RCN picket line RCN picket line. Photo: Lewis Baker

Lindsey German on the Tory-manufactured crisis in the NHS and how we fight back

We all read in amazement of past times when doctors bled their patients and applied leeches to their bodies in order to cure them. Will future generations treat the craven destruction of the health service by politicians and privatisers as any less astonishing?

The NHS needs proper funding and staffing, not more ‘reforms’. Someone should tell Keir Starmer who is following his shadow health secretary in trumpeting the need to look to more private healthcare to ‘supplement’ the health service. We know what damage this has already done, with stealth privatisation of the service over the past decade. We can also see the future if we don’t fight against privatisation which is rife in the care sector. The Financial Times reports that ‘Companies such as market leaders HC-One, Barchester Healthcare, Four Seasons and Care UK could receive up to £200m under the new NHS crisis plan to clear patients from hospital beds by moving them to care homes.’ These big owners of private care homes are demanding dramatic increases in prices paid by the NHS for care home beds, up to £1,500 a week or around double what most local authorities pay at present.

Just as at the height of the Covid-19 pandemic, there is always someone ready to make a quick buck out of the suffering of others. There are around 70,000 spare beds in the private care sector and there are 13,000 people in hospital who could be discharged but have no one to care for them. In any rational society, there would an allocation from one to the other based above all on need and patient safety. But instead we live in one motivated by profit so government money (provided by us) goes into the pockets of shareholders or hedge funds who own the homes.

The Tory response to the acute crisis in the NHS is to ignore the underfunding, pretend the shortage of staff is nothing to do with them, and to use overcrowding, lack of beds and delays in treatment, to bolster the private sector. Excess deaths are up to 500 a week and are largely attributed by experts to be a result of the crisis – waits for ambulances, lack of rapid treatment, not enough medical staff. As one speaker at the People’s Assembly conference this weekend said, this is like several plane crashes, bomb attacks or other disasters happening every week, yet it barely makes the headlines.

These are deliberate policies on the part of the Tory government which has presided over a terrible decline in the NHS and whose aim is to break up its free provision, driving those who can afford it to the private sector and those who cannot into even more desperation and misery. The figures bear this out. Again last weekend the Financial Times recorded increases in use of private medicine. A survey of businesses showed growing concern about long waits and lack of treatment on productivity so more willingness to consider private health insurance for employees. Nearly a fifth were considering offering this, with 37% of companies employing over 1,000 people doing so. There has also been a considerable increase in people using or investigating private GP services (as the prime minister and no doubt many of his colleagues already do).

You don’t have to be a mathematical genius to work out where this is going: a two-tier system where the very poorest get a failing, overcrowded and underfunded system, and those who can afford it see their GP on the day they want to and pay for a range of treatments. We can see where this will end up by looking at dentistry where it is impossible to get a NHS dentist in many parts of the country and charges are high.

Private medical care goes against all the principles of the NHS of free treatment to those in need, it is also extremely costly because of the profit motive. We cannot allow the Tories or Labour to use this crisis to extend it and ruin a health service which was created in a much poorer country in the aftermath of war.

The paramedics’ and nurses’ unions taking strike action are doing exactly the right thing. What a cheek it is to hear press and politicians accuse health workers of putting patients at risk, when they fail to provide a basic service on a daily basis. Even more of a cheek to demand that they increase productivity in return for wage rises when ambulance workers are having to stay with patients for hours, nurses are having to cover for shortages, and they all struggle to fulfil their basic duties.

The same attacks are now being made on teachers, who are accused of putting children at risk by a government which systematically cuts the amount of money paid to schools and refuses to fund free school meals for hungry kids. The teachers’ ballot is out today and I’m sure will record a big majority for strike action – and hopefully will also get across the government-imposed threshold of 50% voting. If so, teachers will join many other groups in taking strike action over the next few months, both over decent pay awards and in defence of decent public services.

On 1 February, the TUC has called a day of action against the government’s proposed new anti-union law which will try to force workers to provide a minimum service in certain unions or face dismissal and fines on the union. This is an outrageous attack on the fundamental right to withdraw one’s labour and is testament to the success and popularity of the strikes so far, where one group of workers after another is achieving the very high threshold for balloting. Consequently the government intends to make it even harder to do so, effectively outlawing strikes in some areas.

Several unions are planning to strike on that day, providing a coordinated action among at least some different unions. On 15 March, Budget Day, there is also talk of a wider set of strikes. This is the bare minimum we should be doing. One problem with the British trade union movement is its sectionalism. It grew from unions based in one sector or industry organising separately and although there have been many mergers and amalgamations, this is still the case. The TUC is supposed to coordinate different actions but is frightened of appearing too militant and therefore chooses lowest-common-denominator politics. But we need much more than a series of one- or two-day strikes. We are facing a concerted attack from the government and employers across all fronts and we need all out action and strikes to halt it.

Building the resistance

All these questions were debated at the People’s Assembly delegate conference at the weekend. I found the panel speeches incredibly powerful about the scale of attacks but also the resistance within the different industries and unions. Hundreds of people from across the country came to hear them, debate motions, discuss a range of questions. The PA was founded a decade ago against government austerity and has been fighting ever since both locally and nationally. We want to provide a challenge the government, which has no legitimacy and is destroying so much of the infrastructure we should take for granted but which is repeatedly under attack. There were motions on the NHS, anti-union laws, climate change, war, and how we organise.

The PA isn’t a political party so it contains many within the Labour Party but also in other left organisations like Counterfire, trade unions, national and local campaigns. It is committed to working with organisations and individuals who share similar aims to fight the government and the effect of its policies. There were some terrible stories of the reality of working-class life in Britain today, but also a real sense of inspiring fightback from some great militants. The scale of attacks is such that no one organisation can do this on their own – we need much greater unity of campaigns to achieve victory. We have a number of tests ahead: escalating and coordinating the strikes, making sure 1 February and 15 March are massive days of industrial action and protest, stopping the new anti-union laws, building solidarity with the strikes and defending the NHS.

The conference was a great way to start a fighting new year.

This week: I’m going to two demos and a conference: on Monday against the anti-union laws outside Downing Street, on Wednesday I’m speaking for the PA at the nurses’ demo (again in Downing Street) and on Saturday we have the Stop the War trade union conference.

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Lindsey German

As national convenor of the Stop the War Coalition, Lindsey was a key organiser of the largest demonstration, and one of the largest mass movements, in British history.

Her books include ‘Material Girls: Women, Men and Work’, ‘Sex, Class and Socialism’, ‘A People’s History of London’ (with John Rees) and ‘How a Century of War Changed the Lives of Women’.

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