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For the first time in the Royal College of Nursing's 103-year history, nurses have voted for strike action. They have been joined by Unison, and likely, the Nipsa and Unite unions which are now balloting for strike action.
Crisis in the health service regularly graces the front pages in the North of Ireland. The region's NHS was recently described as being on the "brink of collapse" by a Westminster committee. Waiting lists are the worst in the UK, and regularly exceed five years for routine operations. Even those with suspected cancer are left to wait weeks and even months for vital diagnostics.
Paradoxically, healthcare funding was the only budget protected in real terms by the Northern Ireland executive in the decade after the economic collapse of 2008.
So, for right-wing pundits, the crisis is explained by the near three-year absence of ministers, following the executive's collapse, to 'take the hard decisions' and close hospitals as per the 'Bengoa' strategy adopted by Sinn Féin. In the absence of these 'hard choices', they claim the entire health and social care system is unsustainable.
Yet the reality is precisely the opposite. While health spending per head in Northern Ireland remains above the rest of the UK, it is inadequate to meet the high levels of post-traumatic stress, mental illness and disability here, and ring-fencing funding in real terms did not meet rapidly rising additional demand.
Key to the current crisis is the neoliberal structural changes adopted by the executive parties over the last 20 years: the internal market, scandalous private finance initiative contracts and widespread outsourcing of services to the private sector.
Most destructive, perhaps, was the failure to provide sufficient places for student nurses and doctors, and the critical decision to regionalise pay - leaving NHS workers here receiving thousands less a year than colleagues elsewhere.
Thousands of newly-qualified professionals have understandably taken job opportunities overseas, leaving a chronic staffing crisis and remaining staff massively overworked. The result has been the closure of wards, services further rationed and huge sums expended on private staff agencies - currently £640,000 a day.
The ballots for strike action were greeted with significant public support. Unison's rolling strike action commenced at Antrim hospital on 25 November with the unions identifying further strike dates in December, January and February.
Union leaderships must now propose a programme of escalating strikes to show angry members and the employer that they're serious about winning this fight. This is against a backdrop where the Labour Party has promised huge investment in the NHS and to boot out the privateers. The genie of militancy is likely to prove difficult for right-wing union bureaucrats to put back in the bottle.
Action by the four unions will be the biggest since the 2014 one-day public sector strike against the executive's austerity policies and represents another leap forward.
All workers must join in solidarity with the strikers to secure an end to private-sector waste and demand full pay equality. As Nye Bevan said, the NHS will remain for as long as there are those with the faith left to fight for it.
Public-Private Partnership (4)
Article dated 27 November 2019
The Socialist, weekly newspaper of the Socialist Party
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