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Safeguarding the Future of the Health Service -----
NHS Support Federation Public Conference "Our
NHS" Exposes New Labour's Agenda for NHS
On Saturday, October 23, the NHS Support Federation
organised a one-day public Conference in Conway Hall, Central London, entitled
"Our NHS". Over 250 people attended the conference with many
people travelling from London and other areas. The participants included
consultants, GPs, nurses and other health staff, as well as a number of
campaigns fighting to save hospitals and hospital and community services.
Members of the Kent and Canterbury Campaign organised a coach to come to the
conference, and a number of campaigners from Health Concern Kidderminster and
Crawley Hospital Campaign also attended.
One of founding members of the NHS Support Federation and
President Professor Harry Keen welcomed people to the conference. There then
followed a session on "The future of our health service" in which
speakers were invited to address the conference and examine in some detail the
agenda of New Labour on Health Care. Dr Ron Singer, NHS Primary Care Alliance,
said among other things that much of the "new money" that the
government has announced for the NHS comes from the operational fund. But, he
said, "Like fishes and loaves the fund seems to stretch and stretch to the
'waiting list initiative', then to 'information technology', 'cardiac surgery'
and so on." This all comes from the operational fund. So, he said, it is
so difficult to know how this new money arrives at health authorities and
Primary Health Care Groups. "There is a feeling of sleight of hand,"
he remarked. At the same time, in his remarks the speaker outlined the role of
the Primary Health Care Alliance, his role, as one of "helping the
government to turn their notions on Primary Health Care into reality". He
characterised the role of the 450 new Primary Health Care Groups and Primary
Health Care Trusts that will emerge from them as "no longer
pretending" that the NHS will provide comprehensive health care. He
explained how that even with lay representatives such bodies would take
decisions on "what would not be provided" rather than what
would be provided by the NHS. He said that this was because the under
funding of the NHS would continue.
Dr Ron Singer's remarks showed that New Labour has no
intention of ensuring that the economy is organised to provide the investments
needed for even the "health initiatives" that they have undertaken.
New Labour's vision for health care in the next century is one in which the
provision of comprehensive health care has been removed from the agenda. The
remarks emphasised the direction of society under New Labour's
"modernisation" of public services as in fact retrogression to
eliminate all the gains over medievalism and to eliminate all notions of a
modern society providing for health care, public welfare and social provision.
Professor Allyson Pollock also addressed the conference. She
spoke about the World Trade Organisation talks in Seattle in November with 134
member states taking part. She said it was very important because the
transnational corporations were seeking at this meeting to open up every sphere
of public life to the market. They were seeking to roll back national
sovereignty and the restrictions which governments have in place as to the
extent which public services can be opened up to the market place. She said
that the profits of the transnational companies have fallen and they are now
seeking to target public funds. They have two agendas, one of targeting public
funds for health education and welfare, and the other of targeting by
privatisation the very services that are being delivered. She pointed out that
this global agenda, as well as the European agenda, is a major agenda in public
services and public utilities. She said that what is going on in Primary Care
Groups and Primary Care Trusts is part of this agenda with the private
companies providing both capital and services. The Norwich Union, for example,
has put up £100 million for which it has now got in Bradford a huge
Primary Care Health Centre.
Speaking about the Private Finance Initiative (PFI),
Professor Pollock said that Tony Blair has continued this from Norman Lamont
under the previous government. Tony Blair likes to rhetorically ask who can be
opposed to the PFI when it is a new source of capital and a new source of
funding for our public services. Professor Pollock emphasised, "This is a
very important point. The PFI is not a new source of funding, it does not bring
money in. It is simply a source of financing. Who picks up the bill for this
financing? It is the public services and the NHS year, after year, after
year."
Professor Pollock said that what we are seeing is handing
over of our land and our assets, and a major shrinkage in our public space at
our schools, hospital sites, our community centres, our playing fields and so
on. She pointed out that at present 8-12% of the operational budgets of Health
Authorities and Trusts are spent on servicing capital debts. At the PFI
hospitals, this has increased up to 18% of the operational budget and at the
same time each PFI project has greatly reduced the number of beds. Britain now
has the lowest number of hospital beds per capita in Europe except for Turkey.
She pointed out that the contracts guarantee no risk to the private sector in
securing their profits whilst the risk to patients in not receiving services is
not even mentioned.
Professor Pollock's remarks reflected the present situation
which is one where capitalism is driven by the contradictions within it, by
trying to counter the falling rate of profit so as to achieve the maximum
profits possible regardless of anything else. This situation is different from
the previous period. Finance capital and the multinationals are demanding
changes at the World Trade Talks because capitalism has passed from a system
where the state provided cheap nationalised public services to the monopolies
so that they could make maximum profits by raising prices and holding down
wages, to a system where through liberalisation and privatisation of those
public services everything is being geared to paying the rich. National assets
such as public utilities and health services are now sacrificed in pursuit of
maximum profits and paying the rich from public funds, or by such mechanisms as
the PFI, in an increasingly globalised economy.
In the afternoon session a number of campaigners addressed
the conference from Health Concern Kidderminster, Watch/ Watford and Community
Care protection Group Bromley. In one of the contributions, Dr Richard Taylor
of Health Concern Kidderminster addressed the conference. He said that there
had been three phases with the campaign to save the accident services at the
hospital. He said that at first there was petitioning, demonstrations and the
like. Then the decision went to the Secretary of State who rubber-stamped the
closures. The Community Health Council then attempted a Judicial Review and
this got nowhere. Within a very short space of time, he said, the campaign
decided to go onto phase two. This was to "harness the power of the ballot
box". In the May council elections the campaign fielded 15 candidates and
got 11 of them elected taking 42% of the votes and displacing the Labour Party,
who were supporting the health cuts, from control of the council. The first
initiative of the councillors was to demand an immediate independent enquiry
into the hospital closures and this was unanimously passed by the council.
Dr Taylor said that they were now onto the third phase which
was a plan to organise such rigid monitoring of the Accident and Emergency
Service that they will pick up the people who die in ambulances because they
have to travel 35 miles from Kidderminster. He said, "We defy any doctor
or paramedic to keep somebody alive for 35 miles in the back of a moving
ambulance." He said that the monitoring will pick up any other disasters
and because of the campaign's financial support it can afford to engage
services of professionals to make this monitoring service fully independent.
Dr Taylor's remarks showed how unrepresentative the
political process is, where the just concerns of the people, even those which
are matters of life and death, are completely ignored. It shows how the people
cannot rely on political representatives but must take up politics themselves.
It also points to the need to take this further and fight for a political
process that replaces representative democracy with a political system that
empowers the people.
Following the address from the campaign, the conference was
opened up for contributions from the floor, and 14 people spoke.
A representative of the Crawley Hospital Campaign spoke
about the struggle of the people of Crawley against the downgrading of the
hospital and the proposed closure of the Accident and Emergency unit. The
speaker called on the NHS Support Federation to organise a national
demonstration.
A representative of the Waltham Forest Campaign pointed out
that the question of private multinationals being involved in controlling and
running our health service for private profit is not a matter of arguments for
or against coming from the "left" and the "right". It is a
matter that such control by the private multinationals is incompatible with
providing a service which meets people's needs and it raises the question of
which direction do we want the economy to go in. She said this is something
which has to become a national issue, which has to be very strongly included on
the political agenda, that the present direction is not the direction that we
want our society to go in.
A representative of the Workers' Weekly Health Group also
spoke in the discussion. In his remarks, he said that the conference had raised
some very important questions on what will become of the NHS in the 21st
century. Rather than creating illusions, he said, the task must be to shatter
the illusion that the Labour government can be relied on to defend the NHS. He
pointed out that the morning's contributions had revealed that the New Labour
government had been driving the NHS more effectively into the private sector
than Margaret Thatcher could have done, and also driving the cuts more
effectively. This is the reality.
He said that the issue for those in the working class and
people's movement is not to take up the agenda of New Labour, discussing on
their terms, which would only lead to further disasters in health care
provision for the people, but it is to address our own agenda. He said that our
agenda was that the right to health care was inviolable, a human right that
everybody should be provided with health care equally, at the highest possible
level. So if this was the principle, then the next question on our agenda was
how should society be organised, the economy organised, so that all these
comprehensive health care needs of the people can be met. He said that the
question on the economy, on funding, that had come up in the discussion at the
conference was that it was the responsibility of government to change the
direction of the economy to meet the needs of the people. Clearly, the present
government was not going to do that. They had not guaranteed health care for
the people, they had not guaranteed beds for patients, or operations, but
instead they have guaranteed that society will continue to be geared to paying
the rich. He pointed out that the only way that society can satisfy the needs
of the people is to change the direction of the economy and to stop paying the
financial oligarchy and stop paying the rich so as to increase investments in
the health service and all other social programmes. He concluded by saying that
this should be firmly fixed as our agenda.
After the contributions from the floor, the Chairman
concluded the conference by saying that all of the discussions and suggestions
would be going to the next meeting of the Executive of the NHS Support
Federation in November.