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Workers' Weekly Internet Edition: Article Index : ShareThis
Collapse of Carillion and the NHS:
Fight for the Alternative to this Profit-Making Racket of Finance Capital in the NHS
Empowering the People to Take a Pro-Social Direction for Society:
Save South Tyneside Hospital Campaign Fights On In Defence of its Health Services
Letter to the Editor:
South East London Campaign Stops Cuts In Children's Mental Health
The recent collapse of Carillion is a vivid example of the ever-deepening crisis and criminally corrupt character of a system that is solely interested in paying the rich without regard for the needs of the people.
The collapse of Carillion brings to light the sheer scale of the involvement of the private sector - in particular, private monopoly interests - in the public sector. Carillion was a large monopoly operating principally in Britain, where nearly half of its 43,000 employees were based, but also internationally, particularly in Canada and the Caribbean, as well as in the Middle East. Its dominant status was such that tens of thousands of smaller firms were connected with or dependent upon Carillion, which are now under threat themselves. Upwards of 30,000 small businesses are owed money by the monopoly according to the Specialist Engineering Contractors Group.
This one monopoly was contracted by the current and previous governments to provide close to 900 schools. Its operations ran end to end across the entire range of infrastructure from construction, including project management, architecture and engineering, through to cleaning, catering and maintenance across widely diverse areas of the economy, both in the public and private sector, from aviation to retail and leisure, from commercial to government at all levels. In particular, it was contracted in key areas of education, healthcare, transport and energy, and ran a reported 50,000 homes for the Ministry of Defence. Carillion therefore played a significant role in the government's long-term aim to privatise the NHS at the same time as directly forming part of the militarised economy. Its infrastructure contracts include the controversial HS2 rail link.
Labour leader Jeremy Corbyn described the Carillion debacle as "an outsourcing racket". The obvious corruption and conflict of interest of a government buried up to its neck in the enormous social and financial detritus arising from the collapse of Carillion, attempting to extricate itself with evasions and outright lies, is revealing of the extent of the penetration of big business into government and the affairs of state in general. It shows how far the government lacks any decision-making power independent of the aims of the monopolies and oligopolies.
In 2011, a year after the election of the Conversative-Liberal coalition, Philip Nevill Green became Carillion's director; significantly, Green was appointed in the same year as an advisor on corporate responsibility to Number 10 by then Prime Minister David Cameron. Murky goings-on are indicated by the fact that, as reported by City AM, Green, who was awarded with a CBE in 2014, left the role as advisor in December 2016 under Theresa May and that neither Number 10 nor the Cabinet Office would comment on the nature of the advice given, or why Green left.
According to The Week, Carillion received £2bn in government contracts despite three profit warnings and collapsed under a debt of £1.5bn after failing to reach a rescue deal with the Government.
Corruption in the present conditions of the anti-social offensive and crisis is not merely a matter of breaking rules or personal conflict of interest but the overthrow of all the rules, institutions and norms of civil society and the conflict between public interest, the general interests of society, versus the self-serving interests of powerful monopolies. Corruption of the kind revealed by the collapse of Carillion is an integral part of the usurpation of the public authority by private monopoly interests.
It was the Thatcher government that launched the anti-social offensive nearly 40 years ago, encapsulated in the notorious declaration that "there is no such thing as society". In that context, it carried out privatisations so as to open up the lucrative public sector for private profit, while abrogating the responsibility of the state to provide social programmes. The continuation of that government under Major introduced Private Finance Initiatives (PFI) in 1992. Such so-called public-private partnership arrangements were taken to the next level by the Blair government according to the "Third Way" ideology, which guided their all-sided programme to politicise private interests and depoliticise public interests. This time the slogan was "make Britain great again", which made all subservient to the empire-building aims of the most powerful monopolies in the global market and was directly connected to the pro-war agenda for which Blair is infamous. PFI under Blair meant the capture of public institutions so that monopoly right would trump public right. The financial crisis and associated austerity launched by the Cameron-Clegg coalition and continuing to the present have been systematically destroying all vestiges of the welfare state arrangements, such that now even the notion of "partnership" is out of date. The collapse of Carillion reveals that PFI itself is now in crisis.
Such destructive arrangements as PFI can ultimately only lead to crisis. Social programmes are a necessity for a modern society, a necessity that asserts itself as crisis when not recognised and given first claim on the economy but instead left to chance.
The pursuit of big scores has become such that private finance has become precarious to the extreme. This latest collapse exposes how private finance subjects crucial areas of infrastructure essential to the economy and society to the vagaries of the market and narrow self-serving aims and interests. It should be noted that the £1.5 billion debt is itself part of paying the rich, a claim by sections of finance capital that itself should be challenged. Furthermore, it is reported that workers' pensions are threatened due to a deficit of £587 million in Carillion's pension fund. Both active and retired workers are therefore to be made to shoulder the burden of the collapse directly by being forced to give up their own claims on the value they have created through their years of employment by the company.
In this respect, it is significant that Carillion was exposed in 2009 for using illegal construction industry blacklisting body The Consulting Association, to deny employment to workers for political, union or whistleblowing activity. The anti-worker nature of Carillion's operations, the denial of their right to organise to protect their interests during the company's existence, and the denial of workers' claims after collapse, go hand-in-hand with a civil society in tatters and the increasing reliance on arbitrary powers that Carillion has been at the centre of bringing about.
In order to organise for an alternative, people need crucially to discuss the politicisation of private interests and the destruction of the old civil society and arrangements of state and governance.
In general, the politicisation of private, particularly monopoly interests, with their associated empire-building aims and need to plunder the global economy without regard for sovereignty is a factor for pro-war government.
Infrastructure necessary for the general interests of society, the public good, should be prevented from being used as a means to enrich the most powerful monopolies. Public-private partnerships should be recognised as inherently corrupt and should be outlawed.
This requires the politicisation of the public interest on a new basis, not through the return to a civil society of the past that is out of step with the times, but through direct empowerment of the polity to create a human society, which is able to organise for itself a pro-social, anti-war government of a new type.
The collapse of Carillion brought to the fore the scale of the involvement of the private sector and private monopoly interests in the public sector. In the NHS, the collapse of Carillion is rightly being seen as yet another exposure of the lie that the outsourcing of NHS services to the private sector is the key to efficiency and that private finance provides "value for the taxpayer" in delivering public services and its infrastructure. But the reality is that it reveals much more. It reveals the criminality of the wholesale outsourcing of hospital-building, maintenance and hospital support services. Gone is the control of these services by the public authority, and with it, any sense of public good, either to the staff employed or the NHS these services support. In its place is a profit-making racket of finance capital that monopolises all activities from the building of Private Finance Initiative (PFI) funded hospitals right down to the level of, for example, maintenance subcontracted by Carillion where hospital managers have reported being forced to pay £70 to change each light bulb and £20 to change single hand sanitiser or soap dispenser.
It is not as if the criminality of this outsourcing of NHS hospital building was not known at the outset. In 2005, an investigation by the National Audit Office into the Darent Valley Hospital, a 400-bed hospital in Dartford, Kent, completed in 2000, revealed the spectacular profits that were made under this first PFI hospital-building scheme . A 60-year contract signed by the Darent Valley Hospital gave contractors a 75-year leasehold. If Dartford and Gravesham Hospital Trust walked away from this contract before the 35-year break point, these private-sector partners would retain the land and assets of the hospital for a further 40 years. Carillion invested £4.1 million in its share of the ownership of this first PFI hospital but its monopoly of the leasehold and huge payments for lease enabled it to sell its share three years later for £16 million in 2003. The audit office was forced to get involved because it had received a 50% "return" on its investment in 3 years raising "questions" about the PFI. Yet this corrupt activity of the system was swept under the carpet and was allowed to carry on under the then Labour government of Tony Blair, which was also launching its criminal invasion and occupation of Iraq. Carillion continued to be given lucrative PFI and outsourcing contracts in the NHS and other areas of public services for the years since.
More recently, Carillion was involved in the £350 million Midland Metropolitan Hospital in Sandwell, whose opening was originally scheduled for October 2018, but difficulties with the heating, lighting and ventilation systems forced a delay of the launch date to spring 2019. Carillion's subsidiary Clinicenta had a contract to run a treatment centre at Lister Hospital in Stevenage, which was terminated in 2013 after the Care Quality Commission found the unit was not meeting minimum standards. The new 646-bed £335 million Royal Liverpool Hospital was due to be finished by March 2017, but the completion date has been repeatedly pushed back according to reports because of cracks in the building.
Today, in its outsourcing of maintenance and hospital support services, Carillion at the time of its collapse employed around 8,000 staff in 14 hospital trusts. All of these jobs have been put into jeopardy or further sold on to another private provider. For example, Carillion provided car park management, switchboard, cleaning, portering, and security at James Cook University Hospital in Middlesbrough, on behalf of South Tees NHS Foundation Trust. According to reports, Serco and other outsourcing firms are now in talks to bid for the James Cook Hospital contract that affects around 900 workers.
Carillion was also the facility management company for Tees, Esk and Wear Valley Mental Health Trust's Roseberry Park, which recently hit headlines due to serious defects at the hospital. Three Valleys Health is the PFI company that included Carillion and was responsible for the hospital. Andy McDonald, MP for the town, pointed out on his website : "I was completely dismayed at the failures to meet anything like acceptable construction standards. The list of defects in a brand new hospital from defective roofs to plumbing problems and much, much more besides is as long as your arm. The main construction contractor's dreadful record reveals an almost cavalier attitude to proper construction standards and more worryingly to safety and security. It will cost a fortune to put this right. Three Valleys Health is the PFI company that ultimately bears responsibility for the appalling work in the building of this key mental health facility... The building contractor Laing O'Rourke should be utterly ashamed of themselves for such shoddy workmanship, as should the facility management company Carillion... how any of this work was ever passed as satisfactory is beyond me."
An Audit office report  released just prior to the collapse of Carillion lists the obscene profits that "the Private Finance Initiative (PFI) and the introduction of PF2" rips off for these monopolies. It pointed out that "there are currently over 700 operational PFI and PF2 deals, with a capital value of around £60 billion. Annual charges for these deals amounted to £10.3 billion in 2016-17. Even if no new deals are entered into, future charges which continue until the 2040s amount to £199 billion."
Health workers, and indeed people at every level in society, have long demanded the end of the outsourcing of NHS services and an end to so-called public-private partnerships such as PFI. Infrastructure necessary for the general interests of society in providing healthcare should not be used to enrich powerful monopolies such as Carillion. The right of health workers and the people to have direct involvement in the control of the healthcare system and its infrastructure should be fought for as the alternative to this profit-making racket of finance capital and all the criminal anti-social and pro-war actions such a system unleashes on the population of Britain and the world.
Part of Hands together at the front of South Tyneside District Hospital during the lunchtime
protest vigil of hospital staff and people from South Tyneside on February 16th 2018
On February 21, the South Tyneside and Sunderland Clinical Commissioning Groups (CCGs) took a brutal decision on the future of the three key maternity, stroke and paediatric services at South Tyneside District Hospital. Under this decision, these services would be moved from South Tyneside to Sunderland Royal Hospital. At the meeting where the decision was announced, no one was allowed to comment, or ask a question. Many people remarked how stage managed it was and most of the issues raised by them were not resolved before they railroaded through the decision.
Below is the statement the Save South Tyneside Hospital Campaign (SSTHC) gave following the decisions of the CCGs to the press following the meeting. As can be seen from the statement, Ken Bremner, Chief Executive of the South Tyneside Foundation Trust (STFT) claimed that he initiated the process long before he became Chief Executive, telling the CCG that "no change was not an option".
In brief, the decision was to downgrade the Children's A&E from a consultant-led 24/7 service to a 12-hour nurse-led minor injuries by April 2021 finishing at 10pm. In the meantime, the consultant-led service would be downgraded to 12 hours finishing at 10pm by April 2019. The obstretric maternity service would downgraded to midwife-led, and no stroke unit at all would be kept at South Tyneside.
The SSTHC is determined to fight on to roll back this decision-making where the views and interests of the people are left out of account. The Campaign is fund-raising to mount a legal challenge. See: https://www.crowdjustice.com/case/save-south-tyneside-hospital/
Save South Tyneside Hospital Campaign Statement in Response to February 21st 2018 CCG decisions.
The consultation has been a complete sham. 7 months ago on July 5th the CCG started a consultation on pre-determined options. Throughout the consultation, or the review carried out before, we never got any information or any sense that showed they had actually listened to the clinical staff, or the people of South Tyneside.
Ken Bremner Chief Executive of South Tyneside Foundation Trust (STFT) and City Hospitals Sunderland admitted at the meeting of the CCGs announcing these decisions that two years before he had told the CCG that "no change was not an option". However this was before he was Chief Executive of STFT! So this was pre-determined and it was no wonder that there were never any options in the consultation that gave the people of South Tyneside anything other than worse access to hospital services and the moving of services to Sunderland.
Our solicitors have written to the CCGs saying that any decision based on this consultation will be unlawful and we reserve the right to challenge these decisions.
Nothing in the consultation, or their decision says that we don't have a right to these services at our hospital. Our clinicians and the people of South Tyneside should decide not those that are in the pockets of the government's down grading of our NHS and its privatisation.
We are still here. We are unvanquished as a united campaign to save our hospital services and we fight on because people have a right to these services at our hospital. Health Care is a Right! It is our Hospital and our NHS!
For the background to the Campaign, see: Save South Tyneside Hospital Campaign and the Fight to Save Hospital Services
The Save Lewisham Hospital Campaign (SLHC) recently led a successful fight to oppose proposed cuts to children's mental health services in Lewisham Child and Adolescent Mental Health Service (CAMHS).
Lewisham Council had already cut local children's mental health funding by £94,000 last year and had planned to cut them further by £15,000 over the next two years. The cuts in CAMHS are the result of government austerity cuts of £153 million imposed on Lewisham Council with more to come. The government has been imposing massive budget cuts to councils throughout the country, severely damaging essential services. This is widely perceived to have the aim of starving these public services of funds and create the conditions for further privatisation while the claims of the people are disregarded.
SLHC ran a vigorous campaign to oppose the cuts to CAMHS, giving out thousands of leaflets at railway stations and streets in the Lewisham area and organising a petition which has been signed by over 6,000 people. The leaflet from SLHC pointed out that the cuts would hit vulnerable children and families very severely and that waiting lists, already unacceptably long, would grow even longer. The leaflet also stated that patients are already being sent to other hospitals, often miles from London, and praised Lewisham CAMHS, saying that "it is a well-respected service - skilled clinicians with high morale, choosing to work here, valuing the support they have given to schools, GP surgeries and other local facilities".
This campaign reached a climax in a very successful local meeting in New Cross to oppose the cuts attended by over 100 people. Speakers included Maggie Palmer from CAMHS/Unite, a parent, a former service user, Chair of the SLHC Dr Louise Irvine, an NUT representative, Dr Omer Magrehbi, and VickyFoxcroft MP. Many parents and NHS service users spoke movingly and angrily opposed the cuts. Tony O'Sullivan from Keep Our NHS Public (KONP) and SLHC chaired the meeting and read out a message of support from Jon Ashworth, Shadow Secretary of State for Health:
"Because of Parliamentary commitments I can't be with you. But I wanted to send my solidarity to you and congratulate the health campaigners of Lewisham who do all of us proud. As I understand it, nearly £100,000 will be cut from CAMHS this year in Lewisham. The truth is under the Tories, children and young people with diagnosable mental health problems are being let down by overstretched and underfunded Child and Adolescent Mental Health Services, which is disgracefully being cut back."
On February 14, the SLHC organised a Valentine Picket outside Lewisham Town Hall to lobby the Lewisham Mayor and cabinet and hand in the petition against the cuts. After the picket, Lewisham Mayor Steve Bullock said at the Mayor and Cabinet meeting that the council was "reversing its decision on cuts to Children's and Young People's Mental Health Services (CAMHS) on the basis of change of circumstances since the decision was made. The next two years' cuts would not happen now." Campaign members applauded in response and Councillor Alan Hall also made a supportive speech.
This successful campaign shows that a crucial issue in the fight to save the NHS is where the decision-making power lies. Is it to be the government, which is hell-bent on undermining and destroying the NHS, or the people of this country who want to preserve their NHS? In this fight to save their local children's mental health services, the people of Lewisham took the decision into their own hands and successfully fought to save them.
No To Healthcare Cuts! Healthcare Is A Right!
Activist of the SLHC
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