One thing you can say about Tony O
Blair - he is consistent. Despite the wafer-thin majority which eventually forced through the controversial legislation to form Foundation Hospitals, and the mounting evidence of equally widespread opposition within his own party to the imposition of student top-up fees, he has made clear his firm intention to press through this and other unpopular and reactionary legislation for as long as his MPs agree to put up with him.
He has issued a New Year's message proclaiming himself "as committed, as optimistic and as determined today as I was in 1997" to see through his package of so-called 'reforms'.
But the common factor in most of Blair's reforms is that they attack public services, working people, the poor and the oppressed, while, for example, one simple and progressive reform that might strike a blow against big business - the long-awaited bill to create an offence of "corporate killing" - has made no progress since first mooted after the Southall train crash in 1997.
So right wing is New Labour's agenda for 2004 that Blair and his refugee-bashing Home Secretary Blunkett are now routinely attacked from the left by a rebranded, if still ghoulish Tory leader Michael Howard.
Howard has condemned New Labour plans (outlined in the Queen's Speech) for legislation which would make life even more difficult for asylum seekers, withdrawing benefits, rights of appeal and threatening to take their children into care if their bid for asylum is rejected. TONY THATCHER JOB SNATCHER* Convention of the trade union left
Who should we vote for
in the next election?
What can we do about
political representation?
What should we do
about the political fund?
and Regional Executive RMT Committee Unison and Humberside Region Natfhe id Emergency Planning Authonty Unisi
Swingeing new anti-terrorist legislation is also promised, which is likely to prove controversial, especially in the context of Blunkett's continued detention without charge of alleged foreign "suspects", and the ARMT Saturday 7 February 2004 11am to 5pm registration from 10am Friends Meeting House Euston Road, London (nearest e Euston) Speakers include: Bob Crow RMT general secretary Mark Serwotka PCS general secretary Paul Mackney Natthe general secretary all personal capacity ongoing scandal of the US incarceration of hundreds of prisoners denied the most basic human rights at Camp X-ray in Guantanamo.
The Tory leader has also challenged not just the policy of imposing new top-up fees for students attending university courses, but pointed to the way in which it undermines the principle of free education.
f Blair claims that it is right to charge
fees for university students on the basis • that graduates tend to earn more than those without degrees, argues Howard, how long before New Labour starts using the same argument to charge sixth form students studying for A-levels?
As with Foundation Hospitals - where the Health and Social Care Bill was eventually forced through only by marching in Blairite MPs from Scotland and Wales to vote for a measure that will only apply in England - Blair can only squeeze the top-up fees legislation through by whipping in support from Scottish MPs, who will again rest safe in the knowledge that the new provisions will not affect any of their constituents.
The new year also brings a new stand-off over Blair's plans for the House of Lords. His proposals fall well short of democratisation, while at the same time antagonising the Tories by booting out the remaining 92 hereditary peers, and hiving off the law lords to a new supreme court.
Meanwhile the package of policy issues posed as questions by Blair in his 80-page document for the so-called "big conversation" with the electorate are described by both the Financial Times and the Guardian as "puritanical" - preoccupied with anti-social behaviour of various sorts and individual responsibility - and all apparently slanted to avoid the underlying question of funding public services through progressive taxation.
Indeed as the "conversation" kicked off one of the topics had already been designated as "off limits", since Blair's mind is already made up over top-up fees, regardless of what anyone says, and regardless of the fact that it is probably the least effective and slowest way of generating extra funds for the expansion of higher education.
The most efficient, rapid and fair way would of course be to raise taxes now for those on higher incomes - a policy that would also tax previous generations of graduates as well as those yet to finish their A-levels.
In extension of nursery education is A proposed - but with no commit.
ment to state funding, leaving the prospect that (as with universities) this can be effectively confined to those on high enough pay scales to cover the substantial costs involved.
The party which has refused to link the state pension to average wages, and presided over a succession of high-profile scandals in which unsuspecting pensioners have been ripped off by collapsing companies, now has the nerve to ask if new measures should be brought in to make it compulsory for workers to save more for their own retirement pension.
This follows suggestions both in Britain and within the EU that workers should be encouraged not to retire at 60 or even 65 but to soldier on until they are at least 70 years old in order to ease the financial burden on state pension funds. Blair can only squeeze legislation through by whipping in support from Scottish MPs, safe in the knowledge that the new provisions will not affect any of their constituents. .....
The government which has notoritobacco advertising, and which has so far done little or nothing to curb alcohol abuse now asks the public whether they want measures to ban smoking in various places, and impose a levy on alcohol advertising.
Once again the race card is played, by inviting people to choose between ways of further oppressing immigrants and asylum seekers - with even greater use of detention and forcing employers to take action against "illegal" working.
The questions are slanted, the choices restricted and the answers already determined by Blair. The "big conversation" really is no more than asking a silly question and waiting to see who is silly enough to offer a reply.
Blair's latest round of proposed reforms, with ever greater privatisation and impositior of charges for previously "free" elements of the welfare state, were summed up earlier in 2003 in his article on "Where the Third Way Goes from Here":
"We should be far more radical about the role of the state as regulator rather than as provider, opening up healthcare for example to a mixed economy under the NHS umbrel la, and adopting radical approaches to self"We should also stimulate new entrants to the schools market, and be willing to experi ment with new forms of co-payment in the public sector:"
Of course, like top-up fees and the use of private treatment centres to deliver ever more NHS treatment, such proposals were carefully omitted from New Labour's 200l manifesto: Blair is setting out his stall not just for 2004, but for a third term in which his party steals even more of the reactionary trappings of Tory policy on law and order.
For much of 2003, Blair's team was able to take advantage of the focus on the war and its aftermath to press forward its offensive against public services with remarkably little active opposition.
But if campaigners, including many radicalised by a year of anti-war protests, and union activists begin once again to take notice of what is happening at home, the combination of issues and unresolved problems from previous rounds of "reform" could yet form a broad platform for a new political opposition that could give Blair and New Labour a seriously rocky ride in 2004.
page 5 of the scan
Harry Sloan
In the surface, the National Health Service has been New Labour's
big success story. Hospital waiting times and waiting lists are reducing broadly in line with ambitious targets set out in the 2000 NHS Plan - largely as a result of the massive injection of new funds since the spring of 2001.
The prospect of yet another winter in which icy conditions in most parts are moderated by the greenhouse effect, and hospitals with minimal free beds escape lightly in the absence of a major flu epidemic might give the impression that all is hunky dory.
But beneath the tranquil exterior of NHS Trusts pointing gleefully to their manipulated performance figures and reaching for threestar status there are a series of problems brewing which threaten to make 2004 a difficult year in many areas.
• Many hospital Trusts have achieved their performance targets only at the expense of running up substantial deficits -often several million - which are supposed to be resolved by the end of the financial year. Some, such as London's Whittington Hospital, have been desperate enough to attempt to rein in spending by imposing petty and ridiculous cuts, including axing tea and biscuits and snacks for operating theatre staff. Debts carried over this year will be even harder to clear from April.
• One of the main factors in the overspending of many hospitals throughout the country has been shortages of nursing and other staff, which have required them to run up massive bills employing agency staff at much higher rates to plug the gap. Oxford's Radcliffe Hospitals Trust for example spent El2m last year on agency staff: these shortterm solutions serve to further demoralise existing NHS staff, while agencies pocket fat profits.
• From April the first wave of Foundation Hospitals will be launched, with unpredictable impact on local health services in their area: unions have warned that the new freedoms they will gain will mean they 'poach' more qualified staff from other NHS hospitals, compounding shortages.
• Among the last-minute changes to the legislation, cobbled together to push the scheme through Parliament, was a clause crises wait in the wings that would permit applicants for Foundation status to include their entire workforce and their entire list of current and past patients as prospective "members" (shareholders) of the Foundation unless they specifically opt out.
This is a desperate attempt to get over the overwhelming lack of public interest in the New Labour scheme: massive London teaching hospitals seeking public support for Foundation applications have been attracting public meetings of just five people. Most firstwave Foundation Trusts have only managed to recruit a few hundred members against a minimum target of 7-10,000.
• Some would-be Foundations are also warning that they may reconsider their bids if they are not allowed to borrow more money than seems likely under new regulations: a few face heavy losses under the new system of "financial flows", beginning in April, under which all Trusts will eventually be paid on a fixed scale of fees for the work they do.
This reversion to Thatcher's market-style system in which the "money follows the patient" will inevitably create losers alongside winners: some large hospital Trusts Ministers are urging consultants to check first for the wallet if there is any chance the patient is from overseas whose costs are currently above the national average are set to lose millions, while some with below-average costs can retain windfall increases of up to 9% of income
One teaching hospital has warned that it could lose as much as £60m a year under the new formula: in many others drastic cuts will be required to squeeze costs down to the average.
• January 2004 marks the launch of a new system under which local authority social services departments are required to find additional places and fund new services to speed the discharge of older patients from hospitals to their own homes or nursing homes.
Those that fail will be 'fined' €100 per delayed patient per day: but social services do not control the provision of nursing homes - these have always been in the private sector, and in many areas are in desperately short supply. Meanwhile Oxfordshire is one area where the NHS is now looking to impose a new round of closures of community hospitals, dumping even more responsibility for long-term care onto social services.
• Government plans to bring in privatelysoclalist res New, shiny, too small ... and broke: Worcester's new PFI hospital is typical of many other: operated "diagnostic and treatment centres" are forging ahead according to plans laid down by Whitehall bureaucrats, regardless of local wishes or needs. The high-profile row over plans for such a unit to deliver cataract operations in Oxfordshire - at the expense of jeopardising the viability of the existing Oxford Eye Hospital - came to an anti-climactic conclusion as the local Primary Care Trust, which had stood firmly against the scheme, collapsed under pressure from the government and the local Strategic Health Authority. So much for local control and accountability.
• After a year of deadlock in which only one or two contracts were signed for building new hospitals under the Private Finance Initiative, the government has promised schemes worth over £3 billion will be signed in 2004.
But with many first-wave PFI hospitals deep in the red and struggling, and mounting evidence that the new hospitals are poorly built and represent poor value for money, the affordability of PFl projects has become an even bigger issue - with a new hospital in Central Manchester losing beds and operatance january 2004 5 A New Year of New Labour Massive London teaching hospitals seeking public support for Foundation applications have been attracting public meetings of just tive people. ing theatres in order to cut the €420m price tag, the new Royal Brompton-Harefield project in Paddington hitting the El billion mark, and the long-delayed rebuild of East London's Royal London and Bart's Hospitals last estimated at £900m before the secret stage of negotiations began.
• However there is one relieving factor for health ministers: the slow progress in negotiating the detailed implementation of the complex new Agenda for Change pay structure in a dozen "early implementer" Trusts has meant that a very large number of health union activists who might be campaigning on other issues are likely to remain snowed under with this issue well into the autumn.
The ballot on whether or not UNISON, the largest health union, will agree to roll out the scheme nationwide is now not expected until late summer. With a number of stub born problems such as unsocial hours payments and pay bands for key groups of ancil lary and admin and clerical staff still unresolved, it is clear that some sections of staff benefit more than others.
Ironically Agenda for Change insists from the outset that it represents a new "partnership" between management and unions: it appears to be the best chance for ministers and NHS chiefs to distract staff from the uni lateral and unpopular reforms they are
page 6 of the scan
6 socka stre Iraq: the crisis continues nce January 2004