- 2013 National Delegate Conference
- 1 January 2013
The creation of the NHS in 1948 was one of the greatest achievements of the post war Labour government. The founding principles were that health care should be funded from taxation and delivered free at the point of use.
Since its creation the NHS has come under attack from successive Tory governments. However, since the election of the coalition we have seen the greatest ideological attack on the NHS since its formation in 1948.
Conference notes the widespread outrage in opposition to the massive cutbacks in the health service.
The new commissioning framework in England, introduced in April 2013, will have serious and damaging consequences for the provision of health care. The sole purpose of the legislation is to remove the oversight and control of health from Parliament. This will allow for the introduction of competition and privatisation.
Private companies now run significant parts of our NHS for profit. More and more business consultants milk it for money.
By replacing Andrew Lansley with Jeremy Hunt, the Prime Minister gave a clear signal as to the government’s intentions for the NHS. Hunt, while in opposition, made it clear that he believed the NHS was ‘this country’s greatest mistake’. In one of his first speeches as Secretary of State for Health he praised Andrew Lansley’s Health and Social Care Act, saying it was the “right legislation to ensure that the NHS was opened up to the private sector”. Conference is alarmed at the way Hunt and the government have looked to use the Francis report into the Mid Staffordshire scandal to make political capital and to denigrate the wider NHS.
Running alongside this costly reorganisation (£2bn, not including the cost of thousands of redundancies) is the severe financial squeeze on NHS Trusts. The requirement to make £20bn savings means that every Trust has to cut their budget by between 4% and 7%. Already many Trusts have declared the need to make significant redundancies and/or are attacking national terms and conditions of employment, in order to balance the books.
Health care services are already being dramatically affected, with most trusts seeing significant increases in waiting times, and missed targets on A&E waiting and cancer care.
We are witnessing the greatest challenge to the NHS since it was created. The government is adopting a two-pronged attack on the service.
Firstly by a costly structural reorganisation designed to break up the regional and central control on health commissioning. This will free up services to be commissioned from the private sector. In addition the introduction of ‘Any Qualified Provider’ will impose mandatory testing of the market for the provision of services. This has already led to an increase in the use of tendering, with essential services such as North West Ambulance’s Patient Transport Service being handed over to Arriva Bus Company.
Secondly by deliberately underfunding the service while subjecting Trusts to crippling financial regulation by Monitor (the NHS Foundation Trust regulator turned ‘promoter of competition’). This has led directly to the possible sacking of 500 staff at Bolton Foundation Trust.
Hospital and community services up and down the country are faced with cutbacks, closures and the prospect of privatisation. NHS staff now face the most serious attack ever on their jobs, their pay and conditions of work.
There has been massive opposition to these attacks with huge local protests (with some 25,000 on the streets of Lewisham on 26 January) against closures, which have involved health workers, trades unionists and local communities. Elsewhere, as in Mid-Yorkshire NHS Trust, UNISON members have struck to defend jobs and basic pay rates.
The coalition government, lacking in any democratic legitimacy, has no mandate for their attacks on the NHS cloaked in the language of choice.
Conference notes and welcomes the Labour Party’s public support for the repeal of the Health and Social Care Act 2012, while urging the Labour Link to campaign within the party to make such a repeal a firm manifesto commitment. This should come alongside pledges to reverse the privatisation of existing health services by bringing them back into the NHS and to end the principle that ‘any qualified provider’ should be allowed to bid to deliver health services. In particular, Conference believes that through the Labour Link UNISON should seek a commitment to the cancellation of the toxic legacy of debt associated with the Private Finance Initiative (PFI) and to move towards the cancellation of the PFI programme for hospital construction and redevelopment as a whole.
Conference believes that it is imperative that the fight to defend the NHS is a priority for the coming year and calls on the National Executive Council to:
1) encourage branches and regions to work with local communities, patient groups, and politicians to challenge the destruction of local services and to develop a clear vision for health care in the localities;
2) encourage work with the TUC to organise a publicity campaign and demonstrations to be held to coincide with the 65th anniversary of the founding of the NHS;
3) monitor the impact of the new Clinical Commissioning arrangements on local health services and highlight any deterioration in services;
4) develop and promote an alternative vision for the provision of health care. Such a vision is to be based on the principles of (a) funding through taxation, (b) free at the point of use, (c) available due to need and not ability to pay, (d) to be delivered by the public sector;
5) defend health workers’ terms and conditions of employment where NHS employers make a concerted effort to impose changes;
6) give maximum support to local campaigns and lawful industrial action (within UNISON rules) against cuts to health workers’ pay and conditions;
7) demand sufficient public funding for the NHS in a publicity campaign to illustrate how this, along with other measures, can be achieved by ensuring the progressive taxation of wealthy individuals and households, and ending the widespread tax avoidance by corporations at the same time as terminating the artificial market of the purchaser – provider split in the NHS, which inflates bureaucratic costs;
8) counter the attacks on the NHS to show clearly that coalition policy will lead to a diminished, fragmented and ultimately more expensive health service;
9) continue to campaign against and highlight the deficiencies of PFI; a massive exercise in financial incompetence which is literally bleeding hospitals dry. The billions of pounds of taxpayers’ money used to pay private companies is causing further strain on trusts finances with many hospitals threatened with closure;
10) work with allies, including the TUC’s All Together for the NHS campaign, to build national rallies and protests in Autumn 2013 in defence of a publicly funded, publicly run NHS, free at the point of delivery;
11) urge the Labour Link to pursue these policies within the Labour Party.