By Nick Holden
When the government placed an advert in the Official Journal of the European Union offering contracts for private companies to run and manage Primary Care Trusts throughout England, they didn’t expect that there would such a speedy outcry.
But the response from health campaigners and trade unions was so fast and so implacably hostile that the adverts were almost instantly withdrawn and hasty denials were issued.
Is it that easy to change government policy on the health service? Perhaps if Unison had been this vociferous against PFI, the last 10 years of attacks and privatisations would not have happened?
Well no. Just as last summer, when the government appeared to backtrack on their proposals for PCTs to outsource all their health care provision the denials and withdrawals are not signs of a governmental change of heart but tactical retreats. The advert may have been withdrawn, but the government still intends to privatise as much of the health service as possible, as quickly as possible.
The evidence for this is all around: Private Finance Initiative (PFI) remains the only route for redevelopment or regeneration of hospital facilities with the Local Improvement Finance Trust (LIFT) (private investment) being the only route for revamping health centres and primary care facilities. Government regulations ensures that Primary Care Trusts are obliged to direct a percentage of their contracts to the private sector — whether any patients wish to be treated there or not. The Payment by Results system means that every single patient who is treated in a private hospital takes money directly out of NHS budgets to pay for their care.
The financial crisis in the health service is a myth — created by the artificial construction of the internal market in health care in order to make room for the private sector and to allow for the possibility of selling off the profitable parts of the service in the name of “efficiency”.
The health unions remain resolutely irresolute in the face of all these attacks. But despite the excellent policy passed at Unison’s health conference in April, there is still no date announced for a national day of action, still no ballot allowed for the NHS Logistics staff facing privatisation and cuts, still no legal advice published on how to take industrial action in defence of jobs and services.
However local campaigns and community based action against health cuts are starting to pick up. There have been local demonstrations in at least one town or district every Saturday throughout the last month and there are plenty more in the pipeline — often organised in places which are not traditionally known for their militancy — marches in Maidstone, Wythenshawe, Leicester, Wakefield, Manchester and many others. Even a demonstration of 5000 people in the Forest of Dean in protest at the closure of their local hospitals.
Local groups of the Keep Our NHS Public campaign are springing up in many different towns, although the size and vibrancy of these local campaigns is variable. The national campaign’s website is reporting almost daily on new meetings, groups and events and is also a useful source of the latest news about new cuts as well as reports of the various demonstrations that are taking place.
All this local activity is an essential part of any campaign that could stop the attacks on the NHS — the basic building blocks of any concerted national campaign. But there must also be industrial struggle in defence of jobs and services. Unless the workers in the health service are prepared to take action, community based campaigning can only take our protests so far and no further.
Some groups of workers, such as the NHS Logistics workforce, have already indicated their willingness to take action, and are being stymied by the national union. Other parts of the workforce need to make clear that they would also be prepared to take industrial action and start to collectively bring pressure to bear on the leadership of the health unions, particularly Unison, to force them into activity.
What’s required now is a national focus to the campaign that could bring substantial news coverage and publicity and help fuel the next stage in the growth of a real mass campaign to defend the National Health Service. It is vital that pressure is brought to bear on the leadership of Unison and the other health unions to call a national demonstration, and to start to positively join in the existing campaign structures. Activists inside the union must work to avoid any repetition of the ridiculous refusal of Unison to participate in the Public Services not Private Profit lobby of parliament on June 27th.
A meeting for health stewards and activists inside Unison has been called for July 29th arising out of a successful fringe meeting at Unison conference to discuss how to bring sufficient pressure to bear on the Unison leadership to force them to carry out union policy on the NHS crisis. This will be an opportunity to start a concerted campaign inside the union to deliver on the policies that were agreed in April and which will make the difference between the campaign to defend the health service winning or losing.