Fightback needed to defend the UK’s National Health Service

The Socialist Equality Party is broadening its campaign to mobilise National Health Service (NHS) workers across the UK to form action committees, independent of the trade unions, to oppose the unprecedented attacks on pay and conditions and prevent the dismantling and privatisation of health care.

The nationwide NHS Fightback Campaign draws on the experiences of the South West NHS Fightback Campaign, formed last year to oppose the pay cartel set up by 19 NHS trusts seeking to slash wages and worsen employment conditions for 60,000 NHS workers. We warned that the pay cartel’s plans were a test case aimed at undermining the wages and working conditions for all 1.5 million NHS workers. We urged NHS workers not to put their faith in the unions—Unison, Unite, the Royal College of Nurses (RCN), GMB and others.

When the Agenda for Change agreement was signed in 2004 under the last Labour government, the unions argued that the radical reorganisation of job descriptions and work patterns it introduced would protect wages and conditions. In reality, at its core were provisions—downplayed by the unions—for the end of national pay scales and an increased dependency on discretionary pay based on productivity gains: exactly the provisions used by the pay cartel to attack pay and conditions.

Since the Conservative/Liberal Democrat government came to power, the unions have agreed a two-year wage freeze (scheduled to continue for a further two years) and reduced pension benefits at the same time as the retirement age has been increased. It is inconceivable that such organisations will lead a struggle against any new round of attacks, the South West NHS Fightback Campaign insisted.

These warnings have been vindicated.

The unions protested that the pay cartel was a Trojan horse constructed by government and trust executives, but did nothing to oppose it. Instead they used the formation of the cartel as an excuse to agree a national deal without a fight in November. Cuts to wages and conditions include many of those demanded by the pay cartel—the introduction of performance-based incremental progression, an end to sickness absence enhancements and the removal of accelerated pay progression for some workers.

The capitulation of the unions has only encouraged the government and employers to demand additional cuts and the speed-up of the privatisation of health care. Job cuts are already having a destructive impact, with many hospitals unable to provide a basic level of care. Claims by both the previous Labour government—which initiated the £20 billion in “efficiency savings”—and the coalition—which is implementing them—that frontline services would be protected are lies. Nurses and health care assistants make up 34 percent of posts earmarked to be cut, according to the RCN.

This is only the start, as the NHS faces death by a thousand cuts. The Kings Fund has outlined five scenarios of what £20 billion of cuts look like in practice: a 30 percent real pay cut for all staff; no medication; the abolition of the NHS in London; the abolition of the NHS in Scotland and Wales or the sacking of all consultants and general practitioners.

The NHS, fought for, developed and maintained by generations of health workers and funded by working people, is being hived off to private equity companies whose sole preoccupation is the accumulation of profit.

The Health and Social Care Act, effective from April, overturns the government’s legal “duty to provide” a comprehensive health service and replaces it with a “duty to arrange” health care. From now on the NHS is to be merely the purchaser of care from the private sector, which will cherry-pick the most profitable areas. Clinical Commissioning Groups, run mainly by GPs, will take control of the bulk of the NHS budget and oversee a major outsourcing process. Public hospitals will be allowed to make available almost half their beds and theatre time to private patients. Those unable to pay will be forced to the back of the queue.

The deadly consequences of these policies are made clear by the closure of Accident and Emergency (A&E) units across the country. Tens of thousands of people will be made to travel further for emergency care—jeopardising their survival. The implications of such closures in the event of a major public disaster, such as that at Hillsborough football stadium in 1989, underscore the government’s reckless and callous disregard for human life.

The trade unions are playing a key role in enabling the government to push its measures through by restricting opposition to job losses, wage cuts and hospital closures on a local or regional basis, while organising token protests and petitions that they know will have no effect on the coalition government.

Working people must understand what is involved. The ruling elite will not be satisfied until they have destroyed all the gains and conditions won by the working class. The economic crisis that began in 2008 made clear how successive governments had enabled the super-rich to plunder social wealth, rig markets and cook the books. Having spent billions of pounds bailing out the banks and super-rich at tax payers’ expense, governments in every country are imposing vicious austerity measures. Their aim is to use the economic crisis to carry through a social counter-revolution against living standards and vital social provisions.

Greece has been at the sharp end of this offensive. Up to a third of the population there no longer has adequate access to medical care, thousands are cut off from vital medication, doctors and pharmacists are owed millions in unpaid salaries and children are contracting previously eradicated infectious diseases.

A similar process is underway in every country, including Britain, where the coalition is implementing the most draconian austerity measures since the 1930s. The poor and most vulnerable are the immediate target, as cuts in welfare benefits will further impoverish millions. But no section of workers or essential provision is to be spared—from teachers and schools through to nurses and hospitals.

The defence of health care and every other basic social right can only be taken forward through a break from the unions and the Labour Party. Action committees must be formed by patients, hospital staff and the workers and youth whose lives and health are being jeopardised. The problem is not a lack of funds or resources, but the monopoly of wealth by the super-rich. This monopoly can only be broken by a mass movement of the working class to bring down the coalition government and replace it by a workers’ government based on socialist policies.

Such a government would carry through a radical redistribution of wealth in favour of working people, which would include ending the obscenity of medicine-for-profit and restoring the health service as a free, high quality state-run facility for all. We urge all those who agree with the need to take up this struggle to visit www.nhsfightback.org and to contact us.