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“Only through planned and guaranteed investment can out of date equipment be replaced, staff shortages be addressed and timely access to services, diagnosis and treatment be secured”,the statemengt said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

NHS crisis – a long project

Every newspaper headline, news bulletin and radio phone-in programme in recent weeks has declared that the NHS is in meltdown: that the system is broken and is on the verge of collapse.

What is seldom examined is exactly what the crisis is, how it has been caused and why it will continue under the present system.

Many of the stories of ten-hour trolley waits, backed-up ambulances, bed shortages and of an exhausted workforce are truly horrendous. These are the lived experiences of patients, relatives and staff.

But this, ongoing, crisis hasn’t been caused by the doctors, nurses, carers and support staff who are struggling to deliver the service. While there are particular organisational issues locally which are contributing to lengthy waiting lists, our healthcare problems are political and they are systemic.

From the day the NHS was founded, over 70 years ago, right-wing politicians, many of them close to home, have been orchestrating its downfall and planning to capitalise on, and profit from, our collective health and care needs. The plotting has been relentless and only the strong public support for the concept of a health service free to all at the point of delivery has helped fend off the many attacks and treachery.

Despite the esteem in which the NHS is often held world-wide, UK spending on healthcare is lower than in Finland, Iceland, Belgium, Luxembourg and Austria. In fact, it is the second lowest, per head of population, of the world’s large developed economies.

Healthcare expenditure based on Gross Domestic Product (GDP) is also the second lowest of the large economies.

The current crisis has been brought into sharp focus by the demands of dealing with the Covid pandemic but its roots lie in the last ten years of austerity, the cuts to funding, staffing budgets and building maintenance; outsourcing, blatant privatisation of a public service and pay freezes. This is what many in the media refer to as ‘financial pressures’, as if they were part of the latest weather front

This is what many in the media refer to as ‘financial pressures, as if they were part of the latest weather front.

In parallel, the number of nursing and midwifery training places has been decimated since 2010. That led to staff shortages and they were filled by agency staff, supplied by private companies at a cost, just a few years ago, of over £115 million.

In that same decade, the number of hospital beds in Belfast alone, where most of the regional services are provided, were cut by 20%. This occurred during a period when the number older people over 75 rose by 12%. The cost of providing care for this age group, and above, is around three times higher than for the under fifties., Meanwhile, the health inequalities gap continued to grow and the ill health effects associated with areas of social deprivation added significantly to the problems and the pressures.

These are not just statistics. It is estimated that last year 5,000 people in Northern Ireland died while they were on a hospital waiting list. That is what austerity, attacks on the NHS and privatisation by stealth looks like.

The NHS has been under attack since its inception. Those attacks continue unabated today. A right-wing agenda to privatise the lucrative aspects of healthcare, politically motivated cuts to funding, staffing levels and resources and increasing calls on the service, are combining to make us believe that the very concept of a national health service is no longer viable. The additional ravages of Covid are being used to boost that deception.

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 and their efforts 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.

Health and Care a Human Right

Nicola Campbell

As health and care services across Northern Ireland become stretched beyond capacity, Workers Party Newry and Armagh spokesperson, Nicola Campbell, has called for an ‘immediate reversal of the policy of bed closures’

“In the last ten years the number of hospital beds in Northern Ireland has dropped by 10%. In the Belfast area, where all the major regional services are based, the figure is a staggering 20%”. Nicola said.

“Locally, the number of hospital beds available in the Southern Trust dropped to a low of 813 a few years ago. That figure has improved slightly but is still well short of the 997 beds available in this area a decade ago”.

“This did not happen by chance. It is the result of successive Ministers for Health and the Assembly cutting back on health service funding and investment. The outcome is that people are dying while they wait for inpatient treatment. In the past five years that figure is in the region of 22,000 deaths”, stated Nicola

“Everyone should have the right to treatment and care. It should be free at the point of delivery and should be centrally funded and centrally planned. These principles are being increasingly undermined and put at risk.

Health and care is a human right and the only way to ensure that our NHS is not run into the ground and then handed over to private companies is for the right to public health and care services to be enshrined in a Northern Ireland Bill of Rights that will provide protection and guarantees for the service, for staff and for citizens”, Nicola concluded.

Health & Social Care staff pay delay: support the UNISON campaign

Exhausted after over a year on the frontline, the same Health & Social Care staff who have given everything during the pandemic will have to keep giving their all to care for everyone whose treatment was delayed because of COVID. A fair & decent pay rise is needed ASAP.

Health & Social Care staff have given so much, they deserve better. 

Support the UNISON campaign and email your MLA asking them to act now to secure a decent pay rise for HSC staff and stop any more delays?

Time to talk seriously about Health

Hospital waiting lists and the future of health and social care services here have been one of the most covered news topics in recent weeks.

Unfortunately, many of the discussions, the radio phone-in shows, the newspaper columnists, the letters to the editor and the contributions in the Assembly have generated more heat than light.

We are probably less informed now than we were at the start.

Founding principles

However, several things are clear. There needs to be an informed public discussion about the future of our health and social care services, there needs to be a re-affirmation of the founding principles of the NHS – that it is a public service, publicly funded and free at the point of delivery, and there needs to be a clear and unambiguous declaration that health and care are human rights not opportunities for profit and financial gain.

Any discussion of the future of services might start by asking “are we running a Health service or a ’Sick’ service”? Currently nearly all our efforts are directed to treating people when the become ill, not on trying to ensure that more people stay healthier for longer.

When we talk about the health of the population, we can’t restrict that to a debate about hospitals, nurses and doctors.  If we are to help prevent more people becoming ill in the first place then we need to be talking about redirecting resources and looking at the impact of a poor environments, housing conditions, job opportunities and working conditions, improved educational attainment, information on diet, opportunities to exercise and avoiding and relieving stress.

How much would a four-day working week contribute to a healthier and less stressed population?  The causes of ill-health, not just the cures, need to be up front and centre in any and all discussions.

Traditionally we have thought, and been encouraged to think, that health was exclusively about hospitals. Much more care and treatment in the community and in people’s own homes is now possible and preferable thanks to new working practices, more developed skills and modern technologies. Developing that must be on the agenda, as must the source of any opposition to its extension. 

Some other issues are blindingly obvious. If dozens of hospital wards and hundreds of beds are closed down if the number of nurses in training is cut dramatically and funding is consistently cut, then there are going to be problems and there are going to be longer waiting lists.

We currently spend less per head of population on health services than France, Germany, Belgium, Denmark, Norway, Finland, Austria, and of course Cuba.

Shaping the narrative

In the past twenty years there have been at least four major reports proposing various levels of change to local health and social care services. 

The most important one has yet to be written. That one will recognise the social function provided by a public health and social care system, it will acknowledge the political agenda which, since the foundation of the NHS in 1948, has sought to undermine it, privatise it and profit from it.

It will concede the role that capitalist working practices and over production have on our environment and our health. Socialists, trade unionists, progressive thinkers and all those committed to a better and radically different future, need to start shaping that narrative now.

Stealth and health – the next big battle

There’s a lot we can learn from the treatment of our health and social care staff and the derisory 1% pay award being considered for front line workers.

Without the NHS, and without the professionalism and dedication of its staff, the outcome of the Covid pandemic, horrendous as it has been, would have been much worse.

The work they have done and the results they have achieved, including the outstanding roll out of the vaccination programme, has been acknowledged in popular support and sustained applause.

But despite their rhetoric and the public commitments to supporting the NHS that respect and adulation has not been matched by government actions.

That’s not entirely surprising. From the earliest days of the NHS the Tory party,  in particular, has been committed to undermining and dismantling the health service as we know it, as it has with much of the welfare state initiatives brought in after the second world war.

Sentimentality, it seems, plays no part in strategic projects like privatising healthcare.

You won’t find it in their election manifestos, it wont be admitted publicly, but  privatising the NHS is a policy that sits comfortably with Tory ideology and with the mindsets of many local parties – including those who claim otherwise.

Privatisation by stealth is probably the best description of what is happening and ironically the pressures of the pandemic and the way in which the NHS has responded has left it more vunerable.

Up to £10bn is being made available in England to buy treatment from private providers so that the NHS can clear the backlog of diagnostic tests and treatments that have built up during the Covid-19 pandemic.

More than half a million people in England now have their primary healthcare provided by private GP consortiums funded by American health insurance companies.

Hiving off NHS services bit by bit to the private sector is creeping privatisation. It is privatisation by stealth.

The second line of threat is equally covert. The longer that waiting lists become, and that is a particular problem in Northern Ireland, the more that people with the means to pay for private healthcare will do so.

Deliberately underfunding the NHS has the effect of accelerating privatisation.

Refusing to recognise the contribution and worth of its staff, by offering a 1% pay award for example, will further demoralise a dedicated workforce and contribute to a potential workforce exodus to better paid and less stressful employment.

Overcoming Covid 19 is a battle that will be won eventually with the help of the NHS and its staff. The battle to save the NHS may prove to be an even bigger task. We should prepare for that now.