30 years of Health EmergencyTuesday 8th April 2014
30 years ago the first issue of Health Emergency newspaper was published by the GLC-funded London Health Emergency campaign. Its purpose from the outset was to reach out to trade unions and campaigners beyond the capital, and to build a fightback against cuts and privatisation.
Health Emergency won affiliations from all of the health unions, many of them working with us at national level.
After the GLC was abolished two years later, LHE was funded as a source of independent information on the NHS for another 12 years by various London boroughs - while the campaigning work has from then on always been financed fromy affiliation fees, donations, and later by commissioned work for the unions.
This has enabled us to be at the forefront of the fight on every major issue in three decades of camaigning.
The governments have changed, the ministers have changed, the unions have changed - but 30 years later, with no grant funding, LHE is still functioning, despite the efforts of some who do not share our principles to close us down - and Health Emergency exists as an occasional newspaper, a website, a wealth of experience and published material, and as a consistent voice fighting privatisation in all its forms.
Health Emergency could not have survived this length of time and these pressures without the loyal support of activists - and some courageous officials - in the health unions who have stood by us, made donations, organised campaigns, commissioned work. They are the real spirit of the NHS.
Now we are faced with the most reactionary Tory-led government in living memory, with the NHS fighting for its life against threats of a decade-long freeze on funding, the deliberate fragmentation of the NHS and privatisation of the Health & Social Care Act – with the dead hand of Blairism still blocking Labour from a full-blooded campaign to defend our most popular public service.
Health Emergency is proud to stand firm with its supporters, to defy its detractors, and to wage the key fight in the next 12 months to ensure that Cameron and all remnants of the vicious coalition are removed from office, and that the government that takes over commits itself it advance to break from Tory cash limits, reverse the Health & Social Care Act, restore the duty of the Secretary of State to provide universal health care, clear out the private profiteers, and put our NHS back together.
We remain a non-party political campaign: this means we will work with anyone from any party or none who will fight to keep our NHS fully funded, and keep it public: and we are also proud to work with Keep Our NHS Public, the campaign that emerged from the fight against Labour's market reforms, and remains at the centre of the fight against the Tory attacks today.
We know that on these issues we have majority support: the challenge is to translate that into a movement that can defend the NHS and defeat the aims of the current government.
Together we can win!
Peoples Inquiry into London's NHSWednesday 19th March 2014
The People's Inquiry into London's NHS, supported by Unite the Union, held seven public hearings in the final months of 2013, heard from 95 witnesses plus many more written submissions and compiled over 140,000 words of evidence in transcripts.
The Inquiry's independent 6-strong panel has since deliberated over the information they accumulated and formulated 18 unanimous recommendations.
The full Report from the Inquiry, London's NHS at the Crossroads, is to be published on Thursday March 20, and the report and summary will be available online.
The Panel invites further discussion and comment on the Report and in particular on the conclusions, which aim to shape policy for this and future governments.
One thing that emerged clearly from the Inquiry was that while London as Europe's biggest and most diverse city is unique, its problems with government spending limits and the coalition government's half-baked "reforms" in the Health & Social Care Act are not a special case.
Almost all of London's problems can also be found in other parts of the country: the recommendations therefore call for national action as well as specific intervention to prevent the capital's health services deteriorating as a result of squeezed budgets and organisational fragmentation.
The Inquiry can be contacted at www.peoplesinquiry.org
Join the Protest, Join the Lobby!Tuesday 18th February 2014
Thursday 27 February
Stop the Hospital
Closure Clause - 118!
10.30am - Protest & Handing in Petition to Downing St
11.30am - Protest & Rally, College Green (opp Parliament).
12.30pm - Inside Parliament for meeting
* Andy Burnham MP, Shadow Health Secretary,
* Louise Irvine, Save Lewisham Hospital Campaign & London MEP candidate for National Health Action Party
* Dr Kailash Chand, Deputy Chair of the BMA,
* Dr DavidWrigley, GPC BMA,
* Caroline Molloy, Editor of OurNHS
Having lost the battle to close Lewisham Hospital the Government are now attempting to change the law. They are rushing through the 'Hospital Closure Clause' - Clause 118 of the Care Bill - making it legal to close any thriving, solvent hospital whenever they want to.
JOIN the protest, join the lobby.
WRITE to your MP
(see model letter at www.savelewishamhospital.com)
Hunt has substituted double-speak and deception for action on Francis reportWednesday 5th February 2014
One year after the Francis Report put forward a massive 200 recommendations for action to prevent the recurrence of the catastrophic failures of care arising from cash-driven cuts in Mid Staffordshire Hospitals Foundation Trust, the danger of further failures is greater than ever.
Dozens of NHS Trusts, seeking as Mid Staffs did to make massive and rapid cuts in spending to meet the criteria for Foundation status, are struggling against the stream of flatline NHS funding and soaring pressures on services: the biggest of all, Barts Health is cutting back on skilled and experienced nursing staff – regardless of quality concerns – as it seeks £77m of “savings” this year. Many Foundation trusts, too are struggling to survive financially. They all face another six years at least of frozen funding under George Osborne’s brutal spending limits.
On staffing levels, as with every one of his claimed achievements, Hunt’s solution has simply been to dump the problem onto others. He has refused to impose a minimum nurse staffing level, resorting instead to the publication of figures without anything to compare them against.
He boasts about increases in nurse numbers in acute hospitals, but ignores the fact that there has been a corresponding cut in community health care – to which ministers are trying to divert patients – and the fact that the result is draining even more resources from mental health care, which is now being cut back each year while the government covers up by scrapping the collection of figures.
Hunt’s warm words about whistleblowers have not been coupled with any measures to protect potential whistleblowers under his own government: already Barts Trust has publicly sacked one prominent union activist, Charlotte Monro, after 26 years unblemished service, for speaking out on cuts to the local council’s health & scrutiny committee. The real message is clear: speak out and desperate managers will victimise or sack you, while ministers look on, mouthing platitudes about a "duty of candour".
Sacking managers, pillorying “failing” trusts, and putting increasingly impossible demands on front line nursing and clinical staff to keep the system going while Osborne starves the NHS of the funding it needs is not the way to establish a sustainable, safe and reliable system.
The cash squeeze is so brutal that even McKinsey, Monitor and NHS England have not been able to address the staffing consequences of the massive continued reduction in payroll costs required bridge the yawning gap between resources and demands. yet staffing levels are key to the quality and safety of health care.
The target for cash "savings" involves annual cuts until 2021 in the prices paid to trusts for front line services, where 70% of trust spending is on staff. This intensified onslaught on jobs, pay, skill mix, terms and conditions comes after four yours of pay cuts have slashed 16% from the value of NHS pay, leaving health workers weary, demoralised and bitter. Meanwhile David Cameron battles on in the EU to protect lavish bonuses for bankers, and rejects Labour's call for an extra 5% tax to be paid on earnings over £150,000 a year.
The funding squeeze is making the the NHS unsustainable. Without a break from this and serious increases in front line resources there will be more failures and scandals – which we know will be exploited to the full by Hunt. In the past the Tory Health Secretary has made no secret of his own ambition to discredit the NHS – and open the door for private medicine and health insurance.
The latest hypocritical nonsense on Francis should be dismissed with contempt by all who care for the NHS. The NHS needs more money, an end to the wasteful fragmentation of the Tory market reforms, and a government that supports its basic principles as a public service rather than working to break off profitable slices for the private sector.
A challenge for 2014Wednesday 1st January 2014
The end of 2013 came in the same way as the year began, with the Tory-led coalition driving through massive cuts in our NHS and public services, coupled with unprecedented levels of privatisation.
In January we were still waiting to see if Jeremy Hunt would rubber stamp the brutal plans of the Trust Special Administrator to close 60% of Lewisham Hospital and bulldoze that much of the site to help bail out the failing South London Healthcare Trust next door: in December, having tried to do so, and having lost twice in court to legal challenges to his right to make these cuts, Hunt is pressing for changes to the law to give arbitrary powers to cut, downsize and reorganise any hospital in the vicinity of a failing trust.
In January we were waiting to see the results of the implementation of the Health & Social Care Act: by December we can see a chaotic picture in which many arrogant, remote Clinical Commissioning Groups - in many cases "led" by just a handful of self-interested local GPs -- are pressing ahead with competitive tendering. Some are even drawing up huge and complex tendering processes for "integrated pathways of care" that threaten to create new, private monopolies at the expense of existing public services - with no consideration of the impact on local NHS providers, and no attempt at public consultation.
One CCG in Bedfordshire is planning to sign a contract for Musculoskeletal Services with a privately-led consortium that includes a company set up and owned by local GPs. Windfall profits for some Bedfordshire GPs could therefore come at the cost of axing services in Bedford Hospital, obliging patients to trek an extra 17 miles for services to Luton & Dunstable. Asked about the obvious conflict of interest, the CCG's only answer was to argue that the decision was taken by "consensus" (so no votes had been required), and to insist even now that the final contract has not yet been signed.
Cambridgeshire CCG -- advised and effectively led by relics of the old privatising Strategic Projects Unit of the now abolished East of England Strategic Health Authority -- is planning the biggest-ever privatisation: another "integrated pathway", for all services relating to elderly care, worth up to £800m over five years.
The plan drew bids from ten consortia, but the massive and complex document setting out the terms of the contract made clear there would be no extra money on the table, and that 15% of the total value would be conditional on meeting various "outcomes". To make matters worse, the winners would have to share any "excess profits" with the CCG!
Faced with this, two of the ten consortia have already pulled out, including the one led by Capita that included Cambridgeshire Community Services, the Trust which has been delivering the majority of these services. CCS has now thrown in its lot with the bid from the predatory Optum, the company previously known as United Health, the US-owned former employer of the incoming chief executive of NHS England, Simon Stevens. So it's clear that whoever wins will effectively be a new provider.
However it's also clear that since there's no more money on the table for what are already poorly-resourced services, no profit can be made from the contract unless savings are made either through reducing numbers of more qualified staff, down-banding them to cut the wage bill, or increasing workloads - almost inevitably at the expense of falling quality of care.
All of which might be expected to mean that the CCG would consult local people on these proposals and the implications for future services: but again no consultation is proposed. The CCG does not want to know local people's views.
Nor does the CCG want to address concerns over what would happen to the various services (most notably community health services for children) that would be left adrift if this big lump of Cambridgeshire Community Services is broken off and handed over to a privately-led consortium. There appears to be consideration of the fact that by handing this whole "pathway of care" over to one consortium, any notion of "choice" for patients in Cambridgeshire and Peterborough would be killed off for at least five years. The new providers would be a real monopoly, subject to no public accountability. What happens if they fail - as more and more private providers are doing? What option is there to bring the service back into NHS control?
But while these bureaucratic horrors multiply in the post Lansley NHS there are even bigger potential horrors being lined up by a bizarre alliance of David Cameron, Barack Obama and the EU. The Transatlantic Trade and Investment Partnership, being hatched up behind closed doors by unelected EU bureaucrats, with Cameron's explicit support, masquerades as a means to generate jobs in the EU, but in practice threatens to open up British health care to the greedy claws of US health corporations seeking easy profits.
The plan is being driven through with minimal public awareness or debate: there is little sign that Cameron's Euro-sceptic backbenchers are aware of the extra powers and control being signed away, under the direction of the Brussels bureaucrats they claim to despise. UKIP is strangely silent. The europhobic Daily Mail and Sun apparently have no view as the proposals take shape.
The big unions have now recognised the danger to public services: Unite, UNISON and other unions have made clear their opposition to any attempt to open up health to the greedy clutched of US multinational corporations, and this has shifted the TUC away from its previous naïve acceptance of the ostensible plan to jobs and investment. Labour leaders too have started to ask critical questions, although there is no clear policy as yet.
Meanwhile there is mounting evidence of the social cost of the EU's horrendously unaccountable, undemocratic bureaucracy lining up increasingly blatantly behind brutal neoliberal policies: the most obvious example is the establishment under German leadership of the "troika" of EU commissioners, the IMF and the European Central Bank to impose savage austerity on Ireland, Greece, Portugal and Cyprus under the guise of a "bail-out" package.
In both Greece and Portugal this has involved especially vicious cutbacks in health spending and public sector health jobs. In Greece a 30 percent cut in spending has run alongside a 50 percent increase in "outsourcing" of contracts. In both countries new and increased charges have been imposed for drugs and treatment, while grim statistics chart the fall in life expectancy, the rise in sickness, suicide and even in Greece the return of malaria.
These policies are being driven by the arrogant Finnish commissioner Olly &&&&&, a failed right wing politician in his own country, who with German patronage has been elevated to high office in the completely unaccountable EU machinery. &&&&& has easily survived the abject failure of his proclaimed economic objectives in Greece and Portugal, which have prolonged and deepened the recession, and hit none of their apparent targets.
But it's more sensible to regard the EU intervention, like Osborne's austerity plan, not so much as an effort to restore the economy but more of a deliberate attempt to take advantage of the situation to drive through far-reaching neoliberal policies, privatisation, reductions in state spending, and destabilisation of pay, pensions and welfare benefits.
This is not blundering bureaucracy, but capitalism red in tooth and claw, prising back open markets that have been dominated by state spending and public provision for half a century or more in much of Europe. This is the rich and super-rich reasserting their power and privilege at the expense of everyone else.
To inflict a delay or a setback to the Transatlantic Treaty would be an important step in halting this effort to turn back the wheel of history. The Treaty aims to create a new, irreversible fait accompli, in which competition laws and the "rights" of corporations are dominant, and the needs and interests of the majority are subordinated to market forces.
The control over public services, and public budgets, like our NHS itself, is under threat. 2014 is the crunch year for fighting back.
Once it's gone, it could be gone forever. Don't let them get away with it!
Let's renew the fight to keep our NHS and similar health services around the world - and keep them in public hands.
Best wishes for the new year.
Pace hots up as Tory Health & Social Care Act shows its teethMonday 4th November 2013
October was one of those months: the big news just kept on happening, and the growing crisis gripping the NHS has become more and more obvious.
To make matters worse, an architect of Labour's costly market-style "reforms," former Blair advisor Simon Stevens - who has for nine years been a high-flying director of the biggest US health insurer UnitedHealth - has now been appointed to replace Sir David Nicholson as chief executive of NHS England.
The rapid descent into market chaos seems set to accelerate further.
The pace was already hotting up. Early in the month, the NHS Confederation threw down its "challenge" to politicians, demanding they sign up to support swingeing and unpopular local cuts and "reconfigurations" in hospital services in the run up to the 2015 election.
The Confed warns that unless they do so, and MPs stop defending their local hospitals and start attacking their own voters' services, the NHS stands little chance of making the massive cutbacks needed to bridge a growing gap between the miserable frozen budgets set by George Osborne and the rising pressures and demand.
The current "challenge" of saving £20 billion by 2015 (for which most savings have so far come from effectively cutting the pay of over 1 million NHS staff) is to be followed by an even steeper "challenge" of saving another £30m by 2020.
In case you are wondering where it went, most of the money "saved" so far has been clawed back by the Treasury, not reinvested in the NHS.
The Confed threat was followed by the medical director of the obscure new 'London Area Team' of NHS England, Dr Andy Mitchell, who emerged from the shadows to claim that London's hospital services were "unsustainable," and that swift action is needed to close half its A&E units and many of its maternity and children's services.
On closer examination it was clear Dr Mitchell was concerned first and foremost with finances, since his warning was that action had to be taken to prevent London's NHS running up a £4 billion deficit by 2020, and he went on to argue that the capital's trusts could "not afford" to staff wards safely.
This blunt statement at least cut through the usual rigmarole in which NHS bureaucrats seeking to drive through cuts insist time and again that the cuts they are proposing are "clinically led". In this case the only real clinical element was it was a doctor insisting on the need for financial balance, and for services and patient to be cut to fit the budget.
This comes alongside the continuing claim by the government and a rag-bag of so-called think-tanks and professional bodies that the NHS has to close A&E units "to save lives" - although these arguments stop dead in constipated silence when the question arises of how the remaining A&E units, and the hospitals to which they are attached, could possibly cope with the additional tidal wave of seriously ill patients who would be brought from ever-greater distances needing treatment - and beds. There is clearly no spare money to rebuild and expand on the scale required.
In Worcestershire, where on average 99% of hospital beds were occupied in early 2013, cash saving plans are seeking to close beds and services in Redditch and Bromsgrove to centre them in Worcester.
There is no serious consideration about the journey times and the problems for elderly and low-income patients who would be forced to make ever-longer journeys to access care: instead we are constantly told about the services that will available to those with the most trivial needs, who would still be catered for locally in "urgent care centres".
There are constant blustering assertions that hospital care could be replaced by community-based care - but on closer examination there is little if any evidence that this can be done, or that there are any real plans to do it where hospitals are scheduled for downgrading, or that proper community based services are any cheaper than existing hospital care. There is even less evidence that this is what patients would prefer to local access to hospital.
In place of concrete plans for expanded community services, all we get, everywhere, is fine words, aspirations and wishful thinking: that's not much use to deal with tens of thousands of poorly patients.
Meanwhile we have been told that hospital budgets will lose another £2 billion per year from 2015, which will be carved out of NHS spending and allocated to social care, where budgets have been brutally slashed by desperate councils facing Osborne's 28% cuts.
A stark reminder of the limits of community-based care came with some stark warnings during the month that year upon year of cutbacks in mental health budgets had reduced beds to dangerous, crisis levels. This is after years of transforming many services from hospital to the community.
There have been days this year in London - and even in the whole of the country - in which there have been NO mental health beds - either in the NHS or private sector - available for those with serious needs. Many other days have seen patients in distress dispatched after long delays on lengthy journeys to beds in other cities, many of them hundreds of miles from their homes and family.
Despite the headlines and crocodile tears from ministers the squeeze on mental health continues.
The competitive market in health care has also gone badly wrong, with the Competition Commission now wading in to block Trust mergers and reconfigurations, private hospital firms forcing the regulator Monitor to investigate where they are not awarded contracts, and Clinical Commissioning Groups ludicrously blocked by the HSC Act from meeting together to plan services.
Meanwhile patient "choice" and competition could be wiped out by a new private monopoly in Cambridgeshire, where the Clinical Commissioning Group is pressing ahead with a hugely complex plan to put whole pathways of care out to tender. The existing, successful NHS provider is no longer among the bids - raising the grim prospect of Virgin scooping up a monumental 5 year £800m contract.
In Bedfordshire too, the CCG is set to hand a similarly complex £120m contract for musculoskeletal services to a privately-led consortium which includes a company owned by almost half of Bedfordshire's GP practices.
As the fragmented, divisive, wasteful competitive market system set up by the Health & Social Care Act began to display its nonsensical side, Jeremy Hunt tried to smuggle through even more draconian legislation to allow "special administrators" to carve up local services as well as bankrupt trusts - in a clause tagged on to the Care Bill in the House of Lords.
Even if he gets his way, it will come too late to rescue Hunt from the embarrassment of losing his appeal against the court ruling that prevented him rubber-stamping the closure of most services at Lewisham Hospital.
And increased powers for the administrator would not help force through the closures in North West London, some of which have been delayed by the Independent Reconfiguration Panel.
The IRP found that there were no convincing plans for community and other services to replace the closure of A&E and services at Ealing and Charing Cross Hospitals - and ordered the A&Es to be "sustained" until alternative services were in place.
Desperate NHS hospital managers have begun hoping for the public to turn their backs on the NHS, and allow them to drive through unpopular cuts.
A shameful article by the chief executive of the Foundation Trust Network, Chris Hopson in the Health Service Journal (and echoed in a wretched Guardian article) celebrated the first small signs of weakening public affection for the NHS, as ministers, the BBC and the right wing press delight in stories of poor care and service failures.
An opinion poll had found fewer people (60%) supporting the view that "the NHS is a symbol of what is great about Britain and we must do everything we can to maintain it" and a larger minority (30%) have been bludgeoned by the right wing media into believing that "the NHS was a great project for its time but we probably can't maintain it in its current form".
By most readings, that's still a substantial majority behind the NHS, despite all the bad headlines and cutbacks. Numbers could be pushed up even further if Labour set its face against further cuts and gave hope some services might be restored rather than closed.
Remember, we are still many, they are few.
Let's fight on, while there's an NHS to defend.
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