It was good to see that Jeremy Corbyn and John McDonnell gave their full support to the Junior Doctors’ Strike last Tuesday. Not only was this the first time in my memory that a Labour Leader and Labour Shadow Chancellor had openly and unequivocally supported a strike, but it was, without doubt, the correct thing to do.
The fight by Junior Doctors for fair treatment at work and by nurses and all NHS workers to retain their bursaries is not only their fight; it is ours too.
Of course, this is about wages, and working hours, and payment for training, but it is also very much about patient safety. And at the heart of the struggle is the fight for something we all hold dear: our Free National Health Service.
Without doctors and nurses we would not have a health service, and without the hard work and dedication of doctors, nurses, and all health support workers and practitioners, our NHS would certainly not be free.
And the issue of ‘free’ is important when we look at the creeping privatisation of our NHS and how it affects not only doctors and nurses, but all of us.
The NHS Privatisation plan:
There are 3 main factors to this:
Soon there will no longer be a ‘national’ health service.
This has already happened in Manchester, and very soon we will have ‘regional health services’ all over the UK, with NHS funding subsumed within local authority funding. And we all know what has happened to local authority funding…it has been cut, and cut again!
The Private Finance Initiative or ‘PFI’:
Since 1992, most large scale public capital investment in the UK has used PFI procurement, whereby a consortium of investment banks, builders, and service contractors raises the finance, and designs, builds, and operates the facilities for the public authority through a project company
Now on the surface, this sounds good – after all, it appears that nothing has been sold off and that the private sector is contributing to the NHS.
But that of course is not the case….
Through the PFI scheme private companies have built NHS hospitals and leased them back to the NHS. They also run support services as part of these contracts. This has of course been highly profitable for the companies involved, otherwise the scheme would not have worked, but it is now becoming crystal clear that the PFI model offers very poor value and is, in fact, draining our NHS of desperately-needed funds.
A number of NHS hospitals are struggling to cope with the cost of meeting their PFI debts. South London Healthcare Trust was the first to be put into administration after being put on a growing list of trusts burdened with PFI debt.
In the early 1990s, hospitals paid no charge on their land, buildings and assets, but today many PFI-run hospitals are paying a substantial percentage to PFI investers just to keep going. And the percentage they pay is rising all the time. At the moment, when new government money is injected into the NHS, most of it goes directly to private investors because of PFI.
We are told that we can no longer afford to pay for universal healthcare, but that simply wouldn’t be true, if only we stopped using NHS funds to pay back the banks and other financiers who control the PFIs.
The Five Year Forward View:
On 1st April 2014, NHS England’s new chief executive, Simon Stevens, laid out his plans for the NHS, and on the surface they sounded positive enough. For example, he talked about:
“Unleashing the passion and drive of the million plus frontline NHS staff who are devoting their professional lives to caring.”
The problem was, that Stevens had a different idea of how to ‘unleash that passion’ than most users of the NHS would have wanted to hear.
By October, 2014, Stevens had published his ‘5 Year forward Plan’; a 39-page report which sets out ways the NHS in England needs to change over the next five years to ensure (and I quote) “it remains affordable in the face of increasing demand and finance pressures.”
On the surface, this ‘plan’ was welcomed by members of the NHS, as it outlined a way of dealing with patient care to fit a more modern age.
However, it has now become apparent that the ‘5 year forward plan’ was based more on business strategy than on patient need (In fact, when talking about his plan, Stevens described it as ‘NHS England’s Business plan’, first and foremost).
One of Steven’s most controversial measures is the call for more ‘super hospitals’, which are, no doubt, more cost-effective in a business sense, but are in actual fact dangerous for some patients living in rural areas, whose access to hospital emergency care and follow-on care will be severely restricted (especially when we take note of cuts to our ambulance services).
But that’s just one example of the problems with this ‘5 year plan’.
The main problem is that it has been designed with profitabilty in mind, rather than patient need.
Now, when you combine these 3 strategies – Devolution, Privatisation, and the ‘5 year forward plan’, you begin to see how much our Free and Public National Health Service is being put under pressure and is already being privatised.
Add to that the ‘profitability factor’, so beloved by PFI investers and by Stevens, and you see where the perceived need to change Junior Doctors’ contracts and to end Nurse’s Bursaries come in. Wages and personel costs being a huge part of the cost of any large ‘enterprise’, something has to be done about them to make them more ‘affordable’ for private investors.
The present scheme of work and pay for Junior doctors is not profitable enough when considered as part of a business plan for investors, and neither of course are bursaries for training NHS staff.
When you take all these things together, it becomes clear that our NHS is not only under threat of privatisation; it is already being privatised.
And this is why it is so important that we all support the junior doctors, student nurses, and in fact all NHS and health care workers.
We may not have access to the boardrooms of private companies, or be able to take part in meetings of private investment consortiums. But we can sure as hell let this government know that we know what they are doing, and that we intend to make them stop doing it!
So, we need to support our Junior Doctors and we need to support our Student Nurses and all NHS workers hoping to train within a free NHS.
Their fight is a fight that all workers and students are having to make – for fair treatment at work; for a living wage; and for free education.
If we as workers let Jeremy Hunt force the junior doctors to sign up to a new contract, how can we expect this Government to be fair to us when we call for decent wages and safe working conditions?
If we as students let this government force all health care workers to pay for their training, we are effectively saying that it is okay to pay for education, and we are therefore giving up the right to call for an end to student loans and for the right to free education for all.
And, if we, as users of the NHS, do not support Junior Doctors and Student Nurses in their fight for fair treatment by Mr Hunt, we are effectively saying “It’s okay Mr Hunt – you go ahead and make their services more profitable to the private sector.” And by doing that we would be giving up our right to demand that our NHS is saved from privatisation.
So we must support our junior doctors, our student nurses and all of our NHS workers.
And as for the Tories, we need to tell them in no uncertain terms “get your thieving hands off of our Free and National Health Service!”