The Conservative / Lib Dem government have pledged to protect “frontline” NHS services and cut back on bureaucracy. In reality, this is another broken promise. They have no intention of saving even frontline staff. It is important that trade unions should unite health workers against their plans, not seek to divide them. The nursing union, the RCN, has a national campaign called “frontline first”. While it has every right to fight for its own members, their approach plays into the government’s agenda that some cuts are necessary, and divides healthworkers against each other. I have seen admin staff in UNISON wearing badges saying “I am frontline”, making the point that we are just as important to the running of the NHS, enabling nurses and doctors to do their jobs efficiently.
The RCN website talks of speaking out against NHS cuts that are harming patient care, but also exposing where there is waste in the system. In reality, the NHS has long been under-funded. The Trust I work for has had vacancy freezes, so that gradually less and less staff are under more pressure to do the same job, resulting in a rise in stress and sickness.
The way to win a campaign is to give workers the confidence that if they take action then these cuts can be beaten. As part of TUSC (Trade Unionist and Socialist Coalition) Socialist Party members attempted to do this, by standing in elections on a no-cuts platform. We need to explain to people that the cuts are not necessary, they are part of an attack on the principles of the NHS – to provide free health care to anyone who needs it, regardless of their ability to pay. UNISON and the RCN should be balloting for strike action, in unity with the teaching unions and PCS, who are taking action to protect their pensions on 30th June. That way we could show the government the unity of public sector workers and that we are determined to resist any attacks on our terms and conditions.
The inefficiencies in the NHS come from the privatisation that has already happened under Labour and the Tories. In 1979, admin costs were only 6%. The introduction of the “internal market” by the Tories doubled this to 12% and with Labour’s foundation trusts, this has risen to nearer 20%. In preparation for my hospital becoming a foundation trust, we will have to record every contact with a patient, even if it is just a phone conversation. This is only because the hospital will then be charged per contact, as if it was a business. The real source of inefficiency is the private market.
So what do we do instead? The party I belong to, the Socialist Party would reverse the privatisation of the NHS and place our public services under truly democratic workers’ control. We would get rid of genuine inefficiencies – pharmaceutical companies overcharging for drugs, expensive PFI schemes and allow NHS hospitals to co-operate with each other and share best practice, rather than have to compete with each other for patients. The NHS brought free healthcare to millions when it was first introduced, but sixty years later these gains are being taken away from us, as multinationals move in for the kill. We need to fight for a socialist society, so that we can win a genuinely public NHS now and for future generations.