The Socialist 11 April 2018 |
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May elections: a chance to fight attacks on health and social care
Councils have real legal powers they can use to forestall health cuts and sell-offs, photo by Mary Finch (Click to enlarge)
Here's how councils can stop health cuts
Mike Forster, vice-chair, Health Campaigns Together (personal capacity)
Too often, councils will wring their hands and pass the buck when it comes to standing up to Tory plans for our NHS. But they have real power to halt NHS cuts and sell-offs and help build campaigns to beat them.
All councillors have a statutory duty to scrutinise the work of local health 'trusts', which run hospital services, and local 'clinical commissioning groups' (CCGs), which decide on things like funding and outsourcing for the area.
Some councils have representatives on 'health boards', meant to coordinate NHS services in an area. But even if they don't, councils have powerful statutory 'joint overview and scrutiny committees' which oversee any proposals to 'reconfigure' NHS services.
They can exercise that power forcefully and veto plans for cuts or privatisation by trusts or CCGs, although the final say rests with the government's health secretary to review.
All health boards in England are drawing up plans to cut and merge services, under instruction from the Tories. These are the misnamed 'sustainability and transformation plans' (STPs).
Councils can refuse to endorse STPs - and are the only public body with the statutory power to do so. Some councils will happily refuse to endorse STPs, but so far they are a minority.
Councils can also initiate legal actions like 'judicial reviews', where a judge decides if the way a public body reached a decision was lawful. Councils can do this on their own - or jointly with campaign groups, like in south London a few years ago as part of the successful campaign to save Lewisham Hospital.
Tory health and social care secretary Jeremy Hunt is also encouraging NHS trusts to set up 'accountable care organisations' (ACOs). This is just a fancy title for new bodies which are neither accountable nor caring.
The idea comes from the US healthcare system. ACOs are health service providers, or groups of them, public or private, which take a single contract to provide all health services in a given area. In reality, they are a vehicle for large-scale NHS privatisation.
Once again, councillors have the power to slow down or halt these plans. Disgracefully, too many councils are failing to stand up to them - some are even colluding with them.
Finally, councils are financially responsible for providing adult social care. The Tories have already slashed this budget to the tune of £6 billion since 2010, according to the Association of Directors of Adult Social Services.
This has put intolerable pressure on care services, and has led to what the NHS refers to as 'bed blocking'. More cuts are on the way and must be resisted.
Hunt is now talking about reforming the budget. But without a massive injection of funding, adult social care will collapse.
Councils must refuse to pass on these cuts. By using reserves and borrowing powers, councils can hold cuts off, and build campaigns with unions and local residents to pressure the government for proper funding.
In the 3 May local elections, the pledge to set no-cuts budgets, and use council powers to stop NHS cuts and sell-offs, is shared by all candidates standing for the Trade Unionist and Socialist Coalition (TUSC) - the anti-austerity electoral alliance including transport union RMT and the Socialist Party.
Any Labour candidates who oppose austerity should pledge the same, and Jeremy Corbyn should call on them to do so.
Health Campaigns Together has produced an excellent briefing for councillors, Into the Red Zone, available at healthcampaignstogether.com/redzone.php. It's thorough and detailed, but it summarises the cuts programme we all now face - and how councils must face up to it.
The Socialist Party demands:
- Reject STPs and ACOs
- Reverse budget cuts and outsourcing in social care
- Use legal powers to stop cuts and sell-offs in NHS and council services
- Fight for a fully funded, publicly owned, socialist NHS, free for all at the point of use
Striking Birmingham carers need pro-worker councillors
Birmingham Socialist Party
Birmingham City Council, led by Labour, is continuing its austerity attacks on workers and the community without putting up an ounce of fight against the Tory government.
After last year's humiliating defeat by striking bin workers, you would expect the council to have retreated with its tail between its legs. Instead it's decided to attack the conditions of the low-paid and predominantly women workforce in home care, as well as reducing the service by at least 40%.
Birmingham home care workers have been on strike over changes to their rotas after the council introduced an unrealistic and chaotic three-split-shift rota, obviously a tactic to push workers out of the profession as a precursor to more cuts or privatisation.
They face daily bullying by senior management, telling them to either accept the new rotas or find a job somewhere else.
Strikers demand that the council scrap the three split shifts and instead introduce self-rostering, where the workers themselves collectively decide their schedule.
On 24 March the home carers went on their first full day of strike action, with six picket lines across the city, including campaign stalls to reach the wider public with information on why they were striking. They are gathering signatures to send to local councillors standing again in May.
What was noticeable was strikers' fury at councillors for allowing these attacks in the first place - and additionally that this was done in the name of Labour. They feel betrayed.
The common sentiment was that if Labour councillors aren't going to defend our jobs and the service, they should be replaced with someone who will! This sentiment was also put forward by the bin workers during their dispute last year.
It is clear to these workers that Jeremy Corbyn's anti-austerity message has not filtered down into the right-wing Labour Party machine in Birmingham Council. The home care dispute is one reason of many why TUSC is fielding candidates against pro-austerity Labour candidates in the 3 May elections.
All TUSC candidates wholeheartedly support the demands of the home carers.
We will fight these and any further cuts, as well as management's culture of bullying - but we will also demand more funding from central government to reverse cuts already carried out.
Councillors must oppose NHS cuts in deeds as well as words
Matt Hirst, Huddersfield Socialist Party
Throughout the campaign to save 400 beds and emergency care at Huddersfield Royal Infirmary (HRI), local councillors of all political colours have come out on occasion in support. The Hands Off HRI campaign welcomed them joining the fight.
No party in Kirklees Council has a majority. Labour is the largest party but needs support from the Tories, Lib Dems, Greens or independents to push things through. Every major local party is using the Hands Off HRI logo on their campaigning leaflets - without the campaign steering committee's permission.
This is despite not taking up requests from the campaign for the council to join our legal challenge, which will now progress to a judicial review.
What the right-wing Labour candidates will not put on their election leaflets is how in their February budget they passed through over £200,000 in preventative health cuts. This included smoking cessation, combating obesity and physical activity.
Kirklees Labour councillors standing alongside us and shouting "no ifs, no buts, no NHS cuts." Yet back inside the town hall, they pass cuts not just to health services, but across the board.
Many campaigners now see these councillors for what they are. They are happy to jump on a campaign bandwagon to further their chances of election on 3 May. However, they are not so willing to put in the hard work that goes into taking that campaign to victory.
TUSC is standing two candidates who are prominent activists for the campaign. But unlike the other candidates, we say fight all cuts to services.