Foundation Hospitals and Redefining "Public Ownership"

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Foundation Hospitals and Redefining "Public Ownership"
Focus Group on Foundation Hospitals

"The Pianist" of Baghdad – Losing Music to the Ruins of War

Reproduced from the Publication of the Health Workers Forum in the Northern region, Safeguarding the Future of the NHS – Giving Health Workers a Voice!, Volume 1, Issue 1, April 16, 2003. This was a special issue on the Unison national Health Group Conference which took place in Harrogate from April 7-9.

The government’s plan to give Foundation Hospital status to the "best performing" hospitals was discussed throughout conference. A motion on the first day of the conference condemned their introduction as creating a two-tier health service where the so-called freedoms given to these hospitals will be at the expense of the resources to other parts of the NHS. A focus group the same afternoon opposed the idea that "stakeholder" governance of these hospitals was in fact "returning these hospitals to the community" and that Foundation Hospitals would not be "owned by the public" as the government was claiming. On the second day of conference John Hutton, Minister of State for Health, in addressing conference emphasised this point. He said that what we have ended is a "model of public ownership that is the state". He said with Foundation hospitals it is "local ownership" and a better way by getting more "local accountability". He concluded. "I think that is public ownership."

When the government says that it is redefining "public ownership" of the NHS from "state owned" to "community owned" it is really trying to continue the deception that the Labour Party is a party of the working class and that the public services such as the NHS are "owned" by the people and will continue to be under New Labour. More to the point it is trying to hide the fact that it is increasingly giving up its responsibility to provide for the health care of the population and handing these services over to increase the profits of big business whose interests it really serves.

In Britain the state has always owned and controlled the public services on behalf of the capitalists as a class. If the public had owned the NHS then the government would not have been able to introduce the changes they have made. The Private Finance Initiative (PFI) would never have been introduced for example. Where is the constitutional law that cannot be touched by government Acts of Parliament that guarantees the right of the people to take the decisions in society so that they can exercise ownership over the NHS? In whose interests is the NHS being run when so many people cannot receive the treatment they need, or have to wait for such a long time? It is not the people who have first claim on society for their health needs.

Foundation Hospitals should not be viewed as a measure to "redefine public ownership" but as a mechanism to place the NHS further in the service of the rich. The government has raised the issue but for health workers it raises the question of who has political power? The rich, or the workers who vest sovereignty in the people. This is what will decide the issue of public ownership. Such a vision means that modern society recognises that the producers of wealth and providers of public services should take the decisions in society on how the goods are distributed and the public services provided. Health workers should be fully involved in taking decisions about the health service and about society.

Reproduced from the Publication of the Health Workers Forum in the Northern region, Safeguarding the Future of the NHS – Giving Health Workers a Voice!, Volume 1, Issue 1, April 16, 2003. This was a special issue on the Unison national Health Group Conference which took place in Harrogate from April 7-9.

The two speakers at the focus group discussion on Foundation Hospitals made a detailed analysis of the proposals showing how Foundation Hospitals would not be locally accountable and how this will not be public ownership under the proposals. For example, it was said that the Foundation Hospitals will decide their own constituency and the arrangements that are proposed will accommodate the vested interests, whilst nothing in the legislation shows how these hospitals will even "consult" with the public or the members. The interest of staff for example will be accommodated with one staff side representative on the board. These hospitals will no longer come under the control of the Department of Health but will be subject to an independent regulator.

The Foundation Hospitals, it was said, have to be taken together with the increasing internal market in health care that the government has re-introduced in spite of its previous promise to remove the internal market from the NHS. It is part of the transition to the diverse providers where BUPA hospitals will be able to apply for foundation status and where 50% of the new Clinics & Drop-in centres are being provided by the private sector. The government’s plan for the NHS by 2005, with its concordat, is for many areas to be completely reliant in part on private sector provision of health care. This is put in terms of patients having a choice between care given by NHS Trusts and private providers. Such a market in health care could mean the loss of services from many local NHS hospitals and clinics whose services are being "cherry picked" by the private sector. At the same time, with the inefficiency of such an internal market in use of resources this would be used as an excuse by the government to increase introduction of tariffs and charges to the patients for non-medical items and their extension into patient care. This was one of Tony Blair’s aims it was pointed out.

The discussion that followed reflected the concern of health workers over the introduction of Foundation Hospitals. Many gave examples of the crisis in the NHS and how staff were increasingly finding it difficult to cope. One of the delegates pointed out that the motion on Foundation Hospitals, like too many of the motions at the Conference on the PFI and so on, made the issue that the government should change its policy. What is clear he said is that they are not going to change even though we have been coming back here year after year to pass these motions. He said that he thought that we have to start from the position that it is only health workers that can save the day. We have to organise ourselves and our fellow health workers to safeguard the future of the NHS. This is the only way forward he concluded.

By Kathy Kelly, AlterNet, April 18, 2003

Baghdad, Iraq – On a recent morning, as nurses dug graves in front of the Al Mansour Hospital, Baghdad University lay in ruins, and the Red Cross warned that the city's medical system was collapsing, two musicians from this wounded city came to our hotel room.

Majid Al-Ghazali and Hisham Sharaf hoped to call relatives outside Iraq on our satellite phone. Hisham's home was badly damaged during the war. "One month ago, I was the director of the Baghdad Symphony Orchestra," Hisham said with an ironic smile. "Now what am I?"

As Hisham tinkered with the phone's solar-powered battery we joked that he could direct the telephone exchange. I told Majid we had some sheet music and a guitar for him. "What are notes?" he asked. "We don't even remember."

Majid had a particularly rough experience. During the first week of bombing, a neighbour called the secret police and turned him in for visiting with foreigners. He was jailed the next day. After the "fall" of Baghdad, the same neighbour claimed he was actually part of the secret police. Majid is terrified now.

"I think they want my house," he said. "No place is safe."

I first met Hisham at the Baghdad School of Folk Music and Ballet last year on one of my visits with Voices in the Wilderness, a campaign to end sanctions on Iraq and prevent further aggression against the Iraqi people. Hisham and Majid taught at the school during the day and rehearsed with the orchestra at night. As the war approached, I told Hisham how meaningful the song "O Finlandia" has been to many people in the United States. At least 150 families who lost loved ones on 9/11 had used this peace anthem as part of memorial services. Sibelius composed the melody in the late 19th century. Following World War I, lyrics were created emphasising the common aspirations and dreams shared by all humanity.

Hisham had chuckled then, and couldn't resist pointing out the irony that someone from the United States wanted to teach his students a peace song. "OK," he said, "Sing it for me. We can do this." Within two days, an entire class was singing an Arabic transliteration of the song.

Now, as they finished with the phone and said goodbye, I wondered if the hopeful, idealistic verses might embitter them today.

The next morning the two returned, shaken and distraught. They had approached US soldiers the previous evening asking for help to protect their school. The soldiers said it was not their job and ordered Hisham and Majid to go away. They went to the entrance of the school hoping they could somehow protect it alone. Five armed men arrived. Majid, Hisham and Hisham's brother pled with them not to attack the school. The looters argued, "We are simple people. Poor people. Soon there will be no food, no money, and we have no jobs. You are rich people."

"Please," Majid said, "we will give you the instruments, give you the furniture, but don't destroy the music, the records, the history."

"No," the armed men said. "Baghdad is finished." They ransacked the school, broke many instruments, burned the music and the records.

Why do desperate people commit deplorable acts of mindless destruction? I don't know. But through decades of warfare and sanctions, powerful elites in Iraq, the United States and the United Kingdom have ignored millions of Iraq's impoverished people, who have suffered tremendously.

"Here," Hisham said, "listen to this. This is all we have left." He handed me headphones borrowed from a Norwegian television correspondent. The orchestra was playing "O Finlandia." Listening to the children craft their music, I softly sang the words:

"This is my song, O God of all the nations. A song of peace for lands afar and mine. This is my home, the country where my heart is. Here are my dreams, my hopes, my holy shrine. But other hearts in other lands are beating, with hopes and dreams as deep and true as mine."

I stopped. Hisham had begun to cry.

* Kathy Kelly is co-coordinator of Voices in the Wilderness and the Iraq Peace Team. She has lived continuously in Iraq since January 2003.