Simple Simon

Ex New Labour Councillor (1998 - 2002, Brixton) Simon Stevens is the recently appointed Chief Executive of the English NHS. Today he issued a report on the NHS over the next five years.

Simon was busy between 2004 - 2013 working in the various offshoots of an outfit called UnitedHealth. He was variously the President of the European bit, then the Chief Executive Officer and Vice President of the whole corporation. In 2013 his speakers' notes described his job as follows:-

'His responsibilities include leading UnitedHealth’s strategy for, and engagement with, national health reform, ensuring its businesses are positioned for changes in the market and regulatory environment.'

The Guardian did a profile of the NHS's new chief in October 2013. They wrote:-

'He is an advocate of local pay in the NHS. One option is that he could join forces with hospital trusts to introduce that, to try to stop staff costs consuming 70% of the NHS's £100bn budget, to free up funds for the rising demand for its services. Health unions would fight that.

He believes that competition between hospitals drives up standards. And he has suggested that the NHS could get its own equivalent of Michael Gove's free schools in the shape of independent GPs who would compete with existing surgeries for patients.'

Stephen's NHS report says that another £30 billion can be squeezed from the Health service in the next 5 years on top of the £20 billion extracted in the last 5. About £8 billion of the last squeeze came from the 15% cut in NHS workers' wages. This time NHS workers will have to do the extra work, just like before, but they will perhaps get some part of the increase in inflation year on year partly covered by small increases in their salaries. (Although local pay would undoubtedly sort all that out.)

Tory Health Secretary Andrew Lansley's £3 billion 'GP led Trusts' NHS reorganisation - that pushed the privatisation door, already opened by New Labour, even wider, - are still busy 'buying' NHS services. So far 10% of total NHS spending has gone private. (Not including the £63 billion outstanding PFI costs inherited from Labour.) Simon is sanguine. He says:-

'I think that the vast majority of care that’s provided for NHS patients will continue to be provided by NHS providers, but ultimately it’s patients that should make that choice, not someone sitting in an NHS office.'

Privatisation continues to be the main worry in all opinion polls taken on the future of the NHS. Even with Labour Simon in charge.

Fair warning

Robert Chote had a cheery chat with Evan Davis on the new look Newsnight (October 21.) Chote is the chair of the Office for Budget Responsibility that was set up to make sure that only one approach to the financial crisis, reducing government expenditure, is acceptable. These two young lions of current British economics were mulling over the curious fact that this financial year's budget deficit is likely to be the same or larger than last year's.

Employment is up. Economic growth is up. Perhaps its the fact that wages are low and therefore less income tax is being paid. Possibly that plays a role, our scions agreed. (50% of British workers now earn less than £10 000 per year.)

Then they considered the thrilling idea that the damage to the British economy caused by the 2008 crisis meant that what we were seeing was a long view of the future economic life of the country. Robert Chote laid it out;

'Wage growth is weak  ... due to low productivity growth.' And increasing wages without productivity going up just causes inflation. So no dice there then. (But no matter how hard you sweep, or clean or care, productivity barely moves. New machinery and technology spur growth. There is a massive capital investment strike in Britain. Companies, many of whom pay little Corporation tax, are holding vast sums of money estimated at nearly £1 Trillion.) Chote and Evans therefore went on to consider what had to happen if our current difficulties turned out to be 'structural' (permanent.)

Chote helpfully agreed that the OBR had done some calculations in light of this possibility and in light of all of the main Westminster parties' commitments to reduce the deficit to nil.

'Look over the next 5 years .. the economy rebuilding will not do much for you ... (it is) the day to day expenditure on public services that will have to reduce the deficit ... public services share of national income would be at their lowest level since the 1930s.'
'Fascinating' murmured Davis.

Public services are 45% of national income today (5% lower than Germany.) In the 1930s they were 25% - 30% of national income. This course of action will take British public expenditure to a lower proportion of national income than that of the USA (currently 37%.)

Fascinating.

Turning hope into practice

The Greek Solidarity Campaign organised another one of their delegations to Athens. The group met and spoke with politicians and cleaners, doctors and farmers who are building a peoples' movement against austerity while working out the route to a new society.

What they saw and what they heard opened their hearts and their minds.

This is what the delegates saw and heard.

Alexis Tsipras, the leader of Syriza said
'Syriza will probably the next government.' And 'our prediction is it will be be the next government after February. (2015)'
He said that Syriza's principle was that not one cent would go to the payment of interest on the loans until the needs of the Greek people had been met.

He said that pensions would be restored to pre 2008 levels as would the minimum wage. (They have been cut by a third - more if inflation is taken into account.) He said anti-labour laws would be repealed. He said banks would be socialised and forced to create loans for new business and employment.

'It is necessary to find the money to meet the needs of the Greek people.'

Sorting out the 60% youth unemployment would be front and centre. He said a health service would be rebuilt. He said taxation would be reversed from its current position where 70% of income tax is paid by workers, the unemployed, pensioners and 30% by business and the wealthy. And where 60% of the tax burden is carried by indirect taxation. These and other priorities would be enacted
'Directly. Without delay.'

The OECD says that in Greece, today, 17%, 1.7 million Greek people, do not have enough to eat. The delegation saw and heard that this figure is a serious underestimate. The reality is much worse - in every direction. For example 33% do not have health insurance which costs 400 Euros a month. (Pensions are now 500 Euros.) Primary care has gone. Childrens' vaccines cost 70 Euros each. Support for births costs 600 Euros, 1200 if you are not Greek or there are complications. One nurse in station for 47 patients during the day, 60 at night. No insurance - you pay. You do not pay -  then your income is taxed. You can't pay the tax they take your house or your car or you go to prison. Birth without money becomes criminal.
'What do you do about this?' the delegation asked.
'We break the law' said the nurses.

But when you have 1640 patents in an A&E with 5 nurses over 16 hours, even if you ignore the law, people die. The delegation learnt that each year gets worse and they saw the mental health patients lined up on both sides of two corridors on their trolleys, all of them quiet and still and unfocused, outside the 25 bed Psychiatric unit.

'The medical crisis' said the doctor 'has become a crisis of public health.'

Last year there was a 40% increase in infant mortality. Last year there were 300,000 official abortions (at 250 Euros each) and last year was the first year since the Nazis ruled Athens that more died in Greece than were born.

The delegates saw the new solidarity clinics. They saw clinics and pharmacies and solidarity markets where farmers provide produce directly to consumers and 2% is left for free distribution in the solidarity food, education and advice centres. They are all self managing. When a young man came to a clinic with no more money in his family for his leukaemia drugs, the clinic put out an appeal across the solidarity network. Sufferers sent small quantities of their own drugs. One women in her sixties sent two weeks worth. The clinic found out her address and thanked her but said she should not sacrifice herself. She said she was old and the young man needed to have a life.

Today the mass actions in the squares and the roads have diminished. But Syriza's polls go up and 3 million have used the solidarity network - born barely a year ago.

Solidarity not charity.
Rights not gifts.

Until people win a government and a state that will defend and carry out their human rights the solidarity movement helps people to stand up, to act, to carry their hopes into practice.

A student delegate said that what he saw was the endless groups of police, hanging around the city like groups of youths in a shopping centre.  Except they were armed for a public war, with machine guns and pistols, riot shields and gas and retractable metal batons that clicked above the noise of the streets as the bored, nervous police flicked them out and in - as their eyes flick about the street. A nurse told the delegation how her leg had been smashed by a policeman's boot as he had chased her into a hospital after a march broke up. They wait for the action to come.

If there is a new anti-memorandum, anti capitalist government in Greece in 2015 a new mass movement of millions of the Greek people will be needed to defend it and to ensure its direction is true. Similarly, those who are preparing; big capital, the police, the Colonels, Golden Dawn, the EU and IMF and even NATO; to defend their money-given right to rule, will need to be challenged by a European, even world wide movement in defence of the Greeks allowing them the space to become again, the hope of the world.







 

A 21st century cockpit of horror and hope

Consider. A small middle eastern town, bordered by dusty hills and a long wire fence is now at the centre of the whole world. We are following the story of the siege of Kobane by Islamic State and its defence by Syrian Kurds. Behind the fence separating Syria from Turkey are rows of US made tanks and howitzers, dug in less than a mile from the town. They point across the fence into Syria. 

In front of the border fence, battle has been raging for two weeks, most recently on the eastern side of Kobane. The street by street fighting follows on from days and nights of bombardment by I.S. using the tanks and cannon taken by them from the Iraqi army that fled from Mosul in northern Iraq. These weapons, like those of the Turks, were also made in the US. Meanwhile regular sorties of US led 'coalitiion' jet fighter/bombers fly overhead, pounding their missiles into the hills around Kobane that have been occupied by I.S. The Kurds in the streets of Kobane are the least well armed of all. They have no US militaria. They will get none. Their main weapon is the Kalashnikov rifle and some machine guns brought in from the Kurdish enclave in northern Iraq.

The Turkish armed forces are watching their traditional enemy, the Kurds, having just broken off negotiations for measures of Kurdish autonomy in Turkey. The Turks fear that the Kurds of northern Syria, led primarily by the the Kurdistan Workers Party, the PKK, will join together in time with the Kurdish community in a disintegrated Iraq, and their Turkish based cousins, and create a new country, dividing up Turkey in the process. 

The US and now the UK's armchair general, the right honourable Philip Hammond, have already countenanced the fall of Kobane. They claim if Kobane falls it will not be significant in the big picture. They point to the disappearance of I.S.'s advances in northern Iraq demonstrating the impact of their coalition's fire power. Soon, they promise, it will be Syria's turn, where I.S. has its centre. Meanwhile the ariel defence of Kobane by the coalition's jets, let alone the idea of equipping the Kurds with weapons is an embarrassment for the US. 

Help for the Kurds offends Turkey, a key NATO link. NATO has already dubbed the PKK as a terrorist group to keep Turkey sweet and the US secretly opposes the Kurdish right to self determination across Turkey, northern Syria and northern Iraq. If I.S., defeat the Kurds in Kobane, it is therefore no bad thing, as far as the US/UK are concerned. It clears the decks and establishes who really has to be in charge. The West wants its victories on the ground firmly in the hands of its so well trained and financed Iraqi army and the ghostly shadows of the 'moderate', read pro West, Syrian opposition. And they know that will take a decade to set up that fantasy, if ever. 

Meanwhile like the Turkish leadership, Assad of Syria hopes his two enemies, I.S., and the Kurds grind each other to dust under the bombs of the third, the US. 

Of course if you live in Syria or Northern Iraq and you need to fight I.S. as they will cut your throat because you are a Shia, or a Christian, or for that matter the wrong type of Sunni, or even an atheist, everybody there knows that your best bet are the Kurds. 

Why? Because the social and political organisation of the Kurds is the most developed in terms of a model of the leadership of the whole of the Middle East. 

Kurdish history, in the Kurds' struggle for self determination, has passed through many stages. They have had to fight huge and bitter wars against many of the stooges that the West have used in the last century to prop up their interests in the Middle East. In the course of which the Kurd's minority status and constant political and military struggles have created a vision of not just national identity but a way of many different national identities and seperate cultural and religious groupings avoiding conflict and yet asserting a combined and collective right in the world. 

The Kurd's current negotiations with Turkey (if resumed) are for an autonomous and federal solution within the Turkish state. In Northern Iraq, the Kurdish enclave has established a similar entity, while committing to a federal Iraqi type solution. These are not theoretical observations by distant scholars. These ideas derive from the most 'concrete analysis of the concrete situation' and form a precious germ of the future for the whole of the Middle East. They potentially answer the failure of grotesque formulations such as those dreamed up regarding the question of Palestine, which is drowning in blood under the fantastical search for its two state solution. Yet the federal autonomy that the Kurds demand, within their wider nations and as a result of their history, includes their right, taken in practice in Iraq, to bear their own arms. These are potential models for a Jewish, indeed for any minority, seeking its assurance within a future United Arab federation of the Middle East. But the absolute precondition for such progress, and for that matter progress in Iraq and Syria, and against I.S. today, is complete and utter independence from the dinosaurs of the West - a truth that the Kurds have learned and re-learned.

Unhealthy secrets

The NHS is the biggest single market for health products in the world. There is a 360 degree attack underway against the NHS's public status - and it is ratcheting up. US firms that sell drugs and other aspects of health care like HCA International, and general companies with a medical section and an associated general investment arm like GHG, are 'front and centre' in the flock of vultures now circling the NHS - or already established within it. We know all this.

Less easy to know is who is on what side when it comes to defending the public Health Service. For instance while we know that Vince Cable is in charge of the big new plan between the EU and the US to force private competition into all state commissioning, and we also know that many Tory MPs have financial interests in the private health companies; on the other hand Andy Burnham, Labour's shadow minister for Health seems to be facing both ways. And he is not alone.

In Andy's case he told us at Labour's recent conference that Labour would
'Reinstate the NHS as our preferred provider. The public NHS; protected with Labour. Not for sale. Not now; not ever.' Andy got a cheer. He had forgotten that with health deficits all over the shop due to chronic underfunding and constant reorganisation, it is almost impossible for NHS bodies to bid for commissions. That's what happened to him in 2010 when as Health Minister he outsourced Hitchingbrooke hospital. He was quite right about the disastrous consequences though. The Care Quality Commission found a poor quality of care and Andy's junior now shadow minister, Jamie Reed, said in last week's Health Service Journal;
'This is exactly what we warned would always happen. David Cameron should learn this lesson ; privatising hospitals does not work . Patients pay the price.' (See Private Eye 1376.) Did Jamie send a memo to Andy too? Is Andy now warned?

This piece of crap would be laughable if it wasn't so depressing.

What is less laughable are the results of Gordon Brown's PFI experiments with the NHS. Labour leader Miliband announced at the conference an extra annual £2.5 billion for the NHS if Labour won the General Election. This is good as it will cover the £1.9 billion annual PFI bill for the NHS deals signed up by Labour. Labour committed the NHS to a total PFI bill of £63 billion stretching forward from April 2015.

More worrying still is the secret list. There is a quiet discussion going on in some major trade unions about the information recently uncovered by union researchers. At the moment union members in the know are being told that it cannot be used. Not only can the information not be brought into the light, it is also blunting the attack on the Tories over health. The researchers have discovered a long list of Labour MPs with connections to private health firms. This means some union leaders are shy about raising the equivalent Tory involvement. If their union research can dig up this new brand of Labour links then so can the Tory investigators. The Tories could then accuse Labour of being the same greedy unprincipled bastards as they are with an interest in a private NHS. And then where would we be?

Just as a small matter of information, Labour's list includes 'men of the people' like Blunkett and Prescott.

Can Labour really defend the NHS? What do you think?

A short essay on Parliament

We have had a referendum on Scottish independence. We are to have another, if the Tory party form any part of the government post May 2015, on membership of the EU. What do we imagine would happen if there were a referendum on austerity? Given the consensus of all the main Westminster parties, including the Labour Party, on continuing the austerity drive (and therefore the tacit agreement on the associated further redistribution of wealth and resources away from the majority to the rich) how could we even get to a referendum? When we see the immense debate about society and the future that the Scottish referendum stirred who would let that particular genii out of the bottle? You might say that the SNP's victories in Scotland forced the Scottish referendum and that UKIP forced the Tories to hold one on the EU. Do we need a new party in Britain to force the issue on austerity? Is it possible, even now, that Labour might be reformed? Or can the British Parliament be moved directly to ask the people whether to continue with austerity, given the solid unanimity of our present political leaderships? The question, how to win for the people against the establishment, including the main political groups dominating Parliament, is an old one.

There have been many arguments among socialists about Parliament down the years. For example it has long been a point of honour for genuine social democrats that western parliaments are the platform for the social and economic advance of the working class. The social democratic point of view therefore logically places their group of MPs at the very centre of their politics and sees election work as the main priority for action. 

In the late 19th and early 20th century Marx and then Lenin noted the limits of Parliamentary power within the capitalist system and therefore thought that Parliament, even with universal suffrage, could not generally act as the political agency for the transition to socialism. (To be strictly accurate, Marx's writing was ambiguous on this question in the case of Britain and the USA.)

In Lenin's writing his consideration of Parliament and the possibilities flowing from universal suffrage were a subordinate part of his theory of the state, and of the capitalist state in particular, based on Marx's writings about the Paris Commune. He argued that the democracy of parliamentary systems were crimped by the inability of Parliament to genuinely represent the whole of the working people, by its limited role in dealing with fundamental issues of society which were decided elsewhere and by the fact that its decisions were not carried through by the deciders but by inaccessible organisations and agencies that were part of the state and commanded by the ruling class and that therefore Parliament was unable to either to lead or to learn. It could not be either responsible or accountable. 

There are nevertheless continuing arguments among socialists who reject the social democratic philosophy and claim to be revolutionists, about the role of Parliament. For example, as recently as the early part of this century a group that emerged from the old 'Militant' / RSL (Revolutionary Socialist League) were still arguing that in Britain we needed a (radically reformed) Labour Party that would win a Parliamentary majority and then pass an enabling act that would allow for the nationalisation of the top 250 monopolies. Perhaps they are still around? This group either kept secret or had not considered their policy on the capitalist state as a whole in the transition to socialism. 

More familiar will be 'The British Road to Socialism', a strategy apparently personally endorsed by Stalin at the end of WW2. This rehearsed the main line of march of the pre WW1 German Social Democrats. The SDP planned to win a majority and pass socialist policies through Parliament. The British communists were given the role of hand maidens to the Labour Party in the British version ... And communist led trade unions and mass movements would also be required to buttress the action taken by a reformed Labour Party in Parliament. This latter idea was much more radical than the views of most European social democrats by 1945 and distinguished the communists from social democracy. 

'The British Road' was based on a certain view of the Attlee regime in 1945-48 and turned on the understanding that the Labour Party could and would continue to be transformed. Several famous Labour MPs tried to follow 'the British Road'. Mass trade union actions were built against the Heath government in the 1970s for example. The Daily Worker and the Morning Star were obligatory reading among the 250,000 strong shop stewards movement. All now long gone. But some of the older CP cadre and 'fellow travellers' still salute this approach, cautioning the rest of us for our impatience and minutely studying the Labour Party for any hopeful trends. 

Again, there is little reference in the 'British Road' to the limits of Parliament, the structural role of the capitalist state and the other ruling class agencies that actually control the country, let alone to the blindingly obvious direction that the real Labour Party has taken since the defeat of Bennism in the 1970s and 80s, a direction that has all but severed ithe party's ties with its historic class base.

But the critical consideration today, here and now, is not so much the objective limits of Parliament's attenuated and marginalised powers in modern global capitalism or the degeneration of Attlee's Labour Party. It is that the mass consciousness of the working class in Britain (parallel with most of the working class in France and Italy) has reached a deep understanding that Westminster and ALL the main parties will do nothing for them and instead belong to a political class that stand for themselves.  Scotland is an example of the fact that working class people, previously entirely alienated from Britain's political system, have started to identify with new ways to deal with Westminster's failure. 

It would be crude and false to say that Parliament has lost all significance for both major classes in Britain. Certainly the working class is not represented there. (It is a matter of historical analysis now, but there are strong arguments that Labour never represented the working class as such, rather that Labour was always the political twin of the huge and powerful bureaucratic leadership organised by the Tade Union leadership over decades.)  And the ruling class has not used Parliament to run the system for years. Nevertheless Parliament has been used, indeed forced into action, at key moments of crisis. For the ruling class there are moments when popular legitimacy is claimed through Parliament, as with Blair's Iraq war, in order to carry through painful and unpopular acts. In an exceptionally bold move, comparable with any of the most damatic moments of the whole twentieth century, £3 trillion, the largest sum of capital ever mobilised at one time by BritaIn, was rubber stamped for the defence of the banks if required, with Parliament's agreement. A few weeks ago Parliament agreed to restart bombing Iraq. 

This last case provides a useful example of how Parliament is utilised by the ruling class. The pressure came from the US, from NATO, from cross Atlantic security agencies and even from global oil companies, as well as some oil producers. They needed BritaIn to increase the world wide legitimacy of renewed war. Parliament was necessary. Which brings us to the question of how the working class interest has also effected and used Parliament.

Since 1968 Parliament was forced to support Britain's lack of involvement in the Vietnam war; it was forced to revoke Heath's Industrial Relations Act; it had to introduce Abortion and family planning rights and defend them at various junctures; it was forced to recognise the Equal Pay struggle, the long war with racism and discrimination and the battle for LGBT rights; it had to drop the Poll Tax (and Margeret Thatcher); the anti Iraq war movement came very close to outright victory - certainly finishing Blair and exposing Parliament's distance from popular opinion, and most recently the anti-war movement stopped the bombing of Syria. So Parliament can be pressurised by both classes and both classes can make advances through action to force Parliament. 

None of this is meant to suggest that Parliament is some kind of neutral institution, somehow separate from the capitalist state. Our rulers have the three mainstream parties, virtually all of the media and the money as well as the influence, personal networks and patronage when they require something specific from Parliament. Consequently Parliament does their bidding in 99 cases out of a100. But Parliament can be used to try and moderate the temperature in society, to release some of the steam, and, on occasion, when it has no other choice, accept that if it does not grant reform, it may get revolution. 

Can Parliament be used to overturn and recreate our society then? Is it a central part of a strategy to win change? 

Those who saw the reform of the Labour Party and its ability to take a new radical programme like 1945 to 48 through Parliament as a winnable objective are no longer a serious current of working class opinion. The Labour Party continues to move in one direction only. Parliament and all of its main parties are seen by a large section of the working class as part of their problem and not an answer to their difficulties. Because of the direction taken by Labour working class politics is now in serious flux. UKIP is the rightwing expression of the frustration of many English working class people. However some progressive political leaders of the working class are also emerging. They are evolving out of the struggles that working class people and their allies are having against austerity and war. Here and there new leaders of real stature become noticeable in society despite the trivialisation of life and the banal 'common sense' promoted by most of the millionaire mass media. As the battle with austerity organises and concentrates (today, only the People's Assembly is carrying out that task) so a new policy and a new active and front line leadership is emerging. 

Over the next years, perhaps decades of struggle, what is absolutely certain is change. But not the sort of change that can be sucked from a magician's thumb. Larger waves of protest and mass action of the working class and its allies may come to temporarily overwhelm Parliament again, as they have in the past. A new leadership might find a way to represent that movement and win to enough elections to be able to speak nationally from Parliament for the anti-austerity movement. Some of them might even be from the Labour Party, but we can be sure it would be from a Labour Party that was crashing. What is certain is that if a new leadership of a new working class movement in action did emerge and took that route into Parliament, its first priority would be for the creation of a completely new type of Parliament, one that was immediately accountable, that was able to master politics by breaking up the old state machine and the informal but deadly power of our current rulers; as well as taking the power to reorganise the economics of a new society while sharing the living standards, experiences, the life and the income of average working class people. 

There is a deep political crisis going on in Britain. The anti-austerity left need to understand and relate to that fact and start raising the discussion about what politics, what institutions, what forms of organisation would be required to defeat austerity and secure its alternative. We could start with the call for a referendum on austerity, a political call like others (on Scotland and the EU) that has the potential to regroup politics even amongst mainstream parties and, most importantly, awaken political and social enthusiasm for real politics among the mass of the people. 

A tale of two conferences

Jim McNaughty, the BBC Radio 4 journalist, was puzzled today by the ebulliance of the Tory party conference compared with Labour's conference last week. Labour are ahead in the polls. The Tory figures continue to flatline on 35 percent. But experienced commentators believed that the Tory conference felt like the party was expecting victory while Labour's conference had been an uncertain shambles. 

Miliband's fatuous speech may have something to do with it, while at least Tories can read autocues. But that seems a bit superficial! A more likely explanation (given that the main parties show little in their central policies - we will carry through austerity - we will save the NHS - that distinguishes them) is the shadow cast by the Scottish referendum. 

Despite Labour's official position in support of no, it is estimated that nearly a million previous Labour voters in Scotland voted yes. The Labour conference felt like the left in British society had just lost a key political fight and not at all as though the right had been held at the pass. The feeling, unlike the platform and Miliban's memory, was accurate. 

The Tories on the other hand sensed that the right in Britain had scored a major, if pyrrhic, victory. And that spurred them on, despite UKIP, in the belief that they could still win.

Feelings at party conferences are not significant in the broad political picture. But a certain sort of line in the sand has just been drawn across British political life for the next period; a line that shows where the new left in society is gathering and where the right will have to continue to make a stand.