An Emergency, but No Accident

Our health and social care systems are under severe pressure.

We see the evidence for this in the overcrowded A&E departments, patients lying on trollies in hospital corridors, ambulances unable to respond to emergencies and an acute shortage of community care packages to support people in their own homes.

We can see it in the overworked and underpaid staff trying desperately to provide quality and lifesaving services. We see it in the ever-lengthening waiting lists, in the targets that are missed month after month, in the chronic shortages of GPs and in the underfunded, but high demand, and outrageously neglected, services like mental health.

Everyone seems agreed that the NHS and its staff are on the brink, but there is far less agreement about why this is the case.

Underfunding

For the past two decades, at least, NHS staff and services have been severely and deliberately underfunded. This is not an economic issue, it’s a political decision.

From its inception in the late 1940’s the NHS has been targeted and undermined by those who wish to profit from a private medical insurance model. They have played a long game, but must now feel that they are perilously close to their objective. Not only are services and staff overstretched and under resourced, but the private healthcare lobby is in the process of securing its greatest victory yet.

It has convinced large numbers of people, many of them young people, that the days of publicly funded, free at the point of delivery health and social care are over and that the NHS, a great thing while it lasted, is now in terminal decline. 

It is now the received wisdom, and a repetitious media message, that the NHS has had its day and that a new, and profitable, model of care is required.  

Two Tier

We are very, very, close to a two-tier health and care system. Private, profitable, care for those who can afford it and an underfunded, under resourced second-class system for everyone else.

The deliberate erosion of our health and care system is part of a larger agenda which seeks to abolish concepts of community, solidarity, citizenship and collective responsibility.

Private healthcare, private insurance companies, investors and profiteers are waiting in the wings, emboldened by the crisis and the culture that they have been cultivating for years.

‘No Society’

The underfunding, under resourcing and privatisation of the NHS is an example of the right-wing agenda which says that everyone is an individual and should only look after themselves – a mantra articulated by Margaret Thatcher in 1987 when she claimed “…there is no such thing as society”. The out-workings of this doctrine are also clearly on view in calls for an end to welfare benefits and the withdrawal of the right to strike.  

The deliberate erosion of our health and care system is part of a larger agenda which seeks to abolish concepts of community, solidarity, citizenship and collective responsibility.

Principle

Can we afford a fully funded, fully resourced NHS? Of course we can. Is the principle of a national health and social care service worth defending? Of course it is.

The NHS’s founding father, Nye Bevan, was well aware of the intentions of the private profiteers and the lengths to which they would go when he said “…there will always be a cradle to the grave Health Service free at the point of use, as long as people are willing to fight for it”

We owe it to the generations of front-line workers and support staff who have developed and delivered one of the best healthcare services in the world to defend it against those who would sell it off to the highest bidder.

For now, a concerted effort will keep the NHS afloat, but only in a socialist society can it be guaranteed to achieve its full potential.

Striking Workers not to Blame

With Prime Minister Rishi Sunak refusing point blank to even discuss nurses’ pay claims and the Department of Health’s Permanent Secretary claiming ‘catastrophic consequences’ if there are more days of industrial action there are concerted efforts to blame nurses and other workers for the rise in inflation the cost of living crisis and the difficulties faced by the NHS.

Nurses aren’t responsible for unsafe staffing levels, nor are workers’ wages responsible for inflation. The absence of an Executive is Stormont isn’t helping but the NHS has been in serious trouble for years from decades of underfunding, cut backs, privatisation and, quite frankly, poor workforce planning and mis management at Departmental level.

As well as nursing staff, ambulance workers, customs and immigration staff, bus drivers and postal workers are all taking industrial action this month. They have been forced to take to the picket lines in defence of jobs, public services and pay and conditions.

Working people cannot and must not be demonised and scapegoated for the failings of a capitalist system which rewards the wealthy by exploiting and penalising those who produce the wealth, deliver the services and keep our society functioning.

This is a struggle working people cannot afford to lose.

Death by a Thousand Cuts

The National Health Service is in crisis. Right wing think tanks and Tories, at home and at Westminster, suggest prescription charges and paying to see the doctor as ‘solutions’. But worse, the very existence of the NHS is under threat.

Emergency Surgery

While the ‘temporary’ withdrawals of emergency surgery at the South West Acute Hospital in Enniskillen and at Daisy Hill Hospital in Newry earlier this year make the headlines and quite rightly attract public attention, even more profound issues are emerging.

The Western Trust, as well as the Department of Health, has a responsibility to set out very clearly its long-term plans for emergency surgery in the south-west and the implications for patients, services and staff. 

We need to see the overall plan for the future of health and care services and discuss it openly and in the round. Drip feeding information and making announcements by instalments is undermining public and staff confidence.

Local healthcare should always be safe, of the highest quality and be professionally delivered – but it must also be accessible. Patient journeys of over an hour to receive emergency treatment falls well outside of that – even on a ‘temporary’ basis.

General Practitioners

As long as GPs remain as private independent contractors there will continue to be the difficulties in recruitment and threats to services that we have been hearing about recently.

GPs becoming NHS employees, instead of private contractors, would improve the service, reduce waiting times and address many of the problems currently faced in primary care – including the closure of GP practices

It would be inconceivable that other health and care professionals like nurses, social workers and hospital doctors would sit outside the NHS rather than be its employees/. Why should GPs be any different?

Community Care

For the thousands of people who receive treatment, care and support in their own home comes the additional health benefits of familiar surroundings, family, dignity, reassurance and a level of control. Yet despite the fundamental nature of community care the service and its centrality to health, well-being, rehabilitation, recuperation and added years, it has always been, and remains, a Cinderella service.

The majority of community-based care is now provided by a plethora of private companies. It is delivered by some of the lowest paid workers in the health and care system and prioritises profit over people.

The community care system is criminally underfunded. Successive Health Ministers and the Department of Health have never accepted it as a valid and vital part of the health and care system and continue to see buildings and technology as the core of the health service

Why is it that twenty five years ago local community care services were receiving international acclaim for their innovation, flexibility, high standard of care and the contribution they were making to patient care, yet today medically fit patients are forced to remain in hospital because no care package is available to them?  .

Decades of Austerity

For decades, services have been cut, wards and departments have been closed, staff have been under-valued and underpaid and waiting lists spiral out of control while private clinics flourish and those with the money to pay go to the top of the queue.

The Scottish Health Department last week drafted a discussion paper which explored the introduction of what it unashamedly referred to as a two-tier NHS.

Of course, the reality is that the ground work for that very scenario has been laid over many years. The privatisation of the lucrative parts of the service is an ongoing process, plans to allow US and other companies to buy NHS services are always on the table and the erosion and underfunding of existing services conditions public opinion to accept anything that looks like a better alternative. grave Health Service free at the point of use, as long as people are willing to fight for it”.


“…there will always be a cradle to the grave Health Service free at the point of use, as long as people are willing to fight for it”

.NYE BEVAN, LABOUR MINSTER FOR HEALTH 1945 -51


We are not looking at isolated cases of the ‘temporary’ transfer of services. We are witnessing the potential death of the NHS by a thousand cuts. Since its inception in the 1940s there has been an active and relentless campaign by some to undermine the principle of publicly funded health and social care, free at the point of delivery, and replace it with private health insurance, private healthcare and priv

The Assembly

The Assembly should be in session, there should be a Health Minister and there should be plans, proposals and public discussions. But the current crisis has not been caused by the absence of an Executive. It has been building for years and it has been happening on the watch of successive administrations and successive ministers.  It is one of the outcomes of the policies of deregulation, privatisation and the breakup of public services.

World Best

The NHS is indeed in a crisis. It is being undermined, underfunded and cherrypicked for privatisation.

We owe it to the generations of front-line workers and support staff who have developed and delivered one of the best healthcare services in the world to defend it against those who would sell it off to the highest bidder.

For now, a concerted effort will keep the NHS afloat, but only in a socialist society can it be guaranteed to achieve its full potential.

Backing Nurses – Supporting the NHS

When nurses in Northern Ireland vote overwhelmingly to go on strike, it confirms the depth of the economic and political crisis we are in.

There are currently almost 2,500 nursing vacancies in health trusts and a similar number in the private sector. Taking industrial action is a situation that has been forced upon the nursing community as they rightly pursue parity of pay with colleagues across the NHS and seek safe staffing levels.

All five main parties in Northern Ireland are collectively to blame. The Northern Ireland Executive broke pay parity in 2014 – a decision subsequently confirmed by successive health minsters.

The media and others claim that strike action puts patents at risk. The stark reality is that patients are already at risk and staff and services are at breaking point.

Nothing is more important than the health and well-being of citizens and the safe delivery of a public health and social care service.

Supporting the striking health care workers and their demands for pay party and safe staffing levels is a demonstration of support for the NHS.   

‘Publish Health Plans Now’

The news that Daisy Hill Hospital is to provide regional elective surgery services has been welcomed by Workers Party spokesperson Nicola Grant, but she has also called for immediate clarification on the future of general surgery at the hospital.

“While today’s announcement, of a planned surgery hub, secures the future of Daisy Hill Hospital and hopefully attracts further regional specialities to the area there remains a very serious question mark over the future of general surgery services, suspended at the start if the year and ‘ temporarily ‘ transferred to Craigavon” Nicola said.

She also called on the Health Minister to publish the overall plan for the future of health and care services arguing that the drip feeding of information and announcements in installments is undermining public and staff confidence.

“Let’s see the full set of plans now”, Nicola said ” and allow the public and health and care staff to evaluate them in the round”.

Care staff expected to fund services themselves

An immediate and substantial increase in mileage allowances for domiciliary care workers, district nurses and those using their own car to provide health and care services in the community has been called for by the Workers Party Committee on Health and Social Care.

The Party has dismissed as derisory the recent offer by the Minister of Health to increase the milage rate by 10p per mile – after the first 3,500 miles travelled – saying it is insulting to front line staff and disrespectful to the needs of the ill, the elderly and the vulnerable who rely on the services provided.

The Party has written to Minister Swann and to the NHS Staff Council demanding that they immediately, and publicly, recognise the financial hardships being placed on staff as they continue to provide services at an increasing cost to themselves.

In the letter the Party also calls for an urgent lump sum payment for staff to offset the money they have spent, the introduction of fuel cards to radically improve the current method of payment and for the introduction by Trusts of a fleet of electric vehicles to provide an alternative, cost effective and environmentally friendly option for community-based staff.

Candidates endorse Radiograhers’ Manifesto

Workers Party candidates have called for the adoption of the five-point manifesto presented by the Society of Radiographers as one of the ways that hospital services can be enhanced and referral times and waiting lists reduced.

“We fully support the call by local radiographers for an above inflation pay settlement as one way in which staff retention and future recruitment can be enhanced”, the candidates said in a joint statement

Hospital Radiography departments provide a wide range of diagnostic imaging services including CT scanning, ultra sound and X-Rays.

“Only through planned and guaranteed investment can out of date equipment be replaced, staff shortages be addressed and timely access to services, diagnosis and treatment be secured”,the statemengt said

“Referral times and waiting lists could be significantly reduced though the development of existing staff and an increase in the number of reporting radiographers”.

Over £10 million was spent last year alone in Northern Ireland outsourcing patient images.

“Nine out of every ten patients attending hospital will be seen by a radiographer for diagnosis or treatment. It is vitally important that we invest in their skills and careers to ensure that high quality services are available when thet afre needed”.

“Consult with people first”, says Crossan

The announcement that the ‘Phone First’ system for contacting a GP is to be made permanent has been heavily criticised by Workers Party West Belfast candidate Patrick Crossan

“I am appalled”, he said “that the Royal College of GPs has taken this decision without either reference to, or seeking the opinions of, the thousands of local GP patients that will be affected by it”

“Our health services are under extreme pressure through lack of investment and there is also significant pressure on our GP services. We all know that from our personal experience, particularly over the last two years”, Patrick said.

“GP services are central to our health and care system; they are at the heart of the community. This is no way to manage that service and shows a serious disregard for the thousands of people who regularly rely on their GP surgery”, Patrick claimed.

“I am calling for an immediate reversal of this dangerous decision and for a period of public consultation – in which everyone’s views can be taken into account – on how best local GP services can be delivered”, he said

“Part of that discussion has to be about ending the private contractor status of GPs and making them NHS employees”, Patrick added

Health services must be accessible

“Local healthcare should always be safe, of the highest quality and be professionally delivered – but it must also be accessible”, says Workers Party representative in Newry / Armagh, Nicola Grant.  

“There is considerable public concern over the announcement that emergency surgery will no longer be performed at Daisy Hill Hospital”, she said  

“We have heard promises of ‘temporary’ changes before and they have nearly always proven to be permanent. That cannot be allowed to happen this time. Every time there is a reduction in service there is an automatic suspicion that it forms part of the privatisation agenda”, Nicola said.

“It looks like the Southern Trust thinks it can use an administrative solution to address a very human problem”.  

“This ‘temporary ‘arrangement and any subsequent reconfiguration of services will mean local patients requiring urgent surgery could face a journey of over an hour to Craigavon”, Nicola added.  

“I have been in contact the Southern Trust calling on them to review and reverse their decision and to bring forward proposals for securing emergency surgery at Daisy Hill”, Nicola concluded.  

Good health in 2022?

While we still need to applaud the work of the NHS and all the staff who help provide it, we also need to watch its back.

The Stormont Executive has been discussing the introduction of charges for a range of services including prescription charges, fees for domiciliary care, and paying to see a GP or attend an Emergency Department (A&E).

Other measures thought to be included are fees for hearing aids, paying for non-emergency patient transport, paying for missed GP appointments and a review of eligibility for free eye tests.

The foundation of the NHS in 1948, and the securing of the principle that health care would be free at the point of use and available to every citizen from the cradle to the grave, was amongst the most significant social developments of the 20th century in Britain and Northern Ireland. These changes were not given freely, they were won by the struggles of the organised working class.

Everyone who values that principle should now be prepared to stand in defence of the NHS and the publicly funded, free at the point of delivery services that it provides.