Building the Organised Resistance against the
Assault on the Living Standards of Health Workers

Picket at QE GatesheadOn Monday, November 24, an estimated 400,000 health workers in England and the north of Ireland continued their rolling strikes against the Westminster government over payment of only a 1% inflationary rise in April. Ignoring the recommendation of the Pay Review body, Jeremy Hunt announced that this would be paid only to some staff on the top of their banding but even this was to be non-consolidated into pay and pensions.

The strike displayed the same enthusiasm as the action on October 10 to fight against pay cuts, the sell-off of resources to the private sector, and a business-orientated health service.

In April, the Scottish government immediately paid the recommendation of the Pay Review body for a 1% pay rise consolidated into pay for all staff and they added the guarantee of a living wage for lower paid workers. In November, a health workers’ strike in Wales was called off for negotiations to take place. Last week the Welsh Assembly came to a negotiated agreement with health unions in Wales. It includes a cash payment this year, the introduction of the living wage for the lowest paid from January, and a 1% rise across the board from April. However, the Westminster government and NHS employers have yet to make any moves to negotiate a settlement with the health workers and their trade unions in England and the north of Ireland.

The Secretary of State for Health and the government as a whole just keep repeating that to pay the recommended pay review body to all staff was not “affordable” and would “cost 4,000 nursing posts” and “that you can only deliver a strong NHS with a strong economy”. Prime Minister David Cameron repeated this mantra almost word for word in PMQs a couple of weeks before the strike. What it shows is that the government’s aim is not a strong economy that meets the needs of the people and upholds their right to health care. This would be the rational course, a direction of strengthening and investing in the NHS as part of building that “strong economy” whose sole aim is to meet the needs of the people. But Cameron and Hunt's aim for the “strong economy” is something else. It is an aim that a “strong economy” is one that serves the interests of the monopolies and that the needs of the people are an unwelcome “cost” and “burden” to that aim and direction.

Picket at South Tyneside District Hospital In terms of their aim for the economy, inflationary price rises must be utilised to lower percentage pay rises, or give no rise at all, to reduce the implied “cost” and “burden” of the wages of working people. This goes against the reality of the economy and its socialised nature. Its products and services are produced by the working class and people and the arrangements of the economy should meet the needs of all and not pay the rich. The reality shows that the working class and people are not the “cost” or “burden” but add value to the economy over and above the wages that they take home, added value that is seized by the rich for their own personal fortunes and finance capital which they control for their own interests.

In terms of society, this irrational approach that “you can only deliver a strong NHS with a strong economy” is a direction that monopoly right should prevail over public right as a matter of course. But this direction that treats the NHS and other public services as a “cost and “burden” actually weakens the economy and plunges it into crisis. The opposite is needed.

The Workers’ Opposition has the direction that public right must prevail over monopoly right. The right to health care must be upheld and guaranteed. In this rational economic direction, it is the rich that are a “cost” and a “burden” on the economy. Paying the rich must be stopped and investments increased in the NHS and all public services and social programmes and privatisation must be ended and reversed. Instead of the rich and the big parties that serve them being arbiters of the health service and of the pay of health workers, health workers themselves must be allowed to take the lead in determining the direction for the health service and to also determine their own worth in terms of remuneration. This is the direction that will guarantee a modern health service and a modern society and end the need for health workers to take strike action when they are empowered to make these decisions that will safeguard the future of the health service.

The Workers' Opposition demands an end to the wrecking of the living standards of health workers and defends public right over monopoly right and stands up for the rights of all. This is the change of direction needed to safeguard the NHS and strengthen the economy for the benefit of all.

St George's Tooting and St Mary's Isle of Wight


Domestics Bristol and Pharmacy Gateshead


Liverpool Anfield Ambulance and South Tyneside

Lambeth and Royal Free

Beverly Todd, Society of Radiographers

WF: Can you say why the Radiographers are on strike?

BT: People are so fed up and this latest insult has been a step too far. We have had all these years of pay freeze and then not even been offered the 1% that had been recommended by the Pay Review Body.

WF: So what do you think when the government says health worker are not worth this pay rise?

BT: What annoys me the most is when they say that the bankers have to have their bonus because we need the right people in the job. Are they the right people? Look at the mess they have got us into. I would much rather have the right person as the radiographer, or the right person as a carer, or the right person as my porter or whoever it is. If these people were so good in their jobs how did we end up in this financial crisis? I know it is the US financiers who started it, but our financial sector did not help it. Then the MPs are taking their 11% pay rise and say they have to have it because it is decided by an independent pay review body. But then they ignore our independent pay review body, or anybody else’s! But it is not just about the pay. They are attacking the whole NHS, they are privatisating its services and so on.

Marion Langley, Branch Secretary South Tyneside Health Branch of Unison

WF: How is the strike going?

ML: I think the strike has been really good. We have got fantastic support. It is all the unions together today and it is really nice to see us all on the picket lines together and fighting for fair pay for all. The fact is that 1% isn’t enough, especially when it is not consolidated into pensionable pay and therefore not a pay rise at all.

WF: Cameron keeps saying that you cannot have “a strong NHS without a strong economy” and seems to be putting the cart before the horse?

ML: My opinion with that is that if we got a decent pay rise I am sure that the majority of health service workers and public sector workers would spend their money in the locality and their local economy would rise and more businesses would boom in their own communities. Also, as you say, it is putting the cart before the horse. Having a strong NHS is part of having a strong economy, and the NHS is something people will always want to fight for, free at the point of need and making sure that we have got everything that would take people from cradle to grave with health care. It definitely should not be privatised or run for profit.

WF: The government keeps suggesting that the NHS and public services are a “cost” to the economy. How do you see that?

ML: I don’t agree. It is not a “cost” to the economy. It is a service that adds value to the economy and a service that every single person needs at some point in their life. From that perspective I think the government has got it totally wrong. To be fair, the Labour Party did not do much to help us when they were in power, and there were a lot of the things they should have not introduced or should have overturned, especially the PFI, but didn’t.

WF: How do you see things going in the future; do you see further strikes?

ML: I would really hope not, health workers don’t want to strike. It is not why they join the health service, but they have had enough. However, I don’t see the government sitting around the table with the trade unions at the moment. So the trade unions need to take some action for the government to change its stance towards health workers.

Hazel Kjebekk – Phlebotomist and Branch Chair South Tyneside Health Branch of Unison

WF: Can you speak about the strike today and its successes?

HK: It was great to see so many people supporting the strike today: nurses, occupational therapists, heath visitors, healthcare assistants, midwives, porters and catering staff. The show of support from the general public was fantastic; they understand our fight and the government has left us with no other choice but to take action.

WF: The government and media are always trying to suggest that the health service – and in particular paying health staff – is a cost and burden. They don’t seem to understand how health workers add values to society, do they?

HK: This government and the media are trying to portray health care workers as a burden, overpaid and underworked. But the real truth of the matter is that healthcare workers add value to society and are highly valued by the people who use these services no matter what their job is. From domestic cleaners to surgeons, we all have the same aim in mind and are all dependant on each other and demand respect and value from this government and media.

WF: How do you see the way forward now?

HK: The way forward is for this government to recognise that we are valued members of society doing good jobs and we have bills to pay, keeping a roof over our heads and putting food on the table to feed our families. A 1% pay rise is not acceptable in a current climate of rising costs. We need a decent standard of living. Increasingly people in work are having to use food banks and can’t afford to heat their homes. It doesn’t have to be this way. We can and must afford a properly funded NHS with enough staff to look after the people we serve and a fair wage for the job we do.

Health Professional at the Royal Free Hospital, London

WF: Cameron keeps saying that you cannot have “a strong NHS without a strong economy”. Can you comment on this?

HP: This is based on a capital-centred economic logic where the rich must profit first. The NHS is being sold off to pay the rich and less is being spent on patient care. Hence the health service is being run down. When I worked for the ILEA (Inner London Education Authority), it was deliberately run down through privatisation by the Thatcher government during the 1980s and it was finally abolished in 1990. The schools were transferred to local borough councils. Is this going to be the fate of the NHS?

WF: The government keeps suggesting that the NHS and public services are a “cost” to the economy. How do you see that?

HP: This is an old trick, where blame is put on public services in order to justify cuts and sell them off to the private sector. The real burden to the NHS comes from PFI and property developers who see it as a source of profit.

WF: How do you see things going in the future; do you see further strikes?

HP: The answer is yes. The ruling class agenda is to enrich the millionaires/billionaires at the expense of the working class. This contradiction only fuels more strikes.

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Film of strike picket outside Lewisham hospital on November24:
http://youtu.be/murLwqlyf7Y

On November 21, the Save Lewisham Hospital Campaign (SLHC) held a successful vigil outside Parliament as MP Clive Efford’s NHS Bill was debated inside Parliament. The vigil was supported by health workers and NHS campaigners from London and elsewhere, and followed an all-night vigil in Parliament Square.

Dr Tony O’Sullivan from the SLHC spoke in support of the NHS Bill which aims to repeal the 2012 Health and Social Care Act (HSCA) which has paved the way for the wholescale privatisation and dismantling of the NHS. He welcomed the opportunity the Bill gave to debate what is needed to do in the fight to save the NHS. Tony O’Sullivan then read out the key demands the SLHC has been calling on people to support: scrap the HSCA; stop blaming migrants for the NHS crisis; an end to cuts and an injection of cash to meet growing health care needs; stop cuts in mental health care beds and increase funding to meet growing needs; Remove PFI burden on the NHS – say NO to PFI!; a decent living wage for all NHS staff; guarantee safe staffing/nursing levels; stop financially driven closures of A&E, maternity and now GP surgeries; an end to the privatisation of the NHS; no to TTIP.

Dr Brian Fisher from the SLHC gave a vivid and telling speech on the “terrible things the Coalition government has been doing to the NHS”: “tearing it apart, wasting its money, threatening patients, threatening continuity of services”. He pointed out that what the Coalition has been doing to the NHS – that is, its fragmentation and destruction – is a form of corruption. The privatisation of the NHS is so that people can make money out of it.

A SLH campaigner condemned the injection of private funds into the NHS dispelling the claim that it would lead to better health care. To illustrate her point she spoke movingly about how her uncle died in America because the time limit on his medical care insurance ended, even though he was comparatively well off.

Dr Louise Irvine, chair of the SLHC, said that what is happening in Lewisham is a microcosm of the whole country – cuts, the threat of privatisation, and so on. She spoke about the new website for the National Health Action Party, “the People’s vote for the NHS”, holding up a poster with its five key pledges to save the NHS. She called on people all over the country to hold local parliamentary candidates to account on where they stand with regard to the five key pledges.

The vigil ended with the spirited shouting of slogans in support of the NHS against its infiltration by Virgin, United Health and BUPA.

The vigil was followed by a successful meeting inside Parliament attended by over 50 campaigners from London and the rest of the country to discuss Clive Efford MP’s private member’s bill.

The National Health Service (Amended Duties and Powers) Bill, introduced by Labour MP Clive Efford, was successfully given its second reading in the House of Commons today by 241 votes to 18. Labour turned out in force, whereas the Tories and Lib Dems were very thin on the ground, hence the voting figures. The Bill will not go forward unless a resolution is passed by the Commons for it to be considered in Committee.

The meeting was chaired by Jill Mountford from the SLHC who posed the question about how the SLHC can influence debate up to the election, making the NHS the central issue. Clive Efford spoke at length answering criticisms and concerns raised from the floor about his Bill and Labour’s plans. Despite criticisms of the plans – some felt strongly that his bill did not go far enough and was not precise enough – nonetheless it was acknowledged that campaigning to take to the Bill forward through the parliamentary process was essential. The SLHC has pointed out that Clive Efford’s Bill provides a valuable opportunity to raise the issue of the NHS in the run-up to the general Election in May.

Jackie Davis from KONP (Keep Our NHS Public) spoke of the £6 billion going to private contractors. She said that while the Clive Efford Bill was not perfect it was “a step in the right direction”.

Barrister Peter Roderick, co-author of a draft NHS Reinstatement Bill (a draft to comprehensively repeal the Health and Social care Act) with Professor Allyson Pollock and others, was critical of the Bill saying that it does not give back responsibility of the Secretary of Health to provide universal health care (Andrew Langley’s HSCA having removed this responsibility), confusing the issue by having “Duty to commission” instead of “Duty to provide”. Clive Efford’s argument is that looking at all the provisions of the Bill as a whole, the Secretary of State is being put back in charge of the NHS.

At the meeting the understanding was that the government might refuse to allow the Bill to go to the committee stage, and that it is essential that the movement should do everything it can to prevent them refusing. The Efford Bill takes a step in the right direction by reducing tendering procedures, and a committee stage would provide a forum for detailed consideration and clarification of several issues and an opportunity for tabling amendments along the lines of the NHS Reinstatement Bill – all steps on the road to the Queen’s Speech in May 2015. Clive Efford himself pointed out that a complete repeal of the HSCA was “unrealistic” for private members, the Act itself being a lengthy piece of major legislation which a Private Member’s Bill could not hope to overturn. He said that the 2012 HSCA compels privatisation while his Bill protects commissioners from privatisation.

A questioner then raised the issue of PFI, asking what Labour would do if returned to power. Tony O’Sullivan from the SLHC pointed out that PFI debts were a major problem for the Lewisham and Greenwich NHS Trust. As the meeting closed, John McDonnell MP said that Labour was still in denial over its role in marketising the NHS.

The SLHC have pointed out that campaigning to ensure Clive Efford’s Bill reaches the Committee stage is an important struggle in the fight to change the direction in which the NHS is being driven. It represents an opportunity raise the crucial issue that privatisation should be reversed and that a fundamental change of direction for the NHS is urgently needed.

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RCPB(ML) made the following film of the vigil and meeting: http://youtu.be/OErS_dIEZfk

Home Secretary Theresa May presented the government’s Counter Terrorism and Security Bill to Parliament on Wednesday, November 26, declaring: “We are in the middle of a generational struggle against a deadly terrorist ideology. These powers are essential to keep up with the very serious and rapidly changing threats we face.”

The Bill was published in the middle of “counter-terrorism awareness week”. The previous day, the Intelligence and Security Committee chaired by Sir Malcolm Rifkind, which has been examining the actions of the intelligence agencies surrounding the killing of soldier Lee Rigby in 2013, published its report. The Bill also comes in the wake of the Birmingham schools “Trojan horse” affair.

The government is using such incidents and developments to create an image of an enemy within and “home-grown terrorism” – a notion originally promoted after the 7/7 attack – allegedly created through a process of “radicalisation”, which begins with “extremist ideologies” at odds with “British values”. On this basis, Theresa May claimed in a speech on November 24 that Britain is facing its biggest ever threat of terrorism, with such radicalisation being fostered by the Islamic State.

Amongst other measures, the Bill contains:

• The bolstering of Terrorism Prevention and Investigation Measures (TPIMs), which restrict a person’s movements, reinstating a previous Labour-introduced power to force a person to relocate to elsewhere in the country. The grounds to impose a TPIM will be raised from “reasonable suspicion” to “the balance of probabilities”.

• Powers for on-the-spot seizures of passports at airports for periods of up to 30 days.

• Temporary Exclusion Orders, which will allow authorities to block a British citizen from returning to the country.

• The requirement for airlines to provide information about passengers flying to Britain.

• The requirement for internet service providers to identify individual users and retain IP addresses.

• A new Privacy and Civil Liberties Board to monitor the balance between security and civil liberties.

In particular, May announced various “counter-radicalisation” measures. Schools, colleges and universities, as well as probation services and local government, will have a legal duty to actively prevent radicalisation. The Home Office will be able to issue court orders to enforce this, such as compelling a body to ban a particular speaker.

Successive governments, particularly since the declaration of the “war on terror”, have been putting forward bills and taking other measures aimed at legislating on and controlling what they refer to as “values” and in the process restricting the right to conscience. The shift in terminology from “terrorism” to “extremism” and “radicalisation” should be understood in this context.

The latest version of the British government’s counter-terrorism strategy, abbreviated as CONTEST, was presented to parliament by Theresa May in July 2011. It builds upon the earlier versions introduced by previous Labour governments in 2006 and 2009.

In her foreword, May said: “As well as catching and prosecuting terrorists, we must also stop people becoming terrorists in the first place. But the Prevent programme we inherited was flawed.”

“Prevent” is the name given to one of the four components of CONTEST. She continued: “Following a comprehensive review we published a new strategy in June of this year. Greater effort will be focused on responding to the ideological challenge and the threat from those who promote it; we will also work harder to prevent people from being drawn into terrorism and ensure that they are given appropriate advice and support. We will work with a wider range of sectors where there are risks of radicalisation to achieve our aims.”

The focus on “the ideological challenge” sums up the main change brought about by the present government. It is not in itself new, in the sense that the Labour Party had previously championed the notion of “British” or “universal values” and had step-by-step criminalised dissent, conscience and national origin through a series of Terrorism Acts, while promoting the hysteria that “the rules of the game have changed”. Rather, it represents a further step and a shift in emphasis.

The most recent summary of the Prevent strategy on the Home Office website, updated in December 2012, tells us that it: “responds to the ideological challenge we face from terrorism and aspects of extremism, and the threat we face from those who promote these views”; “provides practical help to prevent people from being drawn into terrorism and ensure they are given appropriate advice and support”; and “works with a wide range of sectors (including education, criminal justice, faith, charities, online and health) where there are risks of radicalisation that we need to deal with”. Further, it “covers all forms of terrorism, including far right extremism and some aspects of non-violent extremism”.

This shift towards “the ideological challenge” was first announced by David Cameron in his speech at the Munich Security Conference in February 2011, a speech written with major input from the then Education Secretary Michael Gove.

He presented what has been called the “conveyor-belt” theory of the “process of radicalisation”, to explain home-grown terrorism. Mentioning in passing “dissident republicans in Northern Ireland” and “anarchist attacks” in Greece and Italy, his focus was on “Islamist terrorism”. The purpose of the theory is to highlight the supposed danger of “non-violent extremists”, whose role is to influence individuals, who then take these “radical beliefs to the next level by embracing violence”.

“Whether they are violent in their means or not, we must make it impossible for the extremists to succeed,” he said. “Governments must also be shrewder in dealing with those that, while not violent, are in some cases part of the problem.”

Cameron laid out a set of criteria to judge whether a Muslim organisation represents an officially acceptable Islam or something extreme. Questions such as “do they believe in democracy?” or “do they encourage integration or separation?” are posed. Those that fail the test are deemed extreme and must be stopped “from reaching people in publicly-funded institutions like universities”.

The criteria are the set of officially-defined values. This is related to his second point about building “stronger identities at home”. He called for “less passive tolerance”, which “stands neutral between different values”, and advocated “a much more active, muscular liberalism”. In essence converting liberalism into fascism, he declared that “a genuinely liberal country does much more; it believes in certain values and actively promotes them”. Such a society tells its citizens that “to belong here is to believe in these things”.

Since 2011, the Prevent strategy contains the government’s definition of “extremism” consistent with these notions: “Extremism is vocal or active opposition to fundamental British values, including democracy, the rule of law, individual liberty and mutual respect and tolerance of different faiths and beliefs.”

In 2013, following the killing of Lee Rigby, the government launched an Extremism Task Force based around this definition and the Prevent strategy. Its report in December that year contains proposals to “make delivery of Prevent a legal requirement” for local authorities “in those areas of the country where extremism is of particular concern”.

In this context, the Birmingham schools “Trojan horse” affair occurred in March this year, which had all the hallmarks of a state and media-organised attack on minorities based on fabricated evidence. This affair and the creation of suspicion brought out all of the above developing trends, particularly the claimed danger of a conveyor-belt of radicalisation.

In the end, the affair led to Gove’s replacement as Education Secretary, though the ground had been prepared for Theresa May’s speech to the Conservative Party Conference in September. In her rendering: “... to live in a modern liberal state is not to live in a moral vacuum. We have to stand up for our values as a nation. ... And not all extremists are violent. But the damage extremists cause to our society is reason enough to act. And there is, undoubtedly, a thread that binds the kind of extremism that promotes intolerance, hatred and a sense of superiority over others to the actions of those who want to impose their values on us through violence.”

She then stated the intent to go further, particularly on the front of “extremists who stay just within the law”: “Soon, we will make Prevent a statutory duty for all public sector organisations. I want to see new banning orders for extremist groups that fall short of the existing laws relating to terrorism. I want to see new civil powers to target extremists who stay just within the law but still spread poisonous hatred. So both policies – Banning Orders and Extremism Disruption Orders – will be in the next Conservative manifesto.”

But then she took a step beyond the point reached so far: “As part of the Government’s counter-terrorism strategy, Prevent has only ever been focused on the hard end of the extremism spectrum. So the Home Office will soon, for the first time, assume responsibility for a new counter-extremism strategy that goes beyond terrorism.

“This strategy will be devised and overseen by the Home Office, but its implementation will be the responsibility of the whole of government, the rest of the public sector, and wider civil society. It will aim to undermine and eliminate extremism in all its forms – neo-Nazism and other forms of extremism as well as Islamist extremism – and it will aim to build up society to identify extremism, confront it, challenge it and defeat it.”

The latest Bill has been put forward in this context, though even in announcing the legislation, May warned that the measures do not go far enough, speaking of the need for increased powers to monitor people’s online communications.

Indeed, the Rifkind report is itself a political intervention designed to further push legislation in this direction. They state that internet and other communications service providers are unintentionally “providing a safe haven for terrorists” as they do not “proactively monitor and review suspicious content on their systems”, and “none of the major US companies we approached ... regard themselves as compelled to comply with UK warrants ... This is of very serious concern: the capability of the Agencies to access the communications of their targets is essential to their ability to detect and prevent terrorist threats in the UK.”

Furthermore, the report declares: “We have seen in recent months the numbers of young British men and women who have travelled to Syria and Iraq to engage in terrorism. The scale of the problem indicates that the Government’s counter-terrorism programmes are not working. Successfully diverting individuals from the radicalisation path is essential, yet Prevent programmes have not been given sufficient priority. We strongly urge our colleagues on the Home Affairs or Communities Select Committees to consider this issue as a matter of urgency, given the threat our country currently faces.”

The present Bill and the hinted further measures represent a significant stepping-up of the criminalisation of conscience and the arbitrariness of the state and are a serious attack on the rights of all. They do not begin with a definition of what constitutes terrorism that is based on upholding the rights of all, so that the authorities can be held to account. Indeed, as pointed out by director of Liberty, Shami Chakrabarti, “... every government proposal of the last so many years has been about blanket surveillance of the entire population. The Snowden revelations demonstrate that they were even prepared to act outside the law and without parliamentary consent.”

Rather, a climate of terror is fostered and used to justify such arbitrary powers. To define extremism as “vocal or active opposition to fundamental British values” is both implicitly racist and a direct attack on the right to conscience. It is not for nothing that various opponents have drawn parallels with McCarthyism. This “muscular liberalism” is itself profoundly anti-democratic and cannot be allowed not pass.