Plans by the new NHS chief executive David Nicholson to close upwards of 60 clinical units and Accident and Emergency departments across the country have giver another fillip protests the length and breadth of England.
Nothing is more calculated to turn Mr and Mrs Average into political activists than a threat to close down their nearest A&E unit or gut their local hospital of front-line services.
Thousands at a time have been on • a succession ol marches against NHS cuts, closures, redundancies and privatisation from the Cornwall in the west and the South Coast, through the
of middle winole swanne England, to Cumbria and Yorkshire.
The pressure has finally forced the TUC unions, after months of procrastination. to name the day for a lobby of parliament - November 1 -and to try to insert themselves into a leading role in campaigns which have largely sprung up outside the trade union movement.
The union leaders have left their rather timid challenge
the eleventh hour: announcements of job losses have been almost daily events, and jobs at risk now
Lop 20,000, with increasing numbers of Trusts and Primary Care Trusts (the budget-holders) unvelling service cuts and closures of wards, beds and vital community services across the country with little in the way of union opposition.
Privatisation, too has been taking its toll with dozens of GP practices up for grabs to private companies, new treatment centre contracts being doled out to profit-seeking firms, and NHS hospitals facing a loss of crucial funding under the so-called "payment by results" system.
However feeble the union leaders may have been, and however muted their challenge, ministers have been increasingly sensitive to the rising tide of local opposition.
Labour Party chair Hazel Blears indignantly denied that she had been involved in discussing a "heat map" with health ministers, aimed at dissuading them from focusing unpopular hospital closures in key Labour marginal seats. But in refuting this charge health ministers have argued that they were charting the level of local opposition and activity.
The message from this is clear: campaigning can work - and making a big fight is the Defend the driven not by any evidence that their policies are effective or efficient (indeed all the evidence suggests that every aspect of Labour's marketising reforms in the NHS serves to drive up costs, reduce efficiency and undermine local access to patient care): they are driven by pure, undiluted ideology regardless of Common scuse.
recent much-touted report by the Blairite "think tank" IPPR for example proposed the closure of 58 A&E departments purely on the basis of a number-crunching exercise. They appeared oblivious to the fact that their proposals would mean axeing nine A&E units in London (including 1n NW London) and NINE in the north west - or the political
But while ministers follow a clear and dogmatic line of policy, the union response is uncertain and weak. The call for the November 1 lobby for example offers no firm policies, but says limply that:
"The NHS has been getting better. Yet progress is under threat:
sudden budget threaten patients and jobs
• rapid, top-down change has hit morale
• NHS values are threatened by the dash to the privale SeCLOr.
"NHS staff want to see a better NHS - partners in change for the better."
UNISON, too, has toned down some of its excellent early campaigning against privatisation, PFI and cuts in services, to produce the con fusing "Say YES to 5" campaign - which for many might be seen as a campaign to eat more Iresn vegeladies.
The website says lamely:
"UNISON, the UK's largest union, is