The Fight for the NHS Isn’t Over; It’s Only Just Begun

Although the mangled corpse of Andrew Lansley’s wretched NHS reform bill was passed by Parliament a month ago, the fight to save the NHS is far from over.

On the afternoon of April 24, the campaigning group 38 Degrees, which mobilised over half a million people to oppose the government’s plans to hack up the NHS and flog off as much as possible of it to the private sector, organised, at short notice, a public meeting in London to discuss the future of the NHS, and to draw attention to another meeting taking place nearby — a conference organised by Capita and United Healthcare, two of the companies that stand to gain from the carving up of the NHS. Over 22,000 38 Degrees members sponsored the event, each paying £1 to put it on, which is a great example of people power.

The event, entitled, “Citizens and CCGs: Exploring our Future,” was chaired by Guardian journalist Zoe Williams, whose report (which managed to be informative despite striving to find humour where there is none) began by stating, “I always thought this was Andrew Lansley’s true genius — not the dismantling of the NHS itself, not the dark hold he has over David Cameron, but the phrase ‘clinical commissioning group,’ or more ingenious still, ‘consortia.’ If you can jam three words together that all take a bit of unpacking, that’s often enough to make anybody normal walk away.”

That’s true, but those who want to save the NHS do need to grapple with the basics of Lansley’s intentions — to hand over to groups of GPs (CCGs) the budget for “commissioning the medical services they decide their patients need.” With “one member of a CCG, Dr David Wrigley; the leader of the Medical Practitioners’ Union (in Unite), Dr Ron Singer; Dr Louise Irving, newly elected to the BMA council; and Roy Lilley, a founding member of the NHS Trust Federation,” the panel chaired by Williams discussed how to oppose the Act.

As a patient, Dr. Wrigley suggested “getting involved in Healthwatch, which takes over from Local Involvement Networks, officially (LINks) in October,” although Williams was less than enthusiastic. She wrote, “If you want to feel so defeated that you put one of your eyes out, you can Google Healthwatch – the Department of Health and local authorities talk a lot about community engagement, focus groups, facilitated discussions, cascading knowledge, empowerment. I can’t see anything that tells you which meeting you would have needed to go to if you lived in Surrey and didn’t want a £500m health services contract delivered to Virgin before the act’s ink was even dry.”

However she acknowledged that “some CCGs are bound to be progressive, and committed to the NHS as a public institution,” and that, although “it’s not immediately obvious how a concerned citizen would get anywhere near Healthwatch, let alone influence its position, let alone how that position will influence a CCG’s decision,” that “doesn’t mean it will never happen.”

More promising appeared to be the health and wellbeing boards mentioned by Dr. Wrigley, “which will have a statutory role from next April,” and “mainly comprise workers from within the health service, social services and third sector, but it’s mandated that they should have one locally elected representative – it doesn’t say they can’t have two, or 10.” She added, “Of course there will be frustrations, intransigent bureaucrats, privatising zealots, people whose power simply exceeds that of the ‘community.’ But in many areas the clinical commissioners will be receptive to community concerns. They’ll have opposed the bill themselves in the first place. So this is a bad time to shut up and go home, either literally or virtually. All this apparatus will be designed as we go along, and it won’t be designed by people who have left the conversation.”

As for other possibilities, Wiliiams suggested that what we can do is to “club together to get legal support for CCGs, so if they want to award contracts to NHS providers rather than private companies their decisions will be ‘judicial review-proof.'” Pointing out why this is important, she explained, “if you want to get so angry that you put out your other eye, consider that Virgin — or rather, Assura Medical, in which it has a 75% stake — lodged a complaint before the act was even passed against York Hospitals for ‘predatory pricing.’ Because they weren’t trying to make a profit, they were just trying to treat people who were ill — so it wasn’t fair on the private companies tendering for the business.”

That’s disgraceful, of course, and more than enough reason for UK Uncut to have singled out Virgin Care (as Assura Medical now is) for protest last Saturday — and also see this Open Democracy article by a medical student, Joy Clarke, for a detailed explanation of Virgin’s planned profiteering. However, Capita and United Healthcare also have nothing to be proud about. As Williams explained, “the real starting point for the meeting had happened earlier in the day round the corner, where CCGs had been invited to another event, jointly sponsored by United Healthcare and Capita,” who were showing off their money.

As she added, “It is never great, is it, when you have to stage a guerrilla cocktail party to remind the world that United Health and Capita do not own the NHS, they had no hand in its creation, their only care for it is financial and just because they have the cash doesn’t make them the grown-ups?” However, her conclusion was suitably feisty. “On the other hand,” she wrote, “it is increasingly clear that anybody who thinks the fight for the NHS finished with the passage of the bill ain’t seen nothing.”

Williams’ column appeared on the same day that Dr. Louise Irvine, a GP for 27 years, and a 38 Degrees member, also wrote about what she described as “our patient-sponsored event with some of the senior GPs who have been put in charge of deciding the future of local health services.” She explained that it was a great event, and “not just because plenty of senior GPs turned up, despite already having spent all day being schmoozed by private healthcare companies.”

As she also explained:

The event last night helped convince me that although we didn’t manage to stop Lansley getting his NHS changes through parliament, there is still lots we can do to protect our NHS. Those “RIP NHS” headlines were premature. I think the NHS is now like someone with a chronic illness: if we don’t look after it, bits might start falling off. But right now, the NHS is a living body, and one we’re all part of.

I heard senior GPs say how glad they were that 38 Degrees members want to continue to campaign to protect the NHS. They responded positively to 38 Degrees members’ campaign ideas, and many said they were willing to work with us. I heard speaker after speaker say it’s never been more important for citizens to get involved and make themselves heard.

To decide how to proceed, 38 Degrees have launched a poll to ask everyone concerned with the NHS for their opinions on how to proceed, asking, “How much do you think the following suggestions should be our focus in our NHS campaign?” and asking how much supporters like — or don’t like — the following seven proposals:

• 1. Campaign for local GPs to use their new powers to protect the NHS
• 2. Campaign if and when things start to go wrong in a specific local area, by sounding the alarm and calling for a change of plans
• 3. Create a people-powered NHS watchdog
• 4. Build up a national picture of how cuts and privatisation are impacting on the NHS
• 5. Deter private companies from encroaching on the NHS
• 6. Make the NHS an issue in elections
• 7. Help NHS staff who’ve lost their jobs by advising on how to set up alternative organisations to compete with management consultants and big companies

So if you care about the NHS, please fill in the poll. Personally, I like suggestions 3, 4 and 5, but you no doubt have your own ideas. I do believe that it’s important for us not to give up, however, and allow the Tories to destroy what is arguably Britain’s greatest achievement, which has survived for 64 years.

As Dr. Irvine explains:

I’m lucky. As a GP I see every day how important the NHS is and the difference it can make to people’s lives. So I’ve never doubted that the best future for our health service is a people-powered one.

Being involved with the 38 Degrees campaign to Save the NHS showed me how many of us know that our health service is precious and worth protecting. Like most of us, when the government pushed ahead with its plans and ignored our concerns, I felt sad and worried.

But the response from 38 Degrees members since the law was passed has been incredible. Ideas have poured in for ways to continue to support the NHS. The office team has worked through those ideas, and asked NHS experts for their advice on what could work. Now we have a chance to decide which ones to prioritise in the weeks and months ahead.

Like you, I’ve donated, signed petitions, and emailed my MP. I saw the effect of our huge billboard campaign and the thousands of letters and emails we sent to MPs and Lords. I know we’re at our most powerful when we get together to set priorities, plan, and make things happen.

So please get involved in setting 38 Degrees’ priorities for the next stage of the campaign — vote now.

Note: For more voices of opposition to the government’s NHS reform, see these opinions by healthcare professionals and policy makes from the Guardian on April 2, and an article in Red Pepper published online on March 23. For some worrying perspectives on pro-privatisation doctors, see the Independent article, “How GPs are set to make a killing out of NHS reform,” from March 25, and the Guardian article, “GPs’ shares in private healthcare firms prompt conflict of interest fears,” from March 27.

Andy Worthington is the author of The Guantánamo Files: The Stories of the 774 Detainees in America’s Illegal Prison (published by Pluto Press, distributed by Macmillan in the US, and available from Amazon — click on the following for the US and the UK) and of two other books: Stonehenge: Celebration and Subversion and The Battle of the Beanfield. To receive new articles in your inbox, please subscribe to my RSS feed (and I can also be found on Facebook, Twitter, Digg and YouTube). Also see my definitive Guantánamo prisoner list, updated in April 2012, “The Complete Guantánamo Files,” a 70-part, million-word series drawing on files released by WikiLeaks in April 2011, and details about the documentary film, “Outside the Law: Stories from Guantánamo” (co-directed by Polly Nash and Andy Worthington, and available on DVD here — or here for the US). Also see my definitive Guantánamo habeas list and the chronological list of all my articles, and please also consider joining the new “Close Guantánamo campaign,” and, if you appreciate my work, feel free to make a donation.