The question Lib Dem MPs must ask themselves

Will passing the health bill improve patient outcomes in the NHS?

There appears to be some confusion as to what the Lib Dem members were saying about The Health and Social Care Bill at Spring Conference over the weekend. Let me attempt to clarify things.

In short we are asking our MPs and Peers to decide if the cost of passing the Health and Social Care Bill is a price worth paying.

We don't like this bill. We trust our Conservative coalition partners on the NHS about as far as we can throw them. Our peers have done a tremendous job at amending the bill but it still has a very bad smell hanging around it. Even Nick made clear in his speech to conference that "this isn't a Liberal Democrat bill".

Nonetheless, there are some good things in the bill. No one pretends the NHS is perfect. Even Andy Burnham - who wrote an open letter to all Lib Dem members last week - says there is work to do to "enable the NHS to make some of the difficult service changes it needs to make to have a care model ready for the challenges of this century".

But everyone in the party does agree on one thing. Somehow - oh, how has this been allowed to happen - we have been manoeuvred into a position whereby if the bill passes, in the eyes of the electorate the responsibility for it will lie with us. And even if in the long term it turns out that supporters of the bill are right and the NHS improves through the passing of this bill, we wont get any of the credit, and we will get still get hammered by the voters for passing it. The cost of allowing this legislation comes with a heavy price tag for the Lib Dems.

So here is the question our Parliamentarians need to consider. It is perhaps a fairly obvious question - but in the midst of negotiations both around the bill and within the party, it is one that hasn't been asked enough.

Are you absolutely convinced that passing this bill will improve all patient outcomes in the NHS?

If you are - and I'm duty bound to point out this means you believe you know better than just about every professional healthcare body in the country - then you must pass this bill, no matter what the electoral cost to the party. It may mean another 80 years of electoral oblivion but if that's what you believe, you should put the NHS before the party.

But if you're not sure (and until the Risk Register is published, how can you be?), then is the cost of passing, as Nick calls it, the Conservatives' Health and Social Care Bill a price worth paying?

The members have done their bit and been clear that they don't think that it is.

But it's up to you now.

Richard Morris blogs at A View From Ham Common, which was named Best New Blog at the 2011 Lib Dem Conference.

Richard Morris blogs at A View From Ham Common, which was named Best New Blog at the 2011 Lib Dem Conference

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The Future of the Left: trade unions are more important than ever

Trade unions are under threat - and without them, the left has no future. 

Not accepting what you're given, when what you're given isn't enough, is the heart of trade unionism.

Workers having the means to change their lot - by standing together and organising is bread and butter for the labour movement - and the most important part? That 'lightbulb moment' when a group of workers realise they don't have to accept the injustice of their situation and that they have the means to change it.

That's what happened when a group of low-paid hospital workers organised a demonstration outside their hospital last week. As more of their colleagues clocked out and joined them on their picket, thart lightbulb went on.

When they stood together, proudly waving their union flags, singing a rhythmic chant and raising their homemade placards demanding a living wage they knew they had organised the collective strength needed to win.

The GMB union members, predominantly BAME women, work for Aramark, an American multinational outsourcing provider. They are hostesses and domestics in the South London and Maudsley NHS Trust, a mental health trust with sites across south London.

Like the nurses and doctors, they work around vulnerable patients and are subject to verbal and in some cases physical abuse. Unlike the nurses and doctors their pay is determined by the private contractor that employs them - for many of these staff that means statutory sick pay, statutory annual leave entitlement and as little as £7.38 per hour.

This is little more than George Osborne's new 'Living Wage' of £7.20 per hour as of April.

But these workers aren't fighting for a living wage set by government or even the Living Wage Foundation - they are fighting for a genuine living wage. The GMB union and Class think tank have calculated that a genuine living wage of £10ph an hour as part of a full time contract removes the need for in work benefits.

As the TUC launches its 'Heart Unions' week of action against the trade union bill today, the Aramark workers will be receiving ballot papers to vote on whether or not they want to strike to win their demands.

These workers are showing exactly why we need to 'Heart Unions' more than ever, because it is the labour movement and workers like these that need to start setting the terms of the real living wage debate. It is campaigns like this, low-paid, in some cases precariously employed and often women workers using their collective strength to make demands on their employer with a strategy for winning those demands that will begin to deliver a genuine living wage.

It is also workers like these that the Trade Union Bill seeks to silence. In many ways it may succeed, but in many other ways workers can still win.

Osborne wants workers to accept what they're given - a living wage on his terms. He wants to stop the women working for Aramark from setting an example to other workers about what can be achieved.

There is no doubting that achieving higher ballot turn outs, restrictions on picket lines and most worryingly the use of agency workers to cover strikers work will make campaigns like these harder. But I refuse to accept they are insurmountable, or that good, solid organisation of working people doesn't have the ability to prevail over even the most authoritarian of legislation.

As the TUC launch their Heart Unions week of action against the bill these women are showing us how the labour movement can reclaim the demands for a genuine living wage. They also send a message to all working people, the message that the Tories fear the most, that collective action can still win and that attempts to silence workers can still be defeated.