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Health - Why we need a national conference, a national campaign

Kevin Keating 

3 March 2008

After a long time in which the news has been about defeat and retreat, there may be news of a change of pace and of working people challenging the government and capitalist class and organising to defend their rights. 

This possibility, still only a fragile prospect, has arisen in relation to the governments plans for co-location in the health service, the endless scandals and failures of the existing system, and a willingness on the part of a number of groups to begin to organise a defence.

The possibility follows a spurt of activity, firstly involving the organisation of groups of health service workers and protests by consultants, then local area groups, then a Labour party meeting, followed by a meeting organised by the Socialist Party, then a Dublin trades council meeting and a plan for a trade union demonstration.  There are also proposals for a national conference.

There are however many difficulties. As we have seen many times before, residents groups by themselves have great difficulty in breaking away from local structures and mounting a national challenge.

While it is better that the Labour Party oppose co-location than support it, their protestations lack conviction.  It is not so long ago that the party stood in election on a right-wing programme that would easily have accommodated co-location. Its current opposition is unlikely to go beyond parliamentary pantomime in the Dail.

Dublin trades council organised a meeting calling for a decent health service.  It was firmly orientated towards the bureaucracy, organised in conjunction with the youth committee of ICTU and in conjunction with the health union leaderships. The bureaucracy dominated the platform, although Janette Byrne, of the campaign group Patients Together and Conor MacLiam, husband of Susie Long, who died of cancer because she was unable to jump the long queue built into the current health service, also spoke. 

When we strip away the rhetoric, the stories of individual tragedy and the bombastic outrage, the position of the bureaucracy was spelt out very clearly by Liam Doran of the Irish Nurses Organisation (INO).  He supported the ICTU policy of ‘constructive engagement’ as he coyly termed it.  It was a view that cut across the contribution of Conor Mac Liam.  He reported that one of the dying requests of his wife, Susie Long, was that the unions reject partnership with the government and bosses based on such decay of the health service.

Ironically is was not so long ago that ICTU and SIPTU were openly scabbing on industrial action by the nurses, arguing that all their demands could be met inside the partnership tent and specifically within the ‘benchmarking’ mechanism.  Liam Doran for his part managed to lead the nurses to defeat for the second time in 10 years despite the overwhelming public support for their case.  The benchmarking report has come and gone and delivered nothing for the nurses or anyone else. The response from the unions, both Doran and his opponents, was silence. 

In reality it was the previous partnership agreement before the current ‘Towards 2016’ deal where the bureaucracy accepted mass privatisation of public services.  Today the main expression of that privatisation drive in health is the Health Services Executive (HSE).  This unelected quango (it is so immune from public scrutiny that it reports to the Dail in private session) makes all its decisions by declaration, without any consultation – the most striking example of this being its unilateral decision to freeze recruitment of hospital staff. It also operates ‘Health forums.’ These are pretty naked attempts to bring opposition inside the tent and smother it, with no mechanism for the forums to influence policies already decided. Yet it is inside the forums that we find the union bureaucrats, and it is in this light that we should judge their willingness to fight.

Although the trade union meeting was publicised as the launch of a campaign, there was no mention of a campaign in the discussion and no contact list was taken up to keep in touch with those who attended. 

The other point made by Conor Mac Liam was that his wife had understood that her death and the other almost daily atrocities occurring in the health system were driving people to take up private insurance out of fear. The disastrous state of health care is a predictable outcome of government policies and not a series of mistakes or incompetence. The sharp divergence  between the experience of the health system of  Conor Mac Liam and  others who spoke in the hall and the clear intent of the bureaucrats on the platform to do nothing different than they had for the last 20 years meant that the only way to avoid confrontation with the bureaucracy was for the meeting to be tightly controlled and only very short contributions were allowed from the floor. 

What has followed is a demonstration on 29th of March – a march sponsored only by the Trades council, with no mention of ICTU or of a ‘conjunction’ with the health union leaderships.

Some of those involved in the march have already indicated that the bureaucrats do not look with favour on further activity. The likelihood is that, as with so many trade union demonstrations, the march will mark both the beginning and end of official trade union sponsorship or of any meaningful  battle  against the offensive on  health care  that involves the bureaucrats.


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