NHS Devolution Danger

NHS Devolution Danger

Public Meeting held at the Adelphi Hotel in Liverpool on 20th April 2016

Dr Alex Scott-Samuel (Public Health Academic)
Caroline Molloy (editor OurNHS, Open Democracy)
Caroline Bedale (Retired Health Worker and Unison Activist)
Greg Dropkin (Activist and Researcher – Keep Our NHS Public)

The founding principles of the NHS were – and should be – that healthcare is free, comprehensive, universal, funded by general taxation, publicly provided and publicly accountable. We need to be able to understand Devolution as a threat to this, in order to resist. (from Keep Our NHS Public NHS Devolution Briefing for Merseyside).

Chair of the Liverpool City Region Local Enterprise Partnership, Robert Hough, to Business Leaders: ‘…a devolution deal will only succeed if it is materially shaped by the views of the private sector.’ He signed a Devolution deal in November 2015 with Liverpool’s Mayor and 5 Borough Council leaders.

Devolve and Dissolve? Devolution Threatens Our NHS:

By Minnie Stacey – 29/4/2016

This was a public meeting with a panel of passionate healthcare experts warning against regional devolution because it involves the privatisation of our NHS. Local councillors in Manchester and Liverpool regions have signed up to what looks to be George Osborne’s own version of TTIP for the UK, doing deals with business leaders in secret and without consulting the public. Dr Alex Scott-Samuel pointed to the planned and systematic sell-off of the NHS which began under Thatcher and has been going on for decades. With Health Minister Jeremy Hunt trading on public vulnerability in how much the government can get away with, Alex urged everyone to support the Junior Doctors strike which is very much a part of this.

The reality of our Health Service calls for emergency attention in a political and media storm Orwellian in its corporate and mercenary opposition to truth. Caroline Molloy spoke about rhetoric replacing evidence, the foregrounding of jargon, fear and despair – which uses the language of insurance, replaces the toxic word ‘competition’ with ‘partnership’, and separates patients into being ‘deserving’ or ‘undeserving’. For example, East Midlands is planning to withdraw healthcare for people with unhealthy lifestyles. Under devolution, Liverpool’s healthcare may be run jointly with local benefits services, with pilots dressed up as ‘prevention’ to include how work is good for your health. To people who seek profit from carving up our NHS – local control of NHS budgets, commissioning and legal responsibilities, integrating healthcare, and combining the prevention agenda with care in the community negates the need for as many hospitals and justifies their closures.

The Cities and Local Government Devolution Act 2016 places even less duty on health services to meet the founding principles of our NHS and conceals deregulation with slippery phrasing. Devolved regions only need to have ‘regards’ to the standards and duties in 2012’s Health and Social Care Act which killed our right to healthcare. Plans such as ‘Taking Charge of our Health and Social Care’ can cut people’s access to services when personal budgets run out. Without national, pooled treatment, local NHS doesn’t always bid for contracts because there’s not enough money unless a service is run as a loss leader. The NHS’s ‘Five Year Forward View’ is backward in that boards will be suspended if they don’t meet targets and budgets.

Mainstream media has been pushing the government’s privatisation agenda by hardly reporting that emergency care has been carefully planned to be in place during strikes, it’s ignoring the fact that junior doctors already work weekends and there is no strong evidence for the so-called ‘weekend effect’ with patients dying at a greater rate. Head of NHS Simon Stevens, who is an ex-advisor to Blair with several years previous working for US privatised healthcare United Health, has been peddling the notion that national pay bargaining may have been responsible for 3,000 deaths. A recent article in the BMJ said that people have delayed going into hospital due to scaremongering and will have suffered as a result.

Caroline Bedale is a campaigner for Keep our NHS Public in Manchester, where the devolution of healthcare to a combined authority is at its most advanced. She recently retired from working in the NHS and, having been a Unison activist for 35 years, she continues to campaign with branches. She told us that devolution had even caught Andy Burnham on the back foot, and that the Labour Party is involved. ‘It’s not about extending democracy,’ she said, ‘it’s about austerity – inadequate budgets – an illusion of power with the reality of blame’. There’s a 25% fall in funding in Manchester, a £2bn shortfall. A Super Mayor has been imposed there. Caroline stressed that power is being centralised to a mayor with a cabinet cosying up to the private sector with models like ‘Healthy and Together’ which are really about cutting acute hospitals. 100% of all mental health care recovery services have already been cut, ‘If it’s not core business it will go,’ she said.

There is concern that Trade Unions appear to have been duped into being involved in supporting Devo Mancs. They’ve signed a protocol to say they will make sure there is consultation, and make every effort to ensure there is no pay loss or degrading of terms and conditions for staff unless a clear service rationale or legal basis exists for this. Attendees had all been given a model resolution for Unions to oppose devolution of the NHS, and the critical importance of building up a real movement against it in Union branches was stressed.

The Local Government Association has found that 19 out of 34 devolution bids involve health and social care. Researcher Greg Dropkin underlined Devo Mancs as a warning to Devo Scouse. Councillors are denying there are plans to change health services, so why are unasked-for market tests being carried out and scoping exercises going on? Why is there so much secrecy? Liverpool Green Councillor Sarah Jennings asked the City Council committee about the need to be informed regarding who is involved and was told detailed negotiations on devolution were not taking place. Two weeks later, it happened without the city region even voting. Labour Council and Liverpool area leader Joe Anderson talks about devolution and the integration of health and social care. ‘They made an agreement in 2015 but deny it,’ said Greg, adding that high-powered commissions and research have found no evidence for integrating health and social care being in the best interests of patients. Roger Bannister, Liverpool’s TUSC candidate for Super Mayor who was at the meeting, said ‘It’s about a Tory agenda of smashing up health services’. Another audience member highlighted the risks to Liverpool Women’s Hospital moving and being swallowed up in the new PFI-built site for Liverpool’s Royal Hospital. Someone else said moving care into the community almost always means dumbing down.

Consecutive governments have facilitated money being siphoned off from the NHS to PFI and private providers. The only risk to having integrated services cited by those involved in devolution is the risk of not having integrated health and social care! Unions will have to engage with new models to defend health workers. Do councillors even know what they’ve signed up to? Has Corbyn taken his eye off the ball? An audience member asked do we know what threats were issued to Liverpool Council to sign up – is Joe Anderson to be trusted when he even implies there have been no consequences to cuts for Liverpool in his mayoral campaign statement? There was a warning from the floor that we all need to understand the violence and hate tactics of what’s happening, when the government blames the sick for being sick and the poor for being poor.

The Tories accuse workers of ‘the politics of envy’ for wanting higher wages to be less poor, and for taxes to be paid by the rich to fund public services. Their doublethink is exposed by the promotion and business of aspiration in selling off publicly owned services, lowering the wages of workers, and degrading hard-won terms and conditions to make themselves and corporate cronies richer. Our NHS currently faces a £2.5bn deficit and has been set the impossible task of finding £22bn in efficiency savings by 2020.

Junior doctors’ strikes show there is a fightback against profiteering from healthcare – once it’s gone it’s gone forever, so let’s all fight for our NHS. Privatisation is costing billions, we need to roll it back and save billions!

NHS Devolution Briefing plus video of above public meeting at the Adelphi Hotel in Liverpool on 20 April 2016: https://keepournhspublicgmcr.com/2016/04/26/whats-wrong-with-nhs-devolution/

What Actions Can We Take?

  • Discuss the issues raised in this meeting with friends and colleagues.
  • Read the short ‘What’s wrong with NHS Devolution?’ and the longer ‘Briefing: NHS Devolution – Merseyside’.
  • See your councillors. Be ready to explain the issues in detail.
  • Write to Cllr A Moorhead, the Health & Wellbeing lead on the Combined Authority andy.moorhead@knowsley.gov.uk, cc your ward councillors and MP
  • Use or adapt the model resolution for trade union branches ‘Oppose Devolution of the National Health Service’.
  • The next meeting of the Combined Authority is currently listed as Friday 17th June 2016 – 1pm at No. 1 Mann Island, Liverpool L3 1BP. We may all wish to attend this.
  • Make the NHS, and NHS Devolution, an issue with anyone who wants your vote.

Keep our NHS Public Meetings take place on the 1st Thursday of each month at Unite’s offices in Jack Jones House, Churchill Way, Liverpool: keepournhspublic.com/support-konp/find-a-local-group/merseyside/

A good link for NHS and Devolution articles: www.labournet.net/

OurNHS on Open Democracy: www.opendemocracy.net/ournhs

Information is also available through papers on the health and well-being board for local NHS areas.

Picket the Profiteers is a non-violent national, direct action initiative: www.pickettheprofiteers.org/ www.facebook.com/pickettheprofiteers/

Devolution – secrecy, smoke and mirrors – article by Ritchie Hunter: www.catalystmedia.org.uk/archive/issues/misc/articles/devolution_smoke_and_mirrors.php

Photographic Exhibition by Marion MacAlpine starts 7th May in Liverpool’s Central Library entitled “How come we didn’t know? – Privatisation: the corporate takeover of our NHS” (and before this date at Birkenhead’s Williamson gallery).

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