THE NHS in Northern Ireland is under immense pressure. Recurring bed crises leave dozens of patients lying on trolleys for hours or even days at a time. Waiting lists are longer here than in any other area of the NHS. More than 60,000 are currently on the official waiting lists with thousands more not even counted even though they have been referred to hospital.
By Ciaran Mulholland
Across the North, local communities fear that their acute hospitals are on a hit list. If the Hayes Report is implemented, the Tyrone County in Omagh, the Mid-Ulster in Magherafelt, the Mater, Whiteabbey and the Downe in Downpatrick will lose their acute status over the next few years.
With the collapse of the Executive, the health service is now in the hands of a direct rule minister. All the indications are that the new minister intends to take this opportunity to accelerate changes that have been planned for some time. The minister can blame the local politicians, claiming that he is merely implementing plans drawn up by the Assembly and the Executive. The local politicians will blame Westminster claiming that they would not have closed a single hospital if they had been in power.
The reality is that the main parties and the New Labour government have no fundamental disagreements on the future of our health service. Local politicians will oppose the closure of their local hospital but in reality this means supporting the closure of others. This is most clearly seen in Fermanagh and Tyrone where rival campaigns, involving all the main parties, are competing to have a new hospital sited in their area. Only one area can win this competition, and as a result either Enniskillen or Omagh will lose its acute facilities. None of the main parties supports the idea of both hospitals remaining open.
Neither do the local parties and New Labour disagree on the on-going privatisation of our health service. Under the Hayes plan, new facilities will be built under the Private Finance Initiative (PFI). Private companies will build hospitals and then lease them to the NHS at exorbitant rates.
In this way the private companies involved will make up to 22% profit a year. This profit comes directly from the public purse and is created by cutting beds, jobs and wages. Despite the obvious bed shortage locally, Hayes proposes cutting a further 500 to 1,200 beds over the next few years. Again the main local parties do not oppose this proposal.
The trade unions and genuine local hospital campaigns must ensure that the suspension of devolution is not exploited by the department of health to get their way on hospital closures. We simply cannot rely on the main Assembly parties to protect our service. We must mobilise quickly as the government may move quickly. An energetic campaign involving pickets, rallies and demonstrations will make the department stop in their tracks.
If necessary strike action and occupations should be considered. The tactic of occupation was successfully used to save a number of London hospitals in the 1970s. A hospital cannot be closed if staff and patients refuse to move and if management are prevented from moving equipment.
The issue of health cutbacks can also be taken onto the electoral plane. At the last local elections, Raymond Blaney gained a seat on Down District Council on a Save the Downe ticket despite fierce opposition from the main parties, especially the SDLP. Two other candidates performed well though they did not win seats.
In England, retired hospital consultant Richard Taylor won a Westminster seat at the last general election with an overwhelming majority. His victory was the culmination of a campaign to save Kidderminster Hospital. Indeed the Kidderminster campaigners have now won a majority on the local council. At the last general election in the South, seven candidates won parliamentary seats on health tickets.
Ultimately, we require a mass broad based socialist party in Northern Ireland that brings together the best anti-sectarian community, socialist and trade union activists. Such a party cannot be wished into existence and ultimately will be built on the back of big events and mass campaigns.
It is possible however for local campaigning groups and trade union branches to challenge the established political parties at the next Assembly elections. Militant campaigns around the issue of health cutbacks could provide the platform from which to launch such a challenge.
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