The News Line Wednesday October 28th 2015 PAGE 9






JUNIOR doctors are balloting for strike action against a new contract being imposed on them by the government which claims that it is essential for 'seven day working' in the NHS.


The same reason is being used to threaten to impose a new contract on the consultants, and similar contract changes for all one million NHS staff on Agenda For Change contracts are also being proposed.


Jeremy Hunt, Secretary of State for Health, spoke about 'seven day care' on 16th July.


He said:


'We will reform the consultant contract to remove the opt-out for weekend working for newly qualified hospital doctors' and claimed:


'Around, 6,000 people lose their lives every year because we do not have a proper seven-day service in hospitals ... No one could possibly say that this was a system built around the needs of patients.'


He added: 'I will not allow the BMA to be a roadblock to reforms that will save lives. .. But be in no doubt: if we can't negotiate, we are ready to impose a new contract.'


This speech typifies the propaganda promoted by government since 2012, suggesting that a clause in the consultant contract is responsible for an alleged increased mortality in emergency patients admitted to hospital at weekends.


But the 'opt-out' clause complained of has no bearing on emergency care. It is in fact an opt-in clause for elective care.


Managers can invite consultants to perform routine elective work in the evenings and weekends if they would like to. Most consultants already work a 40- 48 hour week and do nights and weekends 'on call' for emergencies.


It becomes apparent that what the government wants is more ELECTIVE WORK; planned operating lists and outpatient clinics on waiting list cases, performed in the evenings and weekends, seven days a week.


The NHS has always provided care for emergency patients in hospitals 24/7. Junior doctors remain in the hospital round the clock and can call consultants in as necessary.


The huge hue and cry about care of emergency patients is a political ploy by the government to cover up a drive to increase routine planned work in unsocial hours.


The record of this government with regard to last winter's hospital crisis, shows that its apparent concern for emergency care of patients is just crocodile tears.


Ambulances were left queuing up outside A&E departments so crowded they could not cope.


Patients spent hours on trolleys risking their lives, because hospitals were full to capacity.


More than 26,000 hospital beds have been closed since 2010.scores of A&E departments have been axed, as District General Hospitals (DGHs) have been closed in giant reconfigurations.


No! The government's 'seven day NHS' is not motivated by improving emergency care for patients.


The real reason is that the incoming private companies must 'sweat assets' and run operating lists and clinics up to 10pm Monday to Sunday, in order to make profits on waiting list work. These need cheap medical labour, both of consultants and juniors, as well as non-medical NHS staff.


Hence, the central demand of all the proposed new contracts is a massive reduction in unsocial hours payments, through increasing plain time working, and the reduction of pay progression.


Back in December 2012 Sir Bruce Keogh, Medical Director of NHS England, explained why 'seven day working' was so essential.


He said:


'It seems strange, in a way, that you cannot have your day case surgery at the weekend when the rest of the commercial world is going in a different direction', adding: 'Tesco have had to go through this ... we will need to look at the terms and conditions of services of people - their employment conditions,' (Daily Mail 16.12.2012).


So Tesco is the model!


It is in the interests of incoming private companies that seven day working has to be installed, and the terms and conditions of people must be changed - i.e. the national contracts of all NHS staff smashed.


Incoming private companies have to make a profit and this can only be done if they 'sweat assets' and perform waiting list work Monday to Sunday, from 7am to 10pm.


Whatever the verbal pledges, elective work will always take precedence over emergency care. This is the case in all commercially run healthcare systems.


'Seven day working' must be cost neutral the government says. By cutting unsocial hours payments and removing banding safeguards more work will be screwed from junior doctors whose labour becomes cheaper.


But seven day elective working will involve the employment of more consultants and non medical NHS staff to make it work, and this will cost money.


Right from the start, those supporting seven day working have proposed reconfiguration - the concentration of acute hospital care in fewer, larger hospitals and the closure of the remaining ones, as the solution. All they want is 40-70 acute major hospitals in the whole of England.


And this is what we are seeing with gigantic reconfigurations up and down the country as DGHs lose their maternity, paediatrics and A&E departments. As the DGHs are lost, so is access to safe consultant-led hospital care for millions of patients, and the training posts of thousands of junior doctors are removed.


The government wants a huge shift of care into 'the community' and 'out-of-hospital primary care providers' - federations and networks in new 'Vanguards', evolving into private Accountable Care Organisations (ACOs).


This is the plan of Simon Stevens in the Five Year Forward View. The new GP contract is designed to entice GPs to give up their autonomy and work for ACOs.


More than 20,000 junior doctors and their supporters poured onto the streets of London on Saturday 17th October. Their placards showed their awareness that, in seeking to destroy their terms and conditions, the government is threatening the very future of the NHS as a publicly provided universal healthcare system free at the point of use, providing safe care for patients.


The junior doctors must not fight alone. The consultants' new contract is just as bad, and so is the new GP contract. The BMA must take action to defend all the current contracts and call on the other health unions to fight alongside the junior doctors.


The issue of defending the NHS is a question for the whole working class, as we can't live without it.


The TUC must organise a general strike to support the junior doctors and the whole NHS workforce and protect the NHS from privatisation.


Every NHS hospital and GP surgery must be saved.


The anti-union laws must be defeated.


The Tory government and their friends in big business must be driven out and a Workers Government with socialist policies brought in, to nationalise the banks and major industries and plan the economy for workers' needs, and restore all the public services.