Union action can save the NHS

Submitted by cathy n on 12 January, 2007 - 12:58

By Mike Fenwick, Kate Ahrens and Nick Holden

The holiday season was used by the government to announce further redundancies and cuts. Redundancies in the Yorkshire Ambulance Service, delays in operations until the new financial year and more penny-pinching and potentially dangerous cost savings — such as reusing disposable clinical equipment, increasing the risk of infections.
The relentless drive to privatise is however causing political contradictions for the government. Senior Labour Ministers have been forced to come out in defence of local services to preserve their seats. The same Ministers are still voting through the reforms in Cabinet and Parliament. Tories and Liberals are quick to make political capital out of the crisis, but they fundamentally agree with Labour’s policy.

The plan to dismantle the NHS as a national organisation remains on track: the first hospital has been handed over to the private sector. With more Trusts moving to Foundation Status, the creation of a market for health care is well advanced. The often reported “postcode lottery” in NHS service provision has never been a question of chance. It is the result of strategic decisions made to limit resources and create inequalities in service provision. Within an unrestrained market, where hospital trusts are able to act as independent businesses, the rules of competition take hold and big hospitals start to swallow up smaller ones, reducing access and choice.

A leaked government document reported in the Health Services Journal has laid bare a parallel plan to break down national agreements for pay and conditions, to discipline the workforce and control the wages bill. A below inflation pay rise is likely this year and further reductions in staff are proposed.

The unions are quick to condemn such moves but slow to organise any effective opposition. Threats of industrial action will do nothing to stop the government. They also weaken the confidence the membership have in their leaders to lead a campaign. Within the main unions there remains a bizarre hope that things will get better after the May elections and if and when Brown becomes Prime Minister.

The idea that the Brown premiership would be any more susceptible to pressure from the union bureaucracies is a complete illue. Much more productive would be to support the only officially declared Labour leadership candidate John McDonnell, who is committed to defending the public services. Such a campaign would push the debate in the Labour Party to the left, and would act as a catalyst for more action within the unions.

After a hastily arranged pre Christmas consultation NHS Together (the coalition of trade unions and professional associations) decided to call for a series of regional activities on 3 March rather than the widely expected, and much needed, national demonstration. Despite calls from local campaigns, and trade union branches which were echoed in the PUSH (People United Saving Hospitals) Conference held in December, there will not be a national demonstration. And the regional actions look to be very small in scale.
There are positive moves however: a plan to combine the “regional” events for the southeast of England into a march in London, and then to invite the rest of the country to attend — creating de facto a national demonstration, and retaining an official status which would make it very difficult for trade unions to disapprove of their members attending.
The unions, primarily Unison, have the ability to determine whether the campaign succeeds or fails. The opportunity is there not just to save the NHS but reinvigorate the trade union movement by taking the lead in what has become the most significant social movement in Britain today. Engaging fully with local communities and drawing on the vast reserve of public support for the health workers could draw in a new layer of activists. Industrial action, even on the level of a work to rule and an end to unpaid overtime, would expose the empty rhetoric that the NHS is somehow overstaffed.
There is a danger that community campaigns will develop their own organisation and priorities, even in opposition to health workers. Frustration with the inaction of the union leaders was very evident at the recent PUSH conference; community campaigners could start to see the unions as part of the problem rather than allies. Union activists feel similar pressures and may opt for a role in a local campaign where they feel they can at least do something positive.
The opportunity to create a united national campaign will be the activists conference called by Keep our NHS Public (KONP) on 20th January.
KONP has been the major national resource for health campaigners. It has the support of both unions and the majority of community campaigns. The conference could establish a united democratically organised national campaign. But it will need a commitment to a programme of national action to consolidate that unity and a strategy of working in the unions to up the tempo, starting with a national demonstration in London on 3 March.
• Support a national demonstration on 3 March with action in trade unions and community campaigns to make it as big as possible.
• Unite community and union campaigns at a local level.
• KONP should form a national campaign to unite all those campaigning for the NHS.
• For the formation of a national rank and file movement in the trade unions, to make the leadership fight, develop an industrial strategy, and create a new militant leadership if necessary.
• Keep Our NHS Public campaigners conference on Saturday 20 January in London. To register send delegates names to olivia@nhscampaign.org or phone 01273 234822. £5 per person

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