Campaigners march for the NHS. Photo: Getty
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"NHS principles aren’t intact": how the public is trying to protect its health service

This conference season, all parties have announced new plans to save the NHS; but how do those members of the public trying to protect their health service feel?

It had been another grey morning in a long line of dismal August days, and the streets of Nottingham were still wet from the latest summer soaking.

I’ll admit, there was a part of me that feared what I might find as I headed out to meet the NHS march. I was afraid of stumbling across a sad, aged version of the legendary 1936 Jarrow Crusade it was honouring; a musty heirloom handed down through generations of waning engagement in politics and activism.

I arrived in the centre of Bulwell, on the outer reaches of the city, and joined a small crowd that had already gathered to greet the marchers. By then the dreary clouds were just loosening their grip over the Midlands sky and the sun was starting to flicker through.

***

At first it was just a pulsating dot on the horizon. But it kept on coming from around some hidden bend; a trickle, then a stream of people, heading our way.

Pretty soon our little huddle was caught up in a flash flood of bustling colour, sound and energy. Campaigners of all stripes filled the square: unions, healthcare workers, pro-NHS groups, the Labour party, the Green party, Women of the World, bearing the tribal colours of a dozen activist groups, together. My fears disintegrated with the clouds.

It was an electric moment, one that was to be repeated again and again before the march was through. The organisers, an all-women group of NHS campaigners from Darlington nicknamed the "Darlo Mums", had set off from Jarrow two weeks before, heading all the way to Trafalgar Square to spread the word around the country.

I found Rehana Azam, one of the founders of the march, and as I walked along beside her I asked what had spurred her and the others into action.  “The principles of the NHS aren’t intact,” she said. “We felt it was our civic duty to bring people’s attention to what’s happening to the NHS. The final straw for us was Clause 119 and the battle for Lewisham before that. If it can happen to one hospital then it can happen to any hospital”.

It’s just one of many vivid memories from that strange day in August. I remember the ambiguous mood; a blend of anger and hope. And the people we passed by, showing anything from bemusement to approval to expletive fury at what was unfolding before their eyes.

We had a chance encounter with a health care assistant who came out of her house just as we streamed past. Slightly baffled, she walked with us for a while. She told me about her own working conditions at a private health care company not too far away, where she works on a zero-hours contract, without holiday pay, sometimes picking up the full 40 hours per week she needs, sometimes only getting 15.

“There’s never any guarantee,” she said, before dashing off to work.

The next time I saw Azam it was in a very different scene. It was seven days later, at the finale of the march, and she was on stage in Trafalgar Square addressing a mass of supporters and onlookers. Wandering around the crowds in that altogether more tumultuous setting, there were some of the same faces I’d seen days before, but this time in among thousands more – GPs, nurses, registrars, consultants, activists, union members, academics and members of the public.

It was one last warm shiver of what I had felt back in Nottingham; the streets were filled again with the colours and sounds of a hopeful movement.

***

These are ominous times for the health service. This week, some of the UK’s most senior medical professionals warned that the NHS is at “breaking point”, morale is shattered, and the whole founding principles of the service are in peril after four years of Conservative reforms.

Yet David Cameron claimed at his party’s conference that he is the only one who can be trusted as the guardian of these principles. Very few in healthcare trust him any more.

With a total reorganisation of the system now well underway despite a solemn promise to the contrary, a tidy majority of new contracts going to private companies since the Health and Social Care Act came into effect, and the web of links between the Conservatives and the health care companies that reap these rewards emerging, the prospect of five more years of Tory rule turns those who oppose privatisation cold.

If the fears of campaigners on that march are realised, there is a very depressing future ahead. Campaigners like Dr Bob Gill, who described to me the gradual “grinding down of GPs by regulations and budgetary restrictions”, when I spoke to him that day, or Dr Lucy Reynolds who said the public “will only notice after it’s all been done and it’s too late”.

But there is hope, and the energy of the Darlo Mums marches on. A lot of the chatter in Nottingham, London and along the length of the march was about Labour MP Clive Efford’s Private Members' Bill, which would go some way to rolling back the marketisation of the past four years, and “re-establish the Secretary of State’s legal duty to provide national health services in England”. Due to be debated in the Commons on 21 November, a fervent campaign to get it adopted is under way.

Speaking to me after the Trafalgar Square rally, Efford said: “People need to wake up to what’s happening to the NHS, and that it’s under serious threat. The marchers used this bill as a rallying cry as they marched down from Jarrow; I see it as a continuation of what they started”.

And there is plenty more to be done. Just last week, the campaign to get the NHS Reinstatement Bill enacted was officially launched, and in the next fortnight a major new independent documentary, Sell Off, written and produced by campaigning filmmaker Peter Bach, will be released.

As the nights draw longer and colder, the health service will be tested, perhaps as never before. The Darlo Mums’ crusade might be over, but our NHS has never been more vulnerable, or more in need of people to keep marching for it.

Benedict Cooper is a freelance journalist who covers medical politics and the NHS. He tweets @Ben_JS_Cooper.

Photo: Getty
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The UK press’s timid reaction to Brexit is in marked contrast to the satire unleashed on Trump

For the BBC, it seems, to question leaving the EU is to be unpatriotic.

Faced with arguably their biggest political-cum-constitutional ­crisis in half a century, the press on either side of the pond has reacted very differently. Confronting a president who, unlike many predecessors, does not merely covertly dislike the press but rages against its supposed mendacity as a purveyor of “fake news”, the fourth estate in the US has had a pretty successful first 150-odd days of the Trump era. The Washington Post has recovered its Watergate mojo – the bloodhound tenacity that brought down Richard Nixon. The Post’s investigations into links between the Kremlin and Donald Trump’s associates and appointees have yielded the scalp of the former security adviser Michael Flynn and led to Attorney General Jeff Sessions recusing himself from all inquiries into Trump-Russia contacts. Few imagine the story will end there.

Meanwhile, the New York Times has cast off its image as “the grey lady” and come out in sharper colours. Commenting on the James Comey memo in an editorial, the Times raised the possibility that Trump was trying to “obstruct justice”, and called on Washington lawmakers to “uphold the constitution”. Trump’s denunciations of the Times as “failing” have acted as commercial “rocket fuel” for the paper, according to its CEO, Mark Thompson: it gained an “astonishing” 308,000 net digital news subscriptions in the first quarter of 2017.

US-based broadcast organisations such as CNN and ABC, once considered slick or bland, have reacted to Trump’s bullying in forthright style. Political satire is thriving, led by Saturday Night Live, with its devastating impersonations of the president by Alec Baldwin and of his press secretary Sean Spicer by the brilliant Melissa McCarthy.

British press reaction to Brexit – an epic constitutional, political and economic mess-up that probably includes a mind-bogglingly destructive self-ejection from a single market and customs union that took decades to construct, a move pushed through by a far-right faction of the Tory party – has been much more muted. The situation is complicated by the cheerleading for Brexit by most of the British tabloids and the Daily Telegraph. There are stirrings of resistance, but even after an election in which Theresa May spectacularly failed to secure a mandate for her hard Brexit, there is a sense, though the criticism of her has been intense, of the media pussy-footing around a government in disarray – not properly interrogating those who still seem to promise that, in relation to Europe, we can have our cake and eat it.

This is especially the case with the BBC, a state broadcaster that proudly proclaims its independence from the government of the day, protected by the famous “arm’s-length” principle. In the case of Brexit, the BBC invoked its concept of “balance” to give equal airtime and weight to Leavers and Remainers. Fair enough, you might say, but according to the economist Simon Wren-Lewis, it ignored a “near-unanimous view among economists that Brexit would hurt the UK economy in the longer term”.

A similar view of “balance” in the past led the BBC to equate views of ­non-scientific climate contrarians, often linked to the fossil-fuel lobby, with those of leading climate scientists. Many BBC Remainer insiders still feel incensed by what they regard as BBC betrayal over Brexit. Although the referendum of 23 June 2016 said nothing about leaving the single market or the customs union, the Today presenter Justin Webb, in a recent interview with Stuart Rose, put it like this: “Staying in the single market, staying in the customs union – [Leave voters would say] you might as well not be leaving. That fundamental position is a matter of democracy.” For the BBC, it seems, to question Brexit is somehow to be unpatriotic.

You might think that an independent, pro-democratic press would question the attempted use of the arcane and archaic “royal prerogative” to enable the ­bypassing of parliament when it came to triggering Article 50, signalling the UK’s departure from the EU. But when the campaigner Gina Miller’s challenge to the government was upheld by the high court, the three ruling judges were attacked on the front page of the Daily Mail as “enemies of the people”. Thomas Jefferson wrote that he would rather have “newspapers without a government” than “a government without newspapers”. It’s a fair guess he wasn’t thinking of newspapers that would brand the judiciary as “enemies of the people”.

It does seem significant that the United States has a written constitution, encapsulating the separation and balance of powers, and explicitly designed by the Founding Fathers to protect the young republic against tyranny. When James Madison drafted the First Amendment he was clear that freedom of the press should be guaranteed to a much higher degree in the republic than it had been in the colonising power, where for centuries, after all, British monarchs and prime ministers have had no qualms about censoring an unruly media.

By contrast, the United Kingdom remains a hybrid of monarchy and democracy, with no explicit protection of press freedom other than the one provided by the common law. The national impulse to bend the knee before the sovereign, to obey and not question authority, remains strangely powerful in Britain, the land of Henry VIII as well as of George Orwell. That the United Kingdom has slipped 11 places in the World Press Freedom Index in the past four years, down to 40th, has rightly occasioned outrage. Yet, even more awkwardly, the United States is three places lower still, at 43rd. Freedom of the press may not be doing quite as well as we imagine in either country.

Harry Eyres is the author of Horace and Me: Life Lessons from an Ancient Poet (2013)

This article first appeared in the 20 July 2017 issue of the New Statesman, The new world disorder