|Volume 50 Number 35, September 12, 2020
Workers' Weekly Internet Edition: Article Index : ShareThis
Health Care Is a Right:
Using Covid to Increase the Dangers to Health through Denying Care to Those Who Need It
The desperation to prevent the alternative from taking root:
Simon Case Appointed Head of the Civil Service
Biscuit Workers Strike in Edinburgh
The Covid-19 pandemic has highlighted the importance of workers speaking in their own name. This is a moment for the working class to define the modern democratic personality which bears its own stamp and unites all democratic and progressive forces around it. It is a moment in history which is calling on the workers to be that leading force which takes up for solution the problems of the economy and society and points in a pro-social direction.
The ruling oligarchs are demanding a return to "business as usual" even though the status quo has proved unsustainable in practice. However, working people demand an economy and a government under their control and organised to serve the public interest not vested narrow private interests.
A state organised to pay the rich is not a free market. It is an economy controlled for the privileged few. The aim of the economy to pay the rich renders it incapable of mobilising its tremendous productive powers to solve the problems the people face. In this context, the working class and people are charged with the task of bringing into being a new mode of production with an aim of serving the people, meeting their claims on society, and resolving national and international problems without violence and war.
Employers like BMW will use the argument that nothing can be done because it is the market which dictates. The workers are encouraged not to be an independent force, but to erect barriers in their consciousness and remain wage slaves. In opposition, the starting point for the workers is to embrace the programme to stop paying the rich and increase investments in social programmes in order to guarantee the rights of all. Why not have the collective will of the society expressed in the form of socialist planning and control by the working people over those affairs that affect their lives?
The immense social product available from the modern means of production can be put to use to solve society's problems and guarantee the well-being and rights of the people and the extended reproduction of the economy. The social wealth necessary to run the economy can be mobilised through the collective authority of the people and resources of the economy. The prices of production, supply of raw material, the training of the working class, the provision of the social and material infrastructure, the relation between supply and demand, and other crucial features are social and public. This requires additional public measures beyond the operation of the mega-companies themselves. Ultimately it requires a public authority in which the people can participate in making decisions on the direction of these enterprises and ensure their viability and stability as part of a pro-social economy.
In short, the working class must take up its own political aim to end the situation whereby the rich marginalise it and confine it to being a subject labour force beholden to a small minority of oligarchs who control competing parts of the economy for their private interests. The working class is a mature, educated international social class comprising the vast majority of the population. It is more than capable of leading and looking after the economic and political affairs of a modern society. The ruling oligarchs with their agendas to serve their competing private interests are incapable of bringing the economy under any control at all. The working class can and must shoulder its social responsibility to empower working people and build the new, bringing the modern economy under its own control to serve the people and society. Only the modern working class with its broad agenda to serve the public interest can do so.
The working class is the largest and most advanced social class, the only social force capable of moving the economy in a new pro-social direction to allow working people control over economic, political and social affairs. Only this can save the day from the disasters that these imperialist elites are causing society, their fanatical defence of their wealth, power and class privilege at all costs. This is the challenge facing the working class - to take up their role of being socially responsible for the well-being of the people and the direction of the economy.
Developing the independent politics of the working class at this time crucially involves the organising of forms which build on the strength of the working class as a force independent of the ruling elites. By consciously participating in building workers' forums to exchange views, analyse unfolding events and set their own orientation to defend the rights of all, the programme to stop paying the rich and to increase investments in social programmes can lead to the establishment of an alternative. The independent politics of the working class to stop paying the rich and increase investments in social programmes is what must be consciously taken up and developed. It is a component of and consistent with organising the people themselves to form an Anti-War Government.
Now is the defining moment in the conditions of the Covid-19 pandemic for the working class to fight to establish an alternative and open society's path to progress. This is the inspiration which unites us all.
In September, the Health Service Journal (HSJ)  revealed a covert plan by NHS England (NHSE), already initiated by government, to roll out a "major A&E shake-up" in the coming weeks, a roll-out which they have been planning for a number of years to implement. Pilots for a new urgent care model requiring walk-in patients to book slots in emergency departments are expected to be rolled out in at least one site in every health system in the coming weeks in England nationwide. This followed an article on July 2 in Pulse  that former health secretary Jeremy Hunt finally admitted that he had wanted a "talk before you walk" system for patients attending A&E departments. An admission that came nearly three years after Pulse had revealed that Jeremy Hunt had been in talks with NHS England urgent care leaders about potentially piloting such a system, even though at the time such a scheme was denied by him and NHS England .
In fact, as far back as 2014, Clinical Commissioning Groups (CCGs) had been encouraging patients to "talk before you walk". On July 23 this year, the Chief Executive of the Northern CCGs, Neil O'Brien, announced a "talk before you walk" pilot in Newcastle, North Tyneside, Gateshead and Northumberland for August, before the trial will then be extended throughout the rest of the North East, as well as North Cumbria and parts of North Yorkshire. He claimed that it "should work" because "what we've learned through Covid-19 is if you put more clinical resource into triage then a lot of patients don't need to go to A&E".
However, in spite the denials that emergency walk-in patients will "not be turned away" from A&E and walk-in centres, there was no clarity on what happens to patients who presently attend A&E and would normally be triaged at A&E itself and given the immediate treatment that they need, even if they had to wait. Dial "111 First" is the bench mark that NHSE and the government has been trying to implement over a number of years to stop patients with relatively "minor illnesses and injuries" from attending A&E. But at the same time, government cuts have led to cuts in GP numbers and walk-in services which have meant that, more often than not, attending A&E is the only way patients can get rely on getting the treatment they need. Adrian Boyle, vice president (policy) at the Royal College of Emergency Medicine, told HSJ  that NHS 111's performance depends on factors such as input from clinicians, availability of alternative services and patient flows through hospitals. He said: "There is a problem that there is a lack of public and professional confidence in NHS 111, but NHS 111 is only as good as the services that are behind it. What [the local NHS 111 concerns] represent[s] is a lack of alternatives to the emergency department. This is illustrating that there really is not adequate community alternatives to emergency department care."
Neither is there any attempt to recognise the lessons of Covid-19 in terms of treating patients who need it. Those lessons reveal the dark truth that so many patients have gone untreated and even died through lack of appropriate and timely treatment. Graham Jackson, senior clinical advisor to the NHS Confed, told HSJ : "We have heard from clinical directors of primary care networks that during Covid-19 some patients were wrongly referred to primary care" when they should have been referred to other hospital and A&E services and others faced "long delays before being directed elsewhere".
During the Covid-19 crisis this has caused huge concern with patients unable to access the healthcare that they need and suffering pain and discomfort and even serious long-term ill-health effects.
Already in April, the Guardian  had reported that "the chair of the Royal College of GPs said that doctors were noticing a spike in the number of people dying at home, paramedics across the country said in interviews that they were attending more calls where patients were dead when they arrived. The A&E chiefs' minutes said that on the weekend of April 4-5 the number of 999 calls in which someone had had a cardiac arrest rose from 55 a day in normal times to 140. Most of the people concerned died, doctors said. The minutes also reveal acute concern among senior medics that seriously ill patients are not going to A&E or dialling 999 because they are afraid or do not wish to be a burden."
Further, by May the Guardian reported  that "about 8,000 more people have died in their own homes since the start of the coronavirus pandemic, than in normal times as concerns grow over the number avoiding going to hospital. Of that total, 80% died of conditions unrelated to Covid-19, according to their death certificates. Doctors' leaders have warned that fears and de-prioritisation of non-coronavirus patients are taking a deadly toll." The Telegraph of July 28 ran an article which said, "Twice as many people are now dying at home from unexplained causes, rather than Covid-19, with experts calling for an urgent investigation into what is causing the excess deaths..."
That the government is keen for the NHS authorities to lock-in the changes to A&E from Covid in such a rushed and covert way without any proper investigation and assessment of the real lessons of the Covid crisis speaks volumes about the intention to further deny health care to those that need it. The government is using the cover of Covid not to decrease but to increase the dangers to health care. The nub of their plan is papering over lack of services wherever they be placed, and just making it harder for people to access them. This is the "new normal" that the government wants to "lock in" to the NHS, giving priority to the takeover by private corporations, and a business-led NHS that rations and denies a range of health services and even vital health services that people need.
However, health workers and people everywhere have other plans about what should be the new normal for health care in society. They are every day speaking out that health care is a right and are demanding better access to the full range of publicly provided health services in their hospitals and communities that people need.
 Exclusive: Major A&E shake-up plans to be rolled out
in coming weeks, September 2 2020
 Jeremy Hunt finally admits he wants 'talk before you
walk' A&Es, July 2 2020
 Listen in full: 'We may well pilot talk before you walk
in A&E, October 2017
 Warning as UK coronavirus outbreak leads to sharp rise
in deaths at home April 16 2020
 More people dying at home during Covid-19 pandemic - UK
analysis, May 8 2020
The data shows 8,196 more deaths at home in England, Wales and Scotland compared with the five-year average for this time of year, including 6,546 non-Covid deaths. It also indicates a drop in non-Covid deaths in hospital, however, leading experts to conclude that many who would ordinarily have been admitted to a ward and died there are instead dying at home.
A petition fighting for the reopening of St Clare's in Jarrow, Tyne and Wear, has been presented to Parliament.
The South Tyneside Clinical Commissioning Group (CCG) preparing to decide the future of end-of-life care in South Tyneside has been urged to "listen to the people", a report in the Newcastle Chronicle states.
On September 8, a petition signed by more than 13,500 people in the Jarrow constituency fighting for the reopening of Jarrow's former St Clare's Hospice site was formally presented to parliament. Kate Osborne, MP for Jarrow, in presenting the petition, insisted questions remain over why the building continues to sit empty more than a year since it closed after the charity collapsed into insolvency.
"St. Clare's provided a vital service for three decades and its closure has had a devastating impact on our local community," she said. "The Primrose Terrace building was purpose built, peaceful and tranquil with beautiful views from each room. The building is ideal in my opinion and with the right plan in place, I strongly feel that there is no reason why a palliative care service cannot be restored to the former St. Clare's site."
She added: "I have already told the decision makers there is such a strong level of public support to bring Palliative care back to Jarrow that they really must listen to the people of this area and what they actually want."
The South Tyneside CCG has suggested that the former Jarrow-based hospice charity could be replaced with a new "spoke and hub" system which it claims would offer more home and community care.
The campaign to return palliative care to Primrose Terrace in Jarrow has been widely supported, which is also a testament to the hard work and fighting spirit of the campaigners. For example, staff at UTS Engineering based at the Bede Industrial Estate and at Westoe Travel among many others have supported the demand.
The Petition on Palliative care at Primrose Terrace, Jarrow, states:
The petition of residents of the constituency of Jarrow
Declares that it is vital that high quality, compassionate palliative and end-of-life care is accessible across the country;
further declares that each person who is nearing the end of their life should feel safe in the knowledge they will receive the very best care and be supported to die peacefully and painlessly;
notes that in the Jarrow constituency, St Clare's hospice collapsed into insolvency in January 2019 after more than 30 years, leaving the borough without an end-of-life care facility;
and further notes that a petition requesting to keep palliative care at the Primrose Terrace site in Jarrow, rather than setting up an alternative site elsewhere within the borough, has received 13,500 signatures.
The petitioners therefore request that the House of Commons urge the Government to support the NHS South Tyneside Clinical Commissioning Group in reopening the St Clare’s hospice site at Primrose Terrace, Jarrow.
And the petitioners remain, etc.
As part of the programme of the Prime Minister and his inner circle to strengthen the rule of the elite through rearranging the state, Boris Johnson has appointed Simon Case to Head of the Civil Service, following the resignation of Sir Mark Sedwill . Case took up the role of Cabinet Secretary and Head of the Home Civil Service on September 9.
At 41 years old, Case is the youngest person to hold the position since 1916, and has had what could be described as a meteoric career in various parts of the state. Just nine years after joining the Civil Service in 2006, he became director of strategy for GCHQ , following which he served as Principal Private Secretary to Prime Ministers David Cameron and Theresa May from January 2016 to May 2017. At that point, he took up the post of Director General for the UK-EU Partnership, and also led the Cabinet Office Implementation Unit. In the same year, he was honoured as Commander of the Royal Victorian Order (CVO) by the Queen.
In January 2018, Case briefly became Director General Northern Ireland and Ireland in the (now-dissolved) Department for Exiting the EU; in July that year, he was appointed Private Secretary to the Duke of Cambridge, in which role he was central to the Royal PR machine . He was seconded from this role in May this year, just after the peak of the first Covid wave, to serve as Downing Street Permanent Secretary to the Prime Minister .
It is reported that Case was asked to make a formal application by Downing Street for the position as Head of the Civil Service , and that Boris Johnson, who works closely with the royal household according to his spokesman, discussed the appointment with the Duke .
The appointment is being seen as a political move, and the installation of a "yes man" by opponents. Shadow First Secretary of State Angela Rayner tweeted that the "problem with 'close allies' or some might say 'cronies' is that they often tend to say what you want to hear".
Moreover, it is part of the continuing "shake-up" of the Civil Service - what Johnson's Special Adviser Dominic Cummings called a "hard rain" following the resignation of Case's predecessor Sir Mark Sedwill in June. The past six months have seen the departure of five Permanent Secretaries. As well as Sedwill, Sir Philip Rutnam, Permanent Secretary at the Home Office, resigned in February, and is now suing the Home Office for constructive dismissal. Sir Simon McDonald, Permanent Under-Secretary at the Foreign and Commonwealth Office and Head of the Diplomatic Service, resigned "at the request" of the prime minister in June. Sir Richard Heaton, Permanent Secretary at the Ministry of Justice, resigned in July. And recently, Jonathan Slater, Permanent Secretary at the Department for Education, was sacked on August 26 following the A-level and GCSE fiasco.
The government is taking further the rearranging of the state around the concentration of political power in the inner circle of the Prime Minister; in the words of Cummings, "a smaller, more focused and more elite centre is needed". As George Monbiot recently put it , the government is reducing "rival centres of power", including the Civil Service, into "satellites of its own authority, controlled from the centre, deprived of independent action". In particular, the change of arrangements is to incorporate the Civil Service as an adjunct of this ruling elite .
The existing, old, arrangements are that the person of state rules over the people, and assumes the authority to act supposedly in the name of all, in a "democracy" divided between those who govern and those who are governed. Not only is it in crisis, riddled with factional infighting and unable to resolve conflicting powerful interests, the existing authority increasingly lacks legitimacy.
In this context, the government, and in particular the Prime Minister's inner circle, are changing the arrangements of the executive power of the state and its bureaucracy. In the name of "efficiency", they have been restructuring the state in the service of private interests, while concentrating power in the hands of the executive. They are seeking the individual personalities that can form the elite, who can deliver results and provide the right image or gloss.
In opposition, the will to be of the modern democratic personality, in which all speak in their own name, demands the alternative in which it can flourish. This alternative is expressing itself in the resistance, through which people are speaking in their own name and rejecting the existing authority. The alternative is one in which the working people themselves constitute the authority and decide matters directly.
This striving for the alternative is pointing to the need for mechanisms based on the vesting of decision-making power in the people themselves. The desperation to prevent this alternative from taking root is creating political chaos, for which the answer is being sought in the police powers and the rearrangement of the state around the wielding of those powers.
1. "Conflict Between Government and Civil Service: Head
of the Civil Service and National Security Adviser Steps Down", Workers'
Weekly, July 11, 2020
2. Camilla Tominey, "How Simon Case rose to the top of
the civil service", The Spectator, August 31, 2020
According to this article, "Case is also suspected of being the author of a Guardian piece by a senior GCHQ officer called 'Peter', explaining why the intelligence services needed to collect bulk data to do its work, which was published when he was working there."
3. According to Tominey's article cited above, "A year spent working on the difficult Northern Ireland borders issue made him want to leave politics for a quieter life at Kensington Palace in March 2018, two months before Harry and Meghan's wedding. Little did he know that the deteriorating relationship between the royal brothers would explode into a constitutional crisis, with the Duke and Duchess of Sussex stepping down as senior royals two years later. Case forged a close partnership with the Queen's private secretary, Sir Edward Young, the most powerful aide at Buckingham Palace, and became instrumental in elevating William's image as a statesman, to the disquiet of Harry, who felt pushed out. It is notable that on Case's watch William and Kate were revealed to have flown by budget airline to Balmoral, after Harry and Meghan had 'snubbed' the Queen to fly by private jet to Elton John's mansion in Nice."
4. Tominey further tells us: "In his role as Number 10's permanent secretary, Case oversaw anything Covid-related that crossed the Prime Minister's desk. He is being hailed as the man to rescue the government's erratic handling of the coronavirus crisis."
5. Alain Tolhurst, "Ex-private secretary to Prince
William set to be new Cabinet Secretary as Boris Johnson shakes up civil
service", PoliticsHome, September 1, 2020
6. "Simon Case confirmed as UK's top civil
servant", BBC News, 1 September 2020
7. George Monbiot, "For Your Eyes Only", personal
blog, September 4, 2020
8. "Reorganising the Arrangements of Government:
Cummings and Gove Push Ahead with their Overhaul of Whitehall and the Civil
Service", Workers' Weekly, July 25, 2020
Workers at biscuit manufacturer Burton's in Sighthill, Edinburgh, Scotland, struck work on Wednesday morning, September 9. It was the first of three 24-hour strike actions scheduled by the GMB union for September over the company's refusal to improve on a "derisory" pay offer. A socially-distanced picket line was set up at 6am Wednesday until 05.59 hours on Thursday morning, complying with the UK industrial action laws and Scottish government public health guidelines on Covid-19.
The biscuit manufacturer is owned by the Ontario Teachers' Pension Plan investment company which holds net assets worth $204.7 billion. More than 400 workers are employed at its Edinburgh factory, which makes around 7.5 million biscuits a day.
Workers at the plant voted by an overwhelming majority of 91 per cent for the industrial action. It not only shows their feeling but their unity. It deeply reflects their considered approach to resolving the problems. Much caution has been approached by their organisation to avoid confrontation but has been met with negative responses in talks, so actions have had to be stepped up. An indefinite tactical work to rule and overtime ban and a series of stoppages strikes are scheduled throughout September. These are carefully planned actions and escalations.
At the start of lockdown, the company was at the centre of a row over failing to meet government guidelines over physical distancing and PPE and pressurising staff to go to work.
In recent times, the workers have had to confront intransigent management to uphold their dignity. They have had to put up with insulting derisory pay-offers. The firm has exposed its blatant interests for profit alone disregarding the conditions of workers during and beyond the pandemic lockdown. On top of this, high-handed attitude and superior complex of looking down on the workforce and its representatives, have been features of the owners' indifference and outlook.
Workers interests for pay and conditions and refusal to be exploited emerges in their independent outlook and has materialised in their dignified protest. The GMB Union has accused the company of not valuing employees who are the wealth creators in the business.
Born on September 12 in 1924, Amílcar Cabral led the fight to overthrow Portuguese colonialism in Guinea-Bissau and Cape Verde.
by Hakim Adi
Greatness is an attribute best judged by circumstances. In every era, humans have had many apparently insuperable problems to overcome. Those who are great are those who can find solutions to these problems, or who can inspire others to solve them.
In the 20th century, most of Africa was faced with the task of liberating itself from foreign colonial rule. In many countries, a form of independence was achieved by the early 1960s. However, the dictatorial government of Portugal refused to acknowledge the rights of Africans to govern themselves in its colonies, which included Angola, Mozambique, Cape Verde and Portuguese Guinea (which became Guinea-Bissau after independence).
The struggle for independence in Guinea was led by the great Amílcar Cabral (1924-73), who also played a leading role in the liberation of Portugal's other colonies in Africa. He was one of the founders of the Movimento Popular Libertação de Angola (MPLA), and founder and leader of the Partido Africano para a Independência da Guiné e Capo-Verde. The armed liberation struggles that he led eventually resulted in revolution in Portugal and the start of a new democratic era in that country, too.
Cabral found ways to unite the nearly one million people of Guinea, women included, even though most were illiterate peasant farmers and they spoke different languages. With limited outside support, the people of Guinea fought to liberate their country and started to build a new society in which they themselves were the decision-makers. They did this even when parts of their country were still occupied by Portugal, which had the military support of Britain, the US and other NATO members.
Under Cabral's leadership, the people of Guinea achieved great advances - progress that induced the government of Portugal to plot to assassinate him. His murder was carried out in 1973, just before Guinea achieved independence from Portuguese colonial rule.
Many Africans continue to be inspired by Cabral's great leadership. His life and work show that, whatever the obstacles, the people are capable of being their own liberators.
(Hakim Adi is professor of the history of Africa and the African diaspora at the University of Chichester)
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