Successful Meeting “NHS in Crisis?”
Held in South East London

A public meeting was held on January 30 at Charlton House, South East London, on the present crisis in the NHS. Discussion focused on the threat to NHS services and on the necessity to defend them. Several speakers addressed the meeting, including Jacky Davis (NHS consultant and joint founder of keep our NHS Public), Theresa Pearce (MP for Erith and Thamesmead), Dr Bob Gill (local GP from Welling, Bexley) and Charlotte Monro (Occupational Therapist and trade union activist at the forefront of fighting for rights and services at Whipps Cross Hospital, for which she was dismissed by Barts Health Trust).

Well over 150 people attended this first public meeting since the victory of the legal campaign to strike down the recommendations of the South London Health Care Trust Special Administrator as taken up by Health Secretary Jeremy Hunt. Nevertheless the Queen Elizabeth Hospital (QEH), Woolwich, and Lewisham were merged on October 1, 2013, with the dissolving of the South London Healthcare NHS Trust and its component parts being run by different NHS Trusts. The new organisation bringing together the QEH and Lewisham is the Lewisham and Greenwich NHS Trust. There is therefore a renewed
movement amongst the people to deal with this new situation, justly asking what is the precise nature of the victory which the Save Lewisham Hospital Campaign won, and how to consolidate the campaign and take it forward to win new and lasting victories. Consequently, as the organisers pointed out, Lewisham and South East London campaigners united to organise the joint meeting. Its aim was to alert people to the threats to all NHS services, and discuss how everyone can work together to safeguard the future of the NHS.

The meeting was chaired by Iain Wilson, a nurse at the QEH and a Save Lewisham Hospital Campaign activist. He pointed out, to loud cheers, that this meeting marked the first anniversary of the huge march of 25,000 people to save Lewisham Hospital. Indeed, the first speaker, Jacky Davis, echoed these words saying that the Save Lewisham Hospital Campaign had shown the way for the whole country to “go out and fight”! She said how important it was that, one year on, there had been such an incredible turnout for this meeting.

Dr Davis pointed out that the government was attacking NHS services and the NHS as a whole, and was now brazenly bringing in privatisation of the NHS “through the front door”, with 22 out of 25 contracts going to private firms. She said that the government’s actual intention was to run down NHS services, in what she vividly likened to a scorched earth policy, blaming health workers, undermining resources and instigating unnecessary and costly reorganisations. She ended by articulating that people need to take a stand against these cuts and she urged people to get together and join their local groups.

Theresa Pearce condemned the fragmentation and privatisation of the NHS by the Coalition, whilst admitting that “Labour had opened the door to this”. She pointed out that the Health and Social Care Act 2012 was based on no democratic mandate. Under the Act, private companies are exempt from the scrutiny of the Freedom of Information Act and can therefore get away with undisclosed deals on behalf of the monopolies. She condemned the £1.8 billion NHS budget cut in the last three years and said that Clause 118 of the Care Bill, the “hospital closure clause”, was acting as a “hand grenade into the NHS”.

Local GP Bob Gill pointed out that both the previous Labour government and the present Coalition government had for the past 12 years been undermining health care. He went into detail describing the dangerous and life threatening effect the cuts in health care services, staff and hospital resources were having on health care.

Charlotte Monro opened her speech by thanking the Save Lewisham Hospital Campaign for its support for her case and praised it for the hope and inspiration it has given to everyone fighting the government’s attacks on healthcare and the wrecking of the NHS throughout the country. She gave the background to the huge financial problems that Barts Trust had caused by the prioritisation of the payment of PFI debts over health care. She explained how money was going to pay off the inflated rate of interest of PFI loans instead of being invested in health care, under the guise of making “efficiency savings”, but that this amounted to nothing more than further cuts in health services.

Charlotte Monro pointed out that a recent report by the Care Quality Commission praised the compassionate and dignified care provided by Barts health workers but raised concerns about low staff morale caused by the “culture of bullying” and fear of speaking out in raising concerns. She said that this bullying culture undoubtedly comes from the top, from management, and that this fear was “toxic”, for both the safety of and improvement in health services. It demonstrated that management had “seriously wrong priorities”, in other words, “financial ones over patient care”.

Charlotte Monro ended by pointing out that because of the successes of the Lewisham Campaign, which has relied on its own resources through mobilising the whole community, the merger between Lewisham Hospital and the Queen Elizabeth Hospital meant that the renewed joint campaign was in a strong position to bring out the issues involved in fighting to defend the health service. For instance, PFI debts and the demand for “efficiency savings” are issues which are crippling the health service, and therefore it is so important to fight on these issues and for everyone to say, “No, this can’t happen!” The renewed campaign can then sum up this struggle and speak with authority, once again serving as a model for the movement to safeguard the future of the NHS. As the Lewisham People’s Commission was able to bring out the issues in the Lewisham struggle, so the joint campaign can through acts of conscious participation, guided by the concrete analysis of concrete conditions in the Lewisham and Greenwich Trust, make headway in rolling back the climate of diktat in the whole NHS and contribute to a change in its direction.

After the main speeches, Louise Irvine, chair of the “Save Lewisham Hospital Campaign” said it was “wonderful” to have this meeting organised by the two merged hospitals, and condemned the government’s aim in destroying health services and introducing a two-tier system of health care. She said this meeting showed a unity of purpose and underlined the need to reach out to all parts of the country in fighting against the health cuts and in safeguarding the future of the NHS.

The meeting concluded with a lively and vigorous discussion about what to do in the very grave situation facing the NHS and health care in general. Several people spoke of the necessity to inform ordinary people about what is actually going on, in particular of the ever-growing privatisation of health care and the stand of health workers and their unions against it. There was a general feeling of determination to support the two local hospitals by fighting to improve health care standards and opposing monopoly right by fighting the programme of privatisation, as the Save Lewisham Hospital Campaign had recently done in January by winning their fight to stop the proposed outsourcing of Procurement and Supplies Department to the health monopoly Serco. The meeting finished with enthusiastic applause and a feeling of unity and determination for the battles ahead.

On Wednesday, February 5, supporters of the Save Lewisham Hospital Campaign (SLHC) confronted Health Secretary Jeremy Hunt as he was about to enter the ICO Conference Centre in London. The conference had been called by Healthcare Conferences UK to discuss the implementation of the recommendations of the Francis Inquiry one year on. The protest was called to demand that the government withdraw Clause 118, the “hospital closure clause”, which Jeremy Hunt is attempting to smuggle into law through tacking it on to the Care Bill. The way this Clause is being introduced is very instructive of the way the government is operating through diktat. Instead of providing funding to meet the right of all to health care, the government declares that hospital trusts must balance the books. If they cannot do this, they are said to be in financial difficulties and “failing”, and Trust Special Administrators (TSAs) appointed. In the wake of the government’s losing two legal battles where the judiciary ruled that the government-appointed TSA had overstepped his powers in the attempt to down-grade services at Lewisham Hospital, the Coalition has tacked on Clause 118 to the Care Bill to give TSAs any power they require.

The SLHC unveiled two huge banners against Clause 118 and in support of the NHS and shouted slogans “Stop the Hospital Closure Clause!” and “Save the NHS!”. The demonstration denounced Hunt as he entered the building demanding answers about Clause 118 and why he is closing hospitals, privatising the NHS, etc. Jeremy Hunt merely said, “It’s to deal with failing hospitals.”

This protest is just one of many up and down the country and is a reflection of people’s determination not to let the government succeed in its plans to cut health services, privatise and put the NHS completely in the service of the monopolies.

The Francis Inquiry report was published one year ago on February 6, 2013, and examined the causes of the failings in care at Mid Staffordshire NHS Foundation Trust between 2005-2009. The report made 290 recommendations.

Among these were the need for openness, transparency and candour throughout the healthcare system (including a statutory duty of candour), fundamental standards for healthcare providers.

In his remarks to the conference called by Healthcare Conferences UK on the implementation of the recommendations, the Health Secretary said: “The last year has been an absolute nightmare for the NHS.

“Everyone has said to me that although not as bad as Mid Staffs there are pockets of what went on there that they have seen in their own work. But there is a resolve to do something about it – there is a can do spirit in the NHS. The culture is changing and the professional code is being updated so that staff can speak up when things go wrong knowing they will be protected.”

This is double-speak by Jeremy Hunt worthy of Joseph Goebbels. The nightmare for the NHS is not one of caring and hard-working staff, but of financial considerations and constraints which have their source firmly in the government’s refusal to accept its responsibility to provide health care as of right. Far from health workers being encouraged to speak up with their concerns, there is a climate of diktat in the NHS. Hospital Trust Boards will not accept the right of health workers to set the agenda. The Trust Boards are accepting the government’s austerity agenda, and doing everything to implement it. The problems highlighted by the Francis Report will only be solved by increasing investments in the health service, changing its direction and outlawing privatisation. Health workers are doing their duty by organising to safeguard the future of the NHS.

In January last year, Andy Burnham, Labour's shadow Secretary for Health, outlined what he called "the first articulation of a coherent and genuine alternative to the current Government’s direction" on the NHS.1 He claimed that "for the first time in 20 years” the Labour Party “has the chance to rethink its health and care policy from first principles". But whilst the starting of Labour's “articulation of the programme” in health posed not a glimmer of a change of direction to that of the present government because of the "unshakeable assumptions" that the imposition of the austerity programme to health will continue, he said he “committed” Labour to repealing the Coalition's Health and Social Care Act, 2012.

Yet again this week we heard Ed Miliband speaking on Labour’s NHS programme which confirmed what Andy Burnham had already depicted in the detail. They will keep the most destructive provisions of the Act including the commissioner provider split, the very mechanism by which the coalition government is wrecking and privatising the NHS under the Health and Social Care Act 2012. In other words, Labour's fraudulent claim for a “coherent and genuine alternative” for the NHS can be likened to Aesop's fable that the mountain laboured and brought forward a tiny mouse. A mouse that is not even intended to stop the present momentum and onslaught of the monopolies to privatise the NHS and in fact is more likely to increase it.

Speaking on February 10 at the Hugo Young Lecture, the Labour Party leader Ed Miliband said: “No change could be proposed by a Clinical Commissioning Group (CCGs) without patient representatives being involved in drawing up the plan. Then when change is proposed, it should be an independent body, such as the Health and Wellbeing Board, that is charged with consulting with the local community.” Realising that there is massive opposition to the wrecking of the NHS he proposes to improve “consultation” with patients when he says, “Clinicians, managers and patients across the NHS know the system we have isn’t working. We need to find far better ways of hearing the patient voice. So a Labour government will ensure that patients are involved right at the outset: understanding why change might be needed, what the options are and making sure everyone round the table knows what patients care about.” Rather than concentrating on the complete lack of any change of direction in Labour's “coherent and genuine alternative”, commentators have focused on the differences that have emerged between the position given by the leader of the Labour Party and Andy Burnham, Labour's shadow Secretary for Health. They point out that under Andy Burnham's vision, health and wellbeing boards, which are run by local authorities, would become the “pre-eminent” decision making bodies across the health and social care system while CCGs would merely have an advisory role. Yet Ed Miliband “appears to have indicated that Labour would retain clinical commissioning groups as key decision making bodies in the NHS”.2 Following Miliband’s speech, Andy Burnham followed suit with one of his own on Tuesday and he gave the idea of a year of care tariff for hospital care in preference to payment by results, but did not specify whether CCGs or HWBs would be in charge of the allocations for this tariff.

What can be concluded from these comments is that even the shift of focus from commissioning by CCGs to commissioning by partially elected local authority Health and Well Being boards does not seem to be any longer part of Labour's “coherent and genuine alternative”. The fact is there is nothing in what Ed Miliband and Andy Burnham are saying that challenges the direction that successive governments, including Labour, are taking with the NHS. Whilst there are noises about NHS being “preferred provider” from Andy Burnham and hospitals having “year long tariffs” instead of “payment by results” there is no challenge to the destructive mechanisms of the Health and Social Care Act 2012 and its marketisation of health provision and the consequences of “austerity” and privatisation on the NHS and on the future direction they are taking the NHS. There is no indication of any real intention to repeal the Act. Should Labour come to power, would Ed Miliband contradict his Shadow Secretary for Health again and pronounce even less “change” to the present Act other than a claim to “find far better ways of hearing the patient voice”. In other words, no change with the present direction that the Coalition government is taking to impose decisions, i.e. in practice no voice at all. Commissioners will still contract services behind closed doors and secrecy, or in “consultations” that are rarely undertaken now and when they do they only have only one “choice” that the commissioners or providers want.

What is revealed is that the Labour Party is trying to secure votes by creating the illusion that it is standing with the people against the wrecking of the NHS by the Coalition government, whilst its main concern is the interests of and support to the financial oligarchy. The Labour Party embodies into their policy on health a policy of responding to the austerity measures by calling at best for not so far, not so deep and not so quickly yet activating no change in the direction on the attack by the health monopolies on the NHS. This is the essence of their anti-social policy. This programme of the Labour Party is not an alternative to safeguard the future of the NHS – in fact it is quite the opposite.

The change of direction needed which the health workers and the workers opposition should fight for is that the NHS is not to be treated as a “cost” on the taxpayer, or to allow the excuse of “austerity” to cut back and privatise in favour of serving the interests of the monopolies. The NHS is not an appendage of the economy, or privilege bestowed by the ruling elite to be cut back and wrecked in times of “austerity”. The health service should be integral to a modern economy that stops paying the rich and upholds public right over the right of the monopolies and the rich. It should be provided as of right to all at the highest level with the wealth created by health workers and that workers in the whole economy produce. Health workers and the working class and people must continue to lay their claims in defending their health services and fight for this new direction by taking this fight with campaigns that unite health workers and communities and bring forward their own best political representatives to fight for a coherent and genuine alternative.

Louise Irvine, Chair of the Save Lewisham Hospital
Campaign, speaking at the Chiswick meetingA public meeting was held on February 15 in defence of the Charing Cross Hospital and to ask a panel of politicians and healthcare experts about proposed changes

Chiswick’s MP, Mary Macleod, joined Andy Slaughter, Hammersmith MP, Dr Mark Spencer, medical director for NHS North West London, community matron Anne Drinkell and Murad Qureshi, Labour GLA member, to discuss with concerned Chiswick residents.

The meeting was organised by Chiswick Homefields Labour Party candidate, Crispin Flintoff, who said: “I don’t think we have had a definitive answer to the very important question of what is happening to our local hospitals under the NHS North West London’s proposals. For people in Chiswick it would be catastrophic if Charing Cross closed its A&E as it would mean a long journey to West Middlesex Hospital, which could take over an hour – and I dread to think what the waiting time will be there.”

Health Secretary Jeremy Hunt is proposing that there will be no emergency surgery, no blue-light A&E, no stroke unit and no intensive care at Charing Cross. The care centre which remains will be GP not consultant-run, and will only handle minor injuries and treatments. Hammersmith may not even have this.

The final proposals for the hospitals are likely to be published in March, six months late. A range of primary care services and some elective (planned) surgery may now stay on the Charing Cross site, but at least half of it will be sold privately. Charing Cross will be downgraded to a “local hospital” with emergencies referred to St Mary’s, Paddington under the proposals.

A campaign is growing within the community to safeguard the future of the local hospitals and their services.

(West London News, Andy Slaughter)