COHSE Conference 1989
20-23 June 1989 Royal Hall, The Spa, Bridlington
26th Delegate conference
Colin Robinson President
DELEGATES AND FRIENDS,
It is my pleasure to welcome you to Bridlington, to our 26th Annual Delegate Conference. Colleagues, in many respects this has been a good year for COHSE. We have had 18 months now of solid campaigning for what we believe in, defending the NHS and fighting for improved pay and conditions for our members.
We have seen a successful start to direct mailing, as Conference was promised last year. And, perhaps most importantly of all, we have seen our membership rise by more than 10,000.
But colleagues, in a number of other ways the pressures upon us have intensified. We have the rampant Right-wing bullying approach of the Government, intent on privatising the service as its ultimate end. And we have to be aware that the shape of trade unionism is changing.
Mergers and amalgamations will mean that a few big unions will dominate the scene within a few years and we must consider our response to that. We must ensure that no matter what happens the interests of working people are protected.
Since we met last year in Blackpool we have been involved in an epic struggle with the Government on behalf of our members facing the biggest shake up in nurse grading since the start of the National Health Service.
By cash limiting the clinical grading exercise the Secretary of State for Health has sold thousands of nurses short, depriving them of their appropriate grades and recognition of their professional experience and expertise.
By adopting a strategy of working to grade, COHSE nurses demonstrated conclusively to colleagues and managers that their case was just. But the unilateral directives from the Department of Health have left many nurses high and dry with no chance of winning higher grades through the appeals system.
Ministers promised to fund the grading review in full. They broke this pledge and transformed it into a cost cutting regrading exercise. So, rather than create a proper career structure for nurses at the bedside, the Government has insulted them.
The magnificent fight put up by nurses meant we won the media battle hands down. The arrogance of health secretary, Kenneth Clarke, demonstrated by his refusal to meet the committee elected to represent the profession and his refusal to put the grading dispute to independent arbitration, has alienated all who care about the future of the health service. In much the same way as he has slandered doctors, Mr Clarke set about attacking COHSE and NUPE, trying in vain to label us as mindless militants rather than dedicated health care staff.
The boost COHSE received in nurse membership clearly indicates who nurses believed. Our nurse members turned to us in their thousands for help, advice and support. Our stewards, branch secretaries, regional and national officials rose admirably to the task. They gave them that support and continue to do so under very difficult circumstances. And as a result, thousands more nurses have joined us, impressed by what COHSE can offer.
Colleagues, we have placed our trust in the independence of the Pay Review Body. But in future the Pay Review Body will have to be wary of the trickery, treachery and deceit of the Government, which would like nothing more than to undermine it and get rid of it all together.
Our rise in membership and our moves towards reorganisation and direct mailing have left COHSE in good shape to face the 1990s. But we have to recognise thatthe world is changing about us. By the 21st century, the trade union sphere could be dominated by just six super unions. In that environment COHSE would have to look closely at all possible options for its future.
More urgently, the fundamental changes proposed for the National Health Service dictate a strong, unified response and may necessitate such close co-operation that full amalgamation might be the logical solution.
We should not set our face against such changes. But we should not also assume that amalgamation is our only way forward. We are the only union that organises exclusively across all health and social services staff. As such we have a coherence, strength and experience which no other union can match. We will not throw that away lightly. But nor will we adopt a head in the sand approach.
That is what the 'twin track' policy put forward by the NEC means. We owe it to our members and to the wider trade union movement to explore all the feasible options. It will always be the members who decide where we as an organisation are going. We must not allow that choice to
be hampered or restricted by past decisions or prejudices.
We proved over the last year that we are a campaigning union. This year, our Conference agenda rightly makes it clear that's the way we must continue. But as an organisation of 220,000 members we must concentrate resources and decide on priorities. Branch motions call on the union to organise over ten different campaigns.
We could support all of these but it would be dishonest. Our resources as a union would be spread so thinly that our campaigning activity would make no impact. To be effective any campaign must go beyond ritual condem-
nations and involve sound organisational work that will mobilise the maximum number of members.
I believe that this Government's strategy for the complete and irrevocable privatisation of the NHS is right on schedule.
It began in 1979 and, with every rise in prescription charges, it has increased in pace and ferocity. As the prospects of electoral defeat now loom large on the horizon, Thatcher's Right-wing think tanks have never worked harder to produce the elements necessary for a successful NHS sell off.
Mrs Thatcher's new model Health Service will mean propaganda, mininformation, insecurity, poverty and fear in varying degrees for the consumer. It will mean bribery, manipulation, disillusionment, harassment and eventual demoralisation for health workers.
But for the market leaders it will be profit, greed, patronage and ambition.
These are the camouflaged ingredients which I believe will form the foundations for this Government's more efficient, more caring National Health Service.
As a union that helped create the National Health Service, we can have no greater priority than the defeat of the Government' s White Paper proposals. We cannot rely on the doctors to do our work for us.
As nurses, as hospital support workers, as ambulance and community staff, we have daily contact with patients and users. We must warn them of the evils of a market health system geared more to cutting costs and standards than providing for the need of users.
If we go down the road proposed by the White Paper, we will soon end up with a nightmarish American style health care system. With private hospitals competing alongside NHS and opted out hospitals for patients and with tax relief for private health insurance, private medicine will be given a new-found status.
Budget conscious GPs will be forced unceremoniously to dump their elderly and chronically sick patients to fend for themselves. Market medicine does not cater for those most in need of health care.
In the USA nearly 40 million people have to survive without health cover. In the United States private medicine has achieved a unique, unenviable double. It has created the costliest and least efficient system in the world.
Over-treatment of insured patients is rife because doctors are paid on a piece-work basis. As a result an American woman is three times more likely than a Briton to have both a hysterectomy and a baby born by Caesarian section.
While the rich suffer from treatment they don't need, the poor and the sick suffer because they can't get treated. As a result, black children die in the shadow of enormous state of the art hospitals.
Our role in defeating the White Paper must be to challenge Government propaganda and to work hand in glove with consumer and community groups, women's organisations, trade unions and professional associations to create an impenetrable wall of opposition to the proposals.
After ten years at Downing Street, Mrs Thatcher believes herself capable of overwhelming all opposition and setting a new agenda for the nation.
Traditionally the Tories have attacked the NHS by starving it of resources and paying staff poverty wages. They have avoided a full assault on the NHS as a national institution. It is a measure of Mrs Thatcher's belief in her own indestructibility that she is now willing to make that assault.
But I believe that Mrs Thatcher has seriously miscalculated. Despite its problems, the National Health Service remains both an island of equality in a sea of inequality and universally popular. The NHS has always figured near the top in opinion polls among issues of importance in the electorate. The Vale of Glamorgan by-election indicated how fragile Tory dominance at elections can be. Our role as the major health union must be to transform that fragility into a slide that will sweep the Tories from power at the next election.
Colin Robinson
COHSE President
(Maidstone)
COHSE President Conference Address 1991
June 11- June 14th 1991
Empress Ballroom, Blackpool
President Colin Robinson
Conference, I am pleased to welcome you all to Blackpool at a time when the health service has once again hit the top of the political agenda.
The "softly, softly' approach to the Government's health reforms heralded in by William Waldegrave's succession to Kenneth Clarke as Health Secretary lasted just 25 days. That is how long it took the Government's flagship trust hospital. Guys, to shatter the carefully created illusion of a reformed health service delivering choice, quality care and efficiency to NHS patients.
Then we saw Health Secretary, William Waldegrave wash his hands of the trust cuts.
But the people ofMonmouth did not allow him to get away with it. They passed a damning verdict on the Government's attempt to create a two tier service.
Nearly 9,000 beds were closed, temporarily or permanently, last winter to wipe away old debts. Yet within days of the new market health system, further cuts were being made. The Government claims that these problems have arisen because of poor management and overstaffing. But the real reason is the persistent underfunding of the NHS.
Just a few months ago, the Government was willing to give hospitals a blank cheque to treat Gulf war casualties. It is not the resources but the political will, the commitment to public services, which this Government lacks.
Thankfully, our hospitals were not inudated with the sick and injured from the Gulf. So why is the moneyavailable during that crisis not being used to rescue hospitals from their present funding crisis?
Nearly one million people are waiting for operations, many for over a year. Mounting aiting lists have been met not by urgently needed new cash but by cosmetic attempts to manipulate the figures.
Now it has introduced a health service where the market rules. One which is untried anduntested — a leap in the dark. The Government promised greater choice for patients, greater value for money and a list of essential 'core services' which the trusts would have to provide. The reality is quite different.
Patients and non budget holding GPs have to use the hospitals where their health authority have signed contracts. Money or the referral of patients outside these contracts is extremely limited. Even for budget holding GPs, choice of hospital is illusory. The price of care and not the principle of care is clearly the overriding policy of this Government however they attempt to dress it up.
The Health Secretary has claimed that his new system would provide better protection to Cinderella services. But the Guy's experience refutes this. Trusts battling it out for survival will opt for the fashionable hi-tech specialties and ignore the less glamorous services so vital for the local communities they serve. This has been aided and abetted by the Government which
far from protecting 'core services' has allowed them to be diluted into designated services on which business led health authorities can decide
Another symptom of the crisis in the NHS is the widening health gap between people in different social classes. The biggest threat to health in the UK is poverty. Since the Black Committee set out its damning statistics ten years ago, no decade century has seen such a widening of
inequalities. Yet this issue is of such vital concern to the Government that they are still shuffling about with a green paper when the World Health Organisation's charter "Health for All" required them to have drawn up a comprehensive strategy by last year.
The green paper sets out several targets for health managers to aim at: reductions in deaths from strokes, cancers and coronary heart disease, increases in immunisation and breast feeding. But how this is to be achieved and what ministers will do is leftunsaid. Worse still, poverty, homelessness and cuts to the social security programmes are not even discussed. So much for the Prime Minister's commitment to a classless, open society with opportunity for all.
We live in an increasingly divided nation. We live too in an increasingly divided world. It is scandalous that we lavish millions on weapons of destruction and pride ourselves on unleashing a precision military machine against Iraq. Yet we cannot effectively organise emergency aid
to Bangladesh cyclone victims or to the millions starving in Africa. Why is it that the Kurds have to rely on fund-raising concerts for aid while the military Just turns to the exchequer? The end of the Cold War is making the peace dividend a reality.
But can we trust this Government to invest that windfall in overseas aid and in public services rather than fritter it away in tax cuts which benefit only the rich.
For over a decade the whole public sector has been under attack. Local authority services, schools and transport are all threatened by the dogmatic Tory onslaught. It is this political assault which the New Union ofCOHSE, NALGO and NUPE will be well placed to repel. As a union of 1.5 million strong, a union of providers and consumers of public services, we will dominate the public sector and be too large to ignore. I would like to thank those re-
sponsible for all the hard work that has gone into the months of talks.
The health group will be a crucial part of the New Union. It will be nearly half a million strong and one in six of the New Union's members will be a nurse. And they will have the backing of a powerful, democratic union run by and for the members united in their support for good, efficient and caring public services. At this Conference, we have the chance to help make this
vision a reality.
Over the last two years, many of us havebeen bogged down in clinical grading. The burden of appeal after appeal has taken its toll on our branch secretaries and on our activists. Our membership is declining We now need to reorientate ourselves and to concentrate on maintaining and building on our membership base. New Union or not, we have no future if we fail to recruit and make our presence felt at the workplace.
The Prime Minister has said that staff morale in the NHS has suffered because of Labour lies at Monmouth. But we are not managers and administrators intimidated by short term contracts and performance related pay into political submission. For us Monmouth demonstrated that we have the people solidly behind us in our fight to defend the National Health Service and the
result was the best possible boost to the morale of health service staff for many years,
As a public sector union with a long tradition of affiliation to the Labour Party there can be no greater challenge than the next General Election whenever it comes. Then we have the chance to rid ourselves of a Government hostile to the ethos of public service and the welfare state, hostile to the principles of trade unionism and hostile to air rewards to working people.
At the Election, there will be a simple choice: between a party committed to investment in public services and the creation of a democratically run National Health Service devoid of market principles and a rty committed only to dismantling the public sector and denying its staff a living
wage.
We in COHSE must not just make that choice ourselves, we must work relentlessly to ensure that our members, our families, our friends all fully understand the persistently gradual and devious threat to a freely available NHS. We must deliver an historic victory for Labour — not just in the North and Scotland but country wide. We owe it not only to ourselves but to the health service which our union helped create.
Colin Robinson
COHSE President 1991
