Health for the peopleBy Steve Sweeney

Communist PartyEastern District pamphlet £1

Save Our Health

Steve Sweeney isformer secretary ofHuntingdonshireTUC and a well-known campaignerfor the NHS

“The Conservativesvoted against theNational Health

Act, not only on thesecond but on theThird Reading.

I do not see why weshould forget this.”

Nye Bevan, 1948.

The NHS is one of our most treasured institutions, however itdid not just drop from the sky. It was fought for and won by workingclass people who had experienced the ravages of war and havingpreviously been led to believe that they would be returning to a ‘Land Fitfor Heroes’ after the First World War, were not prepared to be connedagain. Pressure from returning soldiers who had experienced 6 years ofwar, and an example of an alternative social system, with the existence ofthe Soviet Union, meant that there was no way that people would acceptfurther austerity and poverty. The ruling class were acutely aware. In1943, Quentin Hogg, later to become Lord Hailsham, famously warned,‘give them social reform or they will give you social revolution’. Communistswere at the centre of the fight for an NHS and many of those who wereto play key roles working in a nationalised health system had experiencedsolidarity as medical volunteers in the International Brigades during theSpanish Civil War.

The bold reforms of Attlee’s landslide Labour government saw theintroduction of the modern welfare state, including the NHS. It was notwithout resistance. In language similar to that used by the American rightand Tea Party movement in opposition to the Obamacare proposals, theTories and parts of the medical profession were bitter and oftenhysterical in their rejection of the proposals.

‘Dr Alfred Cox, a former secretary of the BMA wrote to the British MedicalJournal, declaring: ‘I have examined the Bill and it looks to me uncommonly likethe first step, and a big one, towards National Socialism as practiced inGermany. The medical service there was early put under the dictatorship of a“medical Feuhrer”. This Bill will establish the Minister of Health in thatcapacity’ Dr Cox was far from alone. At a meeting of 1000 doctors inWimbledon Town Hall shortly after the Bill was published, Bevan was called a‘dictator’ and an ‘autocrat’. ‘This Bill’, declared one doctor, ‘is strongly suggestiveof the Hitlerite regime now being destroyed in Germany.’ Another denouncedthe hospital proposals as ‘the greatest seizure of property since Henry V111confiscated the monasteries’.

‘There will be no top down reorganisation of the NHS’ (Cameron electionpledge in 2010)

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2013 saw the 65th anniversary of the NHS. While we were absolutelyright to celebrate and commemorate that, we must recognise that theNHS is under threat like never before. Despite their pre-electionpromise that there would be ‘no more of the tiresome, meddlesome, top-down restructures that have dominated the last decade of the NHS’, theCoalition White Paper “Equity and Excellence; Liberating the NHS” laid the foundation for the 2012 Health and Social Care Act, which was to see the biggest reorganisation in NHS history, abolishing StrategicHealth Authorities and Primary Care Trusts and transferringcommissioning responsibilities to GPs. Most worryingly, and an indicationof the direction of Tory policy, the Act removed the duty on theSecretary of State for Health to provide a comprehensive health service. Ironically, plans contained in an amendment to the Care Bill that are likely to have been voted through by the time this is being read, would give unprecedented powers to the Health Secretary enabling them to close down hospitals without consultation with thepublic and without agreement of the Clinical Commissioning Groups(CCGs).

The Tories want to take us back to a time when the NHS did not exist.They have a dogmatic belief in the market and want to hand services totheir friends in the private sector, a regressive step that would see thefragmentation and break-up of the NHS. The NHS was fought for byworking class people who had previously had to rely on benevolence anda two-tier system where only the rich had access to decent healthcare.Itis simply absurd to suggest that the worlds 7th richest nation cannotafford to provide healthcare for its population. While we have itconstantly drummed into us that we are living in times of austerity and‘we are all in it together’, the banks and financial institutions that werebailed out by the taxpayer are once again paying enormous bonuses.There still remains the scandal of legalised tax avoidance, which ifcollected would pay for the NHS itself. This is the effect of neoliberalismand the embracement of market ideology where profits are put beforepeople.The NHS is being deliberately starved of funding, pushinghospitals into debt and into the arms of the Trust Special Administrators(TSA) and the private sector. Hardly a day goes by without a negativeNHS story. The real crisis in the NHS is a funding crisis planned by the

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Tory government and their pals in big business who want the NHS‘market’ opened up to them.

The reforms that have been introduced have paved the way forprivatisation on previously unimaginable scale and threaten the veryexistence of the NHS as we know it. As will be seen in case studies, thebreak-up of the NHS has already started, although not without someresistance and local victories, most notably in Lewisham where acommunity campaign with mass participation coupled with legal actionoverturned a decision to close Accident and Emergency and Maternityservices. With 15,000 people marching and support from all corners ofthe community, including Millwall Football Club whose mascots andplayers donned ‘Save Lewisham Hospital’ t-shirts and even broughtforward a match against Aston Villa to Friday evening to allow a march togo ahead, a court ruled that Health Secretary Jeremy Hunt had acted‘outside of his powers’ in ordering the closure. (Millwall won their matchas well, beating Aston Villa 2-1)

Other areas have not been so lucky. Enfield Council sought a JudicialReview of the decision to close Accident and Emergency and MaternityServices at Chase Farm Hospital in November 2013, however wereturned down in the High Court by Justice Bean who stated that they had‘no arguable case for judicial review’. Council Leader Doug Taylor accusedthe Health Secretary of steamrollering through their plans, describing theclosure plans which were opposed by GPs and campaigners as ‘flawedand shameful’. Just weeks later tragedy struck with the death of a 2 year

PART OF STATEMENT ON MILLWALL FC WEBSITE ‘Whilst changingthe date of our Cup tie is an inconvenience to us, we believe there is abigger picture here.

Millwall Football Club, our players, staff and many thousands of fanshave, over the years, had reason to be grateful for the resources,facilities and care we have received from our local hospital.

We are not persuaded by the arguments put forward in favour ofclosing the A&E department, childrens ward, intensive care andmaternity services at Lewisham.’

old, who’s mother, rushed him to Chase Farm Hospital at 3am only tofind locked doors and no functioning Accident and Emergency service.

In North West London, the Accident and Emergency services atHammersmith and Central Middlesex are to close while Ealing andCharing Cross will see the services there downgraded. This was in thewake of mass opposition involving local political parties, trade unions andhealth activists and an attempt to gain a judicial review. Despite this andflying in the face of clinical evidence, Jeremy Hunt ploughed ahead withthe plans, even trying to claim credit for saving services.

The Tories are intent on destroying the NHS. It represents everything that they hate; co-operation, altruism and solidarity. But they cannot escape the simple fact that it works. Study after study hasshown that the NHS is the most efficient and effective way of deliveringhealth care to the population. In a 2010 study by the CommonwealthFund which looked at 5 areas; quality, efficiency, access to care, equity and healthy lives, the nationalised UK system came top in comparison to the US which came bottom. The market and business model does not fit.

“The Conservatives voted against the National Health Act, not only on thesecond but on the Third Reading. I do not see why we should forget this.”Nye Bevan, 1948.

The Tories opposed the NHS in 1948, and, despite what they say, theycontinue to oppose it today. They are shrewd enough to realise thatbeing open about their intentions would be politically toxic. NigelLawson described the NHS as being ‘the closest thing that the English have to a religion’. Cabinet Papers released after the 30 year rule revealedthat the Thatcher government had considered wide ranging welfarereforms that would have seen the end of the National Health Service. A watered down version of the report leaked to the press lead toThatcher claiming at Tory Party Conference in 1982 that that the ‘NHS is safe in our hands’.

Since its inception in 1948, the Tories have had to continuously defendtheir position on the NHS and reassure the public that the principle of

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universal healthcare for all is something that they support. It does nottake much for the mask to slip however and their true intentions andthoughts are often revealed.

The London 2012 Olympic opening ceremony, produced by Danny Boyleand commissioned under a Labour government was anathema to theTories. The symbol of the NHS, beamed to millions across the globeencapsulated brilliantly that the health service is part of our social fabric.The Tories were quick to distance themselves from tweets sent by Naziuniform wearing, anti trade union MP Aidan Burley who tweeted duringthe ceremony, ‘The most leftie opening ceremony I have ever seen – morethan Beijing, the capital of a communist state! Welfare tribute next?’ describingit as ‘leftie multi-cultural crap’. He later tried to claim that his tweets hadbeen ‘misunderstood’.

These remarks could be dismissed as the actions of a maverick, howeverthis was not the first time that one of Cameron’s Tories had madedisparaging comments about the NHS. In a tour of the USA and inresponse to attempts by Barack Obama to implement reforms thatwould give access to healthcare to the millions currently denied this,Daniel Hannan, Tory MEP described the NHS as having ‘left Britain withlow survival rates for cancers and strokes, a high risk in becoming iller inhospital and with constant waiting lists’ He went on the say that he ‘wouldn’twish it on anyone’.

Cameron was quick to criticise Hannan’s comments, calling him eccentricand claiming that this was not the view of the Tories, who had made theNHS a priority in their election promises. Despite rebuking Hannan, nodisciplinary action was taken leading to criticism from Labour who statedthat Hannan’s statements exposed the reality of Tory attitudes towardthe NHS.

During the Obamacare debates, an American newspaper used StephenHawking as an example of the deficiencies of the NHS. “People such asscientist Stephen Hawking wouldn’t have a chance in the UK, where theNational Health Service would say the life of this brilliant man, because of hisphysical handicaps, is essentially worthless,” it claimed.

This was countered by Stephen Hawking in a brilliant rebuttal of theAmerican right and a staunch defence of the NHS. “I wouldn’t be heretoday if it were not for the NHS,” he said. “I have received a largeamount of high-quality treatment without which I would not havesurvived.” Hawking went further in an interview for Channel 4 in late2013 where he was unequivocal in stating that The NHS “must bepreserved from commercial interests who want to privatise it”.

The Privatisation of the NHS in CambridgeshireCambridgeshire seems to be being used as a testing ground for NHSprivatisation. First it saw the transfer of the management ofHinchingbrooke Hospital to the private sector, with Circle Health – agroup of hedge fund and private equity owners that was headed byformer Goldman Sachs banker Ali Parsa – taking over to much fanfare in2012, quickly followed by the tendering of almost £1 billion of NHScommunity services across the County. Addenbrooke’s Hospital is alsotaking advantage of the raising of the cap on how much revenue can begenerated from private income with the building of a private hospital andhotel being planned for the grounds. All 3 of these cases are aided byTory NHS Policy.

Hinchingbrooke Hospital: Hinchingbrooke Hospital in Huntingdon was threatened with closure in2006 due to debts incurred through NHS marketisation and the PFI builtIndependent Sector Treatment Centre. The ‘Save HinchingbrookeHospital’ campaign drew thousands together as the community and tradeunions fought for their local hospital. The campaign was successful andHinchingbrooke was saved from closure. In 2010 however, a new threatemerged. Privatisation.

In a move that was the first of its type in the UK, hospital chiefs came upwith a plan that would see the management of the hospital ‘franchised’ toa private provider. It was claimed that the ‘deal’ was necessary due tothe £40 million debt that they claimed meant the hospital was strugglingto survive. Campaigners at the time argued that if there was the politicalwill to do so, the debt could have been cancelled and Hinchingbrookecould remain as an NHS run hospital. They argued that Hinchingbrooke

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was being used as a testing ground for NHS privatisation and that thetendering process should not go ahead.

In a process that saw a final shortlist of 3 private organisations biddingfor the contract, meaningful consultation was non-existent and plans,including the length and terms of the contract, remained hidden from thepublic under the guise of corporate confidentiality. The HuntingdonshireTrades Council initiated the ‘Hands Off Hinchingbrooke’ campaign andfought against the plans in what it saw as a ‘battle for the soul of theNHS’. They warned of fears that services and jobs could be at risk as thevultures of the private sector looked to make a profit from our NHS.Campaigners maintained that should the Hinchingbrooke deal be forcedthrough, it would set a worrying precedent for the future of the NHS.Despite local opposition and a march in Huntingdon against the plans,Tory donors and hedge fund capitalists Circle Health were handed thekeys to Hinchingbrooke in February 2012.

Two years into the experiment and the experience has not proved to bea good one for staff or the community. Only 6 months in to a 10 yearfranchise deal, the Chief Executive of Circle Health Ali Parsa ‘steppeddown’, trousering a cool £400,000 for his efforts. This was following agrilling from Margaret Hodge, Chair of the Commons Public AccountsCommittee who alleged that Parsa had been ‘sacked’ following poorfinancial management, when the debts actually increased almost triggering a release clause. She also questioned where the £400,000came from – was it public money? That question was also asked by staffat the hospital who were afraid to speak out for fear of reprisals by thebullying Circle regime and remains unanswered. It was however moneythat could have been used on frontline services or to pay some of the£40 million debt.

Following hot on the heels of Parsa’s departure came the news that theChief Executive of the hospital, Circle appointee Jim O’Connell wastaking ‘early retirement’ at the age of 50. This must have been someconsolation for the hundreds of healthworkers employed in the hospitalwho had recently been told that they had to ‘work longer and pay moreto get less’ in terms of their pension.

The general performance of Circle has been poor. Since they have takenover, 46 nursing posts have been lost, cleaning staff have been reduced byhalf, a ward has been closed and in one of the most mean spirited acts,the hospital volunteer shop which had raised millions for Hinchingbrookeover three decades, was closed as it didn’t fit with their ‘corporateimage’. They have also had to appeal for government bail-outs andrumours of financial instability have never gone away.

The Circle PR machine manages to spin news and present an image thatis far from the truth. In February 2014, they announced to fanfare thatthey had managed to break-even for the first time. This was however asmokescreen for news that Circle feared may break instead. The factsare that in the most recently available figures, parent company CircleHoldings had made a loss of £9.7 million, 22% of turnover. There is also a£60 million debt on its books.

Also, the so-called ‘John Lewis’ style partnership arrangement, whereCircle had claimed to share ownership with hospital staff, putting them atthe centre of decision making, had been brought to an abrupt end. Thearrangement, which was nothing like what Circle would try and portray,supposedly saw 51% of shares owned by Circle Holdings and 49% bystaff. With little real publicity, Circle admitted that they had ended the‘partnership’ as they found it ‘too costly and complex to administer’. The 49% of shares supposedly held by staff were sold and the hospital isnow entirely in the hands of hedge fund speculators and venturecapitalists through Circle Holdings Plc.

One thing that the Hinchingbrooke deal has in common with many othertenders is the links between the private company and the Tories:

• 29.2% owned by Lansdowne Partners whose founder Paul Ruddockdonated £692,592

• 28.7% owned by Invesco Perpetual whose founder Sir Martyn Arbibdonated £466,330

• 14.8% owned by Odey Asset Management whose founder RobinCrispin Odey donated £220,000

• 5% owned by BlueCrest Capital whose founder Michael Platt donated£125,000.

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Whatever lies in store for the future of Hinchingbrooke, it is clear that atsome point the hedge fund vultures will want a return on theirinvestment as they seek to make super-profits. The fight forHinchingbrooke will go on, however there is another pressing threat toNHS services in Cambridgeshire

Cambridgeshire Community Services NHS TrustTory NHS policy is designed to break-up the NHS and hand it to theprivate sector. One way of driving this forward was for the governmentto set an arbitrary target for all NHS trusts to attain Foundation statusby April 2014. In order to meet this target, NHS trusts had to meetcertain financial criteria. This weighed heavily against traditionally poorlyfunded Community Healthcare Trusts, however in a unique move, the bidfor Foundation Trust status by Cambridgeshire Community Services NHSTrust was vetoed by the CCG, operating in shadow form prior to thechanges.

Dr Neil Modha, chief clinical officer of shadow Cambridgeshire andPeterborough Clinical Commissioning Group, said at the time:

“GP members were clear that the CCG, as an emerging organisation, needs toretain as much flexibility over future service configuration as possible, includingthe ability to make changes on how community services are delivered in thefuture.”

In other words, the scene was set. Services in Cambridgeshire were setfor privatisation. Despite the government enforced deadline of April2014 no longer in place, the ball was already rolling and in June 2013, thenewly formed CCG voted on a model that all but guaranteed that the‘adult and older people’s integrated service’ contract would be run bythe private sector. In what they described as an ‘innovative’ move, theCCG put the contract out to competitive tender, inviting the usualsuspects to bid for almost £1 billion of services, the largest tender inNHS history.

The tender has proved controversial and has been met with wideopposition. Trade unions and health campaigners came together to formthe ‘Stop the NHS Sell-Off in Cambridgeshire’ group who have vigorously

opposed the plans and in their fight to defend local services have hadpockets of success.

The contract attracted interest from the expected range of privateorganisations, looking to exploit the NHS reforms and get their hands onwhat they believe will be lucrative long-term deals. Initial bids fromoutsourcers Capita and much maligned privateers Serco, accused offraudulent behaviour on other public contracts were withdrawn afterthey saw key tender documents, citing ‘affordability’ as the reason forpulling out of the running. In other words, they could not see wherethey would make big money out of the contract.

Campaigners have continued to press the CCG on a range of issues,however have been rebuffed at almost every turn. Key documents arebeing withheld and a Freedom of Information Act request was alsorefused. The CCG have cited corporate confidentiality, putting theinterests of big business and the private sector above that of the public.They have been reminded that the NHS belongs to us, not big businessand that key decisions taken behind closed doors make a mockery of theTory mantra of ‘no decision about me, without me’.

Consultation has been farcical and it was only the threat of legal actionby the ‘Stop the Sell-Off’ campaign that forced the CCG to make plansto do so on a wider scale. Even then, the documents that have beenseen so far have been redacted to the point of gutting them of any usefulinformation. How the public can make an informed decision based onsuch lack of information is highly questionable. Campaigners have arguedthat consultation should have occurred prior to the decision to go tocompetitive tender and should have been on the model used and lengthof contract.

The campaign has seen large and vibrant lobbies of CCG meetings,questioning of board members and calls to halt the process. Streetpetitioning and leafleting has taken place each weekend in most towns inthe county and gathered broad ranging support from local people,political parties, trade unions and activists. Shadow Health SecretaryAndy Burnham has described the plans as ‘the most audacious sell-off todate’ and the CCG plans have been criticised from all corners.

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Recent developments have seen the plans pushed back with anannouncement not due until September 2014 instead of March 2014 andthe new provider not expected to be in place until January 2015 asopposed to the original plan of July 2014. This is a significant victory forcampaigners and as the procurement goes on there are likely to be moretwists and turns, with the possibility that the deal could collapsealtogether

Campaigners have questioned how the organisations that are in theprocess have managed to get through the various stages, stating that itposes serious doubts over the robustness of the Pre-QualifyingQuestionnaire and other tests. The line up is a rogues gallery of theworst privateers and shouldn’t be trusted to run a bath, let alone NHSservices.

The bidders are:

ACCORD HEALTH – a consortium including Provide, North EssexPartnership Foundation Trust and Interserve. Interserve are anorganisation whose major shareholders include investment bankers JPMorgan. They have been found guilty of accounting irregularities and‘illegal bid-rigging activities following one of the largest ever investigationsunder the Competition Act. Their CEO, Lord Blackwell is a Tory peerand a former policy adviser to Thatcher. His dedication and commitmentto NHS values includes the writing of pamphlets titled ‘Better healthcarefor all: Replacing the NHS monopoly with patient choice’.

CARE FOR LIFE – the ‘Lead Provider’, Care UK are major donors tothe Tories. Their chair,John Nash, was made a Tory peer and has donated£247,250 to the party. Care UK were bought out by private equitycompany Bridgepoint in 2010 and have a split ownership andmanagement relationship similar to that of Southern Cross who wentbust dramatically in 2011.

OPTUM – current providers Cambridgeshire Community Services NHSTrust have linked with Optum following the collapse of the Capita/Circleconsortium. Optum is the new name for the rebranded United HealthUK, who prior to the bid faced being wound-up by parent company the

American giant United Health after posting losses for the 11thconsecutive year. Their accounts showed an £8.2 million loss in the UKand a 27% fall in turnover in 2012. Hardly the sign of a stableorganisation.

UNITING CARE PARTNERSHIP – this is the joint bid fromCambridge University Hospitals NHS Trust and the Cambridgeshire andPeterborough Foundation Trust. While they may give the impression thatthey are the only ‘pure’ NHS bid, they are linking up with outsourcersMitie.

VIRGIN CARE UK – Better known for making music and runningtrains inefficiently and at great expense, Virgin are now branching out intohealthcare, having bought out care provider Assura. In 2012, currentHealth Secretary Jeremy Hunt (then Culture Secretary) personallyintervened to ensure that a controversial £650 million contract to runservices was signed off by NHS bosses in Surrey. The delays in signingthe contract were due to ‘significant issues’ that had been raised by theDirector of Nursing and legal wrangles over various issues including staffterms and conditions of employment.

Campaigners believe that there is a significant risk to services to patientsand the community as a result of the tender. The organisations above areonly interested in the profit motive and the only way that they canpossibly make any money is though cutting terms and conditions orceasing to run certain, unprofitable services. Across the border inSuffolk, when Serco took on an NHS community contract, theyimmediately announced 137 job losses and patient care has suffered as aresult. In what should be seen as a warning to the CCG, in December2013, Serco announced that the first year of the contract had seen themmake a £9 million loss. None of the bidders has the experience or theability to run such a wide ranging and complex set of services like thosethat have been bunched together in the tender.

‘Stop the NHS Sell-Off in Cambridgeshire’ say ‘None of the Above’ andreject the proposals. The NHS should remain a publicly owned, publiclyfunded and democratically accountable organisation, based on theprinciple of free healthcare for all.

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Addenbrooke’s HospitalIn an announcement that has seemed to escape scrutiny, the worldfamous Addenbrooke’s Hospital has plans to build a private hospital andprivate hotel in the grounds as part of a development they have called a‘Bio-medical Campus’. The plans take advantage of the raising of the capon income that can be derived from private funding and see the firststeps toward a two-tier system and more money flowing from the publicsector into the pockets of greedy fat-cats. Behind the plans areinfrastructre giants John Laing, whose construction arm Laing O’Rourkeare alleged to be users of the Consulting Association who providednames to companies who then blacklisted workers and blighted lives forthe crimes of being trade unionists and raising health and safetyconcerns. They are proposing that the private hotel is run by Ramsay Health Care UK and expect the construction to be completed in 2016.

Recent developments have seen Papworth Hospital, specialists in cardiaccare, have their planned move to Addenbrooke’s Hospital put on hold bythe Treasury. The plans that have been on the cards for around 10 yearshave been delayed with an alternative to move them to the debt-riddenPeterborough Hospital being suggested. Campaigners have questionedthe move asking whether the alternative is being suggested so theAddenbrooke’s site can be used for further private sector development,edging out Papworth and using it to pay off the debt at Peterboroughincurred through a costly PFI deal.

NHS – facing a clear, present and future dangerThere are wider and more general threats that present a real danger tothe future of the NHS.

One of those comes in the form of clause 119, the ‘Hospital ClosureClause’, an amendment to the Care Bill which could see unprecedentedpowers handed to the Secretary of State to close hospitals over theheads of the community and without the agreement of the CCGs. Theamendment has been bitterly opposed, however as with many Torypolicies the pace at which it is being rushed through is so fast that it istoo late when people realise what is happening. Despite the spin placed

on this by the Tories, this is a spiteful and pernicious piece of legislation,meaning that no hospital is safe. Every hospital in every part of thecountry is under threat and there needs to be a united response inopposition. In the short window available to mount a campaign, activistsare pressuring Lib-Dem MPs whose votes can block the clause frompassing into law. As the loyal bag-carriers for the Tories, it remains to beseen how they respond and whether they want to further aid thedestruction of the NHS and add yet another item to their long list ofcrimes as coalition partners. This clause is not clinically driven, butfinancial and a deliberate ploy to add another string to the bow in theplanned break-up of the NHS.

Even if the ‘Hospital Closure Clause’ is defeated, there remains a widerand in many ways an even more potent threat. The Transatlantic Tradeand Investment Partnership (TTIP) is an EU-US Trade Agreement thatpresents a fundamental threat to the future of the NHS. TTIP is aproposed free trade agreement between the United States of Americaand the European Union which would create a market and mean thepotential for privatisation of services is almost impossible to resist orreverse. Through Investor State Dispute Settlements (ISDS),corporations are able to challenge policy decisions taken bydemocratically elected governments however the same governmentswould not have to powers to challenge investors.

Unions, including the GMB have stated that the ISDS should be excludedfrom the TTIP. Commenting on the TTIP,

Bert Schouwenburg, GMB International Officer, said

“The legitimacy of the unaccountable Investor-State Disputes Settlementmechanism has repeatedly been called into question.

This is because it takes away the ability of member states to decide whatsectors like the NHS should stay in the public sector and hands power tounelected and unaccountable corporations.

We know from the tax avoidance scandals what these corporations do whengiven free reign.

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Foreign investors have used it extensively to challenge measures adopted bysovereign states to promote social equity, foster environmental protection orprotect public health.

Countries who are signed up to this mechanism have to face claims up to £70billion and awards up to £1 billion.

In addition, proceedings are usually conducted in secret and arbitrated by arelatively small group of unaccountable specialist lawyers whose impartialityhas been called into question.

If the Investor-State Disputes Settlement mechanism is included in TTIP it isconceivable that a giant American health insurance corporation could insist thatit be allowed to buy up services currently provided by the NHS. If it isprevented from doing so it could sue the sovereign UK Government fordamages. The UK would be bound to accept the decision of a group of tradelawyers based in New York.

David Cameron is fond of wrapping himself in the Union flag and complainingthat British sovereignty is being compromised by decisions taken on our behalfby the EU.

GMB want to see him demanding an opt-out for the UK if the mechanism isincluded in the Transatlantic Trade and Investment Partnership.

GMB cannot support a treaty that will allow the future of the NHS to bedecided outside the UK by a bunch of unelected, unaccountable lawyers inNew York.”

While there is provision within a legal framework for an opt out underthe Treaty of Rome, the deal exposes the undemocratic nature of anunelected organisation which can determine and override electedgovernments and dictate to them that services can be privatised at theirbehest. This unelected bosses club threatens the survival of the NHS.

The NHS represented an advance for the health of the nation and madedrastic improvements to the lives of working class people. This cannotbe underestimated and people have such a strong connection to theNHS as it is something that they fought for in the first place. We haveseen many localised campaigns from Lewisham to Cambridgeshire and

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North West London to Mid-Staffordshire where people have come outin their masses to support local hospitals and services that have beenthreatened by Tory cuts. Over 50,000 took to the streets in Manchesterto protest at Tory Party Conference, coming from all parts of thecountry to send a united message, ‘Hands Off Our NHS’.

Demands for the future of the NHS could include:

• End of the purchaser/provider split

• End and reverse costly PFI deals and call for direct government funding

• Ending the costly internal market that pits Hospitals and Trusts againsteach other and call for a system based on solidarity and co-operation

• Oppose NHS cuts and call for increased funding

• Repeal the Health and Social Care Act 2012

• Call for an integrated health and social care system

We need to fight like never before to defend our NHS. This means manythings. Lobbying MPs over local and national issues. Lobbying CCGmeetings where plans are being discussed and voted on. Forming localgroups to defend NHS services. Getting involved in or setting up KeepOur NHS Public, 38 degrees, The People’s Assembly and other campaigngroups. Become active in your trade union, mobilising members andraising awareness of NHS issues.

Centres of resistance can be found through local Trades Councils, whocan play a crucial role in drawing people together. The attacks on theNHS, although being carried out piecemeal in some circumstances withthreats to local services, are nation wide and require a broad massmovement to defeat them and bring down the Tories. Organisationssuch as The People’s Assembly and The People’s Charter are part of thisresistance and could be the basis for such a movement.

The stakes are high, but if we fight, we can win. Nye Bevan famously saidthat the NHS would survive ‘as long as there are folk left with the faith tofight for it’. We must be those folk.

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“All measures to weaken,break up, commercialise orprivatise the National HealthService (NHS) must be haltedand reversed. Medicaltreatment must remain free atthe point of delivery, fundedlargely through progressivetaxation. NHS coverageshould be extended ratherthan reduced, for example intothe provision of cancerscreening and dentaltreatment. The aim must be todrive profiteering out of theNHS, while involving workersand users more closely inconsultative andadministrative functions.”

CP programme

Britain’s Road to Socialism

“We can defend education,health and welfare provision

funded from generaltaxation and available to all,

or we can surrender thegains that have improved thelives of millions of people for

more than 50 years.

We do not accept thatgovernment's austerityprogramme is necessary. The banks and the major

corporations should be taxedat a rate which can providethe necessary resources.

Austerity does not work: it isa failure in its own termsresulting in neither deficitreduction nor growth.”

People’s Assembly

Declaration 2013

Forewarned,

Fresh and forthright ideas for trade unionists,available to read now.

Order: www.communist-party.org.ukJoin us – 93 years of struggle forthe working class and humanity.

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