There follow the minutes of our April meeting, including a short discussion on the People's Assembly and Brexit, and with a report on the Our NHS demonstration on 4 March and the text of our secretary's speech on the coach attached. Our next monthly meeting will be held on Wednesday 3 May at 7.30 p.m., at the wheelchair-accessible River Lane Centre, River Lane, Cambridge CB5 8HP.
Cambridge People's Assembly, 5 April 2017
- Agreement of the agenda
- Apologies for absence
- Approval of the minutes and matters arising
- Secretary's report
- Treasurer's report
- Report on the Our NHS demonstration, 4 March
- CPA campaign against the library reservation charge
- CPA meeting on the local NHS Sustainability and Transformation Plan
- Camboaters/National Bargee Travellers' Association campaign
- Invitations to co-organize events
- People's Assembly Conference 2017, 13 May
- Pharmacy cuts
- Cambridge Stand Up to Racism vigil after the Westminster attack
- Other business
- Next meeting
The venue was the River Lane Centre, at 7.30 p.m. Present were Dan, Faraz, Hilary (meeting chair), Jenny, Martin, Neil (secretary), Nicki (treasurer), and Richard M. (campaign chair). Names may have been changed.
Nicki shared cakes she had brought to cheer up those downcast by the Conservative prime minister Theresa May's letter of 29 March, which had formally begun the process of Britain leaving the European Union under Article 50 of the Lisbon Treaty.
Dan suggested reviewing the position of the national People's Assembly (PA). Neil recalled that the PA had not taken any position on the referendum vote on European Union membership, before anything else because its national supporters disagreed on the question. In the new year it had organized a discussion under the People's Question Time label, 'Brexit: What Are Our Demands?', but Neil had not seen a report. (Note: the PA did publish an outline of its demands before the 19 January event, based on the concerns of those who had submitted questions.) Jenny believed the PA's object now was to defend against any consequent intensification of austerity.
Richard noted that at Stand Up to Racism's national demonstration on 18 March, one evident priority had been to protect the rights of EU citizens: they had to be able to stay. Theresa May seemed to have accepted as much earlier the same day, when she said there would have to be 'a period of time' in which free movement was still allowed. Richard also noted that the Conservative Party had a slim majority in parliament, while there was a chance negotiations on future trading terms with the EU would go very badly, and that there were chances to win things there.
Hilary wanted to know how. Nicki said it would depend on joining forces with everyone else.
Faraz wondered if the local effect of withdrawal from the EU could be affected by the election of a mayor for the new combined authority of Cambridgeshire and Peterborough. The discussion quickly turned to that subject in its own right, and is presented under item 10 below.
Martin suggested that Faraz might be able to introduce the pharmacy cuts to be imposed by the government as an austerity measure, which was added as a new item 12. Richard wished to speak about the vigil held by Cambridge Stand Up to Racism after the attack on Westminster of 22 March, which was added as a new item 13. Other business was renumbered as item 14.
Herminio had sent his apologies.
The meeting approved the minutes and there were no matters arising.
Neil reported 245 subscribers to the Cambridge People's Assembly's (CPA's) mailing list (no change from last month), while 953 Twitter users followed it (last month 948) and 604 Facebook users liked it (601).
Richard asked if the CPA could provide a report on its recent activities for the next meeting of the affiliated Cambridge and District Trades Council. Neil promised to do so.
Nicki reported overall funds of £362. Income last month was a collection of £16, £14.26 coach ticket revenue, and a £5 donation. Expenditure was £22.50 on venue hire (for October, November, and December 2016), £14.49 on coach ticket refunds, and £5 on the group's regular donation to the national office.
Nicki advised the meeting that she had received but not yet paid in a cheque representing the assets of the former electoral platform Cambridge Socialists, kindly bequeathed to the CPA. The meeting expressed its warm gratitude. Nicki would write to the Cambridge Socialists' administrator to thank him.
Nicki advised the meeting that the building society with which the CPA banked was closing its current account business. The meeting discussed two alternative banks, but agreed that the final choice should lie with Nicki as treasurer.
Neil as the coach organizer gave a report on the Our NHS national demonstration in London, called by Health Campaigns Together and the PA (attached below). The CPA had transported 42 people to a large demonstration for a fully funded, publicly-owned NHS and social care service; no cuts, no closures, no privatization; and an end to pay restraint for NHS staff. The demonstration drew public attention back to the NHS ahead of the chancellor Philip Hammond's budget, which in the event did not so much as mention the NHS. The demonstration sharpened the dividing line between a Conservative government determined to curb the NHS's needs and a people that relied on it, and put the PA and its allies in a good position from which to continue the fight for an NHS for everyone.
Hilary noted that the demo had been cited in a good newspaper article by Paul Mason, 'Demonstrations Matter' (Guardian, 27 March).
Neil reviewed the campaign against the library charge introduced in June 2016 by Cambridgeshire County Council.
He had been unable to organize the direct action approved earlier in the year by the CPA (see item 9 in the minutes for January): too few activists had volunteered at first, and in February he had had to turn his attention to preparations for the 4 March demonstration. Then in the last week the national PA office had deleted without warning the Act Now section of its website, where the CPA's petition (intended as an organizing tool) was posted. These were two setbacks.
But Neil was also concerned that the CPA had lost its grasp of the path of the county council's austerity cuts, which at first had given the campaign its strategic sense. The CPA had effectively publicized and protested the £48m cuts made in the council's 2016 budget, then seized on the reservation charge – by no means the worst measure – as an issue where the council was vulnerable for several reasons (see the CPA article 'No Light on the Library Reservation Fee', 25 October). The CPA had not found the resources to take on the council's 2017 budget.
Neil therefore proposed that the CPA should suspend its campaign. Dan argued that the group should continue to campaign in defence of library services, but change its emphasis: it could divert its efforts to the current campaign to save Milton Road Library. Momentum gained there could even help revive the campaign against the library charge.
Neil said he would support this. The meeting seemed to agree that the CPA should make contact with the Milton Road Library campaign.
In March the CPA had published a detailed article against the Cambridgeshire and Peterborough Sustainability and Transformation Plan (STP), 'Fit for the Few'. The group had previously discussed organizing a meeting on the STP, or perhaps the NHS in general (see item 7 in the minutes for March).
Nicki suggested inviting a well-known campaigner as a speaker. Hilary thought the CPA would have to make it worth his while, with a big audience; Dan agreed that the group would have to make the meeting its main focus. Hilary did not want to see only the familiar Cambridge activists in the audience.
Neil thought there would be value in an activists' meeting, without a guest speaker. It would be a chance for them to get their heads around the lengthy and complex STP.
Dan suggested the meeting could be a first step in building local support for the NHS Reinstatement Bill.
Returning to Nicki's suggestion, Richard advised that a well-known health writer and broadcaster had a comedy set on the NHS, and that he was seeking a venue in Cambridge. Could the CPA help with this? Dan suggested the Junction as a possible venue. He would look into the hire price.
Dan reported that there had been a good meeting of the National Bargee Travellers' Association the previous week: he, Martin, and Neil had attended. The meeting had watched a film on the St Pancras rent strike of 1959–60, and talked about how to move forward with the local campaign, ahead of a national demonstration on 8 April on the Embankment in London. Dan believed Cambridge City Council had managed to break the former solidarity of the Riverside boaters, threatened with rent rises and evictions, but the meeting had worked on a plan to resist the evictions.
The Cambridge Commons (TCC) had invited the CPA to co-organize a hustings on 25 April with the candidates for mayor of the new Cambridgeshire and Peterborough combined authority, on the issue of inequality.
Richard thought the group should accept the invitation, and invite TCC to its meetings. Neil thought it should decline: he argued that the CPA should not involve itself with the politics of office, but should focus on popular mobilization.
Dan protested that there was no conflict with the group's objectives. Richard observed that the CPA could bring up the issue of austerity, and ask how the candidates were going to reverse the cuts. Jenny noted that the hustings was about inequality: it was not just a platform for the candidates to talk about whatever they wanted. The meeting agreed that the CPA would accept the invitation. (Note: Neil as secretary wrote to TCC the following day, but the group's plans had developed and there was no longer an opportunity for collaboration.)
Global Justice Cambridge had invited the CPA to co-organize a speaker event in opposition to the state visit of the US president Donald Trump, under the name of the Stop Trump Coalition. Neil noted the difficulty that the PA nationally was linked to a separate campaign, Stand Up to Trump. Stop Trump's national position was to refuse the participation of Stand Up to Racism, whose Cambridge demonstrations against Trump the CPA had earlier supported. The meeting agreed with regret that unless Global Justice Cambridge had also invited Cambridge Stand Up to Racism, the CPA would have to decline its invitation.
Dan, Faraz, Martin, Neil, and Richard volunteered to attend. The group was able to send six delegates (so that one place was left) and a motion: school funding and the NHS were raised as possible subjects. Nicki suggested that ideas could be invited and texts developed on the group's discussion list.
Faraz explained that pharmacists would have to take a 15 per cent cut in their remuneration while providing the same service to the NHS. Large corporations would be able to absorb this because of their integration with suppliers, but smaller businesses would suffer. Those pharmacists could be forced to cut corners, if not to close. Dan suggested pharmacy cuts might be another possible subject for a motion to the PA conference.
Richard noted that Cambridge Stand Up to Racism had held a vigil on Saturday 25 March for unity after the murderous attack on Westminster by Khalid Masood on 22 March, against its anticipated exploitation by racists. (Neil had been invited to speak for the CPA, but was ill that day; the group had later published on its blog the notes he meant to read.) The Cambridge MP Daniel Zeichner and the East of England MEP Alex Mayer had attended, and Richard thought it was good that politicians had been willing to come out. He thought the effect of events like the Cambridge vigil had been seen when a later demonstration in Westminster by the racist English Defence League only drew 200 people.
After the last meeting's discussion of austerity and homelessness (see item 8 in the minutes for March) Dan mentioned that he had been impressed to meet two women from Ely who for two months had been travelling to Cambridge on the train to feed homeless people in the city.
The next meeting would be held at 7.30 p.m. on Wednesday 3 May, at the same venue of the River Lane Centre.
For a meeting of the Cambridge People's Assembly on 5 April 2017.
Each winter under austerity tells the damage done by the government to the NHS in the previous year. At the beginning of the seventh, in December 2016, Health Campaigns Together and the People's Assembly Against Austerity called a demonstration for 4 March with three demands: a fully funded, publicly-owned NHS and social care system; no cuts, no closures, no privatizations; and an end to pay restraint for NHS staff.
The cumulative damage that came to light that winter was shocking. On 7 January 2017, the British Red Cross announced that it had been enlisted to respond to what it called a 'humanitarian crisis' in the NHS, providing basic care that the service could no longer manage. Days later on 10 January, leaked documents showed record numbers of accident and emergency patients waiting longer than the four-hour target in the previous week, including 18,000 on trolleys and in corridors. The Royal College of Nursing and the Royal College of Physicians separately announced on 11 January that conditions in the NHS were the worst their members had ever experienced.
This damage was done by the continuing underfunding of the NHS. A letter sent to the prime minister Theresa May on 8 February, signed by two thousand senior hospital doctors, observed rightly that:
It is impossible to provide effective, efficient, patient-led innovative healthcare which is free at the point of contact when we spend less on healthcare than other comparable [Organization for Economic Co-operation and Development] countries.
But the politics of NHS finances don't explain themselves, and this extract maybe points to the risks of attempted neutrality. Elsewhere in the letter the signatories made clear that they didn't mean to offer for sacrifice the free NHS, but others (outside the government for now) were keen to get this on the table: the oncologist and private healthcare businessman Karol Sikora described the health service as 'the last bastion of communism' in an interview with the BBC's Newsnight. (This was meant as an insult.) The government for its part tried to push back at around the same time with a line that played to xenophobia and racism, reviving tabloid fantasies about runaway 'health tourism' when it announced a legal duty on hospital trusts to charge foreign patients for their treatment. Our demonstration set itself against all marketization and xenophobic scapegoating, defending an NHS designed for everyone.
The Cambridge People's Assembly (CPA) had agreed in January to organize an accessible coach to the demonstration. Early offers of funding from regional trade union associations led us to drop the ticket prices we'd originally agreed, so that seats were free for unwaged passengers, and cost others £5 only. The coach was eventually supported by Cambridgeshire NUT, UNISON Cambridge Acute Hospitals, and Unite London and Eastern. We publicized the coach on our mailing list, on the lists of friendly organizations, and on the web; we distributed leaflets at the community film screening of I, Daniel Blake that we co-sponsored in February, on Fitzroy Street, and outside and inside Addenbrooke's Hospital. Eight supporters and friends in all helped with publicity in person, and more online. This should be seen as the CPA working at its full present strength. Booking was never fast but it was steady, and for most of the last week the coach was full, with 47 seats booked. After cancellations we finally had 44 seats booked (17 of them free seats).
Action and reflection
On the day we transported 42 people to join what felt like a big demonstration. It was said from the stage at the closing rally that 250,000 had attended; this must be too high. But to speak only of Cambridge, the students' union at Anglia Ruskin University sent its own coach (sadly there wasn't time to co-ordinate our movements) and another dozen or so activists from Cambridge Keep Our NHS Public travelled by train. On the CPA coach I have to thank Dan and Ozzy, who joined me as stewards, for their help and initiative throughout the day. On the streets Richard and I carried the CPA banner, and had to move fast near the end of the route in order to reach Parliament Square in time to hear the main speeches at the rally, including those by Len McLuskey (general secretary of Unite the Union) and Jeremy Corbyn (leader of the Labour Party). After Corbyn's recent silence on immigration, followed by an unhappy new formula on European Union migration, I was pleased to hear him speak without reservations in defence of the immigrants who sustain the NHS.
The demonstration was reported widely (there was a good report by Rebecca Barry on ITV News that evening) and drew public attention back to the NHS ahead of the chancellor Philip Hammond's budget a few days later. In the event that budget did not so much as mention the NHS. The demonstration sharpened the dividing line between a Conservative government determined to bring the NHS to capital's heel, and a people that relies on it. It gave individual people another chance to choose their side. And in its satisfying strength, it put us in a good position from which to continue the fight for our NHS.
Of all the pillars of the postwar welfare state, the NHS must have the widest support.* So many people in this country have turned to it in need, have relied on it; so many have been subject to its care. Its role in the opening ceremony for the London Olympics in 2012 now seems only to have confirmed its status as a national treasure, beyond politics. And that, I think, puts it in serious danger.
For the state to tax personal wealth and corporate profits in order to fund free, universal healthcare is inherently, permanently political: a matter of who's able to do what to whom, as Lenin didn't quite say. And it's not only this redistribution from richer to poorer that the narrow class which holds most property resents (they're used to it the other way round). The NHS also closes off large opportunities to make further profits from sick people.
When the neoliberal New Right first came to power in Britain with Margaret Thatcher's Conservative government in 1979, the NHS soon became a target for privatization and marketization, with non-clinical hospital work outsourced, executive management introduced after a report by a supermarket director, and a few whole areas of care (including long-term inpatient care) abandoned to the private sector in the 1980s. The introduction in 1991 of the internal market fragmented the hospital service 'into hundreds of separate trusts with purely financial obligations' (I'm quoting from my main source, Allyson Pollock's book NHS plc) and 'began the destruction of the NHS's ability to plan and distribute resources on the basis of the health needs of the population'.
Neoliberal ends and means became common sense: the next major wave of privatization was the work of the Labour government elected in 1997. Its private finance initiative or PFI encouraged groups of private companies and banks to 'build, own, and operate' hospitals which NHS trusts would lease together with maintenance and support staff. These crucial years of neoliberal reorganization under Labour are the main focus of NHS plc, published in 2004, but I want to move on to the austerity period which provoked our campaign, the People's Assembly.
The 2010 general election produced a Conservative-led coalition government. The budget deficit following the crash of the neoliberal world economy in 2008 gave the party the occasion, as its seeming inability (later belied) to win an election gave it the impetus, to wreck as much as it could in five years of what was left of the welfare state and public services. In some areas, there was no need for subtle politics: decades of vicious whinging in the rightwing press about unemployment benefits, for example, and the adoption of the same premises by the Labour governments, meant the coalition could boast about its cuts and sanctions. But one does not simply take a pickaxe to a national treasure.
The coalition government announced it would protect the NHS budget: maintain it, just, in real terms. The demography of Britain alone, which records a growing, ageing population, would have meant this spending fell behind demand. But the government's simultaneous attack on council budgets, which led to deep cuts in social care, made the situation much worse. Unmet care needs became urgent medical needs which required hospital treatment, and the lack of beds and support outside hospitals meant these patients couldn't be safely discharged.
So on the ground, maintained budgets felt a lot like cuts, even more so with the arbitrary efficiency savings imposed alongside them. The coalition also prepared the way for unprecedented privatization with the health secretary Andrew Lansley's Health and Social Care Act 2012, which removed every legal brake and finally reorganized the NHS in England as a frank market, in which corporations bid to provide services commissioned by groups of GP surgeries. Cambridgeshire was a testbed for privatization: the £800m contract for older people's services tendered in 2013/14 was the biggest then attempted. I don't want to go into the story of that contract, ending in its collapse, but it does indicate the difficulties of realizing the privatized, market structure set out for the NHS on paper.
That's why the Department of Health's focus under Lansley's successor Jeremy Hunt, into the period of sole Conservative government from 2015, has been on softening the target. The revised junior doctors' contract can be seen as part of this effort, though that battle seems lost. The one ahead of us is against the NHS Sustainability and Transformation Plans, which collectively aim to cut £22bn from the NHS budget by 2020/21. The Cambridgeshire and Peterborough plan, published in November, aims to meet a £500m deficit projected by the same year, fully half of which consists of the efficiency savings demanded for the period by Hunt's Department of Health.
We've been studying the plan in the Cambridge People's Assembly and have discovered it means increased rationing, with major efforts to keep sick people out of hospital, using referral centres among other means. It means privatization, of course: of land, but also of care, as those of us steered away from hospitals may be delivered into the hands of private-sector 'NHS partners'. And it means the continued imitation of American structures, famous for delivering poor care for patients and large profits for shareholders.
Our task is to repoliticize the NHS: to recall to our neighbours that it was something won, conceded to us, and that it's being disowned. That's why today we're marching for a set of specific demands: a fully funded, publicly-owned NHS and social care service; no cuts, no closures, no privatizations; and an end to pay restraint for staff. To win these demands would be to recover our NHS.
4 March 2017
* I didn't find much time to prepare a speech for the coach, and finished my notes at nearly the last minute, as we drove though outer London. For all their roughness, they do record (maybe too well) my understanding of the recent history of the NHS. I've borrowed in one paragraph from a draft for the article 'Fit for the Few' that was in my care.