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Editorial of the Socialist
Tories make token changes - save the NHS
As the Socialist goes to press ministers have accepted the 'changes' to the proposed NHS reform. These recommendations, in reality mere tokens, from the Future Forum Report, follow a ten-week consultation or 'listening exercise' to review the government's Health and Social Care Bill.
The Bill, which effectively proposed the breaking up of the NHS, massive privatisation and fundamentally removing the duty of care to provide the health service in Part 1, Section 1, Clause 1 of the Bill, met with huge anger.
So much so that the Con-Dem coalition took what some have described as an unprecedented decision to halt the parliamentary progress of the Bill, revealing, like their previous u-turns, that this government can be forced back.
However, the changes to the Bill are mostly superficial, continuing in support of privatisation. Andrew Lansley, Tory health secretary told Tory MPs that the 'core principles' of his reforms will remain in place.
One Tory told the Guardian: "Andrew is saying stick with me because the Tory red lines have not been crossed and his main aims - to give GPs commissioning powers and to encourage greater competition - will remain... Andrew can carry on. He will just have to move at a slower pace."
According to the BBC website the changes will also include: reinstating the legal responsibility of the health secretary for the overall performance of the NHS; relaxing the 2013 deadline for the new GP commissioning arrangements to be introduced; strengthening the power of health and well-being boards, which are being set up by councils, to oversee commissioning and giving patients a greater role on them; retaining a lead role for GPs in decision-making, but boosting the role of other professionals alongside them.
Basically the government appears to be proposing to relax the timelines and have token wider involvement in its consortiums, mainly of hospital doctors and nurses. But recently 95% of nurses told a survey that they already worked over their contracted hours - 20% did that on every shift. Nurses were working when they were unwell.
Unite the trade union correctly comments that the 'pause' was to "enable the government's plans to be better sold, rather than the Health and Social Care Bill to be substantially changed or stopped".
The regulator Monitor will no longer have a primary duty to promote competition, instead being tasked with ensuring "patients have choice to drive up standards". Choice is just code for privatisation. What is 'patient choice' in the context of up to £30 billion of cuts?
Who even knew about the "listening exercise"? YouGov research revealed that 95% of the public had no idea how to get involved with the listening exercise. Most events were stage-managed (as shown in the report on page 10) and closed to the public.
The Future Forum was unrepresentative with no input from trade unions or those GPs who are critical of the Bill. Professor Steve Field, Sir Stephen Bubb and other health 'experts' were hand-picked to lead this forum because they supported the government plans.
John Healy, Labour shadow health secretary, said that the "ideological plan to turn the NHS into a market, to open up all parts of the NHS to private companies will remain". He forgot to mention that Labour had carried through unprecedented privatisation in the health service when in power.
In fact Healy himself announced there was nothing wrong with PFI privatisation in the NHS when he spoke at the Unison health conference earlier this year. Labour will vote against the bill, whatever the changes, but puts forward no alternative to it.
Nick Clegg and the Liberal Democrats are trying to take the credit for changes to the Bill. Clegg said their demands had been "handsomely met" but on Twitter explained that: "This is still a major reform of the NHS. We've never been against reform. We've always been in favour of the right kind of reform".
Lib Dem ministers voted the Health and Social Care Bill through when it came before parliament and only raised opposition after they received a thumping in the 5 May elections.
It became clear to the entire coalition that there was overwhelming opposition to the Bill. Most people are not fooled by the government's rhetoric or Cameron's alleged 'love' of the NHS. Most people also oppose privatisation and are determined to save our NHS.
Even as the 'listening' went on the cuts sliced through NHS services. For example three psychiatric hospitals are to close in Liverpool. Hundreds of nursing and other posts are being axed. Cuts to health services are everywhere.
The NHS in England is still on course to suffer the biggest 'savings', in reality life-endangering cuts, in its history. The NHS cuts in Wales will be even more devastating with an 11% cut budgeted for compared to 4% in England.
Health and other trade unions should now organise their own forum on the NHS alongside groups campaigning to save our health service from big business. Its aim should be to organise a national demonstration to save our NHS, as well as campaigning for the preparation of a one-day public sector strike to defend the NHS and public sector jobs and pensions and all services. This could be a powerful first step in the battle.
As the cuts in jobs and public services begin to be widely felt the working class is beginning to show its anger and willingness to fight back. In Southampton over 1,000 council workers, striking Medirest cleaners, and their supporters marched on Monday 13 June against council cuts and privatisation in the NHS. Teachers have voted overwhelmingly for strike action against brutal pension cuts.
As the working class in Britain begins to flex its muscles the urgent need for it to also have its own political voice is increasingly clear.
As the Socialist has argued previously there is an alternative. That is to build a mass campaign to defend and rebuild the NHS and to place it under popular and democratic control. We need a new mass workers' party that will fight for a fully-funded NHS, free of all threats of privatisation, and linked to a socialist democratic planned economy.
The Socialist Party calls for:
- No cuts. Stop Lansley's Health and Social Care Bill.
- A well-funded service, free at the point of use, to provide for everyone's health needs.
- End big business profiteering from the NHS! Abandon the Private Finance Initiative (PFI). No to private polyclinics and GP consortiums. End 'payment by results'.
- Take all health services and buildings back from big business and place them under public ownership. Publicly fund and integrate them with the rest of the NHS.
- Nationalise the pharmaceutical and medical supply industries, and all private health providers, with compensation paid only on the basis of proven need. Bring them under working class control and management.
- Abolish Foundation Trusts. For democratic control of local health services by elected health workers and community representatives as well as elected representatives from local and national government.
- End NHS job losses and low pay. For a 35-hour week without loss of pay. Give health workers an above-inflation pay increase. No pension cuts.
- For united action to defend the NHS, with organised trade union action at its centre, supported by anti-cuts campaigns and service users.
- For a new mass workers' party to fight for the NHS and against cuts and privatisation.
- For a socialist programme and a planned economy to end poverty, bad housing, unemployment, dangerous workplaces, pollution and inequality - the biggest killers and causes of ill health.