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This week, Health Secretary Jeremy Hunt told a Conservative Conference fringe meeting how inspired he was by the Chinese working culture. The richest multi-millionaire in the cabinet said that Tory plans to cut tax credits to millions of the lowest paid workers were essential to preserve those workers' “independence, self-respect and dignity”. He added that the cuts “sent an important cultural signal”:
“My wife is Chinese. We want this to be one of the most successful countries in the world in 20, 30, 40 years’ time. There’s a pretty difficult question that we have to answer, which is essentially: are we going to be a country which is prepared to work hard in the way that Asian economies are prepared to work hard, in the way that Americans are prepared to work hard? And that is about creating a culture where work is at the heart of our success.”
David Cameron has now waded in to the ensuing outcry, helpfully clarifying that in no way did Jeremy Hunt mean to suggest that the Tories’ ‘global race’ was in fact a ‘global race to the bottom’, where the UK competes with China to offer quick returns to investors on the back of a Chinese-style system of long hours, low pay, and oppressive labour relations.
Any resemblance to a global race to the bottom in how Hunt is currently treating his own staff, the 1.6million NHS workers who make up the largest global workforce outside of the Chinese Red Army, is of course purely accidental.
Hunt is currently telling junior doctors – the backbone of our NHS - that they aren’t working hard enough, that 9pm on a Saturday night is no longer considered an ‘unsocial’ hour to work, and that £20,000 a year is a generous sum to pay people making life and death decisions after years of hard training. (Oh, and that if they take time off to have a baby they’ll basically have to start their careers over.)
Nurses continue to work masses of unpaid overtime trying to provide decent care. The reward for this level of commitment to patients? Years of pay cuts under the last government, and no serious attempt to tackle under-staffing that affects nearly half of wards. The Coalition government promised independent recommendations into safe numbers of nurses, as part of its response to the Mid-Staffs scandal. But straight after the May General Election, Hunt’s man Simon Stevens closed that work down. 82% of nurses now turn up for work when they are sick, a poll revealed this week. But Hunt’s NHS ‘Efficiency Tsar’ suggests there’s billions more to be saved by squeezing down further on nurses sick pay and holidays.
It’s not just long hours, low pay and declining standards of training and regulation, though.
Thankfully, the modern day NHS may not quite have reached the level of the Chinese firm that last week forced executives who’d missed targets to crawl on their hands and knees through the streets.
But Hunt’s not above a bit of punishment. Having finished (for now) smearing nurses for their ‘normalisation of cruelty’, Hunt has just told us that the years of underfunding of GPs is their ‘penance’ for the 2004 contract the Labour government signed with them.
Hunt’s culture of punishment extends across the whole NHS. His government fines hospitals if increased numbers of patients turn up in A&E – even though the causes are out of their control. Hospital managers resign after a couple of years on average, fed up carrying the can for historic PFI debts, mounting agency fees, bed shortages, and other bad decisions imposed on them by government policy.
When clinical failings arise as a result of cuts to frontline cash, those who blow the whistle are often bullied out of the NHS. Hunt promised to protect whistleblowers, another of his post-Mid-Staffs promises – and another promise effectively ditched after the May election.
Whilst the bullying culture continues downstream, upstream in Hunt’s own Department, a culture of secrecy worthy of the Chinese Communist Party prevails. The Department of Health now routinely refuses to answer parliamentary questions and Freedom of Information requests about where the NHS’s money is going, and to whom, on the basis that they ‘don’t keep that information’. Conveniently perhaps, no-one’s keeping central tabs any more, since the fragmentation of the NHS into a plethora of competing ‘Trusts’, ‘Commissioners’ and regulatory quangos. Even overdue information on the financial crisis engulfing hospitals was unexpectedly tucked away from view this week, until after the Tory Party conference.
And policy-making is now similarly hidden away, largely outsourced to unaccountable think tanks like the Kings Fund or - worse - Reform.
It’s a bit rich to hear the famously ‘hands-off’ Tory Health Secretary (who since 2012 no longer has responsibility for securing comprehensive health services for us, and blames ‘local decisions’ when things go wrong) lecturing all of us on the value of hard work. It’s particularly galling for those health staff who work so hard to keep us well – and who’ve spent years in long and hard training to do so. Hunt’s own qualifications for one of the most important jobs in politics are uncertain, but they do include a former Health Secretary (Virginia Bottomley) as his cousin. Chinese-style nepotism, anyone?
In 2011 a top Chinese official said that the EU’s troubles were “purely because of the accumulated troubles of the worn out welfare society… The labour laws induce sloth and indolence rather than hard work.” The Tories saw their opportunity. The fact that Britain’s labour laws are already more oppressive than anywhere else in the EU hasn’t stopped this government from launching a wholly unnecessary clamp-down on trade unions that, in the words of the Trade Union Congress, will make legal strikes ‘close to impossible’ and prevent health workers and others from taking action to protect standards and patients from privatisation and cost-cutting. Free unions are an essential check and balance on excess employer power – as the Chinese know. In theory all Chinese workers have had the right (since 1995) to rest periods, no excessive overtime and the right to carry out group negotiations – but the reality is that that organising in non-state sanctioned unions is against the law, the right to strike is restricted, and labour rights abuses continue, even as strikes rise and some improvements are gained.
Doctors and other health workers already work long shifts to provide critical and urgent care round the clock – should we really expect them to work ‘24/7’ to provide non-urgent care too, just so that private sector employers don’t have to allow staff reasonable time off work to see a doctor? And if we do need to improve some aspects of weekend healthcare, let’s have a sensible discussion – not political soundbites based on figures and assumptions that the British Medical Journal says are ‘rash and misleading’.
No wonder morale is plummeting, stress is soaring, two thirds of nurses are thinking about quitting, and doctors are leaving in droves.
Junior doctors will be gathering in Westminster on 17th October to protest the imposition of their new contract and the long working hours culture - and want as many of the public as possible to join them. As argued elsewhere on this site today, this junior doctor contract needs to be seen as part of the wider attack on workers – and human - rights.
Hunt’s comments this week reveal the real agenda of the Tories’ ‘global race’ – a headlong drive to deregulate standards of employment and health protection to better enable investors to squeeze out more profits from the rest of us. This is the context of controversial global trade deals like TTIP, too. The time has come for the 1.6million NHS workers and the rest of the UK’s citizens to stand in solidarity together, and call ‘halt’.
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