Socialist Worker

Striking to stop NHS meltdown

Health workers spoke to Tomáš Tengely-Evans about the crisis that’s gripping hospitals across Britain—and why their strike is the best chance to save the health service

Issue No. 2436

Health workers on strike last year

Health workers on strike last year (Pic: Guy Smallman)


Half a million health workers in England are set to walk out on Thursday 29 January—and the stakes couldn’t be higher.

The strike comes as the NHS is plunging into a deep crisis. Hospitals already hit by the cuts are struggling to cope with patients.

The South Western Ambulance Service set up a treatment tent in the grounds of Swindon hospital last week.

A lack of ambulances in York meant the fire service was forced to transport a patient. 

Aberdeen Royal Infirmary was described as “in meltdown” with exhausted doctors forced to turn away patients.

In London, ambulance worker Claire told Socialist Worker, “The first thing that we tell patients is, ‘sorry’.

“They are waiting longer and longer for ambulances to take them to hospital. Then we’re taking them into increasingly overstretched and overcrowded hospitals, where the A&E staff are on their knees.

“We then apologise to patients again as we’re forced to wait until they can get seen. There are times when we’re waiting up to two hours with patients. 

“Then we’ve had patients waiting 12 hours for a bed—and these are all patients who need to be in hospital”. 

The strike was called in defence of health workers’ pay. Workers are furious that Tory health secretary Jeremy Hunt has refused to give most even a 1 percent pay rise. 

But it’s also a fight for the future of the NHS.

The government and its supporters have tried to use the latest crisis as a stick to beat the health service they’ve always hated.

They to try blame NHS workers, or ill people who go to hospital “unnecessarily”.

But it’s their policies that have brought it to breaking point—and if a major incident pushes the NHS over the edge it could do the Tories immense damage too.

Jordan is an occupational therapist. She said, “There’s so many negative stories in the news about how the NHS is failing. I feel really indignant, because what’s never said is why. 

“The real reason is the cuts—it’s down to the fact that services haven’t been paid for.”

Years of underfunding and privatisation have combined with devastating local government cuts to produce the perfect storm.

More people are going to hospital, partly because of longer lives and a growing population. But it’s also because cuts to social care, local clinics and other vital services have left them nowhere else to go.

Closure

When they get there they find fewer staff and fewer beds. Ian, a mental health nurse in South Wales, explained, “We’re facing the fairly regular closure of wards—one’s just gone in St David’s in Cardiff and the University Hospital of Wales lost its only acute ward last year. 

“We had one man stuck in an admissions ward—where people are supposed to be assessed—for six years. There’s been a big closure of patient beds, and some bed occupancy rates have run over 100 percent.

“We’d have to send someone home for the weekend, but then admit someone else into that bed.” 

The pressure on the NHS is having a major impact on workers and patients. Staff shortages mean patients can wait hours in pain and urgent need without anyone being available to see them.

And the toxic levels of stress are pushing workers into illness or out of the service. Ian said, “If you look at the spreadsheet at the amount of NHS agency ‘bank staff’ being used, it’s clear that there’s a serious level of sickness going on throughout mental health services. And the reason is stress.”

Ian explained that stress is skyrocketing as services undergo repeated “reorganisations”. 

Claire said, “We’re under constant pressure, and the level of stress is huge. We’ve been massively understaffed in the last six months. There’s also a huge shortage of ambulances, including private ambulances.” 

Worse conditions are pushing many ambulance workers out of the service. “It’s down to national pressure, with the growing use of management targets,” said Claire.

Targets

“There’s also been big changes to our shift rotas, which are forcing us to work unworkable patterns.”

For example, ambulance workers with children could try and work around childcare needs. New shift patterns make that impossible.

This is replicated across the NHS. Most hospital trusts across Britain are facing shortages, with around 6 percent of nursing, midwifery and community jobs unfilled. 

In the West Midlands there are around 2,000 out of 40,000 jobs unfilled. Peter Vaughan, the Royal College of Nursing’s regional head, said, “We are standing on a nursing time bomb.” 

In England there were already 7,000 fewer qualified nurses in August 2013 than in May 2010. That doesn’t include the impact on other jobs such as school nurses and midwives. And since then it has got worse.

Ten highly experienced nurses recently left Whipps Cross Hospital in east London, because of bullying related to meeting targets. 

Even official NHS watchdog, the Care Quality Commission, admitted that Barts Health NHS Trust, which runs the hospital, was bullying. 

Radiographer Mahmoud recently left Whipps Cross, finding the pressure too much to bear.

He said, “There were increasing patient numbers, which put pressure on our service. 

“We also had to work overtime to make up what we had been earning as part of our basic salary.”

Many health workers are also feeling exhaustion, through long working hours and bigger workloads. 

“This means that NHS staff will sometimes make mistakes or miss targets under this pressure,” explained Mahmoud. 

“But Barts Health was always particularly ruthless in coming down on people. This whole situation had been building up and getting worse—I just had to leave.” 

Management

There are hundreds of cases like Mahmoud’s, of dedicated health workers who are being pushed past the limit. 

The Tories are piling on more cuts. The number of nurse training places in England is being slashed. 

But there’s a growing mood to fight for the NHS. That’s why the last NHS strikes were so big—and why so many people support them. Many workers have been arguing for sustained action. 

Claire said, “People really enjoyed being on strike, with people from other hospital departments.

“We’re also trying to use the organisation we built up during the national strikes to try and take on some of the things that our own management is doing. 

“They also generally feel that we need to escalate, if we’re serious about this fight.” 

Jordan said, “I don’t think we can afford not to go on strike.  

“We now need to build the next strikes—talk to everyone who went on strike last time, said they would this time, and who you work with.” 

The NHS is in meltdown—but our fightback can save it. 

Some workers’ names have been changed to protect their identities.


Privatisation is still causing chaos

The fiasco at Hinchingbrooke hospital in Cambridgeshire under the private firm Circle has exposed the damage that privatisation has already wreaked in the NHS.

Both Labour and Tory governments pushed millions of pounds of the NHS budget into the hands of privateers.

Services are subcontracted out or pitted in competition against each other—with a huge impact on workers and patients.

Marie has been a patient in the University College Hospital in central London for the last six years.

She said, “People are literally dying in the queue. They are having to wait hours in major departments, like the Macmillan Cancer Centre, at a time when their bodies are already under immense strain.

“This is down to management’s callous and marketised ethos. It’s 

a semi-privatised hospital that’s swallowing up the smaller hospitals to be part of its foundation trust.” 

Most ambulance workers still work directly for the NHS, but the use of private ambulances is rising. 

Abeo, who works for private firm Medical Services in north London, told Socialist Worker, “They’re cowboys, who’re pumping taxpayer money out of the NHS budget—people treat it like a business and there’s little accountability. 

“They don’t replace drivers and there’s definitely a shortage of staff. 

“They’re a private company, so try and keep wages as low as possible, and we don’t have the same pension as NHS workers. 

“You’re on the go all the time and you’re on the sharp end all the time. And if you’re tired you’re also more prone to accidents.”


Fact check: ‘Bed blocker’ insult hides truth

Many patients are stranded in hospitals as there is nowhere left to discharge them to. 

Occupational therapist Jordan said, “It has sometimes been difficult to find beds for new patients. But that’s because it’s hard to discharge existing patients without social care packages in place.

“This leads to bottlenecks.” 

Ambulance worker Claire agreed. “There are more people going to hospital,” she said. “But there’s already a massive backlog of patients who can’t get discharged.

“This then leads to people waiting in ambulance queues and lying in beds in hospital corridors. 

“It’s all combined to create one huge logjam.”

Shocking new figures revealed last week showed that hundreds of elderly patients in Scotland died in hospital simply because of the shortage of care home places.


Fact check: Agency agony

Health bosses increasingly rely on bringing in expensive agency staff to plug the gaps. 

The government’s own figures admit that NHS foundation trusts spent £4.3 billion in the last four years on agency and temporary staff. 

NHS foundation trusts’ spending on agency staff has gone up by around 20 percent for each year of the Tory government. 

In some cases this is because the staffing crisis means they can’t find enough permanent workers.

But in others it’s to give them the “flexibility” not to employ as many people.


A lesson in solidarity

Defending the NHS is a fight for all workers. That’s why strikers are asking trade unionists and campaigners to join their picket lines again. 

NUT union rep Anna Gluckstein collected £187 during the last strike. 

Anna said, “It’s important to do a collection, because it brings the dispute back into your workplace. People are always excited when they here about people fighting back. 

“It’s a practical way of building solidarity, and we’ll have to do it again on the next strikes.”


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