I have spent the last 20 years of my life following my mother around the NHS. Irish and working class she has benefited enormously from a service which is free at the point of need and one that has provided for her as she has moved from an able 70 year old to a disabled 91 year old. She lives in one of the poorest areas of Manchester with some of the worst health indices. But she has also had some of the most committed doctors and health workers who have chosen to work in her local health centres. Her local hospital is a teaching hospital -a 10 minute ambulance ride away - where she has had access to high quality specialist services at different times which have led to her surviving strokes and heart problems.
Since it was founded the NHS has always been a public service which politicians claim to love whilst behind our backs have often been chipping away at it. In their book NHS SOS (oneworldpublications) the editors Jacky Davis and Ray Tallis showed that it was not just the Health and Social Care Act 2012 which has betrayed the NHS: “It has taken thirty years of preparation, during which successive administrations underminded the values and assumptions that made the NHS possible while at the same time seeming to uphold them.”
The NHS, as my mother has experienced it, is under threat but I am not writing yet another article (and there are plenty of them ) which announces its demise. In this article I am going to talk about what is happening in the north west of England where I live and where I am an activist in the campaign to oppose the further privatisation of the service.
Greater Manchester is a sprawling conurbation that includes some of the poorest areas of the country as well as a smattering of affluent spots. There were 19 hospitals across the area serving a community of 2.7 million people but over the last years we have seen the closure of hospitals but also the growing opposition to these and other changes by campaigners.
In February 2013 a conference was held in central Manchester which brought together over 100 activists already involved in campaigns which opposed cuts to health services. Although organised by the Greater Manchester Association of Trades Union Councils, it was much broader than the trade union movement in terms of the individuals and groups who turned up to the meeting.
Since then a co-ordinating group Greater Manchester Keep Our NHS Public KONP has acted to organise and support the many activities that are taking place in different areas. Crucial to its work is telling the public about what is happening, particularly the changes such as the creation of Clinical Commissioning Groups, the tendering out of NHS contracts and the threats to hospitals across the region.
Groups within the network have used different tactics to inform the public about the privatisation agenda: mounting street stalls; showing films and organising discussions; leafleting hospitals and health centres; asking people to contact their GPs on issues such as commissioning;and attending CCG meetings as well as the usual marches and demonstrations that have been the response of organisations such as the trade unions.
The NHS was created by the Labour Party but their involvement in its history of privatisation has been a major stumbling block in activists’ relationship with local MP and shadow Health Secretary Andy Burnham. Mixed messages from Burnham about acceptable levels of privatisation within the NHS has made activists wary of Labour’s future policy on the service. The often feeble response of health union Unison to the attacks on their members and the service has also undermined the anti-privatisation campaign both locally and nationally. Unite the Union, who have less members in the NHS, has provided finance and resources to campaigns.
In July 2014 the new CCGs across Greater Manchester announced: “With many of our hospitals failing, the clinical commissioning groups across Greater Manchester came together three years ago ago deciding that no change is no longer an option. Healthier Together have spent the time between now and then putting together proposals for a sustainable NHS in Greater Manchester that can also become one of the best healthcare systems in the UK.“
They saw the issues as ones about the way healthcare works, concentrating on improving times in A&E and creating specialist hospitals across the region whilst at the same time downgrading other hospitals. They claimed that this would lead to: “one co-ordinated system of care so that all the organisations and facilities involved in caring for you can deliver high-quality care and an excellent experience”. The emphasis would be on improved care in the community which would allow hospitals to deal with the more specialist conditions. However they did not give any financial information about how this would be paid for which, at a time when the NHS is under severe financial pressure, made activists even more cynical about the whole process.
Greater Manchester Keep Our NHS Public were critical of this proposed model of healthcare, stating that ”The proposals are based on a restricted public budget for NHS. The only source of funding to correct the imbalance between community and hospital services is by cutting the hospital budget. Something both parties agree with…only the public don’t agree. So consultation is based on this assumption of a restricted NHS budget…it is a way to get the public to accept this basic assumption.”
KONP has challenged this model which would lead to five local Accident and Emergency units facing closure. They also point to a failed project at Trafford General Hospital, the birthplace of the NHS in 1948. This hospital was downgraded as a local hospital, despite a big campaign led by local people, health workers and councillors. The A&E was closed, the promised local community services were not set up and, as local KONP member Pia Feig comments; “Patients fled from what they saw was a down-graded service in Trafford General”.
Activists’ opposition to the Healthier Together agenda was only matched by the public’s lack of interest and involvement in the whole consultation process. HT decided to hold the public meetings in August, but when I attended one of these meetings there were few real users there: it was packed with GPs, healthcare workers and representatives from charities. Even HT’s own figures showed only 23,490 people completed the questionnaires ie just over one percent of the region’s adult population.
Local MP Graham Stringer commented on HT; I have never witnessed such an incompetent display from professionals in all my time as an elected representative. More than £4million had been spent on financial, legal and PR advice yet nobody knew if the proposals were lawful or financially viable.”Manchester Confidential
One of the most vibrant campaigns in Greater Manchester has been the opposition to proposed cuts in local mental health services at a time when growing unemployment and poverty has led to increased demands on its service. In December 2014 at a meeting in central Manchester 130 people gathered together to launch a Northwest anti-mental health cuts campaign. The speakers included a psychiatrist, a social work lecturer, a member of a user group, a campaigner and a nurse. All of them were active in campaigning and all spoke about the need to get more people involved in challenging the cuts and privatisation of the service and were adamant that the public can make a difference.
They said; “We are a group of users, carers, workers, people interested in stopping health and social care cuts in mental health services in Greater Manchester” and “We believe these cuts to mental health services are not known to the majority of people. We have called this meeting to draw people’s attention to these cuts and to campaign against them, linking up some of the local anti-cuts campaigns.
As an activist and user of the NHS I am both horrified by the government’s savagery in attacking the serice and in awe of people’s determination to defend it. This year there will be a General Election and all the political parties are pledging more money to the NHS. What they do not have is any strategy that delivers a service that reflects the needs of the population of this country. Maybe it is down to the activists to do that? As Aneurin Bevan, Labour Health Minister and founder of the NHS said; “It will last as long as there are folk left with the faith to fight for it”.