16th February 2017
By Dr John Lister
Doctors and Nurses have been saying the conditions in today’s NHS are the worst they have seen, or the worst ever. But for those of us with memories going back 30 years the whole situation in the NHS seems like a blast from the past.
In 1987 we also had a stubborn, right wing woman in Downing Street, orchestrating real terms cuts in health and other public services, starving hospitals of funding through below inflation allocations. A baying right wing press, then as now, sought to exploit every failing by an NHS hospital, to argue that the NHS itself was outdated, unsustainable, and in need of fundamental, privatising, change. But there are important differences: back then the bench-mark for waiting times was years, rather than weeks, with delays of two years or more common, and prolonged trolley waits for emergencies were standard.
Theresa May is clearly no Margaret Thatcher, and her majority is weak, with the Tories hugely divided over Brexit. However May is not confronted by a labour movement as strong, combative and united as the unions and Labour were in 1987, even after the defeat of the miners’ strike.
It has not so far been possible to build as powerful a campaigning movement to challenge the Tory cuts at local and national level. Today’s Labour Party opposition, while improving, still lacks a clear, consistent edge, while many Labour councils and MPs lag way behind and offer no lead or support in defence of threatened services.
Nor has the medical profession yet been mobilised to challenge May’s cuts, in the way it was at the end of 1987. Then campaigners were able to gather a national petition of 1,200 hospital consultants and leading specialists, attacking the cuts and demanding an increase in funding: the leaders of three medical Royal Colleges led a delegation to present the petition to 10 Downing Street. Thatcher grudgingly responded by conceding an extra one-off £100 million cash injection, inflation that year). This was dismissed by Mr George Pinker, President of the Royal College of Gynaecologists (the Queen’s own doctor), as inadequate.
The unions were also more confident then. Unofficial strike action in January 1988 by night shift nurses in Manchester triggered a wave of official and unofficial strikes across the country, which eventually brought the ‘regrading’ of nursing pay, with major increases for many nursing staff.
We can’t do the same today, but it’s clear we need to step up the fight on all fronts in defence of our NHS. Real terms NHS pay has lagged behind much lower levels of inflation, leaving all staff more than 16% worse off in real terms than six years ago.
NHS funding has been effectively frozen in real terms since 2010, lagging way behind the growth in population and the estimated 4% per year increases in cost pressures from an ageing population, new drugs and treatments and higher than RPI inflation. And there is no light at the end of the tunnel: budgets will be even tighter in 2018 and 2019 than this year – forcing health bosses in every area to seek huge and unprecedented cost savings.
That’s why NHS England has redivided the country into 44 ‘footprints’ – each required to draw up “Sustainability and Transformation Plans” (STPs) to force spending back into balance through cuts, closures, job losses, other ‘savings’, and hopes of reducing demand for health care.
The pressure for cuts runs alongside the chaotic mechanisms of the 2012 Health & Social Care Act, which requires local commissioners (CCGs) to put services out to competitive tender – allowing profitseeking companies like Virgin to pick up more and mo
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