Socialist Worker

United against a two-tier NHS

Hazel Croft reports from Harrogate

Issue No. 1846

GOVERNMENT 'MODERNISATION' plans for the NHS came under attack this week from workers gathered at the health conference of the biggest NHS union, Unison. The whole of the conference united against the government's plan for foundation hospitals.

Former Labour health secretary Frank Dobson ripped the idea of foundation hospitals apart when he addressed the conference: 'The plans will mean the best hospitals get better at the expense of everyone else.' Dobson laid into the 'barmy' and 'right wing' idea of foundation hospitals, and said they would mean a two-tier NHS and enshrine inequality as a permanent part of the system.

'Above all, foundation hospitals will reintroduce competition into the NHS. It will pit hospital against hospital, as they compete for foundation status and the rewards that brings. There is not one piece of evidence that says hospitals competing against each other increases standards. One study by Bristol University was titled 'Death and the Free Market'. It found that competition was associated with higher death rates and lower quality. Who supports this idea? The Tories are absolutely drooling at the prospect because they recognise foundation hospitals are a stalking horse for the break-up and privatisation of the NHS. Apart from the Tories, the only people I find who support foundation hospitals who are not on the government's payroll are a few of the usual suspects in think tanks who I call 'modernistas'. The majority of staff, trade unionists, Labour Party members, most Labour MPs and, despite all the favourable publicity the BBC gives foundation hospitals, the public don't want them. An ICM poll found 59 percent against them. Foundation hospitals will get more funding. They can keep the proceeds of land and property, which used to be shared across the NHS as a whole and so will get extra funds whether they need them or not. They can borrow from the private sector, and take all the risks associated with borrowing. And we know what happened to Railtrack and to British Energy. They will be bailed out by the government and every pound they are bailed out with will either come from robbing another part of the NHS, or taking on more private patients, or they'll cut costs. Now it is out in the open what the government wants. Tony Blair wrote in Peter Mandelson's magazine that he wants a mixed economy in health, more privatisation and new forms of 'co-payment' - or in other words, charging for healthcare. That's dangerous for health, equally dangerous for trade unions and equally dangerous for the Labour Party.'

The tone of Dobson's speech shows how keen he is to distance himself from a government he was once a member of: 'Despite the fact that the health secretary and the prime minister are summoning in people to say foundation hospitals are a good thing, or perhaps because they are, large numbers of Labour MPs simply can't support them.'

Frank Dobson's searing criticisms of foundation hospitals were reinforced by delegates at the conference. Jim Keeley from Trafford said Labour was 'deserting a basic ideal, that the health of the nation is the responsibility of the state'. June Bates said, 'Foundation hospitals will be a disaster for the NHS. They will bring conflict and inequalities in care, and open up competition and a commercial market in the NHS.'

A delegate from South Tyneside said, 'The NHS will be split up and privatised under this agenda. We can't be saved by the Labour rebels. We need a genuine movement of health workers to fight this.'

There was applause for Karen Reissmann, a community nurse from Manchester, when she said, 'When two million marched against the war, they were not just angry at this destructive war for oil and US global power. They are also angry at the world America wants, where profits come first, multinationals come first, and where people can be bought and sold and killed to meet that agenda.'


Conference debates the low pay fight

THE UNISON health conference debated the government's pay package for health workers on Tuesday of this week. The conference voted to recommend the package, Agenda for Change, in a ballot of all Unison's health workers next month.

Unison's health group executive argued in favour of recommending Agenda for Change. But the union's leadership know how unpopular the proposals are and were at pains to stress that this didn't mean accepting the package. They claimed that they would be able to renegotiate the deal after several early 'implementation' schemes.

But the government has made it clear that it intends to push the complete package through. Every delegate who spoke in favour of accepting Agenda for Change admitted there were huge problems with the proposals. So Chris Bannon argued, 'Some of Agenda for Change stinks. But we've got to stay with it.' Other comments from those who accepted the proposals included, 'It isn't perfect,' 'It's got huge flaws,' 'Some will definitely lose out.'

But in the conference debate many health workers argued to throw out Agenda for Change. They said the pay package means accepting a derisory three-year 3.2 percent pay 'rise', and institutionalises low pay and divisions between health workers. And they pointed out that health secretary Alan Milburn is holding a gun to health workers' heads by saying they must accept the deal or return to local pay bargaining.

Adrian O'Malley from Wakefield, proposing a motion to reject Agenda for Change, was loudly applauded. He said that the government and the union leadership have accepted that 8 percent of health workers will lose out from the proposed deal:

'Are we going to sit back and say that these workers accept a pay freeze or a pay cut? I didn't join Unison so that we could sacrifice 8 percent of our members. Agenda for Change means accepting one person's pay rise will come at the expense of another person's pay cut. This government wants modernisation. That is the word it used to hammer the firefighters. It wants us to slog our guts out seven days a week, 24 hours a day, and accept a pay deal of just 3.2 percent for the next three years. Yet already national insurance has gone up, council tax has gone up, inflation is up.'

Porter Jim Clarke from North Glasgow Hospitals said, 'As a porter if I work on Sundays I will now get only time and a half, not double time. I potentially could lose a grand a year. Our union always said it would fight for low paid ancillary workers - not just the porters, but the cleaners, the catering staff, all the low paid workers. We should stand together and fight for more.'

Pauline Kempster from Tower Hamlets was loudly applauded when she said, 'In east London we're being balloted for strike action. We are low paid ancillary workers working for private contractors. If we've got the guts to come out and fight, then why can't Unison do the same for all its low paid members?'

Angela Gorman from Cardiff is a nursing sister who will gain a pay rise from the government's package. But she said, 'How on earth can I look my members in the eye and tell them I have accepted a pay rise at their expense?'

She added, to huge applause, 'I find it utterly insulting that I have to be told to modernise and reform by a group of men and women sitting in an old hall who until a few years ago were kept in control by a man in a wig and black tights.' The Agenda for Change proposals will be balloted on in May by all health workers in Unison. Every health worker should organise and agitate for its rejection.


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Sat 12 Apr 2003, 00:00 BST
Issue No. 1846
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