THE biggest strike in the history of the NHS is taking place because of the government’s refusal to talk.
It doesn’t matter how often Health Secretary Stephen Barclay insists that his “door is always open” — as health unions have pointed out, this is meaningless so long as ministers refuse to put pay on the table.
The weekend has seen Royal College of Nurses leader Pat Cullen and Unite general secretary Sharon Graham throw down the gauntlet directly to Prime Minister Rishi Sunak, demanding he get involved personally in resolving this crisis.
Graham’s revelation that Unite is in “no talks at any level whatsoever” on pay is a damning indictment of ministers’ complacency.
That complacency should inform us all as to what is at stake in these NHS strikes.
The successive strikes hitting essential services are not good news for the Tories politically — the impression of chaotic mismanagement and incompetence is one this government will find it hard to shake off.
But ministers are not displeased at headlines day in, day out indicating a health service in meltdown. They want a “something’s got to give” atmosphere — with the aim, as GMB leader Gary Smith tells the Morning Star in today’s paper, of advancing privatisation of the service.
For the right, support for the NHS is a longstanding political problem. Thatcher’s chancellor Nigel Lawson said the health service was “the closest thing the English have to a religion,” indicating both his awareness of popular attachment to the service and his inability to understand it.
Lawson was an arch-privatiser who played a key role in ending public control of our gas, electricity, telecoms and flagship airline British Airways. But dismantling public control of the NHS would be a much longer-term project.
Introduction of the internal market under Thatcher and Major, infliction of PFI debt and private contracting under Blair and a massive acceleration of private-sector involvement under Cameron have all played their part in undermining the service.
Serious underfunding by comparison with continental healthcare systems, with consequent shortages of beds, ambulances and — most dramatically — staff, has helped produce today’s horror stories around vulnerable people waiting hours for medical help and A&E departments clogged up with emergency vehicles unable to hand over their patients because hospitals lack the capacity to take them in.
The scene is then set for warnings like that late last year of British Medical Association Scotland chairman Dr Iain Kennedy that there is “no way the NHS in Scotland can survive in its current form.”
For shadow health secretary Wes Streeting’s claim that we cannot “keep pouring money into a 20th century model of care.”
More bluntly, for what former health secretary Sajid Javid terms a “grown-up conversation” about making people pay up front for care. The former Deutsche Bank director wants GP appointments and accident and emergency trips to come with a fee attached.
Britain’s low pay crisis, the revelation during the pandemic that many households are a single pay cheque from destitution and a quarter have less than £100 in savings, make it fairly clear what such charges would mean: poor people unable to afford medical care.
Or a means-tested service that, as NHS Scotland chiefs mooted, would introduce a “two-tier” model.
This is why the left must stand firm on the NHS: the cause of the problem is underfunding and pay so low it has prompted a staff exodus. The only reform we need is to boot the private sector out entirely.
And the NHS struggle stands for the wider strike wave in other ways: in the systematic degradation of an essential service that is then presented as poor value for money, it resembles the attacks on our public transport and postal networks.
Solidarity with all striking NHS workers. Their fight is our own.
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