(Background  is here)

DEMONSTRATION
Lunchtime protests will be held at all blood centres in England on Friday 15th June. This is one day after International Donor Day (also the first day of a week of national leafleting in support of NBS workers by the UK IWW). Click below for the addresses of affected centres for any available health activists who would like to go along + give the staff a boost.

Leeds Blood Centre, Bridle Path, Leeds, LS15 7TW
Colindale Blood Centre, Colindale Avenue, London, NW9 5BG
Tooting Blood Centre, 75 Cranmer Terrace, London, SW17 0RB
Southampton Blood Centre, Coxford Road, Southampton, SO16 5AF
Sheffield Blood Centre, Longley Lane, Sheffield, S5 7JN
Brentwood Blood Centre, 15 Crescent Drive, Brentwood, CM15 8DN
Newcastle Blood Centre, Holland Drive, Newcastle, NE2 4NQ
Bristol Blood Centre, Southmead Road, Bristol, BS10 5ND
Cambridge Blood Centre, Long Road, Cambridge, CB2 2PT
Manchester Blood Centre, Plymouth Grove, Manchester, M13 9LL
Oxford Blood Centre, John Radcliffe Hospital, Headington, OX3 9BQ

The traditionally conservative Royal College of Midwives (RCM) is planning industrial action for the first time since it was founded 125 years ago.

RCM members are outraged that midwives’ pay is now increasing at a rate slower than inflation – in real terms, midwives are getting their pay cut. Delegates at the RCM’s recent conference voted unanimously for a ballot on industrial action, though the College insists it will stop short of a strike.

RCM General Secretary Karlene Davis commented “There is a groundswell of discontent amongst midwives… it is one that the Government ignores at its peril. Morale amongst midwives is plummeting and the pressure on them is increasing”. She added that midwives felt “real anger” at the pay deal.

Meanwhile, the Royal College of Nursing will also ballot its members on industrial action for the first time in history.

The House of Commons Public Accounts Committee today warned of the dangers of increasing use of agency nurses within the NHS. In a trend being replicated throughout the UK economy, decent, secure jobs are being replaced with temporary or agency work, and nurses and patients are paying the price. Many NHS managers find it more convenient to book temporary nursing staff to deal with short term peaks in demand and holidays, and then get rid of these workers when demand is not so great. Agency workers can also be denied basic benefits such as holiday pay, and agency bosses attempt to save even more money by not providing their staff with necessary training – according to the committee 39% have not received basic life support training and 41% have not been trained in infection control.

The committee even warned that these attacks on conditions and job security could be costing the NHS money – given the high cut agencies take in fees for each hour worked agency staff often end up costing more than regular staff.

It is vitally important that health workers stick together in the face of these creeping attacks on our job security and fight to ensure that agency workers receive the same conditions, job security and access to training as other nursing staff.

An article I wrote for the most recent issue of ‘Direct Action’ magazine (www.direct-action.org.uk) to shed some light on the plans for all hospitals and even PCTs to undergo transition to ‘Foundation Trust’ status, one of the government’s current weapons of choice in the privatisation by stealth of the NHS and the cuts to jobs and services which go with it. The information fed to health workers by hospital managers keen to achieve foundation status is extremely misleading – find out the things they don’t want you to know here.

Foundation Trust status – a guide for NHS workers

We all know that the NHS is undergoing a period of ‘reform’, but what is actually happening? And what does this mean for those of us who work within the NHS? As you might have guessed, the government doesn’t exactly have our best interests at heart, and so their pretty simple policy of privatising any areas of the NHS which are financially profitable and closing down the rest of it are disguised in all kinds of strange new terminology and confusing doublespeak. All to try and minimise the number of us who realise what is happening! This is the first of a series of guides for health workers outlining the nature of specific pro-market reforms going on in the NHS and what they mean for NHS employees.

There is currently a big push for NHS trusts to become so-called ‘NHS Foundation Trusts’. What this means is that the trust in question (usually a hospital) effectively ceases to be accountable to the Department of Health and becomes a privately controlled entity. Its land, buildings and equipment are no longer NHS property and instead are under the control of the Trust directors. An independent monitor (imaginatively named ‘Monitor’) is instead responsible for monitoring the trust’s performance, just as is the case with other privatised industries, and is almost entirely concerned with financial considerations. At first glance this appears to be a clear case of wholesale privatisation and interestingly has even been referred to as such by Unison general secretary and Labour hack Dave Prentis, who has declared foundation trusts to be ‘private hospitals’. However, since privatising the NHS in this brazen way would be extremely unpopular amongst employees and users alike, the government has introduced a number of (pretty feeble, it has to be said) ‘safeguards’ which, the argument goes, mean that this does not count as real privatisation. We examine them below…

Profit-based healthcare

1. Foundation Trusts are, according to the government, ‘not-for-profit’ organisations. The basis of this claim is that they are not permitted to be owned by, and provide profit to, shareholders. However, foundation trusts are allowed to keep ‘surpluses’ (profits by another name) thus providing the clear incentive to run the trust as a commercial concern rather than for public benefit. They can ‘dispose of’ (ie sell off) former NHS land and assets (even those used for the provision of NHS services) and keep the profit. In addition they can provide private healthcare services – the proportion of their income they can earn from these is currently capped, though this cap is under review. They can also enter into joint ventures with private corporations, which essentially allows the trust to engage in all the dodgy commercial activity which it is formally not allowed to do! These joint ventures can, for example, finance private loans out of NHS revenues, charge fees (and these can account for as much of its revenue as it wants) and must make profits and distribute them to shareholders. These joint ventures don’t even have to have anything to do with healthcare!

Corporate structure

2. According to the government foundation trusts are ‘accountable to their local community’ – they even have the cheek to try to present it as some kind of democratic advance! The reality is that executive directors, responsible for the day-to day funding of the trust, are completely unelected. Non-executive directors are indirectly accountable to a vaguely-defined ‘membership’ which is supposedly representative of staff and the local community, though there are no rules as to exactly how representative it should be. This membership (along with interested local bodies such as the council, Primary Care Trust etc) elects ‘governors’, who in turn elect the non-executive directors. All rather complicated, but when it comes down to it the structure of a foundation trust is very similar to that of a private company, with power just as concentrated and unaccountable. Despite government attempts to create an Orwellian new label (‘Public Benefit Corporations’) to define foundation trusts, the Office for National Statistics correctly classes them as private rather than public bodies due to this unaccountability.

So when you combine points one and two the implications are clear. Foundation trusts are structured and run just like private corporations. They can make and keep financial ‘surpluses’ and even distribute profits to private shareholders – just like private corporations. They will compete against private hospitals and other NHS trusts for money from ‘customers’ and Primary Care Trusts – just like private corporations. In short, a foundation trust looks like a private corporation, sounds like one, and clearly it will behave like one. So what are the implications for staff?

Foundation Trusts and you

The responsibility of a foundation trust is to provide health services ‘effectively, efficiently and economically’ – i.e. to focus on the balance sheet, not patient need. They are free to set their own pay scales, and who knows when it might be financially prudent to slash your pay in a way which an NHS trust bound to national pay agreements would not be able to do? FTs are also free to contract staff out to private companies – we have already seen this happening in non-clinical areas such as catering, cleaning, parking, etc. with disastrous results in terms of staff pay and conditions, as well as understaffing problems which have led to the rise in hospital infections. Clearly it’s cheaper not to provide enough staff to clean the hospital properly, and that way more profits can line the pockets of parasitical shareholders. FTs threaten to extend this contracting out to private corporations further, including into clinical areas. If you don’t want to see yourself and your job sold to the highest bidder like chattel, then foundation trusts are something to be opposed!

Even if your job is not outsourced the clear incentives to the directors to run the trust like a business rather than as a public service will place similar commercial pressures on employees. They will want more done for less, which will more than likely mean that your workplace is understaffed and you are overworked. If you work in a less ‘profitable’ area of healthcare, such as with ‘chronic’ long term conditions – various kinds of rehabilitation, elderly care, mental health, etc. – your job may disappear completely. This kind of healthcare is not easily run in the kind of conveyor belt way which sees a steady throughput of patients bringing in the cash, but is rather more complicated, long-term and to put it bluntly, bad for business. It is no coincidence that mental health and elderly care have been among the areas hardest hit by NHS cuts in recent years. Whilst this is clearly a bad thing in terms of our job security, it also surely needs to be opposed by the vast majority of NHS workers who care about the people we treat – we want to work in a service that takes care of everyone who needs us, regardless of how ‘profitable’ they are.

The Future

The government has stated that its target is for all NHS trusts to become foundation trusts by 2008. This includes Primary Care Trusts which purchase healthcare from hospitals – I’ll go into the complicated workings of the (now renamed, but unfortunately still going strong) NHS ‘internal market’ in a future article. It has also stated that private healthcare providers will be eligible for foundation status. The future mapped out for healthcare provision in this country, therefore, is one of private and privatised foundation trusts competing with each other for ‘customers’ under the supervision of the independent ‘Monitor’ – in other words wholesale privatisation of the NHS. Transition to foundation trust status is an integral part of this process.

Prospects for resistance

Unfortunately, but rather predictably, the main criteria by which the government assesses a hospital’s application for foundation status is financial. Despite the usual lip service to accountability, in practice they don’t really need to demonstrate any level of public or staff support for these drastic changes, or even to explain properly what is happening. To date, no campaign to prevent a hospital becoming a foundation trust has been successful, largely perhaps because the whole process of NHS privatisation is so well disguised behind government lies and propaganda. However, it’s important that NHS workers and users know what is going on because at some point we’re going to have to turn things around if we want to live and work with a healthcare service worthy of the name. With the leadership of the main health worker unions irrevocably tied to the Labour Party it’s clear that the massive opposition needed to reverse these changes is not going to be organised for us – we’ll have to do it ourselves. As anarcho-syndicalists we already know that self managed collective struggles employing direct action tactics are the only weapons we have which can really get the goods in this or any other sector – it’s high time we got organised and got angry.

Unworkable reconfiguration plans will threaten patient’s lives and healthcare workers’ jobs.

The vital blood processing and distribution service is to be centralised in management cost cutting insanity which will result in blood being transported hundreds of miles by road and skilled workers losing their jobs. This will directly threaten patients’ lives as the blood is driven on congested motorways from the donation centres to the “super centres” and then back out to hospitals.

The NBS in England currently has 13 regional centres which process and test donated blood before redistribution to the hospitals. However this vital service is under threat with management wanting to condense these regional centres into just 3 to cover the whole of England.

Unlike many NHS trusts, the NBS is not in debt, and operates efficiently with committed workers, many of whom have worked there for decades learning their highly specialised skills on the job.

Notes

• Currently processing centres are in : Oxford, Bristol, Southampton, Tooting, Colindale, Brentwood, Manchester, Birmingham, Liverpool, Newcastle, Cambridge, Sheffield and Leeds.
• The 3 proposed “supercentres” will be : Bristol, Manchester and Colindale.
• The National Blood Service role includes : collecting blood from donations from 100’s of sites daily, testing the blood for Hepatitis, HIV, Malaria and Syphilis, filtering the blood and separating into components. This must then be distributed promptly to hospitals.

More information :
UK IWW launches campaign at the National Blood Service.
Unite members protest at closures in National Blood Service.

Historical article adapted from the ‘Northampton Healthworker’ newsletter. I think it highlights well how the introduction of market forces into the NHS is in reality a disguised form of rationing, which can and does have devastating consequences for those who can’t afford to go private. It also shows, however, that it is nothing new, and can be resisted very effectively if healthcare workers and users get together and stick up for ourselves.

29 years ago: Rita Ward and the Great Northampton Hospital ‘lie-in”

We hear a lot these days about the ‘creeping privatisation’ of the NHS. We have a Labour government committed to turning our free National Health Service into just another business along the lines of the American model, which sees poor people refused medical treatment because they can’t afford it. Although the current Thatcherite leadership of the Labour party is more vicious than most in it’s attacks on the NHS (foundation trusts and PFI schemes being their current weapons of choice) such thinking is, unfortunately, far from new. As far back as 1977 Northampton General Hospital was the scene of a battle against a Labour government’s attempts to marketise the NHS which saw a brave housewife and rank and file trade unionists take on the government and NGH management.

Rita Ward, of St. James’ Park road, Northampton had been in severe pain for 18 months and was waiting for a desperately needed gallstones operation. She was told she would have to wait another year – unless she coughed up £400 (a lot more money in those days) in which case she could have it that weekend! Rightly outraged at this economic apartheid Rita determined that she would get the operation at the same time as she would have done if she was rich. Flanked by her family and local trade unionists Rita walked into the hospital, removed the coat which was covering her nightdress and lay down in an empty bed. The hospital workers were informed of the situation and showed true working-class solidarity, proceeding to treat Rita as they would any other patient, and refusing orders to move her.

The next day it was national news, with journalists descending on NGH to cover the story. The right wing press screamed about ‘queue-jumping’ but others, notably Paul Foot, pointed out that there shouldn’t be a queue in the first place and if there is one you certainly shouldn’t be able to get to the top of it by being rich.

The outcome was that Rita got her operation in the next few days, and no other patients had operations cancelled or deferred. As the Daily Mail and the Labour government tore their hair out Rita Ward, Northampton housewife, and health workers at Northampton General gave the country a lesson in how direct action and working-class solidarity can defeat the attempts of the moneymen to deny us our basic rights. The small victory we won in Northampton 29 years ago has, however, been followed by many defeats. With the NHS being slowly run down and sold off, PFI schemes and ‘foundation hospitals’ introducing market principles into our health service and more and more NHS services being ‘contracted out’ to private profiteers how many more are being told, like Rita, that they have to pay for health care, but are unable to take the action she so bravely took?

Apologies for the clash of colours on this website. Please let me know if you have the will/skills necessary to make us look more attractive!

I started this site to try and develop an association/network that would have :

* A radical analysis of how healthcare is provided in the UK
* A class analysis, whilst also having a critique of the other ways we are divided, oppressed including according to sex/gender and sexuality, age, race, physical ability, legal status.
* A position on the ongoing privatisation of the NHS as well as a vision for how things could be.
* Solidarity and support for healthcare workers within UK and internationally.

With this in mind, I felt I wanted to include everyone whose job was necessary to healthcare provision. I believe that a false division (frequently along class/sex/race lines) exists, whereby the contribution of those not deemed professionals is sidelined. I believe that cleanliness and food in hospitals, for example, is crucial to the healthcare of the patient. I believe in the strength of workers when we are united together to fight for our conditions and our ability to provide the best possible healthcare.

I want to acknowledge that a friendly and dedicated “domestic” on a ward is a boon to the rest of the multi disciplinary team. They are a part of it.

Please let me know your thoughts below.

ARM has been going since the 70’s and offers an alternative to a heavily medicalised and pathology obsessed obstetrician led birthing process.

They currently are campaigning around attacks on independent midwifery by the UK government.

If you are involved with the group, or have opinions about it, please comment below.

This website is at as early and undeveloped a stage as is the inspiration behind it : an Association for Radical Healthcare Workers.

For more information see “About”