A Strategy to win
Build a national conference against co-location and health privatisation
There is growing anger at the government’s cuts and privatisation programme. There is also a growing realisation that this policy will bring about a collapse of the already poor health service and that membership of current health schemes will not guarantee the cover for all the treatment we may need.
But now there is a growing opportunity to organise and do something about it – to build a mass campaign in defence of public health.
The anger has been sparked by the creation of an unelected quango, the Health Service Executive, answerable to no-one and set up purely to make cuts and privatisation easier. It is guilty of a reckless and irresponsible destruction of the current service.
There is a growing realisation that promises that co-location hospitals will treat everyone are simply fairy stories to silence the opposition and that their whole purpose is to build a bricks and mortar two-tier health service. Many people now realise that current health payments would have to increase by many times to get full access to this private service.
Opposition is growing. Not only are patient groups, nurses, doctors and other health workers protesting across the state - we are breaking the bounds of purely local campaigns and we now have the opportunity to turn this protest into an effective national campaign.
An effective public health service
It’s easy to say what we mean by an effective health service. We want a service that provides immediate and effective treatment when we are sick, along with effective support both in hospital and in the community when we are at home. This treatment should be free. There should be no allocation of health based on ability to pay.
How are we to achieve the goal of an effective public health service? Firstly we must stop co-location dead in its tracks. It will immediately set in stone a two tier health service. The US experience is that this leads to an immediate collapse in service and an explosion in costs – after all, the only way to force people to pay in a two-tier service is to make conditions in the lower tier unbearable! For the new private facilities to be profitable the cost of paying for them must go up.
We must also demand complete nationalisation of the health service and the abolition of private medicine. As long as there is private health provision resources will go to where money can be made and public provision will suffer. We have heard all the promises that private medicine will be complementary to public provision, and all the schemes to assure this have proven worthless. If we had a fully effective public health provision why would anyone pay? Private practice depends on public provision being second or third rate, on long waiting lists and inferior care.
Anyone who knows anything about the present service knows that it is already a cash cow for private business, from the upper end of the swish clinics to elderly homes which present inflated bills for negligent services. This arrangement sucks money from the public purse while at the same time grabbing the lion’s share of resources. Over time this parasitic arrangement drains the public service and contributes to its collapse. This is the point we have now reached. Huge cuts are now on the way as the HSE attempts to balance its books, even after it has cut hundreds of jobs from its budget.
The HSE must be abolished and democratic structures set up to control resources and determine priorities. These democratic structures must be under the control of health service workers and representatives of patients groups and local communities. If this is not done then ‘democratic control’ will mean exactly the same as its expression in the Dail and in the councils – corruption, backhanders, the rule of money, and the subversion of the service.
These structures must have the right to see exactly how the health service is being funded and have the right to veto any proposed closure of facilities. Those who work in the service are best placed to decide how to run it efficiently and effectively. This is real democracy and real public service.
The campaign must demand to see all the documents and plans of the HSE, Department of Health and the Government. We should demand that the people health check them before they are implemented.
A national campaign
How can we turn this programme into reality?
The first step must be to build a national conference against cuts and health privatisation – particularly the new co-location hospitals. The call itself is a way of organising in every area and every sector. Already two campaigns have arisen. These should unite on the basis of a common programme and an open and democratic structure.
The movement must be:
Political: It must oppose the cosy consensus in the Dail which allows TDs and even health ministers! to posture in support of local services while supporting cuts and privatisation nationally. Political representatives who claim to support the campaign must publicly break with their parties if they do not oppose health privatisation. Their loyalty is with us or their parties – they cannot be allowed to talk out of both sides of their mouth at the same time.
Blame the Guilty: the Government is responsible for the current chaotic and crisis conditions of the health service but they have had partners in devising and approving their policies. Their partners have been the trade union leaders through social partnership. These leaders also cannot be allowed to speak out of both sides of their mouths. How can they be partners with the politicians who have brought the health service to this?
Leave no room for hypocrisy: ICTU could immediately make the health service a deal-breaker in the current social partnership negotiations and demand the resignation of Mary Harney, disbandment of the HSE and an end to co-location as evidence of the government’s good faith. They won’t. That means we cannot rely on their support never mind leadership. We must seek to organise health and other workers despite these leaders, and against them when they declare once again that they are partners with the Government that is cutting and privatising our service, and partners with the bosses who will profit from this privatisation. Trade union leaders who say they support the campaign must support the final publicly expressed wishes of Susie Long and break with social partnership
Campaigning: organising everywhere, based on local groups and trade union branches, signing up support at every level and targeting health workers as the backbone of the movement.
Interventionist and activist: Able to physically
prevent co-location and privatisation from becoming reality through the
power of mass action and industrial action.