NHS: options for next steps

Introduction

Following the passing of the Health and Social Care Act last month, 38 Degrees members voted overwhelmingly to carry on campaigning to protect our NHS. This post sets out some specific options for what we could do next.

The options proposed here are based on over 50,000 suggestions made by 38 Degrees members, which the office team have read through and collated. They are also informed by suggestions made by a range of experts, from health academics, to people working in the NHS, and lawyers.

It’s 38 Degrees members who will take the actions and chip in to make these options work, so it’s crucial that 38 Degrees members vote together to decide what we do. In the next week we’ll all have the chance to vote on which tactics we most want to take forward.

The purpose of this blog post is to set out a draft list of the options, before they are finalised and put to the vote – to give 38 Degrees members and experts the chance to help refine them before voting starts.

Please post your comments below this blog.

Top-level assumptions

First, here are some top-level assumptions that have been made in proposing this list of options:

– The Health and Social Care Act has set in place a framework that pushes the NHS towards fragmentation and privatisation. But with the right campaigning, we could slow the pace of these changes or even change their direction.

– Now that the Act has been passed, much of the focus will need to be local. We’ll need to focus on local decision-makers who are now tasked with implementing the new NHS structure, and use local issues to create national pressure.

– The next general election will be a major milestone. It’s too early to say what we’ll need to do then, but the commitments of candidates standing for election, and of course who wins, could have a big influence on the future of the NHS. If we can influence implementation of the changes now and keep the NHS on the agenda, we can lay the foundations for it being a big issue come election time.

– 38 Degrees can’t save the NHS on its own! We need to work alongside a whole range of other organisations working on the NHS, and we’ll rely on advice and intelligence from a range of experts. We should continue to play a role in bringing different groups together and encouraging networking, and we’ll need to explore ways in which we could help this happen more effectively – including devoting more 38 Degrees staff time to coordination and networking.

List of options

Below is the draft list of possible tactics:

Options with a local focus

1.Campaign to push local Clinical Commissioning Groups (CCGs) to adopt pro-NHS policies

CCGs are the important new bodies led by GPs who have now been given responsibility for spending huge amounts of NHS money, and will be taking important decisions about the future of our healthcare. Together we could pressure them to steer clear of privatisation and safeguard the NHS:

– Produce template policies, checked by lawyers, which could be adopted by CCGs to make NHS and not-for-profit providers their preferred options for all contracts

– Organised local campaigns to encourage CCGs to do the right thing – with leafleting, petitions, local events etc

– Provide networking and support to pro-NHS CCGs if they come under pressure from the government or private companies

2. Campaign against local market failures, cuts and privatisation caused by the Health and Social Care Act

If and when things start to go wrong in a local area, we could help sound the alarm and call for a change of approach to solve the problems. We could:

– Host and promote local petitions, demonstrations, and e-mail actions against local problems

– Provide resources and networking to local campaigners and 38 Degrees members engaged in these campaigns

– Bring local problems to national attention, and put pressure on the government to fix them

3. Develop local networks of concerned citizens who can act as a people powered NHS watchdog

By joining and working with existing local mechanisms, we can influence how healthcare is handled. Some ways would be to:

– Support 38 Degrees members to join local HealthWatch boards, local Health and Wellbeing Boards, Foundation Trust boards and GP Patient Participation Groups

– Provide training and support to members of local health groups, such as training events, monthly phone conference calls with experts, online briefings

– Offer support for people when they expose dodgy practices and whistleblow

– Look out for key moments and organise local campaigns to ensure decisions about the NHS go in the right direction, for example, decisions about whether or not to lift the limits on how much private work can be done by an NHS hospital

Options with a national focus

4. Build a national picture of market failures, cuts and privatisation

If we draw together local information, this could become a powerful national campaigning tool and keep the spotlight on the national impact of the NHS changes. Together we could:

– Organise an online database to map and aggregate problems within the NHS

– Offer a package of support to prospective whistleblowers exposing local problems

– Pay for investigators to look into Freedom of Information requests, undercover investigations and media monitoring

– Train 38 Degrees members to conduct local investigative and watchdog work and feed this back so it can be aggregated nationally

5. Act as a deterrent to private companies encroaching on the NHS

Private healthcare companies will tempted to aggressively pursue NHS contracts, e.g. by wining, dining and hosting events for CCGs or by using expensive lawyers to demand they are awarded contracts. To protect the role of our NHS, we could:

– Lift the lid on health corporation sponsorship of NHS events/conferences or public events like the London marathon

– Organise protests and stunts at shareholder events and outside offices of senior staff

– Support NHS bodies if private companies attack them e.g. by using competition law

– Use undercover investigation or Yes Men style stunts to expose dodgy dealings and conflicts of interest

6. Make the NHS an issue in elections from by-elections to city mayoral elections

Politicians need to take a stand and pledge a better future for our NHS. To make this happen, we could:

– Challenge local candidates to say what they will do to protect the NHS

– Name and shame candidates who broken election promises on healthcare

– Support pro-NHS candidates in elections

7. Support laid off NHS staff to set up alternatives to expensive management consultancies and multinational corporations

Big private companies don’t have to be the only solution as NHS services are broken up and NHS staff are laid off. We could tried to help the people being forced out of the NHS to setup alternatives to private sector involvement. To do this we could:

– Support staff being laid off to set up their own co-ops or mutual service providers as an alternative to multinationals

– Put pressure on CC keys to consider not-for-profit alternatives to management consultants and multinational corporations

Top line questions and next steps

This blog post aims to set out the list of options for comment before 38 Degrees members vote on the final list of options in a few days time. The more comments and suggestions we get at this draft stage the better – so the poll and options are as good as they can be.

Key questions:

– Are at the top level assumptions the right ones?

– Are there any options for tactics missing?

– Do the ones here look right?

– Are these options for tactics realistic?

– Are there any particular experts or organisations we should be talking to about any of these ideas

– Are there any dates, events or political developments coming up that we should be aware of?

Over the next few days the 38 Degrees office team will read the comments on this blog and continue speaking to experts who will also have key feedback and input. The voting will start as soon as this round of feedback has been incorporated.

Please post your comments below.