For a year Cameron’s health reforms have been subjected to sustained opposition to the point where there are no longer has any discernable supporters. The rush to implement the changes, before the legislation was passed, has already cause damage to our NHS not to mention increasing risks. The Bill is passed but we can mitigate the damage and await repeal by a government which actually believes in a comprehensive universal NHS.
The Lords have made another 400 odd amendments but the vast majority are minor and technical. There are NO changes to any of the key clauses which deal with competition. The core of the Bill which sets out the framework for making our healthcare into a regulated market remains, with a few limited safeguards inserted.
The Bill passed because the LibDems allowed it to. They claimed opposition then pathetically voted the Bill through. Their claims to have made thousands of amendments and to have changed the Bill fundamentally are seen as nonsense when you look at the changes that were actually made.
It is for the political activists to ensure the LibDems pay the price for their duplicity in local and national elections. The issue of the NHS must be kept at the forefront of the campaigns especially in those areas which are marginal for the LibDems. Sadly electors have short memories and the LibDems are well used to saying one thing whilst doing the opposite – and getting away with it.
The idea of clinicians standing as NHS Candidates and opposing sitting MPs or Councillors sounds attractive but success by single issue candidates against the political machines of the established parties are rare and only possible when a major local issue (like closure of a hospital) is very visible and obvious to the electorate.
But the Bill is a complex mess and offers many opportunities for activists to limit or even prevent the implementation of the worst aspects the Bill brings in. The compromises and additional bureaucracy offers opportunities.
The time is right for a much wider campaign to defend that NHS. There are many opportunities for us all to play a part. We can be active in the Foundation Trusts that will be the providers and in the CCGs which will be the commissioners and we can challenge any moves towards breaking up the NHS from within. There are many opportunities:-
- becoming members of Foundation Trusts and raising issues
- standing for election as a governor of a Foundation Trust on a pro NHS political manifesto
- becoming appointed governors of Foundation Trusts raising issues and challenging decisions
- for those who are existing NEDs on trusts asking awkward questions especially the PCT NEDs who are in limbo
- applying for any public appointments to new bodies
- trade union representatives should become staff governors of Foundation Trusts
- trade union representatives can ask questions of Trust Boards through usual machinery for partnership working
- councillors can be appointed on to Health and Wellbeing Boards
- councillors can take every advantage offered by the overview and scrutiny functions
- councillors can put down motions to council
- we can attend council meetings and ask difficult question or demonstrate against bad decisions
- we can apply pressure on councillors when they stand for election
- we can join patient representation groups formed by CCGs
- we can campaign against the activities of GPs within CCGs taking the issues to their surgeries
- we can use local media to identify local decision makers and hold then accountable through the media
- we can get involved in early stages of HealthWatch creation
- we can become members of HealthWatch when they are formed properly
- we can attend consultations run locally over the changes or local reconfigurations
- we can support local “Save our ….” Groups
- we can write to local papers raising the issues
- etc
- and even support Judicial Reviews of improper local decisions
If opposition to implementing the Bill comes from the bottom up whilst political pressure is applied from the top down we can halt the rush to the market.
We need hundreds of local campaigns and activism by many thousands of those who genuinely love the NHS. We have to keep stoking the anger than the attempts to break up our NHS have generated and use it to fuel opposition at every possible opportunity.
There needs to be support through provision of campaigning information and materials and even training in the necessary skills. We can offer mutual support to those who are active in many ways so they are not isolated and victimised. We can use 38 Degrees and others to run bigger wider campaigns on key themes. Above all we can ensure we make full use of the emerging social media to keep the campaign running, exchanging ideas, experiences and insights.
If we believe we can protect our NHS – then we can.
Irwin Brown