Saluting our community nurses

Unite general secretary Len McCluskey spoke at the Community Practitioners and Health Visitors Association (CPHVA) conference this morning (November 18).

In his address, he hailed members who he noted were “on the frontline of nursing care in our communities” and who are “committed to defending our National Health Service.”

“The last time I addressed this conference, the Health and Social Care Act had just become law,” he said.

“The impact has been all too real for the services you deliver; and most importantly the people and communities that rely on them.

“Since 2010, the top-down changes and re-organisations that have taken place across all of our publicly funded health services, have sought to dramatically alter the vision and the values that were the founding principles of the NHS.

Our voice, our direction

“You will have heard this 100 times; it must never be forgotten,” McCluskey added. “When Bevan said, ‘The NHS will last as long as there are folk left with the faith to fight for it’, he meant it.

“That’s why Unite is so proud to represent you and over 100,000 health professionals across our union – and you can be confident that with me as your general secretary, this union will never let up on that fight.”

He thanked the members for their work and promised that it is the members working in healthcare themselves who will determine what the union does, bound together, in defiance of the government and in defence of the services that they are “rightly so proud to deliver.”

McCluskey praised the theme of the conference — “Our Voice — Our Direction: Implementation, integration and inspiration”.

“Because,” he said, “it was the voices, the direction and the determination of a group of pioneering women 150 years ago that formed the Manchester and Salford Ladies Sanitary Reform Society.

“Their aim was to support working class women and families living in poverty, to educate and support them to ensure better standards of health, sanitation and child care. These brave, forward thinking women were the precursors to modern public health and health visiting.

“Those early health visitors and public health campaigners were amongst the first to envisage how, working collectively, they could eradicate the evils caused by poverty and deprivation.”

McCluskey noted that it would be another hundred years before the state took similar action and Beveridge would famously coin his own five “Giant Evils” in society — squalor, ignorance, want, idleness and disease.

“And therein lies the lesson for us all,” he went on to say.

“We have never, and must never, allow government to dictate the terms when it comes to public health and our National Health Service.

Radical roots

“The pioneers of the organisation you are here representing today were never meek or mild.

“They were radicals. Whether it was on health and safety at work or women’s suffrage, public health care or public housing, they saw it as their duty to speak out on behalf of the disenfranchised.”

McCluskey reminded the conference that the CPHVA’s roots go back to 1861. They were an entirely women’s union and the first health union to affiliate to the TUC.

“What a fantastic history that is,” he noted.  “To this day their legacy is the emblematic colours green, white and violet, representing their allegiance to the women’s suffrage movement – Give Women the Vote.

“And if we brought these visionary women into our working class communities today what would they see?

“Growing health and income inequality made worse by cuts to the vulnerable, the disabled and even the working poor. The fragmentation and selling off of our NHS in England. They would see their modern day Community Practitioners referring families to burgeoning food banks.

“They would see your ever growing workloads fearful that important safeguarding standards may not be met.

And going into people’s homes with you, they would see the re-emergence of diseases of the past, like rickets,” he added, “but also a disease of the present day — obesity.”

Deeds not words

McCluskey highlighted a central tenet integral to the suffrage movement — “deeds not words”.

“When women decided that if they were to be deprived of their human right to be law makers, then they would be law breakers in their quest to win the vote for women,” he said. “It was this that began their movement of civil disobedience.

“I know that you take pride in that history and that’s important when you’re facing a government that would happily return us to those Edwardian times.”

McCluskey gave the example of chancellor George Osborne’s tax credit cuts, which he called a “fiasco.”

“Even when this chancellor is sitting on a surplus (derived only from historically low interest rates) he remains committed to cuts to in-work benefits that will leave the poorest thousands of pounds worse off in each and every year,” he noted.

McCluskey called the National Health Service the “envy of the world” and lauded the “highly developed professional public health workforce which has been responsible for ensuring the wellbeing of mothers and their children for generations.”

“And it’s your professional knowledge and experience that should be driving improvements in our NHS and public health – it should never be left to the whims of ministers or the forces of the market,” he argued.

“Instead, piece by piece we are seeing our nation’s health service sold off.”

McCluskey said that in the long-term this will mean “profit taking precedence over care; fragmentation when what we need is cooperation; and, when pressure mounts: attacks on staff terms and conditions whilst profits are creamed off the top.”

Public health

The general secretary then turned to public health, which he said “should be the preventative arm of the NHS, but instead it is being farmed off to local government, cutting it loose from wider health services and taking away any political accountability.”

“In Whitehall, the secretary of state won’t take responsibility and locally councils are left to take the blame; when they themselves are left powerless in the face of swinging cuts,” he said. “What we’re left with is a postcode lottery, a lottery with few winners but all too many tragic losers.

“We know that protecting patients and protecting staff are two sides of the same coin,” he added. “If we are to invest in the next generation’s health, every child and young adult needs access to a school nurse, equipped to look after their health.

“And if we are to truly protect the public, we need high standards in statutory regulation for the likes of community nursery nurses.”

“And let me be clear about one thing,” McCluskey went on to say. “Austerity economics is a bankrupt philosophy. It is always the problem; never the solution.

“You cannot cut your way to a strong and vibrant economy. We know what we need is strategic planning, government investment and support for our key industries.

“Just like you cannot cut your way to a reliable and responsive National Health Service,” he added. “The only model that has ever worked is one that is publicly-funded and publicly-provided, with well-funded local services offering crucial support.

“So let’s be clear — only significant public investment will solve the ongoing challenges in health and social care for the future.”

Politics of hope

McCluskey went on to argue that the election of the new Labour leader Jeremy Corbyn offers hope to the NHS because of his rejection of the “politics of managerialism”.

He pointed out that it was this very same managerial approach which cased the re-organisation of the NHS and brought the private sector “into the heart of our greatest national asset”.

McCluskey closed his speech by highlighting the importance of strong trade unions, and why the trade union Bill poses such a grave threat to working people and the public services they proudly seek to protect.

“Only last year the Royal College of Midwives for the first time in their long history took strike action to get the 1 per cent pay rise recommended by the Pay Review Body,” he said. “This year the RCM joined the TUC and let me say they are really very welcome.

“The industrial action by NHS unions forced government around the table and the 1% was finally agreed. Far from perfect but government moved their position for NHS staff in England.

“But they are not done yet – Agenda for Change is under review and we all know what that means, doing more for less,” McCluskey added. On top of this is four more years of pay cuts – that is what the 1 per cent pay ‘envelope’ represents.

“Now more than ever health professionals need a trade union,” he noted. “Now more than ever health professionals need a trade union that fights for secure work, a strong voice and decent pay.

“Now more than ever we need to hold true to your roots – ‘deeds not words’ in defence of your standard of living and just as importantly in defence of our NHS.

“Have faith in your beliefs and a just society will prevail.”

Read more about the Community Practitioners and Health Visitors Association (CPHVA) here.