CP Eastern District Health For the People

Save Our Health

Health for the people

By Steve Sweeney

Communist Party Eastern District pamphlet

ÂŁ1

“The Conservatives voted against the National Health Act, not only on the second but on the Third Reading.

I do not see why we should forget this.�

Nye Bevan, 1948.

Steve Sweeney is former secretary of Huntingdonshire TUC and a wellknown campaigner for the NHS

The NHS is one of our most treasured institutions, however it did not just drop from the sky. It was fought for and won by working class people who had experienced the ravages of war and having previously been led to believe that they would be returning to a ‘Land Fit for Heroes’ after the First World War, were not prepared to be conned again. Pressure from returning soldiers who had experienced 6 years of war, and an example of an alternative social system, with the existence of the Soviet Union, meant that there was no way that people would accept further austerity and poverty. The ruling class were acutely aware. In 1943, Quentin Hogg, later to become Lord Hailsham, famously warned, ‘give them social reform or they will give you social revolution’. Communists were at the centre of the fight for an NHS and many of those who were to play key roles working in a nationalised health system had experienced solidarity as medical volunteers in the International Brigades during the Spanish Civil War. The bold reforms of Attlee’s landslide Labour government saw the introduction of the modern welfare state, including the NHS. It was not without resistance. In language similar to that used by the American right and Tea Party movement in opposition to the Obamacare proposals, the Tories and parts of the medical profession were bitter and often hysterical in their rejection of the proposals.

‘Dr Alfred Cox, a former secretary of the BMA wrote to the British Medical Journal, declaring: ‘I have examined the Bill and it looks to me uncommonly like the first step, and a big one, towards National Socialism as practiced in Germany. The medical service there was early put under the dictatorship of a “medical Feuhrer”. This Bill will establish the Minister of Health in that capacity’ Dr Cox was far from alone. At a meeting of 1000 doctors in Wimbledon Town Hall shortly after the Bill was published, Bevan was called a ‘dictator’ and an ‘autocrat’. ‘This Bill’, declared one doctor, ‘is strongly suggestive of the Hitlerite regime now being destroyed in Germany.’ Another denounced the hospital proposals as ‘the greatest seizure of property since Henry V111 confiscated the monasteries’.

‘There will be no top down reorganisation of the NHS’ (Cameron election pledge in 2010)

3

2013 saw the 65th anniversary of the NHS. While we were absolutely right to celebrate and commemorate that, we must recognise that the NHS is under threat like never before. Despite their pre-election promise that there would be ‘no more of the tiresome, meddlesome, topdown restructures that have dominated the last decade of the NHS’, the Coalition White Paper “Equity and Excellence; Liberating the NHS” laid the foundation for the 2012 Health and Social Care Act, which was to see the biggest reorganisation in NHS history, abolishing Strategic Health Authorities and Primary Care Trusts and transferring commissioning responsibilities to GPs. Most worryingly, and an indication of the direction of Tory policy, the Act removed the duty on the Secretary of State for Health to provide a comprehensive health service. Ironically, plans contained in an amendment to the Care Bill that are likely to have been voted through by the time this is being read, would give unprecedented powers to the Health Secretary enabling them to close down hospitals without consultation with the public and without agreement of the Clinical Commissioning Groups (CCGs).

The Tories want to take us back to a time when the NHS did not exist.

They have a dogmatic belief in the market and want to hand services to their friends in the private sector, a regressive step that would see the fragmentation and break-up of the NHS. The NHS was fought for by working class people who had previously had to rely on benevolence and a two-tier system where only the rich had access to decent healthcare.It is simply absurd to suggest that the worlds 7th richest nation cannot afford to provide healthcare for its population. While we have it constantly drummed into us that we are living in times of austerity and ‘we are all in it together’, the banks and financial institutions that were bailed out by the taxpayer are once again paying enormous bonuses.

There still remains the scandal of legalised tax avoidance, which if collected would pay for the NHS itself. This is the effect of neoliberalism and the embracement of market ideology where profits are put before people.The NHS is being deliberately starved of funding, pushing hospitals into debt and into the arms of the Trust Special Administrators (TSA) and the private sector. Hardly a day goes by without a negative NHS story. The real crisis in the NHS is a funding crisis planned by the 4

Tory government and their pals in big business who want the NHS ‘market’ opened up to them.

The reforms that have been introduced have paved the way for privatisation on previously unimaginable scale and threaten the very existence of the NHS as we know it. As will be seen in case studies, the break-up of the NHS has already started, although not without some resistance and local victories, most notably in Lewisham where a community campaign with mass participation coupled with legal action overturned a decision to close Accident and Emergency and Maternity services. With 15,000 people marching and support from all corners of the community, including Millwall Football Club whose mascots and players donned ‘Save Lewisham Hospital’ t-shirts and even brought forward a match against Aston Villa to Friday evening to allow a march to go ahead, a court ruled that Health Secretary Jeremy Hunt had acted ‘outside of his powers’ in ordering the closure. (Millwall won their match as well, beating Aston Villa 2-1) PART OF STATEMENT ON MILLWALL FC WEBSITE ‘Whilst changing the date of our Cup tie is an inconvenience to us, we believe there is a bigger picture here.

Millwall Football Club, our players, staff and many thousands of fans have, over the years, had reason to be grateful for the resources, facilities and care we have received from our local hospital.

We are not persuaded by the arguments put forward in favour of closing the A&E department, childrens ward, intensive care and maternity services at Lewisham.’

Other areas have not been so lucky. Enfield Council sought a Judicial Review of the decision to close Accident and Emergency and Maternity Services at Chase Farm Hospital in November 2013, however were turned down in the High Court by Justice Bean who stated that they had ‘no arguable case for judicial review’. Council Leader Doug Taylor accused the Health Secretary of steamrollering through their plans, describing the closure plans which were opposed by GPs and campaigners as ‘flawed and shameful’. Just weeks later tragedy struck with the death of a 2 year 5

old, who’s mother, rushed him to Chase Farm Hospital at 3am only to find locked doors and no functioning Accident and Emergency service.

In North West London, the Accident and Emergency services at Hammersmith and Central Middlesex are to close while Ealing and Charing Cross will see the services there downgraded. This was in the wake of mass opposition involving local political parties, trade unions and health activists and an attempt to gain a judicial review. Despite this and flying in the face of clinical evidence, Jeremy Hunt ploughed ahead with the plans, even trying to claim credit for saving services.

The Tories are intent on destroying the NHS. It represents everything that they hate; co-operation, altruism and solidarity. But they cannot escape the simple fact that it works. Study after study has shown that the NHS is the most efficient and effective way of delivering health care to the population. In a 2010 study by the Commonwealth Fund which looked at 5 areas; quality, efficiency, access to care, equity and healthy lives, the nationalised UK system came top in comparison to the US which came bottom. The market and business model does not fit.

“The Conservatives voted against the National Health Act, not only on the second but on the Third Reading. I do not see why we should forget this.”

Nye Bevan, 1948.

The Tories opposed the NHS in 1948, and, despite what they say, they continue to oppose it today. They are shrewd enough to realise that being open about their intentions would be politically toxic. Nigel Lawson described the NHS as being ‘the closest thing that the English have to a religion’. Cabinet Papers released after the 30 year rule revealed that the Thatcher government had considered wide ranging welfare reforms that would have seen the end of the National Health Service.

A watered down version of the report leaked to the press lead to Thatcher claiming at Tory Party Conference in 1982 that that the ‘NHS is safe in our hands’.

Since its inception in 1948, the Tories have had to continuously defend their position on the NHS and reassure the public that the principle of

6

universal healthcare for all is something that they support. It does not take much for the mask to slip however and their true intentions and thoughts are often revealed.

The London 2012 Olympic opening ceremony, produced by Danny Boyle and commissioned under a Labour government was anathema to the Tories. The symbol of the NHS, beamed to millions across the globe encapsulated brilliantly that the health service is part of our social fabric.

The Tories were quick to distance themselves from tweets sent by Nazi uniform wearing, anti trade union MP Aidan Burley who tweeted during the ceremony, ‘The most leftie opening ceremony I have ever seen – more than Beijing, the capital of a communist state! Welfare tribute next?’ describing it as ‘leftie multi-cultural crap’. He later tried to claim that his tweets had been ‘misunderstood’.

These remarks could be dismissed as the actions of a maverick, however this was not the first time that one of Cameron’s Tories had made disparaging comments about the NHS. In a tour of the USA and in response to attempts by Barack Obama to implement reforms that would give access to healthcare to the millions currently denied this, Daniel Hannan, Tory MEP described the NHS as having ‘left Britain with low survival rates for cancers and strokes, a high risk in becoming iller in hospital and with constant waiting lists’ He went on the say that he ‘wouldn’t wish it on anyone’.

Cameron was quick to criticise Hannan’s comments, calling him eccentric and claiming that this was not the view of the Tories, who had made the NHS a priority in their election promises. Despite rebuking Hannan, no disciplinary action was taken leading to criticism from Labour who stated that Hannan’s statements exposed the reality of Tory attitudes toward the NHS. During the Obamacare debates, an American newspaper used Stephen Hawking as an example of the deficiencies of the NHS. “People such as scientist Stephen Hawking wouldn’t have a chance in the UK, where the National Health Service would say the life of this brilliant man, because of his physical handicaps, is essentially worthless,” it claimed.

7

This was countered by Stephen Hawking in a brilliant rebuttal of the American right and a staunch defence of the NHS. “I wouldn’t be here today if it were not for the NHS,” he said. “I have received a large amount of high-quality treatment without which I would not have survived.” Hawking went further in an interview for Channel 4 in late 2013 where he was unequivocal in stating that The NHS “must be preserved from commercial interests who want to privatise it”.

The Privatisation of the NHS in Cambridgeshire Cambridgeshire seems to be being used as a testing ground for NHS privatisation. First it saw the transfer of the management of Hinchingbrooke Hospital to the private sector, with Circle Health – a group of hedge fund and private equity owners that was headed by former Goldman Sachs banker Ali Parsa – taking over to much fanfare in 2012, quickly followed by the tendering of almost £1 billion of NHS community services across the County. Addenbrooke’s Hospital is also taking advantage of the raising of the cap on how much revenue can be generated from private income with the building of a private hospital and hotel being planned for the grounds. All 3 of these cases are aided by Tory NHS Policy.

Hinchingbrooke Hospital: Hinchingbrooke Hospital in Huntingdon was threatened with closure in 2006 due to debts incurred through NHS marketisation and the PFI built Independent Sector Treatment Centre. The ‘Save Hinchingbrooke Hospital’ campaign drew thousands together as the community and trade unions fought for their local hospital. The campaign was successful and Hinchingbrooke was saved from closure. In 2010 however, a new threat emerged. Privatisation.

In a move that was the first of its type in the UK, hospital chiefs came up with a plan that would see the management of the hospital ‘franchised’ to a private provider. It was claimed that the ‘deal’ was necessary due to the £40 million debt that they claimed meant the hospital was struggling to survive. Campaigners at the time argued that if there was the political will to do so, the debt could have been cancelled and Hinchingbrooke could remain as an NHS run hospital. They argued that Hinchingbrooke 8

was being used as a testing ground for NHS privatisation and that the tendering process should not go ahead.

In a process that saw a final shortlist of 3 private organisations bidding for the contract, meaningful consultation was non-existent and plans, including the length and terms of the contract, remained hidden from the public under the guise of corporate confidentiality. The Huntingdonshire Trades Council initiated the ‘Hands Off Hinchingbrooke’ campaign and fought against the plans in what it saw as a ‘battle for the soul of the NHS’. They warned of fears that services and jobs could be at risk as the vultures of the private sector looked to make a profit from our NHS. Campaigners maintained that should the Hinchingbrooke deal be forced through, it would set a worrying precedent for the future of the NHS. Despite local opposition and a march in Huntingdon against the plans, Tory donors and hedge fund capitalists Circle Health were handed the keys to Hinchingbrooke in February 2012.

Two years into the experiment and the experience has not proved to be a good one for staff or the community. Only 6 months in to a 10 year franchise deal, the Chief Executive of Circle Health Ali Parsa ‘stepped down’, trousering a cool £400,000 for his efforts. This was following a grilling from Margaret Hodge, Chair of the Commons Public Accounts Committee who alleged that Parsa had been ‘sacked’ following poor financial management, when the debts actually increased almost triggering a release clause. She also questioned where the £400,000 came from – was it public money? That question was also asked by staff at the hospital who were afraid to speak out for fear of reprisals by the bullying Circle regime and remains unanswered. It was however money that could have been used on frontline services or to pay some of the £40 million debt.

Following hot on the heels of Parsa’s departure came the news that the Chief Executive of the hospital, Circle appointee Jim O’Connell was taking ‘early retirement’ at the age of 50. This must have been some consolation for the hundreds of healthworkers employed in the hospital who had recently been told that they had to ‘work longer and pay more to get less’ in terms of their pension.

9

The general performance of Circle has been poor. Since they have taken over, 46 nursing posts have been lost, cleaning staff have been reduced by half, a ward has been closed and in one of the most mean spirited acts, the hospital volunteer shop which had raised millions for Hinchingbrooke over three decades, was closed as it didn’t fit with their ‘corporate image’. They have also had to appeal for government bail-outs and rumours of financial instability have never gone away.

The Circle PR machine manages to spin news and present an image that is far from the truth. In February 2014, they announced to fanfare that they had managed to break-even for the first time. This was however a smokescreen for news that Circle feared may break instead. The facts are that in the most recently available figures, parent company Circle Holdings had made a loss of £9.7 million, 22% of turnover. There is also a £60 million debt on its books.

Also, the so-called ‘John Lewis’ style partnership arrangement, where Circle had claimed to share ownership with hospital staff, putting them at the centre of decision making, had been brought to an abrupt end. The arrangement, which was nothing like what Circle would try and portray, supposedly saw 51% of shares owned by Circle Holdings and 49% by staff. With little real publicity, Circle admitted that they had ended the ‘partnership’ as they found it ‘too costly and complex to administer’.

The 49% of shares supposedly held by staff were sold and the hospital is now entirely in the hands of hedge fund speculators and venture capitalists through Circle Holdings Plc. One thing that the Hinchingbrooke deal has in common with many other tenders is the links between the private company and the Tories: • 29.2% owned by Lansdowne Partners whose founder Paul Ruddock donated £692,592 • 28.7% owned by Invesco Perpetual whose founder Sir Martyn Arbib donated £466,330 • 14.8% owned by Odey Asset Management whose founder Robin Crispin Odey donated £220,000 • 5% owned by BlueCrest Capital whose founder Michael Platt donated £125,000.

10

Whatever lies in store for the future of Hinchingbrooke, it is clear that at some point the hedge fund vultures will want a return on their investment as they seek to make super-profits. The fight for Hinchingbrooke will go on, however there is another pressing threat to NHS services in Cambridgeshire Cambridgeshire Community Services NHS Trust Tory NHS policy is designed to break-up the NHS and hand it to the private sector. One way of driving this forward was for the government to set an arbitrary target for all NHS trusts to attain Foundation status

by April 2014. In order to meet this target, NHS trusts had to meet certain financial criteria. This weighed heavily against traditionally poorly funded Community Healthcare Trusts, however in a unique move, the bid for Foundation Trust status by Cambridgeshire Community Services NHS Trust was vetoed by the CCG, operating in shadow form prior to the changes.

Dr Neil Modha, chief clinical officer of shadow Cambridgeshire and Peterborough Clinical Commissioning Group, said at the time: “GP members were clear that the CCG, as an emerging organisation, needs to retain as much flexibility over future service configuration as possible, including the ability to make changes on how community services are delivered in the future.”

In other words, the scene was set. Services in Cambridgeshire were set for privatisation. Despite the government enforced deadline of April 2014 no longer in place, the ball was already rolling and in June 2013, the newly formed CCG voted on a model that all but guaranteed that the ‘adult and older people’s integrated service’ contract would be run by the private sector. In what they described as an ‘innovative’ move, the CCG put the contract out to competitive tender, inviting the usual suspects to bid for almost £1 billion of services, the largest tender in NHS history.

The tender has proved controversial and has been met with wide opposition. Trade unions and health campaigners came together to form the ‘Stop the NHS Sell-Off in Cambridgeshire’ group who have vigorously 11

opposed the plans and in their fight to defend local services have had pockets of success.

The contract attracted interest from the expected range of private organisations, looking to exploit the NHS reforms and get their hands on what they believe will be lucrative long-term deals. Initial bids from outsourcers Capita and much maligned privateers Serco, accused of fraudulent behaviour on other public contracts were withdrawn after they saw key tender documents, citing ‘affordability’ as the reason for pulling out of the running. In other words, they could not see where they would make big money out of the contract.

Campaigners have continued to press the CCG on a range of issues, however have been rebuffed at almost every turn. Key documents are being withheld and a Freedom of Information Act request was also refused. The CCG have cited corporate confidentiality, putting the interests of big business and the private sector above that of the public.

They have been reminded that the NHS belongs to us, not big business and that key decisions taken behind closed doors make a mockery of the Tory mantra of ‘no decision about me, without me’.

Consultation has been farcical and it was only the threat of legal action by the ‘Stop the Sell-Off’ campaign that forced the CCG to make plans to do so on a wider scale. Even then, the documents that have been seen so far have been redacted to the point of gutting them of any useful information. How the public can make an informed decision based on such lack of information is highly questionable. Campaigners have argued that consultation should have occurred prior to the decision to go to competitive tender and should have been on the model used and length of contract.

The campaign has seen large and vibrant lobbies of CCG meetings, questioning of board members and calls to halt the process. Street petitioning and leafleting has taken place each weekend in most towns in the county and gathered broad ranging support from local people, political parties, trade unions and activists. Shadow Health Secretary Andy Burnham has described the plans as ‘the most audacious sell-off to date’ and the CCG plans have been criticised from all corners.

12

Recent developments have seen the plans pushed back with an announcement not due until September 2014 instead of March 2014 and the new provider not expected to be in place until January 2015 as opposed to the original plan of July 2014. This is a significant victory for campaigners and as the procurement goes on there are likely to be more twists and turns, with the possibility that the deal could collapse altogether Campaigners have questioned how the organisations that are in the process have managed to get through the various stages, stating that it poses serious doubts over the robustness of the Pre-Qualifying Questionnaire and other tests. The line up is a rogues gallery of the worst privateers and shouldn’t be trusted to run a bath, let alone NHS services.

The bidders are: ACCORD HEALTH – a consortium including Provide, North Essex Partnership Foundation Trust and Interserve. Interserve are an organisation whose major shareholders include investment bankers JP Morgan. They have been found guilty of accounting irregularities and ‘illegal bid-rigging activities following one of the largest ever investigations under the Competition Act. Their CEO, Lord Blackwell is a Tory peer and a former policy adviser to Thatcher. His dedication and commitment to NHS values includes the writing of pamphlets titled ‘Better healthcare for all: Replacing the NHS monopoly with patient choice’.

CARE FOR LIFE – the ‘Lead Provider’, Care UK are major donors to the Tories. Their chair,John Nash, was made a Tory peer and has donated £247,250 to the party. Care UK were bought out by private equity company Bridgepoint in 2010 and have a split ownership and management relationship similar to that of Southern Cross who went bust dramatically in 2011.

OPTUM – current providers Cambridgeshire Community Services NHS Trust have linked with Optum following the collapse of the Capita/Circle consortium. Optum is the new name for the rebranded United Health UK, who prior to the bid faced being wound-up by parent company the

13

American giant United Health after posting losses for the 11th consecutive year. Their accounts showed an £8.2 million loss in the UK and a 27% fall in turnover in 2012. Hardly the sign of a stable organisation.

UNITING CARE PARTNERSHIP – this is the joint bid from Cambridge University Hospitals NHS Trust and the Cambridgeshire and Peterborough Foundation Trust. While they may give the impression that they are the only ‘pure’ NHS bid, they are linking up with outsourcers Mitie.

VIRGIN CARE UK – Better known for making music and running trains inefficiently and at great expense,Virgin are now branching out into healthcare, having bought out care provider Assura. In 2012, current Health Secretary Jeremy Hunt (then Culture Secretary) personally intervened to ensure that a controversial £650 million contract to run services was signed off by NHS bosses in Surrey. The delays in signing the contract were due to ‘significant issues’ that had been raised by the Director of Nursing and legal wrangles over various issues including staff terms and conditions of employment.

Campaigners believe that there is a significant risk to services to patients and the community as a result of the tender. The organisations above are only interested in the profit motive and the only way that they can possibly make any money is though cutting terms and conditions or ceasing to run certain, unprofitable services. Across the border in Suffolk, when Serco took on an NHS community contract, they immediately announced 137 job losses and patient care has suffered as a result. In what should be seen as a warning to the CCG, in December 2013, Serco announced that the first year of the contract had seen them make a £9 million loss. None of the bidders has the experience or the ability to run such a wide ranging and complex set of services like those that have been bunched together in the tender.

‘Stop the NHS Sell-Off in Cambridgeshire’ say ‘None of the Above’ and reject the proposals. The NHS should remain a publicly owned, publicly funded and democratically accountable organisation, based on the principle of free healthcare for all.

14

Addenbrooke’s Hospital In an announcement that has seemed to escape scrutiny, the world famous Addenbrooke’s Hospital has plans to build a private hospital and private hotel in the grounds as part of a development they have called a ‘Bio-medical Campus’. The plans take advantage of the raising of the cap on income that can be derived from private funding and see the first steps toward a two-tier system and more money flowing from the public sector into the pockets of greedy fat-cats. Behind the plans are infrastructre giants John Laing, whose construction arm Laing O’Rourke are alleged to be users of the Consulting Association who provided names to companies who then blacklisted workers and blighted lives for the crimes of being trade unionists and raising health and safety concerns. They are proposing that the private hotel is run by Ramsay Health Care UK and expect the construction to be completed in 2016.

Recent developments have seen Papworth Hospital, specialists in cardiac care, have their planned move to Addenbrooke’s Hospital put on hold by the Treasury. The plans that have been on the cards for around 10 years have been delayed with an alternative to move them to the debt-ridden Peterborough Hospital being suggested. Campaigners have questioned the move asking whether the alternative is being suggested so the Addenbrooke’s site can be used for further private sector development, edging out Papworth and using it to pay off the debt at Peterborough incurred through a costly PFI deal.

NHS – facing a clear, present and future danger There are wider and more general threats that present a real danger to the future of the NHS. One of those comes in the form of clause 119, the ‘Hospital Closure Clause’, an amendment to the Care Bill which could see unprecedented powers handed to the Secretary of State to close hospitals over the heads of the community and without the agreement of the CCGs. The amendment has been bitterly opposed, however as with many Tory policies the pace at which it is being rushed through is so fast that it is too late when people realise what is happening. Despite the spin placed 15

on this by the Tories, this is a spiteful and pernicious piece of legislation, meaning that no hospital is safe. Every hospital in every part of the country is under threat and there needs to be a united response in opposition. In the short window available to mount a campaign, activists are pressuring Lib-Dem MPs whose votes can block the clause from passing into law. As the loyal bag-carriers for the Tories, it remains to be seen how they respond and whether they want to further aid the destruction of the NHS and add yet another item to their long list of crimes as coalition partners. This clause is not clinically driven, but financial and a deliberate ploy to add another string to the bow in the planned break-up of the NHS. Even if the ‘Hospital Closure Clause’ is defeated, there remains a wider and in many ways an even more potent threat. The Transatlantic Trade and Investment Partnership (TTIP) is an EU-US Trade Agreement that presents a fundamental threat to the future of the NHS. TTIP is a proposed free trade agreement between the United States of America and the European Union which would create a market and mean the potential for privatisation of services is almost impossible to resist or reverse. Through Investor State Dispute Settlements (ISDS), corporations are able to challenge policy decisions taken by democratically elected governments however the same governments would not have to powers to challenge investors.

Unions, including the GMB have stated that the ISDS should be excluded from the TTIP. Commenting on the TTIP, Bert Schouwenburg, GMB International Officer, said “The legitimacy of the unaccountable Investor-State Disputes Settlement mechanism has repeatedly been called into question.

This is because it takes away the ability of member states to decide what sectors like the NHS should stay in the public sector and hands power to unelected and unaccountable corporations.

We know from the tax avoidance scandals what these corporations do when given free reign.

16

Foreign investors have used it extensively to challenge measures adopted by sovereign states to promote social equity, foster environmental protection or protect public health.

Countries who are signed up to this mechanism have to face claims up to ÂŁ70 billion and awards up to ÂŁ1 billion.

In addition, proceedings are usually conducted in secret and arbitrated by a relatively small group of unaccountable specialist lawyers whose impartiality has been called into question.

If the Investor-State Disputes Settlement mechanism is included in TTIP it is conceivable that a giant American health insurance corporation could insist that it be allowed to buy up services currently provided by the NHS. If it is prevented from doing so it could sue the sovereign UK Government for damages. The UK would be bound to accept the decision of a group of trade lawyers based in New York.

David Cameron is fond of wrapping himself in the Union flag and complaining that British sovereignty is being compromised by decisions taken on our behalf by the EU. GMB want to see him demanding an opt-out for the UK if the mechanism is included in the Transatlantic Trade and Investment Partnership.

GMB cannot support a treaty that will allow the future of the NHS to be decided outside the UK by a bunch of unelected, unaccountable lawyers in New York.�

While there is provision within a legal framework for an opt out under the Treaty of Rome, the deal exposes the undemocratic nature of an unelected organisation which can determine and override elected governments and dictate to them that services can be privatised at their behest. This unelected bosses club threatens the survival of the NHS. The NHS represented an advance for the health of the nation and made drastic improvements to the lives of working class people. This cannot be underestimated and people have such a strong connection to the NHS as it is something that they fought for in the first place. We have seen many localised campaigns from Lewisham to Cambridgeshire and 17

North West London to Mid-Staffordshire where people have come out in their masses to support local hospitals and services that have been threatened by Tory cuts. Over 50,000 took to the streets in Manchester to protest at Tory Party Conference, coming from all parts of the country to send a united message, ‘Hands Off Our NHS’.

Demands for the future of the NHS could include: • End of the purchaser/provider split • End and reverse costly PFI deals and call for direct government funding • Ending the costly internal market that pits Hospitals and Trusts against each other and call for a system based on solidarity and co-operation • Oppose NHS cuts and call for increased funding • Repeal the Health and Social Care Act 2012 • Call for an integrated health and social care system We need to fight like never before to defend our NHS. This means many things. Lobbying MPs over local and national issues. Lobbying CCG meetings where plans are being discussed and voted on. Forming local groups to defend NHS services. Getting involved in or setting up Keep Our NHS Public, 38 degrees, The People’s Assembly and other campaign groups. Become active in your trade union, mobilising members and raising awareness of NHS issues.

Centres of resistance can be found through local Trades Councils, who can play a crucial role in drawing people together. The attacks on the NHS, although being carried out piecemeal in some circumstances with threats to local services, are nation wide and require a broad mass movement to defeat them and bring down the Tories. Organisations such as The People’s Assembly and The People’s Charter are part of this resistance and could be the basis for such a movement.

The stakes are high, but if we fight, we can win. Nye Bevan famously said that the NHS would survive ‘as long as there are folk left with the faith to fight for it’. We must be those folk.

18

“All measures to weaken, break up, commercialise or privatise the National Health Service (NHS) must be halted and reversed. Medical treatment must remain free at the point of delivery, funded largely through progressive taxation. NHS coverage should be extended rather than reduced, for example into the provision of cancer screening and dental treatment. The aim must be to drive profiteering out of the NHS, while involving workers and users more closely in consultative and administrative functions.”

CP programme Britain’s Road to Socialism

“We can defend education, health and welfare provision funded from general taxation and available to all, or we can surrender the gains that have improved the lives of millions of people for more than 50 years.

We do not accept that government's austerity programme is necessary.

The banks and the major corporations should be taxed at a rate which can provide the necessary resources.

Austerity does not work: it is a failure in its own terms resulting in neither deficit reduction nor growth.”

People’s Assembly Declaration 2013

Forewarned, and forearmed

Fresh and forthright ideas for trade unionists, available to read now.

Order: www.communist-party.org.uk Join us – 93 years of struggle for the working class and humanity.