NHS: End of Lessons
Greetings. If you’ve read my previous post, you’d be forgiven for thinking I was advocating giving up. I’m sorry, that’s not what I was trying to get across.
We know the NHS is crumbling, and deep down, we know a “perfect” contract will never fix it. So what can one do? Its very easy to loose hope, give up and drown in the endless stream of bullshit emanating from westminister. So, I’m going to outline some politics. This should be a basis for your research, allowing you to plan effective actions, that will actually achieve something.
Step one: Know your enemy
The whole point of Hunt is to stage manage the lack of funding from the treasury. His job is to provide bread and circuses. This is to distract from the underlying problem: The Tory’s future in government is tied to giving its voters tax cuts (or the illusion thereof). If this means that non Tory voters die from services cuts, then so be it.
When they started to “balance the books” they had a choice: tax rises and cut softly, or savage cuts and tax cuts. Because pensioners vote Tory, they get an above inflation bung. If you look at who the biggest cut hurt the most, its everyone who doesn’t vote Tory. This isnt a conspiracy, its just a nasty side effect of politics.
The genius of the present government is that they’ve managed to blame the crumbling of the NHS on a mixture of immigration and the labour party. If we had a press that didn’t have a hardon for “imigrints” and “muslamic rayguns” they might question why the government is allowing underfunding to kill “our greatest generation” they saved from pension cuts. Its simple: once you fall into social care, you don’t vote, and you don’t spend money. In the eyes of professional politicians, you are dead weight.
Why does this matter?
Hunt is just a puppet. When he gets shuffled out, you might reasonably think it’s a fresh start. You’re wrong, the real cause of the NHS crisis is Osborne’s calculation. He’s betting that using NHS money to fund tax cuts will allow him to become PM.
BMA referendum referschmendum
I’ve covered this before, the contract is coming, a no vote won’t stop it, nor with J4H (not to belittle the achievement, but its just not going to stop “imposition”) It’ll just cause the BMA to churn. I suspect this is partially deliberate; after all a strong BMA is a pain in the arse.
If you really want to stop the contract, you’ll need to start planning for lots of Industrial Action. This means getting decent numbers for prolonged full walkouts. I mean, if you manage it, well done, what are you going to put in its place? I think that effort is better places else where.
This leads me neatly onto the next section:
The contract isn’t the problem, the culture is.
Do you know how my hours are decided? Here is a direct quote from my contract:
Your standard hours of work will be as stated in your offer letter. The exact timings are to be agreed with your manager. However it is expected that you will work such additional hours as the Company may direct to ensure the proper performance of your duties.
You agree to opt out of the EUWTD, yadda yadda yadda
That’s right one paragraph. Also I could be made to work all hours. I’m not and I don’t. We are trailing a ‘new’ way of working called “devops” (don’t bother googling it, unless you have the horn for spoilt twenty something proto-nerdy hipsters) which basically boils down to: You ship it, you answer the fucking bleeper at 04:00.
The Super Boss asked me if I’d like to volunteer to go on call. I asked, “how much are you going to pay me?”, they replied: “nothing”, I laughed and said no. I still have a job. They can fuck right off if they think I’m going back on call for zero cash.
If that was in the NHS, I suspect that most people would have buckled and said yes. This is my point. You cannot have a nice place to work if you are not prepared to challenge working practice.
The new contract is coming. You can wait for someone else to fix it (big fucking hint: they won’t that’s why you’re in this mess) or you can engage and make the system work for you. Changing culture is hard, but rewarding. You are making things better, for you.
Local problem: local solution.
One of the main points about the new contract is that people don’t believe that HR can cope. HR can never cope, that’s the point of them: repeatedly fuck up payroll and dream up stupid procedures that delays their inevitable replacement by charismatic excel macros. Technology solved “clocking in” 116 fucking years ago Seriously, technology is ace. HR’s utter fucking incompetence is no excuse. Get a meeting with your CEO, get one of the big three payroll companies in and demand a swipe card system. Shout and scream until it works.
Do you think I have to email my manager if I work late? Do I fuck. I update the time sheet, its payroll’s problem now. How is this possible? Because the Union strong-armed them into doing a proper job. I have to update the equivalent of patient notes for each incident that I deal with. If there is a problem, or someone questions why I made a claim, I direct them to the notes and let them figure it out.
I keep on harping on about this, use your fucking union. I don’t care which one, just fucking use them. Do you know why tube drivers have such a cushty settlement? Because they drag their unions everywhere. Boss shouting at you? Union. Driver failing two breath tests? STRIKE. Why do you allow your bosses to treat you like children? Why do you allow even the possibility of negative feedback on your ARCP form for doing your job properly? Stand up for your selves, stand up for your patients, use your union so you’re not battling alone.
People literally died for the right have a union If that union doesn’t represent you, then you should have fucking voted in the council elections. Or find another.
This leads me on to the next point:
Who’s going to negotiate next years pay increment?
What, you thought this contract was forever? My dear doctor, no! Next year, assuming the JDC chair has any genital fortitude, they’ll stroll into the DoH, say: “1% or RPI, is that it? It’d be a shame if my member had to see your insulting offer wouldn’t it sonny me lad? ” Pause for dramatic effect, tilt the water jug menacingly and say “it’d be a an unfortunate slip ” knocking over the jug “for your career, if you were the one that caused more strikes, wouldn’t it?” Pats the DoH wonk on the face “I’ll back tomorrow for your real offer”
Look at it this way: all ST3s just got a 32% fucking pay rise. You can’t get everything everytime. Next year is your chance to change something else. Like all these things, you need iterations. Just look at the EU referendum, it took at least 6 months to go full Nazi Farage worked really hard to make that look almost respectable.
You need a strong union, in January next year, you need to send your reps into the DoH with a big horse whip, and don’t let them out until they changed something pressing that you as its member want changing. Like LTFT.
Finally, who is going to fix the NHS?
There are lots of problems with the NHS. The biggest is the hilarious underfunding. Here is a quote from the man himself (yes, Bat signal….):
— Shaun Lintern (@ShaunLintern) June 17, 2016
The only way to change this is though coordinated broad-spectrum action. As a first salvo, you need to get everyone in your family (because I assume you’re all well brought up middle class people) to write into their local MP detailing their disappointment with the service they’ve had, and why they think deliberate underfunding is to blame.
I don’t mean a 38 degrees thing, or some online petition. They mean fuck all. Hands written letters from registered voters actually have weight. Next you need to get people to attend MP’s surgeries and repeatedly ask why they are not doing more to get better funding for local NHS services. I know the local press are a joke, but actually its local issues that decide the fate of your MP.
So here is secretbatcave’s hand guide to political change:
1: write letters to your MP
2: get everyone else to write to their local MP (note, individual letters)
3: get the local press to whip up the oldies (they are desperate for real stories)
4: attend your local MP’s surgery
5: get everyone else who’s had a shit time at the NHS to attend a MPs surgery
6: Organise protests at local scale aimed at local MPs on local NHS issues
7: join your local MP’s political party, and make it an agenda item
8: Direct lobbying in parliament (its your democratic right)
None of them involve the BMA. Why? because that’s not their job. You need to go out into your local community, join a political party, and show some leadership.
Yes its hard, yes its tedious, but what would you rather, a private health system?
I’m here if you need me. just flick on the search light…