One of the most crucial strikes in the National Health Service for more than a decade has erupted in defence of sacked union rep and senior nurse Karen Reissmann.
Karen was dismissed after she spoke out against cuts and privatisation of services provided by her mental health trust. Now more than 150 community mental health workers in Manchester have launched an indefinite strike, and branch-wide action involving all 700 workers is set to follow.
The outcome of this strike could determine the ability of union reps in the NHS to speak out when services provided by their members are under threat.
On Friday of last week Socialist Worker met with strikers Laura, Samantha, Nina and Bev – all of whose names have been changed to protect them from management reprisals – to discuss the dispute and the issues that triggered it. Between them they have decades of experience as mental health practitioners.
Nina says, “When your job is to help some of the most vulnerable people in society, the decision to go on strike, especially all out strike, is not an easy one. But we have done so because we can see no other way of defending our service and our union.”
“This is not just a fight for Karen’s job, or even the union – though both of them are vital – we are also on strike to defend the services we provide and the NHS,” says Laura.
All are agreed that mental health is the poor relation in the health service family, and that the stigma attached to mental illness means patients rarely receive the quality of care they deserve.
In Manchester that situation has been made worse by last year’s reorganisation of services, called Change in Mind.
Samantha says, “My job is to help people with mental health problems live as full lives as possible. I help them find work and college courses, help them integrate into their communities, help them keep contact with family and friends, and generally attempt to raise their expectations of life.”
“To do the job well, you have to establish long term relationships.
“Before the changes I co-ordinated the care of eight people – which is about the right number of clients per workers. That rose to 16 a few months ago. Now our managers are saying that we should care for as many as 25 people.”
That rise is having a devastating effect on the quality of care, and putting patients and the public at risk.
“The changes mean we cannot spend much more than half an hour with a client per week,” says Laura
“All we can do is turn up, check that the client is managing to feed, wash and clothe themselves and is not in immediate danger of suicide or self-harming. And that’s it.”
“All our years of training, all our experience, and all we are able to do for our clients is tick a few boxes – it’s a disgrace,” says Samantha.
Despite this limited approach, many people in need of care are not even receiving a weekly visit.
Nina says, “Because our management miscalculated the total number of patients, lots of people don’t even have a care co-ordinator. And, because people with mental health problems often lack the confidence to challenge their situation, they can end up with a steadily deteriorating quality of life.”
That situation can lead to vulnerable people feeling isolated and unsupported – a position that can put them in danger. Last month William Scott, a Manchester patient whose long term support worker had been “moved on” by trust managers, took his own life.
The strikers all felt that underlying the attacks on services is the threat of privatisation – the issue that Karen Reissmann spoke out against.
“Whole chunks of our trust are being put out to tender to providers outside of the NHS, and once that happens, patient care and profit become competing motivations,” says Samantha.
“Because lots of people understand this, and because many other NHS services are being privatised, getting our message across to the wider public has not been difficult.”
Nina agrees. “The public support for us has been fantastic,” she says. “And there is a real feeling of solidarity among all of us who are on strike.”
Being on strike has raised important questions about the relationship between the NHS, the government and the unions.
“I wasn’t at all political before this,” chips in another striker, who passes by our interview. “But the attack on Karen has made me question everything.”
Samantha agrees, “What’s happened in Manchester has caused me to look more deeply at issues like the Private Finance Initiative (PFI).”
“PFI is what is behind the financial crisis in our trust,” says Bev.
“When they closed the Withington hospital, where many of our in-patients were, they replaced it with the Wythenshawe – a PFI hospital. And now the beds cost the trust up to four times as much as they used to.
“Our strike is for the right of our union to speak out against cuts and this kind of privatisation.
“That’s why it is a fight for us here in Manchester, but it is also for everyone else who believes in the principles of the NHS.”
NATIONAL DEMONSTRATION TO REINSTATE KAREN REISSMANN
Saturday 24 November
Assemble 1pm, Peace Gardens, St Peter’s Square, Manchester