’s  Guardian. New Labour was evidently determined to end 2008 as it started it – doing everything possible to damage and undermine the NHS. Ben says that he never goes on holiday without consulting Trip Advisor. Fine, that’s entirely up to Ben. Apparently, though, Ben thinks we need to give ‘consumers’ of healthcare access to a ‘Rate Your GP’ equivalent of Trip Advisor. The plan is to set up a national website where everyone can post their judgements of their GP’s competence and report on whether or not there is a ‘rude receptionist’.

This is really pretty silly. A moment’s consideration of the Shipman story does at least demonstrate that a GP being popular is not necessarily a good thing. A few moments more consideration flags up pretty quickly that a good GP will be willing to challenge patients on unhealthy lifestyles (smoking, obesity, alcohol and drug misuse and so on). You don’t necessarily get immediate Brownie points for popularity that way. A moment’s more thought and you realise that patients quite often want the antibiotic or ‘magic drug’ that will make them better – even when there isn’t a drug treatment that will improve their condition. A ‘popular’ GP will write the prescription. A ‘good’ GP will spend the time explaining why this isn’t an option. There’s a difference.

Ben also fails to understand that seeing your GP – when you might be in pain, scared, upset, and vulnerable – is not an experience that can be meaningfully compared with choosing a nice holiday. Most health workers are familiar with patients or clients who are very distressed, and who – not in any way maliciously – might direct that distress at the doctor, nurse, therapist or receptionist. And most health workers, whenever we possibly can, seek to support patients through their distress, listen to them, explain to them, and give them the very best care we’re able to. It probably isn’t going to build therapeutic relationships to set up a national website where we encourage people to slag off GPs, practice nurses and receptionists. And if the comments are anonymous – as Ben says they often will be – how does this help a health worker to talk through a problem with someone and try and sort out whatever’s gone wrong?

Ben might also want to check out the libel laws! The kind of site he envisages is very likely to leave whoever hosts it – presumably the Department of Health – open to legal challenge. Just in case you’re looking in, Ben, a quick guide to libel law is here.

When I first read the Guardian article I thought Ben was just being a daft wee boy. On reflection, I think it’s more sinister than that. The Government is on a mission to demonise GPs – probably because GPs have become the major barrier to the Government driving through its ghastly polyclinic/ ‘GP-led Health Centre’ agenda. The Government is committed to replacing our existing (and much-valued) family doctor service with reduced access to a primary care service provided by (and for) big business. There’s therefore a political motivation for New Labour’s obsessive hatred of GPs.

I’m very clear indeed what I want from my own GP. I don’t want my GP to spend her time trying to be popular. I want my GP to have strong clinical skills, to take me seriously and treat me with respect, and to explain complex issues in a way I can understand. And if I did have a problem with my GP, or any other health practitioner, I’d see someone different, and I’d use the existing complaints procedure if I thought it was warranted. A ‘Slag Off Your GP” website is simply not useful.

The bottom line, though, is this: a GP who tries to be popular is probably not going to be providing high quality health care. If Ben can drag himself away from planning his next holiday for a moment or two, he might want to think about this issue a little bit more carefully.