How can we build an effective campaign to defend the NHS?

The NHS is under attack as never before. Hospitals and other trusts are finding themselves 'in deficit' and being forced to make cuts and declare redundancies. Thousands of patients wait for treatment while doctors, nurses, midwives and other healthcare professions look for a job. There seems to be nothing safe from privatisation and 'outsourcing' whilst the NHS now employs more management consultants than the whole of manufacturing industry. The socialist answers the question:

Link up the many local campaigns into a national, democratically run campaign.

There have been protests and demonstrations in defence of the NHS all over the country. In the last few weeks the socialist has reported on demonstrations in Nottingham, Hastings, Leamington, Redditch, Southampton and many more. Tens of thousands of people have joined these demonstrations, including the 27,000 who marched through Hayle in Cornwall at the end of August.

Local campaigns are very important and play a vital role in mobilising and informing local communities about the attacks. They can score victories. In Stroud, a campaign of lobbies, petitions and demonstrations forced the local primary care trust to reverse its decision to close Stroud maternity hospital. But campaigners there realise they have to be vigilant to protect what they have won.

It seems like the health service is being attacked in a piecemeal way - one hospital forced to close wards here, community services cut there - but these attacks are part of the government's national policies, which need to be challenged nationally. They want to strip the health service down into convenient chunks, which can be privatised and run for profit.

We need to defend the whole health service. The NHS should be designed to meet the needs of the community now, not what the government's 'balance sheet' can withstand.

Already some local community campaigns have met and founded People United Save Hospitals (PUSH). This and any other similar initiatives, are to be welcomed.

We would argue that the key task for all such co-ordinating bodies is to build towards a mass national demonstration, with the date to be set before Christmas, involving the trade unions, community campaigns and all those who want to defend the NHS.

The demonstration and the TUC lobby of parliament on 1 November should be a step towards such a mass national demonstration.

The government declares that health trusts are 'in deficit', or that they have missed this or that target. They use this an excuse to demand massive cuts and closures and to bring in private companies to drive health workers' wages down and provide an inferior service.

But how can a hospital be in deficit? If people need hospital care it should be provided. We are living in the 21st century not the nineteenth, when if you couldn't pay you were left to fend for yourself. Workers fought for the setting up of the NHS, one of the greatest achievements since 1945.

When the Tories introduced the market into the NHS in 1990 it was the biggest single threat to those services. New Labour have picked up where the Tories left off - with further nonsensical 'marketisation' of health care, targets instead of real monitoring and accountability and the wholesale hiving off of successful and efficient services to the highest bidder. Priorities are being decided by accountants and management consultants, not healthcare professionals.

Action by health service workers and the health service trade unions, is key to winning the campaign.

One of the roles of community campaigns is to give confidence to health service workers that they have the support to take action at local level. And a national demonstration would link these campaigns and make them more effective.

But if a national demonstration does not force the government to change its policies, a national one-day strike of a health service workers, with emergency cover determined by the trade unions, would put real pressure on the government.

One of the few recent victories against low pay and the health service privateers has been that of the Whipps Cross hospital workers in east London.

These low-paid porters, cleaners and other ancillary workers took on their employer, Initial and through a campaign of strike action, forced them to end the two-tier workforce. Those workers would not have got their pay rise, sick pay and extra holidays without strike action. They even had go on strike for eight days this summer to force the company to abide by the deal they won through strike action in 2003.

Strike action would be an inspiration to all workers worried about what is happening to the NHS and it would show that the government cannot have it all its own way.

But the trade union leaders are doing their best to resist the pressure from below to organise a national demonstration and national industrial action.

They pay £ millions of their members' money to the Labour Party, saying this will give them 'influence' over Labour's policies. They believe that organising national protest action, even a demonstration, would spoil that relationship and cut across that 'influence'.

But all that millions of pounds-worth of 'influence' has not kept one nurse's job or prevented the closure of one ward.

Many trade union leaders are still clinging on to the idea that the Labour leadership can be persuaded to change their policies - and some are hoping against hope that a Gordon Brown-led Labour Party will be different.

But Gordon Brown's policies are the same as Tony Blair's - the working class must pay to make sure big business profits are protected. The public sector is bad, the private sector is good. This is behind the drive to hive as much as possible of the NHS off to the major 'healthcare' companies.

The campaign must challenge and expose the government's policies.

The Labour Party is now a big business party, of privatisation and cuts - the same as the Tories and the Liberal Democrats.

In many areas, MPs are jumping on the 'save the NHS' bandwagon because they are scared of losing their seats. But they still back the key policies of their party leaders - which inevitably mean the cuts and privatisation we are fighting against.

That's why the Socialist Party has launched the Campaign for a New Workers' Party to begin the task of building a party which represents the interests of the working class, that fights for the public services we all need, not just what capitalism thinks it can afford.

We believe the only way the health service can be defended and rebuilt into the service we need for the 21st century is to fight around a socialist programme. £10 billion a year - 14% of NHS expenditure - is taken by the pharmaceutical industry. The big construction companies like Balfour Beatty, Tarmac and Jarvis are all making fortunes out of NHS contracts, especially through the Private Finance Initiative.

Accountants and management consultants like KPMG and PricewaterhouseCoopers have all found themselves lucrative niches in the health service. And of course private healthcare companies like Kaiser Permanente are now flooding over from the USA to join their pals in BUPA and the others in taking a profit from the health service.

These companies should be taken over and run democratically by healthcare workers and the wider community. Instead of their profits being used to line the pockets of their shareholders, these billions could be used to provide a modern health service we can all be proud of.

A socialist democratically planned and run economy could provide good housing and education, a safe environment, a shorter working week and a real living wage for all. An end to the profit system is the only way an efficient and effective health service can be guaranteed.