Join the Socialist Party Join us today!

Printable version Printable version

Facebook   Twitter

Link to this page:

From The Socialist newspaper, 12 March 2008

Hospital trusts... who makes the decisions?

"THE NHS of the future will be one of patient power; patients engaged and taking greater control over their own health and their healthcare too." This was said by prime minister Gordon Brown, as reported in the guardian on 7 January 2008.

Hugh Caffrey, Manchester Socialist Party

However, only last summer, I read in the Manchester Evening News: "Health bosses at Wythenshawe Hospital have voted to stop holding monthly board meetings in public, in order to protect commercial information".

So what does Brown's "patient power" mean in practise? While his cronies take hospital management further out of the public eye, he is going to abolish the 'public-patient involvement forums' (PPFIs) that patients currently exercise limited 'power' through.

This year, all National Health Service trusts will become Foundation trusts, moving further from the remnants of democratic control and closer towards the private sector. As the Manchester Evening News noted: "NHS hospitals are required to hold open meetings unless discussing sensitive information. But Wythenshawe has more freedom because it is a Foundation Trust".

Other Foundation trusts have done the same. They are driven by profit, with "growing numbers setting up joint ventures, special purpose vehicles and charities to get around a legislative cap on the amount of money they can earn from private patients" (Financial Times 1/2/08).

New Labour tries to hide privatisation behind their version of democracy. Trusts have 'members' - staff and others, who elect a minimum of 51% of hospital 'governors', including one staff representative. Almost anyone can be a member, but the governors cannot be held accountable. And staff are banned from the board of directors, which actually makes the decisions.

With up to 49% of governors being appointed by NHS bosses, local politicians, and 'partner organisations', such committees are easily stacked in favour of the trust.

To ensure no-one steps out of the pro-privatisation line, the trust regulator can fire governors and directors, and appoint more directors. One study summed this up as: "a transfer of ownership and control from the Secretary of State to independent corporations... the claim about local control is not supported by the arrangements... NHS consultative and complaints machinery is waived for Foundation Trusts" (Pollock & Price, In Place of Bevan?, 2003).

The government engineered a reorganisation of the NHS in 2003 to push many hospitals towards privatisation and ensure those in charge could do so without obstruction. Soon, all 400 public-patient involvement forums will be abolished.

The replacement 'local involvement networks' (LINks) will have less funding, channelled via local authorities, and their 'hosts' could be any of a number of voluntary-sector bodies.

Anti-cuts campaigner Judie Collins, member of Trafford PPIF, said in a personal capacity: "The abolishing of PPI forums is a nightmare. The trusts aren't actually forming a farewell committee to wave us off but it's a close run thing. I think hardly any councils are prepared for LINks. Meanwhile Trafford health trust are closing wards and flogging them off to other trusts to lessen the debt. Staff are having aspirational interviews and we all know what that means!"

Privatised NHS

The Tories and New Labour have consistently eroded any means of democratic control over the direction of our NHS. Community health councils had to be consulted by NHS bodies over major changes, and if they disagreed, could refer them to the government. Community health councils were abolished. PPIFs were introduced to cut across opposition - but they didn't, so now they too are being scrapped.

Under New Labour's agenda, private health companies are certain to gain. The miserable 'choice' increasingly offered to us is a privatised NHS, profitably absorbed by the private sector, or a privatised NHS bankrupted by the private sector. The bosses' newspaper, the Financial Times, actually debated (15.11.07) which would be best!

What is to be done? Workers need to reclaim their unions, especially Unison. Nationally, left candidates, including Socialist Party members, are standing for the Unison health service group executive.

Legal challenges and tribunals are no substitute for a national campaign. At workplace level, a stronger solidarity network between groups of health workers can prepare a serious struggle.

The NHS was won in the first place by tremendous pressure from working-class people.

Now it can only be saved in the same way it was won. Starting with the vital community campaigns and the 250,000+ people who have participated in local demonstrations, linking up with health workers and others, a united movement can be built.

Elected in Kidderminster, Huddersfield and elsewhere, anti-cuts campaigns have shown we can defeat the representatives of the pro-cuts parties.

This May's council and assembly elections should see the widest possible expansion of this. Winning local elections can significantly boost local campaigns. More broadly, workers and campaigners need a mass new party, a platform for organising and fighting.

The NHS can only be rebuilt as a public service; the capitalist market cannot organise health care for all. Private health companies like BUPA and the pharmeceutical multinationals should be nationalised and integrated into a socialist plan for health care.

Waste and bureaucracy can be combated through democratic control by elected representatives of staff, patients and the wider community both locally and nationally.

Huge resources exist, enough to provide a high class health service for everyone. But a small number of millionaires, shareholders and rotten politicians stand in the way. They haven't yet killed the NHS. But with every cut, the need for a unified national movement and a socialist alternative becomes more urgent. Join us to fight for it!

Why not click here to join the Socialist Party, or click here to donate to the Socialist Party.

In The Socialist 12 March 2008:


End the occupation

Gaza - end the bloodshed!

Iraq, Afghanistan: The bitter fruits of war and occupation

School student strikes

US & UK students in anti-war protest

Workplace news and analysis

Fight for a living wage!

Coastguards strike

Land Registry votes to reject pay offer

Wales further education pay dispute: Vote 'yes' in strike ballot

Shelter workers' strike success

Prison officers reject pay offer

March for pay justice

Socialist Party NHS campaign

Derby nurses fight PFI pay cuts

Hospital trusts... who makes the decisions?

Cuts continue despite financial surpluses

Post Office closures

Stroud - Save our post office!

London - Fight the closures

Socialist Party feature

World's poor hit by rocketing food prices

International socialist news

New period of workers' militancy in Germany

Socialist Party review

Profit motive and the whispering wind


Home   |   The Socialist 12 March 2008   |   Join the Socialist Party

Subscribe   |   Donate  

Related links:


triangleNHS meltdown - fight the Tory cuts

triangleNHS secret cuts plans exposed

triangleNHS cyberattack: budget cuts and spy agency to blame

triangleCuts, profit and bureaucracy lead to 50% rise in mental health deaths

triangle40% of GPs plan to quit - reverse all NHS cuts and sell-offs!


triangleNorth London hospital workers fight cuts and job losses

triangleUprising to save the NHS!

triangleNo cuts - hands off King George A&E!

triangleTories wreck our NHS


triangleObesity epidemic: end food market anarchy

triangleTories scrap the NHS pay cap: now fight for real-terms pay rises!

triangleOne in four teenage girls depressed - crisis made worse by cuts


triangleNasty party out the Tories

triangleCarlisle NHS campaigners hand in petition to MP


triangleArriva North West bus drivers strike over pay

Gordon Brown:

triangleHow Blairism sank its claws into the Labour Party

Reports and campaigns

Reports and campaigns


North West

Arriva North West bus drivers strike over pay


Democratic rights

Conference on state spies: who's watching who?



Striking back against sackers' charter at Leeds Uni


Royal Mail

Royal Mail bosses block strike - back postal workers



Balloting members on the pay cap



'Dazzling' Bad Art show points to socialist future



Sheffield Labour council threatens peaceful protesters with prison


South West Wales

Hundreds turn out for rally aimed at removing west Wales Tory MP



Uprising to save the NHS!



Can you donate to the Socialism 2017 appeal?


East London

No cuts - hands off King George A&E!


North London

North London hospital workers fight cuts and job losses



Nationalise to save jobs at BAE Systems



Schools "can't go any further" - stop the cuts: set deficit budgets now



Socialist Students 'welcome' Hillary Clinton to Swansea

triangleMore Reports and campaigns articles...

Join the Socialist Party
Subscribe to Socialist Party publications
Donate to the Socialist Party

triangle19 Oct Arriva North West bus drivers strike over pay

triangle18 Oct Russia, October 1917: When workers took power

triangle18 Oct Tories torn - bin them now

triangle18 Oct Royal Mail bosses block strike - back postal workers

triangle18 Oct Balloting members on the pay cap

triangle13 Oct The end of the Tories?

triangle11 Oct Nasty party out the Tories

More ...

triangle21 Oct Birmingham: NSSN Solidarity Forum

triangle23 Oct Chesterfield Socialist Party: The continuing struggle for abortion rights

triangle24 Oct Liverpool Socialist Party: The October Russian Revolution 100 years ago to the day

triangle25 Oct Salford Socialist Party: The October 1917 Russian revolution

More ...

Socialist Party Facebook page
Socialist Party on Twitter
Visit us on Youtube



October 2017

September 2017

August 2017

July 2017

June 2017

May 2017

April 2017

March 2017

February 2017

January 2017





















Platform setting: = No platform choice