NHS

Tory Health Bill: further privatisation on the agenda

February 24, 2021

Socialist Alternative members in Unison
Cervical smear backlog shows impending next wave of crisis

January 25, 2021

Elizabeth Cox, Wales
2021: an opportunity for building the socialist fight against capitalism

December 31, 2020

Sarah Wrack
The race for Covid-19 vaccine: Is this the end of the pandemic?

November 24, 2020

Nof Azulay
NHS contracts scandal: Tories are still putting profit before people

November 20, 2020

Tom Barker
Fight to save our National Health Service

November 9, 2020

Andrew Walton

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UPCOMING EVENTS

Tory Health Bill: further privatisation on the agenda

The Tory government has announced that the NHS in England is to be reformed so health and care services can work more closely together. A closer look at the available detail tells a different story.

This white paper is a power grab by ministers, further reducing democratic control over services by proposing to remove all local health scrutiny powers from local councils and will consolidate and encourage privatisation, as we have recently seen with the scandal of contracts issued to private companies during the pandemic. This will give big multinational health companies a way to access a seat at the top table where decisions about national contracting out of health services can be made.

There will be no extra funding for social care and health services, which have been devastated by over a decade of austerity. This new legislation seems to be aimed at delegating responsibility for the next round of cuts to the proposed ‘Integrated Care Systems’ (ICS). These local bodies will be tasked with doling out the misery, especially in the areas hardest hit by austerity, where there was already a deepening health emergency even before the pandemic. NHS and Local Government will pool their diminishing resources to deal with the crisis.

The Labour Party have done nothing but question the timing of the announcement, during a pandemic, rather than the substance, the profit driven ideology behind it and the lack of funding detailed in the legislation.

Tory Ministers say the changes will put the NHS in a better position to cope with an ageing population and a rise in people with complex health conditions. One-in-three patients admitted to hospital as an emergency have five or more health conditions, such as diabetes, obesity or asthma – up from one-in-ten a decade ago. These figures are a damning indictment of the previous ten years of Tory austerity policies – directly linked to the government’s promotion of the privatisation agenda in Health and Social Care services.

We are facing a period of mass unemployment, where the capitalist system will be unable and unwilling to take the measures necessary to defend jobs, terms and conditions and services. They will look to make working-class communities pay for the economic recession and pandemic. It will mean a deepening of the poverty of many working class areas, already reeling from a decade of Tory attacks, and the proposed ICS will be the new agent for delivering this.

Integrated Care Systems: embedding privatisation

The plans involve embedding the private sector further in the delivery of services and NHS England has already approved a list of over 80 providers, including many American companies. There will be two ICS boards, one for NHS commissioning and the other an ‘ICS Health and Care Partnership’ board, which would include private companies, but they use the term ‘voluntary and independent sector partners’ to hide their true aims.

We recognise these Tory proposals as more of the same: a continuation of the privatisation agenda in the health and social care sector, further erosion of democratic control and scrutiny and more cuts to vital services.

Nigel Edwards, of the Nuffield Trust (private healthcare provider) think tank, said the changes would be a “re-wiring behind the dashboard” and should not be too noticeable to patients. We do not need more tinkering with “the wiring behind the dashboard”. Big business and big pharma need to be prevented from strengthening their stranglehold on health and social care services.

We can do this by building a mass, national campaign to stop these cuts and attacks, which demands:
- An end to the attacks of cuts and privatisation
- Full funding for our health and social care services, with democratic control by workers and service users
- A decent pay rise for the key workers that are keeping the country going during the pandemic
- Nationalisation of the pharmaceutical companies under democratic workers’ control and management
Cervical smear backlog shows impending next wave of crisis

As everyone is now well aware, the NHS is in dire straits. Since 2015 the Conservative government has handed a whopping £15 billion of taxpayer money over to private contracts, fracturing our healthcare service down into the bare essentials and creating a culture of competing for profit, cutting corners, and skeleton staffing. Never has this been felt more than over the past year, since Covid has taken hold and all non-essential procedures through the NHS have had to be put on hold in order to focus on imminent life-saving emergencies. Private companies have proven themselves useless in favour of raking in yet more profit during this crisis.

The consequences of these changes are already being felt. Since Covid, there exists now a backlog of 1.5 million missed cervical smear appointments. Every year over 3,000 new diagnoses of cervical cancer are made. Worst still, up to 2,000 of these are people living in recognised deprived areas. By contrast, studies show that living in an affluent area halves your risk of getting the disease. Once again, the poor are left to suffer the consequences of the class system.

There is hope, however. Cancer Research states that, if caught early enough, 99.8% of all cases are preventable. The most accessible method of catching cancer early is currently through cervical smear tests, a service offered to people over 25 years of age. If found in the early stages, the fatality rate drops to an impressive 4%. If caught late, the mortality rate is almost 50%. Following the statistics, 75,000 of these missed appointments would result in a new diagnosis. If delayed too long, 50% of these cases will be fatal.

That’s over 37,000 preventable deaths from cervical cancer.

This is completely unacceptable. Already countless lives have been lost due to Johnson’s government failing to organise effectively through Covid, leaving us vulnerable and unable to protect our communities from the virus. And now, with the vaccine signifying the coming end of the pandemic, it seems another wave is inbound. Once again the NHS will be overwhelmed, this time by a backlog of patients whose treatments were delayed and cancelled over the last year, who will now be coming in far sicker because of it. Not only from cervical cancer but countless other uninvestigated conditions. Patients who will likely suffer horrific and preventable outcomes because of this failure to deliver care.

These statistics show that yes again women suffer disproportionately. Alongside forming a majority of frontline workers, suffering an increase in domestic violence, and bearing the majority of the burden of increased pressure in the home from childcare and homeschooling, this is just one way in which women’s health will be impacted by the Covid crisis. Women’s health issues are historically underfunded and under-researched, largely as a result of a deeply entrenched underplaying of pain and suffering related to women’s reproductive health.

There needs to be change. The NHS must be properly funded to ensure the staff and resources can be allocated to protect the people. The government must be held accountable for ongoing back-door privatisation and syphoning of taxpayer money to profiteering companies. The NHS needs to be returned to the organisation it was originally created to be, with healthcare free and readily available to all who need it, and this needs to happen before more preventable lives are lost. Without a mass struggle to ensure this, the NHS will never recover from the cracks the Covid pandemic has widened, and the wellbeing of the many will suffer for it.
2021: an opportunity for building the socialist fight against capitalism

Most working class people welcomed the end of 2020 with relief, and may greet 2021 hoping for a better and easier year. For millions around the globe 2020 meant isolation, fear, illness and loss. It meant stress, job losses and trauma. But for a big and important section of working class and young people, it also meant an awakening. The capitalist system has rarely been so exposed for its destructive, chaotic inability to meet the needs of humanity. And so, as well as hope for an easing of personal difficulties, Socialist Alternative steps into 2021 with confidence in the possibility of important struggles against capitalism and its ills, and for the growth of socialist ideas to combat them.

The capitalist class and their political representatives are also probably glad to see the back of 2020, but if they hope for an easier ride in 2021 they are likely to be disappointed. The fallout from the Covid pandemic will continue for years to come. The battle to roll out vaccines to sufficient numbers to allow a safe opening of the economy will be only the first stage (and this itself complicated by the scepticism of some towards the vaccine, which is entirely the fault of the capitalist governments’ disastrous response to the pandemic so far). The devastation of whole sectors, particularly hospitality, retail and tourism, is yet to be fully appreciated. Not to mention that, in another showing of the horrendous inequality of capitalism, there is no realistic prospect of the vaccine reaching the majority of the neocolonial world any time soon – which in this era of interconnectivity leaves the whole world at risk.

Crisis of political representation

In Britain, the pandemic rapidly undermined the idea at the time of the Tories’ election victory last December that Boris Johnson would be in a strong position as prime minister. His government has been forced to make at least 18 U-turns, on issues ranging from extending the furlough scheme and the ban on evictions, to mandatory face coverings. Some U-turns have in part reflected the deep divides inside the Tories, others more so a huge social pressure and the government’s desperation to prevent the anger that exists in society pouring onto the streets. On issues like the grading of A-level exams and extending free school meals, small but determined mobilisations played an important role, giving a glimpse of what may be possible on a much bigger scale when lockdown restrictions are eased and the vaccine takes effect.

The divisions within the Tory Party will not disappear in 2021, and in fact can be widened as the impact (or lack thereof) of Brexit is revealed. The devastating last minute curbs on guidelines about seeing loved ones over Christmas was met with rage around the country, leading senior Tory politicians to speak out against Johnson. The long-term future of this government and it’s prime minister is far from certain.

But unfortunately the challenge presented to the government has been weakened in the last year by the mistaken resignation of Corbyn as leader of the Labour Party and his replacement by right-winger Keir Starmer. Starmer’s approach to the pandemic has largely been to (in his own words) support “whatever measures the government takes” in the interest of ‘unity’. The counterrevolution has not stopped at the top, but has been followed by a flurry of suspensions, including of Corbyn, and of left activists at branch level too. There have been multiple waves of resignations from Labour as a result and an important part of the struggle in 2021 could be sections of the workers and young people who were drawn into political activity by Corbynism fighting for alternative ways to have their political voice heard and make an impact on events.

Health crisis

Over two million people in the UK have had positive Covid-19 tests, and over 80,000 have died where Covid is mentioned on the death certificate – the fifth highest death rate in the world. The true cost in lives lost is hard to measure, taking into account those who have had treatment for other illness delayed, or avoided seeing a doctor for longer than they otherwise would. It hasn’t been an even impact across society, with decisively higher rates of infection and death amongst poorer communities, and particularly those of Black And Minority Ethnic backgrounds. This fed into the resurgence of the Black Lives Matter movement in the summer in solidarity with the protests against the killing of George Floyd in the US. These facts led to a generalised discussion about inequality, which cannot be allowed to slip backwards.

As we have pointed out, the scale and impact of this pandemic was not inevitable, but reflects the inability of capitalism to plan for crises and respond rapidly and efficiently. That was shown in the embarrassment of the track and trace app failure; the scandalous figures on private companies with links to MPs being given government contracts; and perhaps most clearly in the first spike when basic medical supplies, particularly gowns, reached critically low levels in many areas. While it is not yet the case that big sections of the working class are drawing the necessary, socialist conclusions, this series of scandals has undoubtedly increased anti-capitalist thinking and planted seeds in many minds of the need to search for an alternative way to organise society.

A popular vote would almost certainly give health workers in particular, and key workers in general, ‘hero of the year’ status. Millions took part in the ‘clap for carers’ for many weeks. Health workers themselves are likely ending the year justifiably feeling mainly exhaustion and frustration, which can undoubtedly have an effect in delaying the potential for explosive struggles of health workers in 2021. But fundamentally the bitter anger towards the government, alongside the public support built up, will not dissipate, and the ingredients exist for this to feed mass protests and even strike action down the road. A glimpse of this has been seen in the very active and angry rank-and-file health workers’ Facebook groups that have developed and the limited but vibrant protests organised in the autumn.

Economy and jobs

2020 saw the worst recession the UK has experienced in more than 300 years. We’re yet to see figures on the performance of the economy at the end of the year – likely to show further contraction aligning with the latest lockdown measures – but despite a rise in GDP in the summer quarter when the economy had largely re-opened, there remained a 9.7% gap between the position in September and before the pandemic. While the wealth of billionaires hit record levels, so too did the number of people in Britain using food banks. Nearly 700,000 in the UK have been forced into poverty because of the pandemic. The rate of job losses in the autumn was a record high, despite the continuation of the furlough scheme likely staving off many others that will follow. For example, in November 32% of accommodation and food service industry businesses said they had low or no confidence they would survive the next three months.

There will be further pressure on the government to step in to bail out businesses – either through further extensions of the furlough scheme or government-backed loans. The retail sector is in crisis with many shops laying empty, and companies who own the properties looking to local authorities to buy them out, potentially to turn them into housing. The crisis of funding in local authorities themselves will continue to be an issue, but due to the political situation it’s likely that central government will either relax borrowing rules or step in to give extra funding to councils to stop them going bust. Increasingly, councils are looking towards taking services back in-house as a cost saving exercise. Even though there are splits in the Tory party on this issue, Rishi Sunak is likely to announce more stimulus measures in the economy in 2021. The question will be, who is made to pay for it?

Brexit has been a source of uncertainty for businesses and even with a deal being reached, there will be economic problems. Workers will need to fight any attempt to use Brexit to attack pay, conditions or health and safety in the workplace, as well as any attempts to further push a race to the bottom. All of the problems – such as the feeling of alienation from the capitalist establishment, the lack of jobs and attacks on services – which led to a majority voting to leave the EU have not gone away, and in reality have actually been deepened in the four years since the referendum. The blatant truth that Johnson lied about having an ‘oven ready’ Brexit deal will not be lost on working class people and the fact that Brexit will not lead to a fundamental improvement in their lives will potentially lead to a questioning of what else should be done.

A major question in 2021 is how the trade unions will respond to the bonfire of jobs that is coming. In general the trade unions have not made a decisive impact in the working class experience of Covid. This has been in contrast to some vital battles at local level – the rights won for care workers in Salford for example, or the ongoing campaign to reinstate Louise Lewis, teacher trade unionist suspended after raising Covid safety concerns.

Mass unemployment can sometimes make workers more cautious of organising and fighting back in the workplace. But it also puts greater responsibility on the trade unions to place themselves at the forefront of a movement for decent, environmentally sound jobs with trade union-agreed pay and conditions, as the only way to unite those in and out of work. Those unions who fail to meet the challenges of this period, including potential complications like the rise of homeworking and bogus self employment, may well find themselves pushed aside by those most willing to fight in this way.

Young people

In particular, it is young people who are suffering as a result of the jobs cull, with a 348% increase in redundancies of 16-24 year olds in the third quarter compared to the same time last year. This particularly reflects the concentration of young workers in retail and hospitality – jobs that already held the lowest wages and poorest conditions.

The next generation of workers have already shown their willingness and ability to organise and fight back – notably in the significant campaigns taking place on university campuses last term. The rent strike movement has spread to dozens of universities, with students at Manchester University securing a 30% reduction in rent for term one, which can become a beacon for others to continue demanding the same. The scenes of students locked into halls and charged extortionate fees for poor quality food while paying full tuition fees for online teaching was met with widespread solidarity from workers too.

In fact education at every level has been a central issue for the working class as a whole throughout the Covid crisis. In schools there has been a constant battle to try to ensure safe working to enable education to continue. Instead the government refused first to ensure such safety measures and then to close schools when the situation had become so bad as a result. Only now, when the situation has become completely untenable, have they been forced to partially delay the start of the spring term. And even then, they have made none of the necessary provisions for things that would ease the impact of school closures on working class families – for instance guaranteed indefinite full pay for those needing time off for childcare, and the cancellation of all exams. The anger among education workers over these issues can manifest in 2021 as further battles over safety, but also longer-standing issues such as workload.

Women on the frontline

Those who have had to take the biggest burden as a result of school and childcare closures, as well as informal childcare arrangements being cut off, have been women, and working class women in particular. The ‘double burden’ found whole new meaning in 2020, highlighting the previously widespread lack of understanding of the scale of women’s unpaid work in the home. That’s not to mention the horrific situation facing those suffering from intimate partner violence when being cut off from friends, family and work. Or the disproportionate impact of job losses in sectors like retail on women workers, and the impact of stress and burnout on frontline women workers.

But on these points too, an increased consciousness of the issues and resulting pressure has led to some small victories – for example the NHS conceding that all women should be entitled to one person to accompany them in labour and to pregnancy scans, and also the discounting of children under school age in the rule of two during lockdown, meaning mothers of young children could meet others outside.

For many women, the experience of the last year will have been eye-opening on the need to struggle for decent pay, childcare and genuinely affordable housing, but also more generally the need for socialist feminist ideas to fight oppression.

Strength of the working class

Here we have outlined the huge and often unprecedented difficulties faced by working class people in 2020. That has been reflected in a spike in, for example, mental health crises. But the overwhelming lesson should surely be not the difficulty, but the ability of ordinary people to overcome this adversity; that in their millions they made huge sacrifices and rapid adjustments to their lives in the interests of the common good. The capitalist class has exposed its weakness, the working class has shown our strength. This potential strength can and should be brought to bear in 2021.

2020 was Socialist Alternative’s first full year as an independent organisation, since we launched in September 2019. We have experienced significant growth on the basis of a determined and methodical approach to how we organised under the pandemic. Our members are itching to get back to normal meetings and activity as soon as is feasible, and to throw ourselves into the struggles of working class and young people to come this year. Make 2021 the year you join us in the fight against capitalism and for a socialist world – the only way to guarantee a safe, free, and decent future for all.

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NHS

Tory Health Bill: further privatisation on the agenda

Cervical smear backlog shows impending next wave of crisis

2021: an opportunity for building the socialist fight against capitalism

The race for Covid-19 vaccine: Is this the end of the pandemic?

NHS contracts scandal: Tories are still putting profit before people

Fight to save our National Health Service

GET INVOLVED!

UPCOMING EVENTS

Tory Health Bill: further privatisation on the agenda

Cervical smear backlog shows impending next wave of crisis

2021: an opportunity for building the socialist fight against capitalism