Don’t let GP services go the way of hospital cleaners!

Two stories on health, both significant, the latter having implications across England (and reinforcing my view that this country desperately needs a parliament and a fair electoral system so that the privatisation of the NHS can be better resisted).

Whilst cleaners working for private contractors are usually conscientious and hard-working individuals, they are not part of a team within the hospital and this means there’s a lack of accountability. So from the people on the ground, we have a reality check – cleanliness is a medical concern in hospitals, and should not a source of profit for big business:

Nurses have called for hospital cleaning to be brought back in-house to tackle hospital infections.

The Royal College of Nursing conference overwhelmingly voted for a motion proposing an end to contracting out cleaning to private firms.

Cleaning contracts have been outsourced since the 1980s and about 40% of hospitals now use the private sector.

Nurses at the Bournemouth conference said it had led to a drop in standards and a rise in infections.

The government has made cleaning one of its highest priorities to tackle infections such as MRSA and Clostridium difficile.

It recently oversaw a deep cleaning programme of all hospitals in England and its infection strategy published in January said good quality cleaning was essential.

MRSA rates have been falling since early 2006 with the NHS on course to halve the number of infections this year based on a 2004 baseline.

But nurses still maintained infections was a pressing issue that was not being helped by the contracting out of cleaning, something which has been particularly popular in England.

No public sector ethos

May McCreaddie, a nurse from Glasgow, said: “There has been an increase in hospital infections and decline in cleanliness. It is quite simple.”

She said private cleaning firms did not have the public sector ethos of in-house teams and there was higher staff turnover which contributed to poorer performance.

“We know what works we have been there before, we have had them. They are called ward domestics, they are an integral part of the team.”

Sheila Dunbar, a nurse from Liverpool, added: “The increase in hospital infections is a big issue. NHS trusts in north west England have started to come back in-house to have cleaner wards.”

But Derek Blackshaw, from Salisbury, said as well as bringing cleaning back in-house, it was important nurses on the wards were given responsibility for overseeing cleaning.

“It is not enough to bring it back in-house if you still need to deal with a chain of authority.”

The delegates also heard from a number of nurses who described how in-house cleaners were much more part of the NHS family.

Dominic Walsh, a nurse from London who works on an intensive care ward, said he was proud to work on a ward where the cleaners employed by the hospital.

“I can say to Monica and Arnie ‘you are coming to our Christmas party aren’t you? You’re an essential part of our team’.”

George Monbiot writes in the Guardian today of the threat of GP services – and the entire NHS in England – being privatised:

Everything is getting bigger and further away. Hospitals, post offices, schools and prisons are being “rationalised” and “consolidated”. The government says this process improves efficiency. Instead, it outsources inefficiency: we must travel further to use public services. This is bad for the environment, bad for community life, and bad for universal provision. But we haven’t seen anything yet. We are about to be confronted with the biggest shutdown of all: the government has started the process of closing England’s network of doctors’ surgeries.

If you know nothing of this, don’t blame yourself. The announcement was buried in an interim report published last October by a junior health minister. The report was 52 pages long, and the policy was explained in a single paragraph on pages 25 and 26. Rather than being brought before parliament, it was released four days before MPs returned from their recess. Since then there has been no further public announcement. But in December, the Department of Health sent a letter to all the strategic health authorities in England, demanding that the policy be implemented immediately. The greatest transformation in the history of the NHS is taking place without public debate, public consent or formal consultation.

The government’s policy is to consolidate doctors’ surgeries into a series of giant health centres, or polyclinics. Thousands of small practices will be closed and patients will be processed in buildings containing up to 50 GPs. The new clinics will also house some services at present provided by hospitals, which allows the government to claim that it is bringing healthcare “closer to home”. The net effect will be a massive reduction in convenience.

The policy was launched by Ara Darzi, a colorectal surgeon who has been raised to the peerage and made an undersecretary of state for health. He wrote his interim report in three months, during which he claims to have spoken to thousands of people. But it contains no record of who they are, how they were selected, or what their answers were: he reveals only that “their views have helped shape this interim report”. His final report will not be published until June, but the Department of Health has instructed England’s primary care trusts to advertise for bidders for the new polyclinics by May 2008: the first notices have already been posted in the Health Service Journal.

During a parliamentary debate launched by the Conservatives last week, health secretary Alan Johnson claimed three times that this policy is not being imposed on PCTs. “There is no national policy for replacing traditional GP surgeries with health centres or, indeed, polyclinics”; “we are not specifying polyclinics as any part of the exercise”; “[the Tories say] we are imposing a system of polyclinics throughout the country. We are not.” Three times, in other words, he misled the House. The letter sent by the Department of Health in December ordered that “each PCT will be expected to complete procurements during 2008/09”. In a parliamentary answer in February, health minister Ben Bradshaw confirmed that “every PCT in the country will be procuring a new … health centre during 2008-09”. A press release published by the Labour party on April 15 confirmed that the new centres would be built “in every town and city”. I hope MPs demand that Alan Johnson apologise to parliament.

Lord Darzi insists that polyclinics will offer “a more personalised service”. This is nonsense: in the enormous new centres we are less likely to be able to see the same GP, and more likely to get lost in the system. A recent paper in the British Medical Journal reveals that “patients in small practices rate their care more highly in terms of both access and continuity”, and that small practices “achieved slightly higher levels of clinical quality than larger practices”. The centres will be built not where they are most convenient for patients but – as Darzi revealed to the Commons health committee – where the NHS happens to own land. If you live in a village or a distant suburb and depend on public transport, as many elderly and sick people do, visiting the doctor could take all day. Ara Darzi is the new Dr Beeching, shutting down the branchlines of our primary health service.

So why is this happening? In seeking to surreptitiously privatise healthcare, the government has a problem. Primary care is already in private hands – GPs run their own practices. But they are the wrong hands: the corporations demanding guaranteed streams of income from the taxpayer can’t play in this field. Polyclinics are perfectly designed to let them in, while preventing doctors from competing.

It’s not just that GPs can’t raise the capital; because the contracts are much bigger than ordinary practices’ and involve many different services, the tendering process is expensive and fiendishly complex. The big service companies can produce the same bid for any number of clinics: they need spend their money only once. The Department of Health says that PCTs should use a type of contract called Alternative Provider Medical Services, which is designed to allow corporations to bid. This is not a public-private partnership: it is the outright privatisation of primary healthcare.

Do I need to explain the implications? The American health system, which the British government seems determined to emulate, is both more expensive and less efficient; those who can’t afford to pay are either excluded or treated like battery pigs. The independent sector treatment centres (ISTCs) – private clinics which carry out routine NHS operations – have been a costly disaster since being introduced in England in 2003. Private companies receive their money regardless of whether they carry out the work they are contracted to do. The government refuses to release comparative figures, but the little evidence we have suggests that their costs are much higher than the public sector’s.

The risks have been transferred back to the taxpayer, and the standards of treatment are sometimes appalling. In 2006 Angus Wallace, professor of orthopaedic and accident surgery at Nottingham University, told the Guardian: “We expect failures of hip replacements at approximately 1% a year and knees at about 1.5% a year. But we have got some of the ISTCs that are looking at 20% failure rates.” Because they put profits first, companies that run these centres have generated a stack of litigation claims and a huge NHS bill for repairing the damage they have caused. Far from reversing its policy in the light of this evidence, the government is setting up a competition panel to ensure that the health service never discriminates in favour of the public sector when awarding contracts.

Did any of us ask for this? Are there crowds on the streets demanding the privatisation of the NHS? Even the Tories have come out against it: David Cameron’s speech last week placed them to the left of Labour. Why, after the 60-odd quarters of consecutive growth that Gordon Brown keeps boasting about, can he not maintain a public service founded in the midst of poverty and rationing? What mysterious hold on policy do the corporations possess, that they can persuade this government to wreck Labour’s finest achievement and damage its chances of re-election?

Billionaire booed by striking workers

In the blue corner (naturally) it’s number 25 in the Sunday Times Rich List, Jim Ratcliffe, billionaire boss of Ineos. He’s one of the select few, the super-rich, who aren’t struggling to get by – no worries about paying the mortgage or the utility bills, no sleepless nights over outstanding debts or the possibility of being made redundant.

In the red corner (naturally!) it’s the workers at Grangemouth oil refinery, who have returned to work after a two day strike. Ordinary hard-working men and women, fighting to ensure they get what they’ve worked for and that their kids don’t face worse terms and conditions when they grow up and find work.

Gee, which side are you on? (If you say Ratcliffe I’ll assume he’s your daddy, so to speak.)

So, they didn’t face each other directly, but a sheepish Ratcliffe was booed and jeered at by striking workers as he left a meeting with management. For some reason he didn’t want to meet the men and women who were striking at his refinery…

This dispute is a direct result of the credit crunch, and is not limited to Scotland – see for example the case of Butler and Tanner.

Private equity pirates like Jim Ratcliffe and Mike Dolan are under pressure to sweat the assets – screw the workers – and if it wasn’t for the fact that the enterprise in question is an oil refinery, there’s a good chance Ratcliffe would have followed Dolan’s lead and shut up shop rather than see the strike go ahead.

Socialist Appeal’s website carries this report from Sunday’s walkout:

Grangemouth: Workers Justified and Determined to Win.
By Gray Allan, Falkirk Council Unison Branch Secretary & Falkirk West Labour Party (both in a personal   
Monday, 28 April 2008
Sunday 27th April 2008: a red and white Unite flag hung out of a window of the union office. More banners and placards were held by the pickets, their bright orange overalls clashing with yellow fluorescent vests as they gathered for their rally.

Mark Lyon (Unite Convenor) welcomed around 200 striking members, some with babes in arms, saying it was the families that had to bear the brunt of the action. Mark also thanked friends attending and looked for further support. Mark said “union members have never seen the likes of this action at Grangemouth. Since Jim Ratcliffe (on behalf of Ineos) took over, there have been planned closures, including of the Research  facility.”  There had been “fraught negotiations with BP,” the previous owners, but now there was the “disgraceful scene” of  being forced out on strike. Mark “applauded the lengths taken by our members to safeguard their pensions and retirement benefits. The pension scheme is in surplus, with little liability”.  grangemouth2.jpg “The good people of Scotland would be devastated by the effects of the strike, but the blame lies fairly and squarely on owners Ineos and “could be afforded by this immensely profitable business. This is a stand against all employers up and down the country. Every worker is entitled to a dignified and secure retirement, a secure home and a little bit of luxury in their old age.” ”What is the truth a of the earnings of £60,000 a year? A shift worker on basic pay plus anti-social hours payments and working 500 hours overtime a year might manage to get  thousands of pounds.”  The £60,000 claim “is a smear campaign against our members, an absolute and utter disgrace. What are the retirement plans of Jim Ratcliffe?”

Strikers were aware that the billionaire owner of Ineos had been named that morning in the ‘Sunday Times Rich List’. “Our members insisted on keeping full safety cover so production could restart Quickly, and to  reduce the inconvenience to the public. No payment would be given for this work, but I call on Ineos to put that money towards our pension scheme.” “Not one pensioner, hospital or emergency service would be without fuel” as members would make sure of supplies  “A cargo to the Highlands and Islands had been loaded that morning in the docks. The honest, hardworking and thoroughly decent members had been forced to make this stand.There was no way they would give in. Not now, not ever.” Linlithgow and Falkirk East Labour MP Michael Connarty knew the workers are “responsible and level headed” . From his students days as a cleaner in the plant to the many meetings with them over his sixteen years as a local MP. “Restructuring had reduced the workforce from 3,500 to1,500 permanent employees now. The company are telling lies on the pension,” Michael said and explained “the Scottish Affairs Select Committee had asked about the takeover by Ineos”. At the time Jim Ratcliffe had asked to meet him. This took place in the plush Pugin Room  of  the House of Commons. He had been told how Ineos   “were great employees  and the company was safe in his hands”. Where are you hiding now Jim?” Michael called. “Why not come and see me now?”

“What is this all about? What is the other agenda?” to the workers Michael said, “the pension is your share in the wealth you create and  your product brings in revenue for the Government.” To cheers Michael finished saying the workers must not lose.” Somebody had to have the guts to take on these companies, not allow them to get away with it. Back off Jim, let them have the pension. Cathie Peattie, Falkirk East Member of the Scottish Parliament, had been brought up in Grangemouth and the trade union movement. She was “appalled at the treatment “of the workers and had “asked Alec Salmond  (Nationalist First Minister of the Scottish Government) to come out in support of them.” “Jim Ratcliffe is holding the country to ransom, but we will win.” Pat Rafferty, Senior Industrial relations Officer for the T&GWU (Unite) congratulated the “brilliant campaign of the Shop Stewards” and condemned the company’s attacks on individuals, who he was proud to be working with.

The employers were welcome to invest and the Union would work with them for secure employment, but “attack our member’s terms and conditions and there would be a bitter battle to defend them, and we will win it !” Senior Convenor Steven Deans expresses thanks “for this heartening visible show of support. 800 workers had told Jim Ratcliffe to get your hands out of our pockets, and off our family’s future. He has £3.3billion in a bank for himself, yet wants to steal money for himself off working people” “We are all in this together, whether you work on the tools or in offices. We do not want to be on strike and for the good people of Scotland, we are restricting he action which also affects us and our families. This action was a last resort and taken with a heavy heart. ”We will meet day or night for discussion with Ineos. Yes, we would be delighted to make it a better place to work for both union members and the company, but don’t touch our pension. There was a sham consultation lasting over eight months and no significant proposals presented at  during the conciliation meetings at ACAS.”

“Ineos has hit out at our members, that’s the truth, but we’ll sit down with them at any time. We will also, continue safety work and fuel would go to those who need it in all life critical situations. We will win!”

Hundreds of print workers sacked by private equity pirates!

After an overwhelming majority of balloted workers backed strike action, private equity pirate Mike Dolan threatened to shut down Butler and Tanner Printers Ltd.

First of all he claimed the original ballot was rigged, then he went ahead with an unofficial ballot, which was shunned by unionised staff – and when it was certain that the strike was going to proceed as planned on Wednesday he threatened to sack all of them, even though negotiations were ongoing at ACAS.

On Saturday, all 287 workers recieved letters informing them they were sacked with immediate effect, as the company has been put into recievership and they will not be paid the wages they are owed!

From the BBC website:

The news came as negotiations between the Unite union and Butler and Tanner were taking place at conciliation service ACAS in Bristol.

Unite said an average salary of £1,200 was due to each employee this month.

The letters received by staff stated that the company was “unable to invoice sufficient work to pay this month’s wages” and that “strict security” had been imposed at the site.

Sounds like a big “fuck off” to the people who have built the business up from the pirates who bought it last year.

Dolan is a particularly obnoxious character, damned by his own words:

Chairman, Mike Dolan, said: “Shareholders were unwilling to pour good money down what they consider to be a drain and they declined to make further funding available.

“Their [the union’s] miscalculation has cost 300 people their jobs and sadly, 100 of those people were not even in the union

But, erm – you’re the one shutting up shop, Mike… Haven’t you just sacked 300 people because you wouldn’t continue negotiating with their union? They’ll be mad at you, hence the “strict security”.

“The union has shown utter contempt for its own members and Butler & Tanner by unnecessarily publicising their strike threat in a crass attempt to exert pressure on the company.

Gee, Mike – why else would workers go on strike? The withdrawal of labour is done precisely to exert pressure on employers. It’s not crass, it’s the whole fucking point!

Mr Dolan said if the threat of industrial action had been lifted MPI would have funded the business through what is traditionally a quiet time for Butler and Tanner. […]

National officer for Unite Ann Field said: “Unite will be demanding recompense in full from the perpetrators of this despicable act sacrificing people’s jobs and livelihoods.

“Mike Dolan and former boss Andrew Hillman should be called to account for what they have done to the workers’ jobs, their pensions and their community.”

The management was still at the debating table on Friday and gave no indication the company was about to be closed, Ms Field said.

Morrissey saves Love Music Hate Racism carnival

Here’s the good man performing “Irish Blood, English Heart”…

And here’s the story from the LMHR website:

Morrissey has personally stepped in with a significant financial contribution to the Love Music Hate Racism campaign in order to allow their 30th Anniversery Rock Against Racism concert to go ahead in Victoria Park, London this weekend without financial loss or burden to the campaign. In addition to his own contribution he has rallied his management, booking agency and promoters to make up the majority of the £75,000 deficit LMHR was faced with after a main sponsor pulled out.

Morrissey commented, “This is a historic event spreading an important, anti-racist, message so it must be allowed to go ahead. Love Music Hate Racism got in touch and explained that the NME had pulled support, possibly as a result of their association with me, and asked if I could help as they had not been able to replace them. This is something I am commited to and we appreciate everyone coming together so quickly to make it happen.”

K2 Agency, Live Nation, Pacifica Artists Group and SJM Concerts are all associated with Morrissey and have made donations to Love Music Hate Racism at his request.

LMHR’s Martin Smith & Lee Billingham said, “After an expected contribution to the Carnival from a major sponsor fell through, we contacted Morrissey – and other artists who support the cause – to ask for their help, and we’re extremely grateful for Morrissey’s generous financial contribution.”

LMHR Carnival ‘08 takes places on Sunday 27th April 2008 in Victoria Park, London E3, and is FREE. Headliners include The Good The Bad & The Queen, Jay Sean, Hard-Fi, The View, Roll Deep, Jerry Dammers RAR Allstars, Get Cape.Wear Cape.Fly, Natty, and Babyshambles’ Drew McConnell’s Helsinki project ft. John McClure, Fyfe Guillemot, Poly Styrene, Jimmy Pursey and many more. Full details at

Ineos out!

Time for an obligatory post on the Grangemouth strike against private equity pirates Ineos – which has made an impact before it’s even started – and since others have already said it better than I ever could, prepare yourself for some excessive quotation…

The strike is definitely going ahead, according to Unite general secretary Tony Woodley, speaking at a mass meeting yesterday:

Speaking before addressing a mass meeting at the plant, Woodley said: ‘There’s no possibility of withdrawing the strike action. We need to understand what we’re dealing with here.

‘We’ve got a company that is owned by a multi-millionaire close to being a billionaire. We’ve got a company that is cash-rich with a pension scheme that is also cash-rich.

‘We’ve got a pension scheme that is viable and we’ve got a pension scheme that the company has already cut its own contribution to by 30 per cent for the last couple of years.

‘And in spite of all those reasons they still want to remove the scheme for new starters and I believe eventually remove it for all of our members and we are not prepared to accept that, not under any circumstances.’

David Semple remarks of Ineos, in an excellent post on the dispute:

This is the same company, owned by Jim Ratcliffe, that tried to extort £300 million pounds from the government with the threat of 133,000 job losses. Most of Ratcliffe’s rapid expansion has been funded by debt, according to speculation, in an era when liquidity was much more readily available. The credit doesn’t seem to have affected expansions though.

Ineos can fund a seventy million pound expansion in France and ten times that amount in Scotland, but it can’t fully fund the pension scheme it had previously agreed with its employees. In fact, according to Unite, Ineos has pilfered £40 million from the pension scheme as well as slashing it’s own contributions. It’s all very well to make these arguments in a period of financial success but even worldwide economic collapse wouldn’t mean we should accept cuts in workers’ wages.

As John McDonnell has posted,

This dispute cannot be charicatured in the usual way by the media as a group of selfish workers striking out of self interest. These workers are striking to prevent their company’s pension scheme being undermined for future workers joining the scheme. They are standing up to protect the pensions of future generations of workers in their industry.

Gordon Brown is currently supposed to be writing another of his books on heroes and heroism. I suggest that he includes a chapter on the selfless sacrifice of the Grangemouth heroes who have had the courage and determination to stand up and fight to protect for the pensions of workers yet to come.

Perhaps Brown will have a lot of time on his hands in the next few months in which to get writing…

Ian has some comments pilfered from the BBC’s comments section of their site, which are supportive of the action being taken. And there’s a good summary of the dispute at the Socialist Appeal website, by the way.