Militant trade unions save lives

Submitted by Matthew on 8 May, 2013 - 4:59

In a row with Jeremy Hunt, the Royal College of Nursing has rejected calls for it to split into two organisations — a professional body and a trade union.

Hunt, parroting the conclusions of the Francis Report into the Mid Staffordshire Hospital scandal, argues that the RCN was complicit there because they “allowed their trade union responsibilities to trump their responsibilities as a Royal College to raise professional standards.” But this conclusion was nothing but Francis’ own bourgeois prejudice.

In fact, the problem was that the RCN did not behave like a trade union. As the report documents RCN had a very cosy relationship with management and barely any with members.
The RCN sang the praises of management and ignored concerns raised by staff.

The report paints a depressingly familiar picture of trade unionism in the NHS. RCN had only a handful of reps at the hospital and was heavily dependent on paid, full-time officials. Out of a membership of 600 they rarely got more than 10 people to a meeting.
Like many health union branches they favoured a “partnership model” of trade unionism where the officials become cheerleaders for management. The main convenor even wangled herself a job in the senior management team! The approach pulled the reps up into management’s ivory tower where they remained willfully ignorant of the horrors on the wards.

A strong union telling the truth about the reality on the ground could have smashed through the management’s collective fantasies. It could have stood up to bullying managers hell-bent on meeting financial targets and organised an industrial battle over safe staffing levels.

The RCN and the other unions at the hospital failed because they failed to act as militant trade unions.

111 call centre deaths

The introduction of the 111 call centres, replacing NHS Direct, has been chaotic and has cost some patients their lives.

The national NHS Direct line was replaced by this 111 service which is run by 46 different (mostly private) providers.

The new centres have cut down on staff, waiting times have gone up and patients are being referred to the wrong services. The RCN report that while NHS Direct had a ratio of two call centre staff to one qualified nurse, the new system operates on 15 call centre workers to one nurse.

The backdrop to this story is the closure of A&E departments. Due to multi-billion pound PFI debts and multi-billion pound “efficiency savings”, hospitals are being forced to merge and close the departments.

The government is trying to change our attitude to A&E. Hospitals have erected signs outside their gates: “STOP — do you really need A&E? If your condition is not a serious, life-threatening emergency you may be directed to more appropriate health services.”

“More appropriate” services are the 111 call centres or local pharmacy.
There are now 24 A&E departments under threat across the health service. Health Economist Allyson Pollock explains: “The accident and emergency department ... is the last point of entry to funded care when all other routes are closed, the canary in the mineshaft: when A&E admissions rise, it is a signal that there are problems in all the other parts of the system.”

The government is deliberately culling the canary in the mineshaft and allowing the toxic atmosphere of capitalist market relations to kill off the rest of the NHS.

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