Try Red Pepper in print with our pay-as-you-feel subscription. You decide the price, from as low as £2 a month.

More info ×

Vital resistance

Donald Morrison looks at the resistance needed to beat the health white paper

September 30, 2010
7 min read

The coalition’s health white paper represents a new and extreme threat to the NHS which must be met by grass-roots and national resistance. Luckily (or unluckily as the case may be) we’re not starting from scratch. The pro-market policies of New Labour sparked considerable activity and there are already many health service campaign groups and networks in place, as well as lots of experience of which strategies are most successful.

There is a plethora of health campaign groups, ranging from national organisations such as Keep Our NHS Public to entirely local initiatives like East Riding Hospitals Action Group, and even single-issue political parties. This reflects different forms of campaign activity, with straightforward anti-cuts movements existing alongside more broadly focused organisations.

North London

Camden and Islington in North London are good places to look for examples. The debate has been particularly heated here because London is where New Labour’s reforms were pushed hardest and fastest.

The most visible and often successful form of health protest is the local ‘defend our hospital’ anti-cuts campaign. In summer 2008, services at the Whittington Hospital in Highgate were threatened with closure. This destructive proposal caused a groundswell of opposition. The Defend the Whittington Hospital Coalition (DWHC) was duly formed.

In February 2009 its protest campaign peaked in a vibrant 5,000-strong march. In April, as a follow up, the DWHC held a day of action to which it invited political leaders to speak. With the election just around the corner, then health secretary Andy Burnham made a dramatic U-turn and bowed to public pressure, overruling the NHS primary care trust (PCT). His Tory shadow Andrew Lansley, now the secretary of state, also pledged to honour that decision.

The Whittington campaign was a powerful community alliance driven by the real and acute threat of losing a treasured hospital. According to organiser Candy Udwin, ‘We were successful because of the sheer breadth of support. We were also a highly visible campaign out on the street, in the paper and on line. We built broad links with other campaigning groups.’

Yet fears about the future of the Whittington are still palpable. Campaigners delivered a 25,000 signature petition to the Department of Health in July. The coalition white paper proposes to give GP consortia commissioning power, and health bosses have said they could resurrect their hospital closure plan if GPs agree. Despite the massive show of public opposition, Lansley may still oversee cuts, so the campaign is not over yet.

In the same area of London, a different form of health campaign has also gained a high profile. The Camden branch of national organisation Keep Our NHS Public was active in the Whittington campaign too, but it has a broader, more long-term set of objectives in opposition to the imposition of the market on the health service.

Camden Keep Our NHS Public has been a thorn in the side of the local PCT, frequently challenging the failure of NHS bosses to carry out their legal duty to consult the public when downgrading local health services. Most recently the PCT tried to award an out-of-hours GP service to Harmoni Ltd, a private company that plans to cut costs by replacing out-of-hours GPs with nurses. Keep Our NHS Public member Regan Scott made the case to the borough’s health scrutiny committee that this represented a substantial change requiring consultation. As a result the tendering process has been delayed and at the time of writing is pending.

Meaningful consultation when imposing cuts and privatisation has continued to be a stumbling block not just for NHS Camden. North East Derbyshire PCT fell short in 2006 and was challenged in the High Court. Haringey PCT also failed to consult in 2008 when Hornsey Central Hospital was demolished in favour of a PFI health centre, and there are many other examples.

The North East

Another form of resistance is being employed in the North East of England, this time led by health workers directly. Earlier this year Unison in Durham successfully quashed proposals to turn the local NHS trust into a social enterprise – an independent body not part of the NHS proper. Unison insisted that before any decision was made a vote among staff had to be taken. Members campaigned hard to raise awareness about the negative impact this change would have on local health services and staff voted against.

This kind of action by health workers will be seen more and more if the government’s health white paper becomes law, as forcing NHS bodies to become ‘social enterprises’ is a central plank of the coalition’s health policy. One of the fears is that social enterprises are a soft cover for privatisation, breaking the NHS up into independent businesses that must compete with each other rather than collaborate for the good of patients. Social enterprises are likely to be easy pickings for profit-making corporations to buy up in the future.

Concerned locals in the North East also formed the Public Services Alliance (PSA). The PSA is a broad community alliance between organisations opposed to cuts and privatisation in general. At present it includes all the public sector trade unions and it aims to expand to include organisations in the voluntary sector, political and academic representatives, as well as public service user groups.

In the Northern Region one in three jobs are in the public sector. As Unison convener for the region Clare Williams says, “With the threatened abolition of PCTs, Strategic Health Authorities and NHS Direct as well as cuts in hospital services, there is a real worry what this means for jobs and the quality of services.”

The PSA is not just about defending jobs. It has come together to challenge the pro-market agenda and to provide an alternative vision for the future of public services. “We have been leafleting and awareness-raising with health workers and the public,” says Clare. “One of the first hurdles to get over is making people aware of the seriousness of the danger posed by the White Paper: that if more NHS Trusts become social enterprises this will take more NHS hospitals and staff out of public oversight. This will ultimately fragment services, resulting in a postcode lottery.”

The PSA has already started branches across the North East, including in Newcastle, Gateshead, Durham and Sunderland. Branches are meeting regularly, a website is in the making and coalitions with other local groups are being built – support is growing.

National

On a national level, health campaigners are looking to the unions to lead the fightback, freed from any fetters now that Labour is out of government. Unison has launched an important legal challenge in the High Court, seeking a judicial review over the government’s failure to consult on the white paper before beginning its implementation. Meanwhile Unite has started a Unite 4 Our NHS campaign.

Beyond resistance to government policy, campaigners are developing visions of how the NHS should look. A recent British Medical Association-sponsored roundtable event on ‘An NHS Beyond the Market’ called for a health service based on principles of ‘risk pooling, free access and comprehensive care based on need alone’ and an end to the purchaser/provider split, first introduced by Ken Clarke during the last Conservative government, which is the foundation of all the market reforms.

What next?

The campaigns outlined here represent a fragment of what has been going on in communities across the country. As the pro-market agenda becomes more aggressive it is imperative that a nationwide campaign mounts a robust and unified defence. Unions will have a key role, not just health unions, but all public sector unions. This campaign must be a broad one building on the strategies that have proved effective.

Health will be a big issue over this parliament. The most radical reforms since 1948 are being pushed through at the same time as £20 billion of cuts. If these two phenomena become linked in the public mind, and unions, local and national campaigns coordinate their efforts, there is a real chance of stalling government policy.

Red Pepper is an independent, non-profit magazine that puts left politics and culture at the heart of its stories. We think publications should embrace the values of a movement that is unafraid to take a stand, radical yet not dogmatic, and focus on amplifying the voices of the people and activists that make up our movement. If you think so too, please support Red Pepper in continuing our work by becoming a subscriber today.
Why not try our new pay as you feel subscription? You decide how much to pay.

Contribute to Conter – the new cross-party platform linking Scottish socialists
Jonathan Rimmer, editor of Conter, says it’s time for a new non-sectarian space for Scottish anti-capitalists and invites you to take part

Editorial: Empire will eat itself
Ashish Ghadiali introduces the June/July issue of Red Pepper

Eddie Chambers: Black artists and the DIY aesthetic
Eddie Chambers, artist and art historian, speaks to Ashish Ghadiali about the cultural strategies that he, as founder of the Black Art Group, helped to define in the 1980s

Despite Erdogan, Turkey is still alive
With this year's referendum consolidating President Erdogan’s autocracy in Turkey, Nazim A argues that the way forward for democrats lies in a more radical approach

Red Pepper Race Section: open editorial meeting – 11 August in Leeds
The next open editorial meeting of the Red Pepper Race Section will take place between 3.30-5.30pm, Friday 11th August in Leeds.

Mogg-mentum? Thatcherite die-hard Jacob Rees-Mogg is no man of the people
Adam Peggs says Rees-Mogg is no joke – he is a living embodiment of Britain's repulsive ruling elite

Power to the renters: Turning the tide on our broken housing system
Heather Kennedy, from the Renters Power Project, argues it’s time to reject Thatcher’s dream of a 'property-owning democracy' and build renters' power instead

Your vote can help Corbyn supporters win these vital Labour Party positions
Left candidate Seema Chandwani speaks to Red Pepper ahead of ballot papers going out to all members for a crucial Labour committee

Join the Rolling Resistance to the frackers
Al Wilson invites you to take part in a month of anti-fracking action in Lancashire with Reclaim the Power

The Grenfell public inquiry must listen to the residents who have been ignored for so long
Councils handed housing over to obscure, unaccountable organisations, writes Anna Minton – now we must hear the voices they silenced

India: Modi’s ‘development model’ is built on violence and theft from the poorest
Development in India is at the expense of minorities and the poor, writes Gargi Battacharya

North Korea is just the start of potentially deadly tensions between the US and China
US-China relations have taken on a disturbing new dimension under Donald Trump, writes Dorothy Guerrero

The feminist army leading the fight against ISIS
Dilar Dirik salutes militant women-organised democracy in action in Rojava

France: The colonial republic
The roots of France’s ascendant racism lie as deep as the origins of the French republic itself, argues Yasser Louati

This is why it’s an important time to support Caroline Lucas
A vital voice of dissent in Parliament: Caroline Lucas explains why she is asking for your help

PLP committee elections: it seems like most Labour backbenchers still haven’t learned their lesson
Corbyn is riding high in the polls - so he can face down the secret malcontents among Labour MPs, writes Michael Calderbank

Going from a top BBC job to Tory spin chief should be banned – it’s that simple
This revolving door between the 'impartial' broadcaster and the Conservatives stinks, writes Louis Mendee – we need a different media

I read Gavin Barwell’s ‘marginal seat’ book and it was incredibly awkward
Gavin Barwell was mocked for writing a book called How to Win a Marginal Seat, then losing his. But what does the book itself reveal about Theresa May’s new top adviser? Matt Thompson reads it so you don’t have to

We can defeat this weak Tory government on the pay cap
With the government in chaos, this is our chance to lift the pay cap for everyone, writes Mark Serwotka, general secretary of public service workers’ union PCS

Corbyn supporters surge in Labour’s internal elections
A big rise in left nominations from constituency Labour parties suggests Corbynites are getting better organised, reports Michael Calderbank

Undercover policing – the need for a public inquiry for Scotland
Tilly Gifford, who exposed police efforts to recruit her as a paid informer, calls for the inquiry into undercover policing to extend to Scotland

Becoming a better ally: how to understand intersectionality
Intersectionality can provide the basis of our solidarity in this new age of empire, writes Peninah Wangari-Jones

The myth of the ‘white working class’ stops us seeing the working class as it really is
The right imagines a socially conservative working class while the left pines for the days of mass workplaces. Neither represent today's reality, argues Gargi Bhattacharyya

The government played the public for fools, and lost
The High Court has ruled that the government cannot veto local council investment decisions. This is a victory for local democracy and the BDS movement, and shows what can happen when we stand together, writes War on Want’s Ross Hemingway.

An ‘obscure’ party? I’m amazed at how little people in Britain know about the DUP
After the Tories' deal with the Democratic Unionists, Denis Burke asks why people in Britain weren't a bit more curious about Northern Ireland before now

The Tories’ deal with the DUP is outright bribery – but this government won’t last
Theresa May’s £1.5 billion bung to the DUP is the last nail in the coffin of the austerity myth, writes Louis Mendee

Brexit, Corbyn and beyond
Clarity of analysis can help the left avoid practical traps, argues Paul O'Connell

Paul Mason vs Progress: ‘Decide whether you want to be part of this party’ – full report
Broadcaster and Corbyn supporter Paul Mason tells the Blairites' annual conference some home truths

Contagion: how the crisis spread
Following on from his essay, How Empire Struck Back, Walden Bello speaks to TNI's Nick Buxton about how the financial crisis spread from the USA to Europe

How empire struck back
Walden Bello dissects the failure of Barack Obama's 'technocratic Keynesianism' and explains why this led to Donald Trump winning the US presidency


1