DOCTORS’ anger at the drive to privatise the NHS dominated the British Medical Association’s Annual Representative Meeting in Edinburgh this week.
Delegates voted overwhelmingly for motions to stop the privatisation, including Motion 39, which states: ‘The private sector should have no role in the commissioning of public services.’
Moving the motion, Dr Chaand Nagpaul said: ‘Two years ago at this very ARM many will remember the furore regarding the government putting out an advertisement of private companies to tender for PCT commissioning.
‘We resoundingly deplored and opposed this, and amidst adverse media publicity, the then Secretary of State withdrew the advertisement as a “mistake’’.
‘Two weeks later, the advert was repackaged in new wording, and a procurement of private organisations was put in place, called the “Framework for External Support to Commissioners’’ – with the acronym FESC, innocuously phrased to provide commissioning support to PCTs but, worryingly, this allows for the entire PCTs commissioning function to be run by a private company.
‘Fourteen organisations were approved last December and include multinationals such as AXA/PPP, BUPA, Humana, KPMG, United Health and McKenzie’s.’
He warned: ‘Money spent on these private companies will be money taken away from PCTs which will necessarily become downsized with a progressive transfer of commissioning to the private sector.
‘Added to this is the ethical objection that some of these organisations have a conflict of interest in simultaneously being providers to the NHS.’
He concluded: ‘We must expose the government’s real commercialisation agenda for FESC and oppose it outright, and we must vigorously oppose this government’s smokescreen to privatise both commissioning as well as provision in the NHS.’
Speaking for the motion, Jackie Davis, north-east London, said: ‘The government has extended its privatisation agenda to primary care.
‘This is giving commercial companies the ability to commission and provide care.’
After voting overwhelmingly for Motion 39, delegates went on to vote overwhelmingly for a motion defending doctors against the attacks of the government.
GPs were angry at the attacks on the profession by the government.
Moving Motion 65 in the section on general practice, Dr Gill Beck said: ‘The government has been attacking GPs.
‘It’s using spin to try to undermine us, making out we have big salaries.
‘But I do not have the resources to pay my staff and I’m facing a second year of a cut in pay.
‘Why do the government want to stitch up GPs? Could it be they want to destroy public confidence in GPs so they can get on with privatising primary care?
‘But the public see through their spin: 1.2 million patients showed a lack of confidence in the government, and we thank them for it.’
She warned: ‘It’s not just GPs they are coming for.’
Citing an article in ‘The Times’ attacking the British Medical Association as ‘screwing the public’, she said: ‘This is a slur on all doctors and their patients.’
Delegates went on to pass motions opposing the creation of a sub-consultant grade.
They also warned against junior doctors having to work extra hours because training posts were not being filled.
Moving Motion 116 on junior doctors, Lucie-Jane Davis warned: ‘There is a potential for 2008 to be worse for junior doctors than 2007.’
She said it was very difficult to find out the situation as no figures were made available and the health service was losing out.
She added: ‘People are leaving for Australia and New Zealand because there are delays in finding a post.’
She said criminal records checks are taking six weeks-plus and added: ‘We need to keep the pressure up.’
Other delegates warned that doctors are getting so tired that it is becoming dangerous for patients.
In the evening, a meeting of the News Line-All Trades Union Alliance heard of a mechanism by which the government was driving forward the privatisation of the NHS.
David Price, senior research fellow, Centre for International & Public Health Policy, told the meeting: ‘The marketisation of the NHS is a political betrayal of unparalleled proportions.
‘Labour came to power “to restore the NHS as a public service’’.’
He added: ‘By 2000, the NHS Plan was introduced.’
He said: ‘This directed money into the private sector.
‘Blair sought to end public ownership and attacked the workforce.
‘In 2003, the veil was lifted and we saw it was the drive to full privatisation.
‘In order to introduce private commercial providers, legislation had to be changed.
‘It’s been brought in piecemeal. Discreet acts to bring in PFI and private providers.
‘The new GP contract provides a commercial arm to provide primary care and that will be followed by secondary care.
‘We have Foundation Trusts beyond government control operating in an increasingly commercial environment. They have to produce surpluses.
‘Other hospitals have to close as a result of Foundation Trusts: £140 billion has been sucked in by Foundation Trusts from the NHS.
‘PFI is the biggest closure programme in the NHS.
‘These developments involve cost pressures: millions going out to commercial stakeholders.
‘On top of this are the enormous administrative costs.’
He warned: ‘For GPs, the new contract is no longer between the state and the doctor but the state and the contractor.
‘So now we have commercial contracting, with companies like United Health and Atos.
‘The new Darzi review floated the voucher system – a measure to introduce charges.
‘The BMA played its part in it. It negotiated it, the GPs contract.’
He added: ‘No doubt they will soon want to introduce fees. It’s a betrayal.’
The meeting was also addressed by Mick Napier, of the Scottish Palestine Solidarity Campaign, who spoke on the medical situation in Gaza.
He said: ‘This year is the 60th anniversary of the NHS and the 60th anniversary of the massive ethnic cleansing of Palestine.’
He continued: ‘I went to Gaza in January. I was only able to go because the Palestinians had blown open the wall.
‘I can see why the Israelis didn’t want people to go there: what is happening is genocide.’
He added: ‘When I got there, I met an extremely brave people.
‘They are optimistic despite horrific treatment.
‘Physicians for Human Rights have accused Israeli doctors of being complicit in torture, of not reporting torture and not reporting the results of interrogations.’
He added: ‘Palestine has the most arrested and detained people the world has ever seen.’
He said that prisoners are kept for years, six months at a time.
He said: ‘Prisoners are let out, then immediately taken back in for another six-month sentence.
‘Palestinians have been tortured to death.
‘No one has ever been tried.’
He added: ‘There is persistent violation of the most fundamental medical ethics.
‘I’ve seen an old lady die as a result of standing in the heat.
‘She could well have been saved if she’d been let through the checkpoint to go to hospital.
‘I’ve been to the apartheid wall: the clinic is on one side and the hospital on the other side. It’s 25 feet long.
‘Many people have described what is happening in Gaza as a catastrophe: the thing is it’s deliberate, and the British government is supporting it – it’s engineered.
‘Palestinians are dying in their hundreds and hundreds of malnutrition.
‘It’s engineered hunger.
‘If you want to gaze into the heart of darkness at those who are wrecking the health service, look at Gaza.
‘Blair is in the Middle East at present as a peacemaker. That hurts Palestinians.
‘Israel is a bulldozer. There’s still occupation of Gaza: Israel issues the visas.
‘Ninety-three per cent of land can’t be built on by non-Jews, when Jews are 25 per cent of the population.’
He added: ‘When they blew the wall, there were thousands of people going past Egyptian riot police, like fish through water.
‘A crime is what’s happening in Gaza and the British government is entirely complicit.
‘For the first time in history, an occupied people is subject to sanctions.
‘But Israel has lost public sympathy.
‘In the US unions have begun to implement sanctions, and in Britain the unions are beginning to implement sanctions.’
Mrs Anna Athow, BMA Council member-elect, told the meeting: ‘The NHS was born at the end of the Second World War.
‘There was a revolutionary wave across Europe.
‘In Britain, people wanted change. Workers wanted a free NHS.
‘There was a landslide Labour government elected.
‘It was this social movement that brought in the NHS.
‘The NHS came in with a revolutionary movement.
‘This is relevant today.
‘We’ve a Labour government carrying out Thatcherite, Blair policies.
‘They have brought in privatisation piece by piece.
‘The reason they are privatising now more than ever is because of the economic crisis of capitalism.
‘They are talking about a crash worse than 1929.
‘Their answer is war abroad: in Iraq and possibly Iran.
‘And it’s war on us at home. They are trying to abolish the Welfare State.
‘Brown is no different to Blair and the Darzi plan is lethal.
‘Polyclinics are the best thing for big business to smash up general practice and District General Hospitals.
‘The Darzi plan was brought in to smash up these two bulwarks.
‘In London they want 150 polyclinics with 70 per cent of GPs put in them.
‘They want to privatise primary care.
‘And these ISTCs aren’t abolished: they’ve just commissioned three more.
‘In my area, at Chase Farm Hospital, they plan to close the Accident and Emergency and Maternity and replace them with a polyclinic and elective services.
‘And they’re planning this all over the country.
‘Commercial companies see that there is millions of pounds of profit to be made out of community care.
‘The CBI is calling for failing hospitals to be closed and replaced with private clinics and the government is bringing in a new failure regime.
‘We have to mobilise the BMA and turn to other trade unions to take action to defend our NHS.
‘The same revolutionary movement that brought it in will have to save it.’
