Will the NHS survive another winter crisis?

This article is reposted from OpenDemocracy, where it was published back in October. I'm republishing it here as the winter crisis is starting to bite, and our hospitals are full to over capacity, putting patients at risk and pushing staff beyond their limits.

This Saturday’s doctors' march could be the start of a vital NHS-wide fight-back against cuts and demoralisation. The alternative is frightening.

Over fifteen thousands of doctors marched down Whitehall this weekend, in protest at the imposition of a new contract. The contract sets a dangerous norm which could be applied to other NHS staff. It permits longer working hours, including til 10pm on Saturday as ‘normal’, and slower pay progression for part-time workers (disproportionately women). 

These signs of opposition from doctors are much needed. Staff morale is being crushed. Workloads are spiralling as a further £22bn budget cut by 2020 is imposed. A quarter of staff report management bullying as pressure is piled on to meet targets. Running short of staff, management turn to expensive private agency firms, who have increased their costs to the NHS from £1.8 billion in to £3.3 billion in just three years.

Why we need independent worker/professional organization in the NHS

Over the past year there has been a growth in organization and activism among NHS staff, and increasing engagement in speaking out about the appalling conditions the NHS is being driven to by austerity.

This is an enormously positive development and can not come soon enough. NHS privatisation is rapidly accelerating and engulfing more of the service daily, and the government is committed to limiting the NHS budget in order to force $ 22 billion of savings out of the service over the next 5 years, an impossible target which if met would mean wholesale destruction of huge swathes of service, and much damage to patient's and staff's lives.

Much of the organising has taken place on social media, beginning with doctors and healthworkers speaking out during last winter's A & E crisis, laying the blame publicly on government policy for the crisis. It has been organized around certain campains, like the NHS Bill 2015 campaign for the NHS reinstatement bill, or the Resilient GP campaign around Dr Meirion Thomas. The issue which galvinised the biggest coordinated response was Jeremy Hunt's attacks on Consultants and doctors in general for not working weekends. This generated the #Iminworkjeremy hashtag which was taken up by thousands of healthworkers across the country and received widespread media coverage.

There are indications that activists are now taking steps to cohere this newly politicized layer of healthworkers into organization, forming organizations like NHS Survival. This is necessary as while social media campaigns can secure some victories and raise awareness, they are not enough to secure changes in government policy, or management policy in the workplace.

The next goal for activists should be developing coordination and organization among activists nationally, with the aim of developing local workplace organization which can connect this newly energized and engaged layer with the rest of the NHS workforce, so they can be organized and mobilized together against the governments attacks .

Government u-turn on safe nursing levels branded a "betrayal" by Mid-Staffs campaigners

This article was originally published on OpenDemocracy

Independent work on safer ratios of nurses to patients across the NHS, was a key recommendation of the Francis inquiry into failings at Stafford hospital. This week, the government quietly shut that work down.

In a shock move, the government has abandoned its key project to ensure hospitals have enough nurses to look after patients safely. The move comes in response to a speech yesterday by NHS England boss Simon Stevens, who told a conference of NHS leaders in Liverpool that he wanted to move away from the “more mechanistic approach to the setting of nurse staffing ratios”.

In response the clinical advisor NICE moved swiftly, with NICE chief executive Sir Andrew Dillon saying “I have taken the decision to suspend further work on our safe staffing programme, including any further meetings of the advisory committee.”

Setting safe staffing levels will now be carried out by Chief Nursing Officer Jane Cummings, as part of NHS England reviews of urgent and emergency care and mental health services. While it might seem sensible for the Chief Nurse to set safe staffing levels, this removes the process from the independent, clinical and evidence-based oversight of NICE and puts it firmly in the hands of a loyal government institution.

It IS racist to worry about "foreign" nurses - a reply to Dr Max Pemberton

Max Pemberton's Daily Mail comment piece “It's NOT racist to worry about foreign nurses” is a truly shameful article of writing. Using the deranged actions of a single individual who happens to be Filipino as an excuse to mount a vicious, scapegoating and largely evidence-free defence of racist attitudes is just lazy journalism. And coming from Pemberton - usually one of the few medical commentators in the Tory press who's willing to actually defend the NHS - it's a double kick in the teeth'. 

The Immigration Act undermines the core principles of the NHS, together we must stop it

The NHS has always given free health care to UK residents. Its founding principles were healthcare free for all, regardless of ability to pay. This was a universal right, which applied to all who lived in Britain.

Under the Immigration Act 2014, the government is planning to charge certain migrants for GP and emergency treatment. Non-EU migrants and students will be forced to pay before being allowed NHS treatment, and refugees, asylum seekers and undocumented migrants will be excluded from many crucial services.

This will fundamentally undermine the right to healthcare enjoyed by all since 1948, and ultimately hurt all of us.

Report on "The Right to Speak Out", a public meeting at BMA House

Last month there was a public meeting on whistleblowing and defending public services at BMA House. The meeting was organised by Local East London Save Our NHS campaigns and hosted by the London Regional Council of the BMA. The meeting was organised to bring together NHS whistleblowers and union members who had acted in defence of services and been victimised for it, to share their experiences and discuss how it could be ensured staff can speak out safely.

Speakers were Kim Holt, Consultant and whistleblower on Haringey Children's Services, Charlotte Monro, sacked OT & whistleblower from Whipps Cross Hospital. Julie Davies from Haringey NUT, Tracey Boylin a HR director for an NHS Trust who was removed from her role when she tried to stand up for bullied clinicians,Polly Toynbee, Guardian columnist and Nick Clarke, Department of Health representative working on the Francis Review 'Freedom to Speak Up in the NHS'

The speakers recounted the harrowing experience of raising concerns and being ignored, and then subsequently bullied and victimised when they continued to press concerns.

Reject the deal – restart the strikes

Last week UNISON and UNITE's leaderships voted to call off NHS strike action in response to an offer from the government. The offer is outlined below and Jeremy Hunt's full letter to NHS Staff Council can be read here

If agreed the deal will:

• Abolish pay point 1

• A new minimum pay point of £15,100

• 1% plus £200 flat rate, both consolidated, for pay points 3-8

• 1% consolidated pay rise for all staff up to point 42 from April 2015

• An increment freeze in 2015/16 for staff on pay point 34 and above for one year.

• Urgent talks to take place with a view to the proposed redundancy changes being implemented from 1st April 2015, including a floor for calculation of redundancy payments of £23,000, and a ceiling for calculation of £80,000 with an end to employer top up for early retirement on grounds of redundancy.

What does this mean in practice?

This.... 

For the well behaved monkeys

Striking to win – use the NHS pay strikes to fight for the NHS

We're now heading towards our third national NHS strike. The decision by UNISON and GMB to call a further 2 days of strike action is welcome, and gives the strikes and the campaign to save the NHS a much needed boost.

The continuation and escalation of the action is a welcome break from the tendency to call off action which has plagued all unions the last several years.

However NHS workers are alone on strike among public sector workers. All the other public sector strikes taking place at the same time as the NHS dispute have been called off; schools, local government, civil service, universities and further education and the London Underground were all cancelled, despite ballots that were as good or better than the NHS unions.

So what is at work here? And what can NHS activists and trade unionist do to make the most of this period of action.