One of the strangest things about the passage of the Health and Social Care Act 2012 was the divide between social media platforms and traditional media. Stories could rage across the blogosphere without gaining any traction, or indeed even a mention, in the press. And the BBC was by no means the only offender here; it was simply the most disappointing.
With the exception of The Guardian, the resulting geography of NHS ‘resistance’ is one of patchy, but at times excellent, coverage in the press – The Telegraph and The Daily Mail in particular – with enormous amounts of activity from the public, bloggers, academics, activists and NHS staff bubbling underneath. This is not to underplay the limited but growing interconnectivity between social media and ‘big media’, but merely to recognise that there remain important differences which have been particularly acute in the NHS debate.
What the NHS needs now if it is to be reinstated post-2015 is large scale, co-operative, creative and well organised campaigning. The first stage is to engage the public with the realities of what has happened. That the Coalition’s NHS “reforms” lack a democratic mandate is not in serious doubt. It has been confirmed, whether implicitly or explicitly, even by senior Conservatives. David Cameron himself, in a typically dishonest display, announced his “surprise” at the contents of Andrew Lansley’s White Paper when he realised the scale of public outrage and the damage it was doing to Brand Cameron. Yet according to a Conservative special adviser,
“James O’Shaughnessy [Cameron’s director of policy] would have penned quite a lot of the words. And all those things were cleared by a policy board chaired by Cameron. So the idea that Cameron didn’t know what was in it… He and Oliver Letwin helped write the Green Papers.” (Timmins, 2012, p38)
The lack of a clear mandate is important because the changes are fundamental, they go to the heart of what the NHS is and rip it out. The Secretary of State for Health no longer has a legal duty to provide or secure comprehensive healthcare to all English citizens – that has been the legal foundation of the NHS since 1948. The state need only now “promote” a comprehensive service. Cherry-picking of patients, fewer and fewer services being provided for free and large scale privatisation are the real fundamentals of the Health & Social Care Act – not “empowering GP’s” as the Coalition (and the BBC) claimed.
Consequently, the road to US style health provision becomes clear: reduced NHS services and cherry-picking of patients will force more and more people down the route of medical insurance and ‘top up’ plans. For the first time in over 60 years, medical insurance will start to become a normal part of life. This is not strictly a party-political issue – New Labour were instrumental in reconfiguring the NHS as a branded marketplace for private providers. Rather, it is demonstrative of the way our entire representative system has been bought out. That the NHA Party even had to be formed is a clear indictment of our democratic health.
Two conclusions must be drawn. Firstly, the press, taken as a whole, have failed to inform the public adequately about what is happening to the health service. Mass campaigning to reinstate the democratic basis of the NHS in England will not come from the press. Secondly, Labour are deeply implicated in what has happened and despite encouraging words from Andy Burnham it would be unwise to presume that, if left to their own devices, they will reinstate a genuine NHS come 2015 – that’s if they form a majority, or if they find willing coalition partners. The NHS is too important to leave to a kaleidoscope of red and yellow ‘ifs’ and a dysfunctional electoral system.
Campaigning will be left to the public, patients, medical staff, unions, individual journalists and bloggers, local press, academics and many more. Organisation, communication and cooperation are all major challenges. Much of the best material on what’s happening is found on personal blogs and campaign sites, which are rarely established publishing platforms and are often run by people working flat out in their spare time on top of full time jobs. Burke’s ‘little platoons’ have not been manifested in Cameron’s “Big Serco”, a smokescreen for the mass looting of public services, but in the wave of civic energy that has mobilised to oppose it.
Yet this does leave a role for the more established but non-mainstream platforms, such as openDemocracy. We asked ourselves how we could best use our resources, infrastructure and networks to assist what is a nationwide NHS campaign. We had already published some excellent material on the NHS bill but we wanted to do more. As of August 2012, we raised funds, built an expert advisory board, partnered with many of the leading sites for NHS action in the country and built a dedicated section of openDemocracy – OurNHS. The site is not finished but it’s functioning, we are publishing, and we will be adding many features to it over the coming months.
What we intend to do now:
Firstly, publish as much original and high quality content as we can. The site was launched with a long essay written for us by David Owen, introducing his NHS reinstatement bill (a shortened version was published at the Guardian). Already this week we have published ‘The great NHS robbery’ by Marcus Chown and an illuminating piece of investigative work by Andrew Robertson, of the Social Investigations blog. Next week, we have articles from Clive Peedell of the NHA Party and Anna Cootes, formerly of the King’s Fund.
Secondly, we want to cross-post and help publicise the best content from across the web. On Tuesday we cross-posted an excellent piece by Max Davie on the battle to keep Lewisham hospital fully operational and we intend to highlight and reproduce the best of the web regularly.
Thirdly, campaigning. We will continue to work with our partners, advisory board and many others on this front.
What do we need: input. Article submissions, suggestions, ground level reports, personal accounts, video/audio submissions, ideas for campaigns, information on events that we can help publicise – all the above. You can submit material here, and contact us here.
And we need funding. To run OurNHS properly, with editorial time, publishing costs, editing, commissioning, office space, meeting space, financial controls, web support – it all costs money. The ‘How the BBC betrayed the NHS’ report was a 50 hour job, for instance, it would not have been feasible without being funded by openDemocracy. We want to raise £40,000 a year and run the project until 2016, by which time we hope to see a new government in place and a democratic health system restored. We have already raised £12,500. To make the project sustainable we urgently need to raise the rest.
On a budget of this size every single donation helps. We are mostly supported by charitable grants and donations but this is a political project – we are relying on non-charitable donations.
If you want to make a contribution you can donate directly to the OurNHS project here.
OurNHS partners, supporters and advisory board:
Richard Murphy’s Tax Research UK
Andrew Robertson’s Social Investigations
Andrew Wainwright Reform Trust
Dr Clare Gerada, Chair of the Royal College of General Practitioners
Prof Allyson Pollock, Professor of Public Health Research and Policy at Queen Mary, University of London
Prof Sir Al Aynsley-Green, former Children’s Commissioner
Dr Ingrid Wolfe, Honorary Research Fellow at the London School of Hygiene and Tropical Medicine
Gabriel Scally, formerly of the Department of Health, now an IPPR fellow