Two events over the next few weeks could put new impetus into the campaign to defend the NHS.
Firstly the release of the film Sicko, by US documentary filmmaker Michael Moore will help demonstrate to a general audience the reality of a privatised healthcare system. In the US the movie has helped generate a new national campaign for socialised healthcare. It is a damming indictment of the inequalities and mistreatment of patients where profit not compassion is the motive.
Many local Keep Our NHS Public groups, trade union branches and others are leafleting screenings, block booking seats and providing speakers at some showings to get the message out about the dangers of privatisation in Britain. Big multinationals exposed in the film are now starting to get a foothold here.
The film showing will also be an opportunity to build support for the London demonstration for the health service on 3November called by a coalition of trade unions in “NHS Together”. The demonstration is a step up from the regional action organised this March, but it seems most of those attending will be from the local community groups, rather than directly from the trade unions.
The lack of a united national campaign around the NHS is a huge weakness. NHS Together does include most of the important trade unions and professional associations in health but seems to be based full time officers and general secretaries on getting together and not on a network of local branches and activists.
Keep Our NHS Public on the other hand has been suffering from a lack of funds and active hostility towards it from some unions. It has been difficult for it to fulfil its promise to become a national coordinating centre for local campaigns.
However renewed interest and debate may push the NHS back to the top of the political agenda. We certainly need that to happen. A report by Lord Darzi, surgeon and new junior minister for Health, on the future of the NHS in London has made clear that cuts and privatisation remain the focus of government policy.
In a critique of Darzi’s report by John Lister, of London Health Emergency, outlines the future reality in London: further cuts in beds, the downgrading of the District General Hospitals, closure of A&E departments and the handing over of more work to the private sector in new polyclinics and treatment centres. Local access to services will continue to be reduced as specialist services are centralised and the market is let loose to turn local hospital trusts into competitors.
As the market becomes the sole regulator of healthcare provision further cuts and mergers will follow, as big trusts swallow up smaller hospitals and the private sector cherry pick the low risk, high turnover, “profitable” procedures. This NHS will be left to deal with the higher risk more complex cases. It will become a dumping ground for people when their illness is too chronic to make any money out of it.
This plan for London will be the testing ground for similar changes throughout England. Old principles that used to inform the NHS, such as having local and comprehensive services, accessible to all, will be replaced by a new set of beliefs. This is despite the fact that public opinion is surveyed about health choices people say they want a decent local NHS hospital not a choice of four, or the private sector. Because such results fly in the face of government policy this question has been dropped from NHS opinion polling.
NHS managers are scrabbling around to find a business model to work to. They have fixed on the concept of “lean production” developed by Toyota to make their car production line more efficient! Any sense that this is inappropriate to healthcare, that reducing treatment to a set of set procedures done to a product rather than a person, has passed them by. The concept of care, the basic humanism and compassion that helped create the NHS, is being bled out of the system as patients become numbers to be counted and audited on standardised spreadsheets.
Michael Moore’s nightmare picture of our possible “privatised” future should motivate more people to get involved in the campaign. We now need to organise public meetings, local rallies and get our message into the local press. We need a recall conference of Keep Our NHS Public to create a democratic, accountable and national campaign to carry on our fight in a more organised way.
With the same process of cuts and privatisation going on across the public sector, in education, housing and social services the time is right to draw them all together in broader campaign against privatisation.
The forthcoming Labour Representation Committee conference will have the opportunity to take the lead in that process by turning out its Public Services Not Private Profit campaign into the communities. Socialists serious about the future of the NHS and labour movement should support that effort in order to create a pole of opposition to the market and competition driven policies of all three major parties.