John Lister

Interesting times for the NHS

John Lister
Interesting times for the NHS

THE INSTABILITY AND CONFUSION CREATED BY THERESA MAY’S disastrous general election campaign have created interesting and favourable times for campaigners wanting to defend the NHS. It’s clear in some areas that the situation has moved from interesting to testing, with decisions rubber-stamped in Shropshire and Oxfordshire to press ahead with highly controversial downgrading of hospitals and closures of beds.

In Yorkshire the slow-moving Kirklees and Calderdale councils’ joint scrutiny committee at last rather grudgingly agreed to hold up plans to downgrade and close many services at Huddersfield Royal Infirmary - while the matter is referred to Jeremy Hunt and the ‘Independent Reconfiguration Panel’, chaired by Tory Lord Ribeiro.

Polls by Sky Data have consistently shown that the state of the NHS was voters’ number one concern, although this was not reflected in the obsessive, selective, skewed reporting of the mainstream news media, which attempted to view the whole campaign as one about Brexit and immigration.

The media connived with NHS Improvement, the regulator which succumbed to government pressure to withhold more highly embarrassing figures on the dire state of the NHS after six years of frozen real-terms budgets. Financial figures giving a partial glimpse of the growing deficits of hospital trusts were delayed till after polling day.

Alarming information leaked through the Health Service Journal revealed pressure on NHS managers to draw up “savage” plans for spending cuts and closures, restricting funding and reducing availability for treatments such as IVF or elective treatment for a range of non-life threatening conditions. Figures showing a tenfold increase in numbers of patients waiting over four hours for treatment in A&E, record levels of bed occupancy in cash strapped hospitals and other aspects of the crisis were largely kept out of the headlines.

Labour could have made much better use of this information, especially in the areas where the cash-saving plans are the most extreme and where pressures already caused chaos last winter. Many older voters would also have been concerned by the Tory plans to subject home care to charges that could force families to sell their homes to pay soaring costs. However, the impact of these social care proposals was also inadequately explained to a section of voters that remain predominantly loyal to a Tory Party that treats them and their needs with utter contempt.

Jeremy Corbyn’s hard-hitting election manifesto was a step forward. It offered a clear and radical alternative, for the first time since the 1990s putting England’s NHS centre stage, with commitments to increase funding, lift the cap on NHS pay, restore bursaries, repeal the costly and chaotic Health & Social Care Act - which aimed to open up an ever-widening range of NHS services to the private sector - and “halt and review” the 44 hugely controversial Sustainability & Transformation Plans (STPs). These STPs in many areas set out proposals for hospital closures, wholesale bed cuts, and “new models of care” for which there is no evidence and inadequate funding.

Labour’s message, culminating in the warning that there were just “24 hours to save the NHS”, no doubt played a key role in mobilising the new surge of support that gave Labour the biggest swing in its favour since 1945, and the biggest share of the vote since Tony Blair’s landslide in 1997.

The young people and activists who responded to this will be watching closely to see whether the Party sustains this commitment to the NHS and to public services - but should also be watching what happens in the areas where Labour was unable to unseat Tory candidates.

This is where the interesting times come in. There has seldom been a time when local elected politicians could be subjected to sustained pressure on the level that is now possible in every area where the quality or safety of services are at risk, or where local access is threatened by cuts and closures. May’s failure to secure a majority and a hastily cobbled-together deal with the creationist, homophobic reactionaries of the DUP have created the widespread assumption that another election will be called well before the theoretical five year term is up.

This means that every MP, Tory and Labour alike, knows that any collusion with cutbacks, closures, privatisation or any controversial measures in local health care could face swift retribution from a hostile electorate that sees no good reason why their local health care should be sacrificed on the bonfire of self-imposed austerity.

Corbyn’s alternative approach, challenging the need for austerity cuts, and focused on defending public services and rejecting privatisation, has helped create the basis for a new critical approach. This applies not just to Tory MPs, but also to Labour and Tory councils, many of which have shamelessly collaborated with the development of secretive STPs along with other undemocratic plans for ‘devolution’ that give local communities even less influence over services and accountability than ever.

The time is ripe for action now, as NHS managers reveal even more cutbacks they have been hatching up in secret, and plan to flog off property assets to bail out growing deficits.

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A new layer of activists has discovered how effective political action can be. MPs must be hunted down in their surgeries and local appearances, and put on the spot, with demands they actively back campaigners resisting cuts and make clear to Theresa May and ministers that they are willing to take this fight into the Commons.

During the election campaign a Devon Tory MP vowed to chain himself to the railings of his local hospital and quit his party if its A&E department is closed down. Torridge and West Devon MP Geoffrey Cox made the statement during a hustings event. We need every MP in areas where services are at risk to be put under similar pressure.

Bear in mind in Canterbury the Tory had an 18.3% majority until booted out on 8th June. Even more significantly, pressure from thousands of campaigners as well as Geoffrey Cox and other Tory MPs no doubt played a role in the acute services review in North Devon, which concluded that all services should remain on all four sites.

In similar fashion pressure on Southend’s Tory MP Sir David Amess and other South Essex Tory MPs, who managed to hold on to their seats in June but faced a growing challenge from powerful local campaigns, has no doubt helped persuade local health bosses since the election to drop hugely controversial plans to downgrade A&E and other services at Southend and Chelmsford hospitals to centralise in Basildon.

Not only can the juggernaut of hospital closures be held up, but the very legality of the bodies being created in 44 local areas to drive through STPs has been challenged, on legal advice, by City & Hackney Clinical Commissioning Group (CCG) and Hackney council. They have argued CCGs cannot be compelled to accept and implement decisions taken by ‘majority vote’ of other CCGs or new STP Partnerships.

We must take advantage of every such division and contradiction, and make sure we condemn all our elected politicians to live in interesting times, building campaigns strong enough to pose a threat that if things become too interesting it could mean they lose their precious seats.

CLPs are urged to affiliate to Health Campaigns Together and join with trade unionists and campaigners in a major conference in Hammersmith Town Hall on Saturday 4th November: details, more information and booking online at