The NHS is under attack. From the companies using PFIs to milk millions from local trusts, from the subcontracted cleaning firms screwing their workers with low wages and terrible conditions and screwing patients with dirty, infection breeding, wards, from the government with its ‘agenda for change’. Everywhere we see private companies making out like bandits while patients and staff suffer. Behind it all stands the government, with its agenda of closures and job losses for the NHS and obscene profits for its friends in industry.

The NHS is Ours
But the NHS does not belong to the politicians and the bosses. It is not theirs to abuse for their profit. The NHS is ours. It only exists in the first place because ordinary people have fought for decades to create and defend it. They stood up against the rich and powerful few and demanded that the needs of the many should be met. The government and their allies have never forgotten this, and they take every chance to claw back what they can.

Divided
We have to defend ourselves; we have to defend the NHS. Thousands have already started this work: communities defending their local hospital from closure, workers striking against job losses, low pay and overwork. National organisations like Keep Our NHS Public bring unions and pressure groups together to lobby politicians and march in protest. There is good work being done, but still the PFI projects go on, the private companies move in and jobs are lost and hospitals and services are closed. The government and its allies are strong and united; they know what they want and how they’re going to get it.

We, on the other hand, are divided and unsure of how strong we are. Different groups deal with different parts of the problem, defending themselves as they are attacked, often unable to reach potential allies. Health workers are divided into many unions. Nurses, technicians, doctors, cleaners, consultants, caterers; separated by red tape even if they work side by side. Communities campaign outside hospital walls whilst inside staff feel isolated and vulnerable.

Unite to Win
This is not the way it has to be, and it is not the way it’s been in the past. A wave of Tory cuts in the 80s and 90s was met with fierce resistance. Hospitals were occupied by workers and the communities they served. Strikes spread from workplace to workplace as workers in different places and different jobs came out in sympathy and solidarity with each other. Not all of this was legal, and even less of it would be legal now after years of Tory and New Labour anti-worker laws. Not all of it worked, some hospitals were still closed and some services were still cut. But there were significant victories and the government backed off. The militancy and struggle that got us the NHS in the first place has successfully defended it in the past – and it could in the present. The government is again on the offensive, believing that years of grinding stealth cuts and attacks have weakened us so much that we can’t fight back anymore. We have to prove them wrong.

Alternatives for Resistance: Occupations
A hospital occupation, sometimes called a work-in, is where workers take over the hospital buildings and take control over whether equipment and patients are moved. A hospital can only be closed if there are no patients in it. So the main goal of an occupation is to keep the patients it has, if it is a long stay hospital, and to ensure new admissions if it is an acute general or cottage hospital.

Hospital occupations are not new. In 1922 workers at the Radcliffe Hospital in Nottingham occupied. From the late 1970s to the early 1990s occupations were used to defend hospitals scheduled for closure. Across the UK health workers took control of their workplaces to keep the bailiffs away and look after their patients. Indeed, they often look after their patients better. During the eight month occupation of St Benedicts, patient deaths fell way below the national average, yet within six months of the end of the occupation 30% of the patients had died.

Occupations unite workers from different sections of the hospital. They need the cooperation of GPs and the general public. They unite the community and the workers against management and the government and force them to show their true face if they move for eviction, or to back down. No hospital can be closed while still occupied. An occupation can’t guarantee victory, but it at least forces the government to fight.

What We’re Facing: Some Figures
Taken from Freedom: Anarchist News and Views, 13th January 2007
While hospitals are forced to continue to sack health workers in order to balance the books, the NHS is facing a shortage of key staff, according to a leaked Department of Health (DoH) policy paper.

Panic cuts in the NHS’s £4 billion annual training budget this year will, the DoH itself predicts, lead to a shortage of 1,200 GPs, 14,000 nurses and 1,100 medical consultants. This year up to 37,000 jobs will be lost in the health service. Shortages of nurses, doctors, radiographers, porters and others will hit patient care and lead to longer waiting lists for treatments. NHS trusts are already reported to be cancelling operations as they run out of money.

The root cause of the health services’ current financial problems is privatisation. The influential health think-tank Reform has, for example, reported that there is a “clear link” between hospital deficits and PFI projects. Eight of the twelve hospitals where new PFI projects were approved last year are in deficit. Despite the fact that private construction projects are bleeding the NHS dry New Labour plan to spend a staggering £13.5 billion on PFI.

Despite deficits the DoH are spending £330 million on private sector management consultants – more than enough to reemploy the health workers currently being sacked by hospitals.

NHS spending on non-NHS provided services grew by 227% last year to £4 billion according to Reform and just before Christmas the first hospital was handed over to the private sector. From July the new Lymington New Forest Trust will be run by the private Partnership Health Group. Unison fear that this will be the first of many hospitals to be privatised.

Although the NHS’s problems have been caused by government policy, it is the workers who are taking the brunt of the consequences and not just through job losses. The DoH is attempting to peg this year’s pay increase to just 2% - below the rate of inflation and effectively a pay cut. The government also wants to dismantle national pay bargaining and introduce regional pay. This will mean that workers doing the same job will be paid different rates.

An IWW member and anarchist who works in the NHS told Freedom “what is going on is crazy. Only two years ago the government negotiated a new pat system, now they are trying to dismantle it. They acknowledge there will be shortages of staff but they are trying to reduce pay which will drive more workers out of the NHS. Morale is at rock bottom.”

Instead of a conventional strike, workers with demands that the bosses are unwilling to meet can collectively decide to have a good work strike.

One of the biggest problems for service industry workers is that many forms of direct action, such as go-slows, end up hurting the consumer (mostly fellow workers) more than the boss. One way around this is to provide better or cheaper service - at the boss's expense, of course.

Workers at Mercy Hospital in France, who were afraid that patients would go untreated if they went on strike, instead refused to file the billing slips for drugs, lab tests, treatments, and therapy. As a result, the patients got better care (since time was being spent caring for them instead of doing paperwork), for free. The hospital's income was cut in half, and panic-stricken administrators gave in to all of the workers' demands after three days.

In 1968, Lisbon bus and train workers gave free rides to all passengers to protest a denial of wage increases. Conductors and drivers arrived for work as usual, but the conductors did not pick up their money satchels. Needless to say, public support was solidly behind these take-no-fare strikers. Tram workers in Australia did likewise in 1990.

In New York City, USA, Industrial Workers of the World restaurant workers, after losing a strike, won some of their demands by heeding the advice of IWW organisers to "pile up the plates, give 'em double helpings, and figure the checks (bills) on the low side."