By Mike Fenwick, Unison
Announcements of cuts in the NHS have become routine— each day the newspapers find a new story to highlight increasing debt, job losses and closures. Yet the unions seem to be standing on the sidelines, with no concerted national campaign in place to respond to the crisis.
The latest, and biggest story has been the failure by private sector contractors to put the national computer system Connecting for Health into place. It’s not the first time that the timetable for implementation and standards for quality of work by private firms has proved inadequate… it is now running two and a half years late! It is not the first time that IT projects in the public sector have fallen behind, failed to work and wasted public money.
The total cost of the project is now likely to be almost £20 billion (compared with the official figure of £6.2 billion). Many Trusts are also likely to face fines for failing to provide staff to the computer companies involved. In the south of England this may mean a pay-out of £19 million to Fujitsu.
MPs on the parliamentary Health Select Committee have called for a review of the whole project and independent audit of where the money has gone. The money hasn’t disappeared but gone, once again, into the pockets of the private sector companies who were contracted for the job. Companies which were chosen because of the “high level of efficiency and expertise” found in the private sector!
But not learning lessons is a feature of Blair’s government. Dogmatic commitment to profit-making private enterprise ensures they continue to give money and work to big firms.
At a recent meeting Blair and Patricia Hewitt called together Chief Executives from 15 Foundation Hospitals and the directors of FTSE 100 companies including Unilever, Glaxo Smith Kline Beecham, Tesco and Cable and Wireless. New Labour’s message was that it was time to “break the notion” that public and private sectors had “contradictory value systems”. The big companies wanted to know what they were going to get out of it. The hospital chief executives wanted freedom to make financial decisions independent of government scrutiny and control. But that is only the view of the people who call the shots in the NHS. In a Health Services Journal poll, the majority of staff and patients (including 63% of hospital mangers) felt there was a difference between providing a service for need and for profit.
PFI was New Labour’s flagship initiative for working with the private sector — but the project is sinking and bringing the NHS down with it. Trusts are now carrying the burden of 30 year mortgages on new buildings and find they cannot afford to provide simple services at anything but a loss under the fixed price tariff of the new internal market. Because the PFI deals included contracts for services such as cleaning, catering and security, the only options are to cut beds and front line staff.
The drain of money from public to private sector has also meant ongoing restrictions on access to long term NHS care. New hospitals are built with fewer beds and shorter stays in mind. Patients suffering from chronic illnesses find themselves in private sector nursing homes usually at their own expense. In Scotland the NHS still provides long term nursing care free. But in England and Wales most people have to pay something.
One group that used to be exempted are people previously detained under the Mental Health Act. But now the NHS is focused on efficiency, that rule is being ignored in favour of meeting targets. It’s a crazy situation and doesn’t even save money! Nursing home care is often so poor patients become regulars at Accident and Emergency departments and on medical wards to be treated for infections and falls.
So what are the unions doing? Unison members passed a motion calling for a national day of action at their Health Conference. But nothing has happened yet. A further emergency motion to the National Conference in Bournemouth (19-21 June) calls on the executive to name the day.
There is a real mood to fight on this issue. Local demonstrations against specific cuts continue to be well supported and the Keep Our NHS Public campaign has recently held launch meetings in major cities such as Leeds. Key sections of the NHS — NHS Logistics and the Prescriptions Agency — face imminent privatisation and cuts. The union needs to support specific action there.
Local activists may have to seize the opportunity to develop campaigns and support demonstrations in order to put pressure on the national unions to move. We need to build the local heath service demonstrations coming up in Birmingham, Maidstone, Manchester and Leicester. And local activists need to consider which issues in their own areas can be opportunities for a fight.
The wholesale handover of the NHS to the private sector and demands of the market is not here just yet. But we can’t afford to wait around for some big bang national day of action. In the meantime money pours into the pockets of shareholders and jobs, beds and in some cases whole hospitals go to the wall. A concerted drive to build local campaigns needs to start now.
• Manchester 24 June, 11.30 am
Assemble at Victoria Station (Walkers Croft)
• Maidstone, 1 July, 12 noon
Assemble Brenchly Gardens
• Leicester, 8 July, 10am
Assemble Humberstone Gate
• Birmingham, 15 July, 11 am
Assemble at City Hospital, Dudley Road. March to rally in Centenary Square at 13:00.
• Keep Our NHS public campaign