How can we effectively protect our  Health Service?

Huge public demonstrations in Lewisham have mobilised support for the NHS against cuts, and inspired people all over the country who face similar politically motivated moves to break up our health service for privatisation. Following the prescribed routes, with mass marches and a co-ordinated response to public consultation, has not saved Lewisham’s A & E Department, critical care wards or maternity services from drastic cutbacks though. Many of us didn’t think it would, and want to find more effective ways to resist.

Kings nurses - save Lewisham Hospital march

‘Occupy’ is a rising call, along with support for meaningful strike action that goes beyond the one day actions of November 30th 2011 and January 25th 2012 to defend pensions. These are something to build for, but  we need to explore a range of other actions to bridge the gap between polite protest and militant resistance. Government tactics over the last decades have been to gradually erode public services by stealth, increasing outsourcing and requiring or bribing GPs to buy into market reforms, while simultaneously removing workers rights to organise for anything more than defence of pay and conditions. The one day strikes co-ordinated across the public sector showed many workers  wanted to do more to defend not only their own working conditions but the ethos of public service too. This was not on the agenda for the Trades Union leadership, despite widespread support from local branches. And regardless of history, many of the changes to break up the NHS, Private Finance Initiatives in particular, were enthusiastically implemented by the Labour leadership, despite the lack of support from their members..

As anarcho-syndicalists, SolFed believes that there are better ways to run the Health Service than as a government agency. We advocate working towards workers’ control, an ideal that  Labour has thrown aside. This doesn’t stop us from working with other principled people for our common needs. After WW II there was a widespread popular movement for real change – for housing, education and health provision to be free and accessible to everyone. We had some politicians who paid more than lip service to Socialism, and the NHS was one of the results – something we should all be proud of – but we can’t rely on any political party to defend our Health Service. We can only do it by working together.

See – http://www.solfed.org.uk – for more on the aims, principles and actions of the Solidarity federation

Hospital film poster A5

Will direct action alienate people?

Leaders of mainstream campaigns seem to fear this, thinking popular support will be lost if we fight back with more than our feet and voices. How many campaigns have been won without civil  disobedience and active resistance though? The last big victory for ordinary people in the UK  was the defeat of the Poll Tax. Many people couldn’t afford to pay it, so they didn’t, and others supported them in solidarity. Resistance and solidarity won the day. Corporate government has learned a bit since then, and worked on divide and rule tactics to try and prevent another popular resistance movement arising. Despite their efforts to undermine our education, working and housing security, to make us more passive, the issues – widespread poverty and inequality – have now become very stark, and are bringing us together rather than dividing us.

A good example of imaginative actions are the ‘Buggy Protests’ organised by Save Lewisham Hospital. Parents and toddlers blocking the entrance to the Department of Health sends a visible message to the right people. People Before Profit have occupied Barclay’s Bank branches, as Barclays, along with Innisfree and other profit-led companies are beneficiaries of the PFI deals that have crippled the South London Healthcare Trust with debt. There is a lot of public  support for these kinds of protest, and no-one seems to be outraged by them, except perhaps readers of the right-wing press. UK Uncut have gone even further, and been prepared to break the law while targetting capitalist enterprises. The public response has been mostly supportive. The law is rigged against us – students have been beaten up by police for protesting against the trebling of University fees. Alfie Meadows was nearly killed. We must defend the right to protest by using it, and refuse to be intimidated. Not everyone is in a position to risk their safety, particularly people with children, but the example of disabled people’s actions against Atos over their murderous targets to cut Disability Living Allowance payments is inspirational.

Faced with the current scale of attacks on our common humanity what we really need is to make links between community action groups and workers on the front line, and work out strategies that will take control back from the bosses who exploit us.. We will have  to escalate our response to cuts if we want to win, as is becoming pretty obvious.

What kinds of actions can save the Health Service?

Occupations of downgraded but working hospitals are hard to contemplate, at least until facilities are closed down ready to be sold off, without the staff being the motivators.. However, the University College Hospital strikes and occupations of 1992-4  are an example of what can be achieved:


At UCH when managers moved in to close a ward nurses spontaneously blocked their way. An indefinite strike followed, with support from porters and patients, and even junior doctors and some consultants. The workers were effectively in charge for a few weeks.  Management backed down,  and tried again to close the hospital the following year. Resistance to this was also strong – it was met by a strike, but union structures didn’t help to build solidarity with other unions or support ‘unofficial’ actions. When wards were eventually closed an occupation followed, initially for one night, but lasting for much longer and including storming the hospital chief executive’s office when management moved to close another ward. The issues were very similar to those we face again now.

From the occupiers’ leaflet to support the strikers:


Between them they plan to reduce UCH to a skeleton emergency service — those considered non-emergency or needing more than 2 days care will be sent elsewhere, and GPs will not be able to send patients. This skeleton service will not work because the Accident & Emergency section has always been dependent on the wide specialist knowledge of the other sections. Any cuts mean a reduction in the range of skills available to bring us back to health.

A reduced service also means more pressure to classify patients as non-emergency, and that any major tragedy, like the Kings X fire, will simply not be catered for. Their idea for sending people somewhere else doesn’t make sense anyway, when these other hospitals are also under threat.

Another inspiring example comes from the Victoria Nurses in Australia, with both their hard-won strikes in the 1980’s and successful actions in the last year over the same issues – staff patient ratios affecting patient care as well as low pay, and attempts to ‘downgrade’ nurses:


Victoria nurses - who do you want

They held out against intimidation, with gradually escalating withdrawal of labour, supported by other rank and file workers and most of the public, despite growing waiting lists:

Trying to work within the system finally came to an end when 5,000 nurses thronged to a 31 October stopwork, overwhelmingly endorsing a rank and file motion to go out indefinitely. Critical care units were still staffed and all wards had skeleton staff. A nurse from PANCH said, ‘We had to do something, the government just keeps breaking promises.’ Calls for a total walkout were defeated, but nurses reinforced their message with a noisy march through the city.

The next day, 1 November, most metropolitan hospitals were picketed although, for the first days, no goods were stopped. On the picket lines nurses met many well-wishers. Encouragement to ‘toot in support’ resulted in continuous honking of car horns outside hospitals. Food, firewood and money poured in, and letters and telegrams backing the RANF overloaded Australia Post’s deliveries to RANF headquarters in St Kilda. Workplace meetings and collections took place across Victoria and interstate, support coming from blue and white-collar unions as well as from many rank and file HEF members.

The strike itself, while not completely in the hands of the rank and file, was often effectively run by the militants. When the people taking the action are the ones planning strike tactics, it strengthens their resolve. The strike committee met daily at the RANF offices to work out tactics and go over experiences. To ensure the members and other workers got the facts regularly, the union ran a program on community radio station 3CR and put out a daily strike bulletin. To maintain morale and solidarity, the strikers held regular picket line barbecues and sporting competitions, as well as fundraisers and an occasional champagne breakfast. Groups of nurses toured the country regions every day, building support and keeping country members informed. The RANF representative at Wimmera Base Hospital commented, ‘I’ve never seen nurses so united and strong.’

This tradition is still strong!

From the RANF – Respect Our Work :

Victorian public sector nurses and midwives general agreement
The Victorian public sector nurses and midwives voted to accept a new agreement at a statewide meeting on 16 March 2012. Following a nine-month campaign nurses and midwives stopped the Baillieu Government replacing nurses with health assistants, saved the state’s unique nurse/midwife patient ratios, achieved some improvements to ratios and secured increased money between 14 and 21 per cent.

The Victoria nurses are an inspiational example that direct action gets the goods!

So let’s organise!

Groups are springing up wherever services are under attack. It will be a hard fight. It’s one we need to win. We need to work together to make sure we do. Any ideas from people who share a genuine commitment to beat these vicious profit-motivated attacks on our communities are welcome here. Let us know what you think. Together we can make it happen.