Today in radical history, 1982: a day of action during the Nurses’ Strike

‘Nurses Are Worth More’: The 1982 Health Workers’ Dispute

An account by Dale Evans, NHS worker

The 1982 pay dispute was the largest strike in the history of the NHS and greatest show of solidarity across the trade union movement since the 1926 General Strike. Unfortunately this complex and often contradictory dispute that coincided with the Falklands/Malvinas War has been forgotten. Historians of trade unionism and the Thatcher era have not recorded it. This is not hard to understand, after all nurses and other women health workers rarely count in the arena of male dominated trade unionism; their disputes – because they lack ‘industrial muscle’ are hardly noticed. But the 1982 health service pay dispute is a great story. It was a strike that involved the workforce of the single largest employer in the whole of Europe, lasted for several months, challenged new anti-trade union legislation, gained enormous public support, received solidarity action from across the trade union movement and was the largest pay dispute of the Thatcher era.

Background to the 1982 dispute

From the beginning of the NHS in 1948 nurses’ pay was regularly falling behind comparable occupations in other sectors. Nurses found themselves campaigning to catch up as their salaries were eroded by government policies on wage restraint and post war price inflation. In 1974 the Halsbury enquiry into nurses’ pay awarded them increases of between 20 and 40 per cent. The severe inflationary period of the 1970s quickly undermined the gains of 1974 and a further enquiry – the Clegg commission of 1979 – awarded nurses 9% plus additional payments. The new Tory government of 1979 implemented the Clegg awards. However, by 1982 continuing inflation and limited public sector pay increases had left the nurses’ pay lagging behind again.

There were other paternalistic and structural reasons for successive governments not taking the remuneration of nurses seriously. Nursing was overwhelmingly staffed by women and nursing was viewed as an extension of caring for a family, that is not a professional occupation. Nurses’ pay was viewed as secondary income for families where the main income was provided by men. However nearly one third of nurses were single, and in places where the economic recession of the early 1980s hit hardest nurses became the main family wage earner. The NHS policy making mechanisms were dominated by doctors and their interests came first. On a structural level the NHS was expanding. Between 1976 and 1983 the number of nurses increased by 16% to nearly 400,000. At the same time the hours worked by nurses also decreased hence increasing the overall wage bill. In 1950 they worked 48 hours per week, by 1982 this had been reduced to 371/2. Successive governments fought to contain the costs of the NHS by restricting pay increases to nurses and other non-medical employees in the NHS, by far the largest section of the NHS workforce. By 1974-75, nurses real income had increased by only 9% since the beginning of the NHS. From this peak the real value of nurses went into decline and by 1982 had decreased by 18% since the mid-1970s.

In order to redress the decline in pay for nurses and low pay for other NHS workers the unions argued for a 12% increase across the board for the 1982 pay round. However, the Tory government had already announced that public sector pay increases would be limited to 4%, but by March Norman Fowler, the Secretary of State for Social Services, issued a statement that more money was available for nurses, midwives, and the allied health professions (radiographers and physiotherapists etc.) and that an offer in the region of 6% would be made. All other non-medical staff (that is porters, cleaners, ambulance personnel, clerical staff) were to receive the 4%. To what was an obvious provocation, the health service unions had to respond.

Beginnings of the Dispute

The trade unions responded to the offer with derision; one NUPE (National Union of Public Employees) official denounced the offer as an ‘unacceptable prescription which will do nothing to alleviate the problem of low pay affecting thousands of health service workers’.

In 1981 health service trade unions affiliated to the TUC had formed the TUC health services committee under the chair of Alan Spanswick from the Confederation of Health Service Employees (COHSE). The 1982 date for the pay round was April 1; for the first time in NHS all staff except doctors were to receive their annual pay increase from the same date. This gave the unions an organisational advantage in being able to organise and negotiate for all employees on the same basis from the same date. The unions believed that their claim of 12% for all NHS staff was reasonable. The rejection of this claim by the government quickly led to industrial action by the TUC affiliated unions.

All the unions were conscious of the fact that public support for their campaign was paramount; they had no wish to alienate the public as they believed the public workers’ dispute had done in 1979’s ‘winter of discontent.’ Although an all out strike was discussed most action in the course of the dispute consisted of work stoppages by nurses and nursing auxiliaries, porters, cleaners and other staff that would not endanger patients. This was the course taken by COHSE and NUPE and the other TUC unions. The first days of action took place in May. These actions were varied across the country. In some places the NHS only offered emergency services on these days, in other areas staff worked by only performing limited duties.

At a local level unions officials received support from other public sector workers. As the summer progressed the Scottish miners came out on strike in support of the day of action. By the end of June sympathy strikes had taken place with miners, shipyard workers, factory workers and staff from government and council offices all taking part. Examples of this solidarity action came from all over the UK. Shipyard workers joined a demonstration by health workers in Glasgow, 77 schools in Nottinghamshire were affected, swimming pools in Yorkshire were closed, stoppages occurred at some of the major power stations in Yorkshire, council workers in Hackney and Tottenham also took action. By July 750 hospitals had only emergency cover. In Wakefield 4 hospitals did not have any services at all on days of action. Further solidarity action saw seamen stop a ferry leaving Felixstowe for 2 days. All of this action was in breach of the 1980 Industrial Relations Act that outlawed secondary action by one group of workers in support of another. However in August the Electricians Union managed to stop the Fleet Street printing presses rolling with a 24 hour stoppage. Sean Geraghty, the shop steward involved. was fined £1300 for contempt of court after ignoring an injunction banning the stoppage. Hundreds of health workers demonstrated in his support on the day of his hearing.

In spite of the stoppages and inconvenience to patients the dispute was widely supported by the public who perceived that the nurses were being given a raw deal. Of course patient care was compromised as waiting lists soared and operations were cancelled but this did not undermine public support.

Divisions between the unions

Outside of the TUC affiliated health service unions were the Royal College of Nursing (RCN) who represented 180,000 nurses, and other smaller unions such as the midwives, health visitors and those representing the allied health professions. These organisations were also professional bodies as well as trade unions. As professional bodies they had a regulatory role over members, provided education, and set professional standards just as the BMA (British Medical Association), and the Royal Colleges do in medicine. For these reasons the RCN did not sit easily with trade unions affiliated with the TUC, COHSE and NUPE, which had 135,000 and 80,000 nurses in their membership respectively and were also the unions representing tens of thousands of other NHS workers. This split between TUC affiliated bodies and non-affiliated unions such as the RCN was to prove crucial in the conduct of the dispute, and its final resolution.

The RCN argued that because of the public support shown for the nurses’ cause it was not necessary to engage in industrial action. Indeed its president Trevor Clay later wrote:

‘The nurses had the high moral ground through balloting at a time when the government were lambasting other unions about their lack of balloting and unrepresentative activity.’

During the days of action members of the RCN worked normally, because strike action would have been in breach of its rules (Rule 12). The RCN had only become a trade union in 1977 and in 1979 its membership had rejected the opportunity to join the TUC. A debate in 1982 concerning amending Rule 12 came to nothing.

Throughout the dispute the RCN acted independently of the TUC health unions, often meeting ministers and engaging in talks without any acknowledgement of the need for greater unity. The RCN only paid lip service to supporting non-nursing NHS staff but made it apparent that it wanted a settlement whereby porters, clerical staff and nursing auxiliaries would receive a lower pay rise than qualified nurses. Unlike the TUC unions it was willing to support the government’s idea of establishing a permanent pay review body (PRB) for nurses that would be similar to that already set up for doctors. The PRB would annually compare nurses’ pay with other sectors of the economy and make recommendations to the government.

The RCN wanted to have its cake and eat it. Its President Trevor Clay genuinely believed that its position of no strike action and talking to the government whilst constantly balloting the membership of the RCN on various matters was the most productive way to settle the dispute. This of course allowed the government to split the campaign effectively into two camps, those for and those against industrial action. Norman Fowler’s statement to the House of Commons on 18 October 1982 clearly thanked the RCN for continuing to work and lambasted the TUC unions.

COHSE and NUPE felt that the RCN was only gaining advantages with the government because of the strength of their action. Without industrial conflict the RCN would not have been invited to the negotiating table. Rodney Bickerstaffe, general secretary of NUPE, diplomatically expressed the differences:

‘I think that the RCN line ….has been that whilst they are still talking there is still hope. I don’t wish to drive any more wedges between ourselves and the RCN. It’s fine to say that whilst we are talking there is still hope, but less people would be hurt if we all threw our weight behind the industrial campaign to get proper talks.’

For both COHSE and NUPE it was a matter of principle that all the health service workers received 12%. They had major concerns about low pay in the NHS that they felt the government should address. These unions had a different approach to striking. COHSE’s 1982 conference rejected an all-out indefinite strike and supported the call for extra days of action with emergency cover only. NUPE’s conference on the other hand voted in favour of an indefinite strike with only basic emergency cover. COHSE’s position was strongly influenced by the winter of discontent. After that the union had drawn up a code of conduct for disputes whereby its members were expected to provide emergency cover and ensure that the dignity and welfare of the patients is paramount. Both unions rejected the idea of the government’s PRB, as both unions believed in annual pay negotiations based on the principles of collective bargaining.

During the course of the dispute the RCN balloted its membership on two offers both of which were rejected by the membership. From the views of the membership its seems clear that the RCN wanted to extricate itself from the dispute as quickly as possible. The members of one RCN branch wrote to the Nursing Times:

We find it distasteful that you [Dame Catherine Hall, an RCN negotiator] held a press conference without first referring the detail of your discussions with the secretary of state to the RCN labour relations committee for a vote….There is no mention in your misrepresented statement of referral back to the membership.’

And another member complained

‘I have just received my RCN News. Cutting through the waffle it seems that the College is attempting to sell us out for an extra 11/2p in the pound.’

Such was the divergence of views that the RCN issued a leaflet in which it fully defended its position against the accusations levelled against it.

The government also exploited the split to argue that the TUC unions had a political agenda, that is that the strike was not about health service pay but was to undermine recent trade union legislation and re-establish the former power that the unions supposedly enjoyed. On the 21 September the Health Minister Kenneth Clarke said:

‘The TUC hopes to smash the cash limits of the National Health Service in order to end pay restraint in the public sector and prepare the way for bigger claims for miners and others this winter. They are taking secondary action in order to challenge the Government’s legislation and defend their old immunities above the law.’

This lack of unity and the government’s endorsement of the RCN’s position undermined the strength and purpose of the TUC unions after the largest day of action on 22 September.

22 September 1982

22 September saw a huge show of solidarity for the NHS dispute right across the country; an estimated 2.25 million people took part in one form or another. In London 120,000 demonstrated, Aberdeen 12,000, Edinburgh 10,000, Liverpool 20,000, Norwich 2,000, Derry 3,000 – and these were just some of the many demonstrations that took place all over the country. Strikes were evident in many hospitals with only emergency cover provided. Some ambulance crews walked out and refused to provide emergency cover.

Secondary support for health workers was also very significant, 80% of the mines were closed as were 43 of 65 docks. Fleet Street workers stopped the publication of the national newspapers and many local newspapers were disrupted as well. There was some disruption to television programmes broadcast by Granada and Ulster TV. Local government services were affected with many schools being closed for part of the day. Supporting strike action was also taken by car workers at Ford and Vauxhall, and Post Offices were closed.

This day was an undoubted success and was the high point of the whole dispute for the TUC unions. Such enthusiasm would be difficult to repeat and the time for indefinite strike action had passed. The RCN was still talking to the government and seeking a way to end the dispute. And the government, very much buoyed by it victory in the Falklands/Malvinas war, took a hard line, proclaiming that the day of action had changed nothing. As many nurses pointed out the government could always find money for wars but not for funding the health service.

The fact that this historic day of action had failed to move the government left the unions in a quandary: what to do next?

The end of the dispute

Attempts to organise further days of action petered out. The dispute dragged on with only a few local actions occurring. COHSE called a delegates’ conference for 14 December to discuss the possibility of an all-out strike. In reality the split in the nursing profession between the RCN and the TUC unions had undermined the possibility of further action. Most of the action had been carried out by the other health workers. As one participant commented:

There was considerable resentment among the ancillaries about the nurses. The press had gone on about the nurses this the nurses that. The cleaners knew that they had stayed solid for months. Most of the nurses had crossed the picket line time after time. The cleaners felt used’.

Many of the nurses did however recognise the contribution to the dispute by other NHS workers:

‘The ancillary workers are helping us by taking action, as well as themselves…

Nurses do not have the power to fight the government on their own, they need other workers’.

By December the RCN was effectively leading the dispute with most of the discussion centred on the establishing of the PRB, which the TUC unions still rejected. The government improved its offer to 12.3% for nurses over 2 years with 7.5% to be received in the current year, and the promise of a pay review body for 1984. The RCN put the offer to its members, 80% of whom accepted. NUPE and COHSE tried to scupper the deal by recommending to its members 6.5% for the coming year without any conditions for future years. The membership rejected this. NUPE and COHSE also found themselves outvoted in the TUC health services committee where each member (14 in all) had one vote even though NUPE and COHSE represented the majority of health service workers between them. Furthermore the RCN and the other professional bodies such as the Royal College of Midwives had a slender majority on the national negotiating committee, the Whitley Council. NUPE and COHSE had been effectively outmanoeuvred. Ancillary staff received a 10.5 % deal over 2 years, receiving 6% in the current year. Both pay deals were only backdated to July even though the date for a new pay rise was the 1 April. No doubt this was an extra punishment for a workforce that had fought for a living wage.

Aftermath

The conservative government won the 1983 general election and the PRB was set up. Nurses were awarded between 9 and 14% in 1985 and 8% the following year. Work done by ancillary workers (porters, cleaners) were increasingly privatised with two thirds of contracts awarded to private contractors by the end of 1984. This section of the workforce was reduced by 40,000 by 1988. COHSE’s membership had peaked at 231,000 in 1982 had fallen to 218,000 by 1988. The RCN membership which had been 162,000 in 1979 reached 282,000 in 1988.

Sources used

The Times

The Guardian

Marxism Today

New Statesman

Nursing Mirror

Nursing Times

Christopher Hart, Behind the Mask: Nurses, their Unions and Nursing Policy, London 1994

Jonathan Neale, Memoirs of a Callous Picket, London, 1983

Trevor Clay Nurses, Power and Politics, London, 1987

Mick Carpenter, Working for Health: the History of COHSE, London 1988

COHSE (Britain Health Service Union) blog 

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Lifted from ‘The NHS is 60‘, a collection of radical articles on health, working in the health service and the history of the NHS, published in 2008 by the Radical History Network of North-East London

According to the COHSE history blog,

“Wednesday 22 September 1982 was one of the largest acts of solidarity in the British trade union history, with millions on strike and a national rally in London with 120,000 taking part. There were demonstrations in the following towns (not full list)

Aberdeen 12,000

Inverness 1,000

Elgin 500

Lerwick 400

Oban 100

Stornaway 500

Dundee 10,000

Edinburgh 10,000

Kirkcaldy 2,000

Glasgow 20,000

Dumfries 1,000

Newcastle 5,000

York 1,000

Sheffield 10,000

Barnsley 1,000

Leeds 6,000

Hull 4,000

Chesterfield 3,000

Manchester 2,000

St Helens 2,000

Liverpool 20,000

Bolton 2,000

Blackpool 400

Wigan 5,000

Leek 300

Coventry 2,000

Gloucester 500

Hereford 400

Swindon 1,000

Milton Keynes 1,200

Cambridge 2,000

Colchester 1,000

Braintree 100

Norwich 2,000

Kings Lynn 300

Harleston 500

Fakenham 100

Southampton 1,500

Bournemouth 1,000

Eastbourne 500

Yeovil 1,000

Belfast 3,000

Derry 3,000

Armagh 300

Ballymena 200

Enniskillen 350

Swansea 1,000

Aberystwyth 200

Rhondda 500

There were also many rallies/marches in London eg in Hackney and Hillingdon.”

Today in London healthcare history, 1978: Bethnal Green Hospital staff launch Work-in

The Bethnal Green Hospital in East London served the local population as a community hospital valued for its continuity of care and accessibility to local residents. Hospital staff at Bethnal Green were told in October 1977 that the local Area Health Authority wanted to reduce services at the hospital to just care of the elderly. A campaign was mounted to safeguard its future.

In the early-mid 1970s, with pressures on the NHS mounting as life expectancy became longer, but global economic meltdown having a sharp effect on resources, successive UK governments made decisions which would have a long term effect on hospital building and closures. This would have a particular impact in London, considered to have a disproportionately high number of acute hospital services compare to the rest of the country, especially the north of England. The Labour government elected in 1974 adopted a policy of relocation of resources from the southeast to the north of Britain; in NHS terms this was focused through the Resource Allocation Working Party, set up in July 1975.

In reality, however, RAWP represented not a massive increase in resources to other regions of the UK – in the context of the recession, it meant merely that these areas were being cut slightly less severely than in London.

And cuts in London were to become very harsh.

The Bethnal Green Infirmary in London’s East End opened in 1900, built on land purchased from the London Society for Promoting Christianity amongst the Jews.  The 4.5 acre site had previously contained a chapel – the Episcopal Jews’ Chapel – and had been known as Palestine Place.  The clock from the demolished Chapel was installed on the tower of the administration block.

The three-storey red brick building was designed to accommodate 669 patients and was intended mainly for the chronically ill (by 1901 it had 619 in-patients) and this remained so until WW1.

In 1915 civilian in-patients were moved to St George-in-the-East Hospital or to the workhouse in Waterloo Road and the military authorities took over the building for wounded soldiers – it became the Bethnal Green Military Hospital under the London District Command.  It had 709 beds for wounded and sick servicemen.  During this time a pathology laboratory was installed.

Only in 1920 did all the patients and staff return.  A wider range of services were added, including an Orthopaedic Clinic, established at the request of the Ministry of Pensions, to provide treatment for ex-servicemen with damaged joints. By 1929 Casualty and X-ray Departments and admission wards had been opened and an operating theatre was being constructed.  There was also a VD clinic (which closed in 1952).

The LCC took control of the administration in 1930, when the Hospital had 650 beds, of which 551 were occupied.

During WW2 the Hospital suffered minor bomb damage. In 1948 it joined the NHS as the Bethnal Green Hospital and came under the control of the Central Group of the North East Metropolitan Region.  By this time it had considerably fewer beds, just over 300.

In 1953 there were 313 beds, with an average occupancy of 260.

A geriatric unit was established in 1954.  In the same year the Group Pathology Laboratory was sited here and served the Central Group hospitals – Mile End Hospital, St Leonard’s Hospital, East End Maternity Hospital, St Matthew’s Hospital, Mildmay Mission Hospital, the London Jewish Hospital and the Metropolitan Hospital(all of which have now also closed).

During the 1960s a new dental hospital, a pathology institute and a School of Nursing and Midwifery were established.  In 1966 the Postgraduate Medical Education Centre opened.  In the same year the Central Group was dissolved and the Hospital joined the East London Group.

The Obstetrics Department closed in 1972.  In yet another NHS reorganisation in 1974, during the first wave of cutbacks in the NHS, the Hospital passed to the control of Tower Hamlets District, under the auspices of the City & East London Area Health Authority.  In the same year the Gynaecology department closed.

From 1977 the role of the Hospital changed from acute to geriatric care, with 167 acute beds closing and being replaced by 120 geriatric beds for the patients transferred from St Matthew’s Hospital.

When plans to heavily cut the hospital services were announced in 1977, a campaign to defend them and try to overturn the decision was launched. The hospital was still working to capacity, and its patients would have nowhere to go if its facilities were withdrawn, except to extend already over-long waiting lists.

As socialist doctor David Widgery noted, the cuts took “no account of social deprivation or incidence of disease in awarding resources, relying simply on out-of-date mortality rates. The result is a geographical interpretation rather than a class one, generating the lunacy of designating areas like Tower Hamlets, hackney and Brent as possessing more than their fare share of resources, which are therefore deemed suitable for siphoning off to East Anglia.” Widgery, a junior casualty officer in the hospital, was elected hair of the Save Bethnal Green Hospital Campaign.

A Tower Hamlets Action Committee was established with over 700 people attending the first meeting held on 24th November 1977. The campaign included support from GPs, regular picketing of the hospital, huge meetings and strikes and stoppages across East London…

On the 28th January 1978 over 500 attended a march from Weavers Field to the London Hospital to protest at the closures.

In March it was agreed that a regular picketing of the hospital should take place to highlight the plight of the hospital

On the 16th March 1978 at another huge meeting Bethnal Green Hospital was declared unanimously a “protected hospital”

A planned march against hospital closures in East London arranged by Plaistow Hospital campaign on 18th March was banned by the police due to events at the anti-fascist protest in Lewisham in August 1977.

10th March a 2 hour stoppage was staged in five East London hospital’s in opposition to the health cuts

30th March 1978: East London Hospital unions called strike action in nine hospitals for between six and twenty four hours, the Royal London and Mile End hospitals stop all routine work for 24 hours. Strikes had spread to local brewery workers, posties and printers. 800 campaigners marched to the Health Authority headquarters to protest.

102 East End GPs had signed a letter objecting to the cuts.

Meanwhile, the staff decided to ‘occupy’ the hospital.

On 1st July 1978 at 8pm, the time of the official closure, the hospital staff, applauded by a large crowd of local people and filmed by the News at Ten (ITV) put up a notice announcing the occupation of the casualty unit at Bethnal Green hospital. Detailed arrangements are made with medical staff, GP’s , the Emergency Bed Service (EBS) to guarantee admissions and safety. The first hospital casualty work-in in history began, with patients arriving at 8:02.

The only people to move out of the hospital were the administrators. Doctors, nurses and other staff continued to perform their duties, GP’s continued to refer patients, locals continued to attend the casualty department and ambulance drivers continued to respond to emergency calls.

While patients remained at the hospital, the health authority had a duty to pay staff salaries – and so the occupation took effect.

On the 30th July managers arrived at the hospital threatening staff with legal action, nursing staff instruct under threat of dismissal to move, medical staff who refuse to do so were “harangued” and threatened. The Bethnal Green Hospital work-in was called off on 30th July 1978 having treated over one thousand local patients.

An account of the campaign written shortly after the smashing of the occupation:

“The Green is a medium sized general hospital in a part of East London with notoriouly high incidence of illness and a community health service which is only now emerging from decades of neglect. It has about 280 in-patient beds and sees nearly 48,000 cases each year in its casualty and outpatient clinics.

It is no medical derelict; from the specialist hip replacement unit, its patients’ kitchens, reputed to be the best in East London to its excellent postgraduate Medical Centre it’s a busy working hospital with high medical standards and unusually good relations with general practitioners.

But, Enter The Cuts. The Tower Hamlets District not only have the national nil-growth ceiling now strictly enforced by the cash limit which was introduced as part of the IMF’s loan terms. It also has the RAWP (Regional Allocation Working Party) tax to pay.

RAWP is a classical social-democratic cock-up; designed to level up the regionally uneven levels of medical spending noted by socialist critics in the 1960s. Now in the 1970s it has become a formula for rationalising cuts. RAWP shifts still more money out of the Thames regions, long overdue fireproofing and internally financed pay increases for junior doctors further reduce the Tower Hamlets District coffers already ravaged by the rocketing supply costs, especially of drugs.

It’s a national story but East London is feeling the full impact first and hardest. The Tower Hamlets Health District are attempting to ‘save’ £2 million or 300 beds (beds aren’t strictly the things with mattresses on but a unit of medical currency). This abolishes at a stroke, 1 in every 3 acute bed in the district although last winter the existing beds were frequently chock-a-bloc.

The scheme was to smother the Green quietly, under the guise of a conversion, labelled temporary but likely to be permanent, to an all geriatric ghetto. This would achieve the rquired acute beds cut without involving the other better organised hospitals and care.

But the plan blew up in their face and the battle to save the Green has achieved the widest working class action against the cuts so far in London this year.

An increasingly vicious management succeeded in smashing the 24-hour casualty work-in which had run throughout July on 1 August by withdrawing staff and threatening senior medical staff involved with legal action. But it has proved a Pyrrhic victory and at the Council, the Community Health Council, the hospital and general unions against them and the East London public in angry mood.

There is now no chance of conversion to the all-geriatric unit unless at least some of the demands of the Campaign – retention of medical beds, open X-ray services, the Postgraduate Centre, a 9-5 Casualty Station – are met.

What is important to realise is the very slender basis from which the campaign was nursed. The Green has an unhappy trade union past and was clearly seen by management as a push over, especially since the all-geriatric future gave the impression that jobs would be safe.

For months a tiny committee of staff who wanted to make a stand, and local people, did careful groundwork, sat through visiting know-alls who would monopolise a meeting and not be seen again, petitioned GPs, tried to change the pessimistic mood inside the hospital. Only two years ago when the Metropolitan, a Hackney hospital opened in 1886, was closed, its secretary said, ‘The staff have been incredibly loyal and have steadfastly refused to strike and now it is us who face the chop’. The Green could easily have had the same obituary.

Carefully argued critiques of the plans were put into the complicated ritual of paper shifting called ‘consultation’ but at the same time Green campaigners knocked, wrote, and implored the entire local trade union movement to rise to the issue.

After two highly successful public meetings, the biggest the York Hall could recall, the Campaign called its first two hours stoppage on 10 March and in much trepidation. Myrna Shaw, NALGO shop steward remembers:

‘We stepped out of this hospital yesterday to give two hours to the community and in the true spirit of the East End we found the community waiting for us.

‘Anyone who could not be stirred by the sight must be dead. There were the massed banners of the trades councils and the trade unions. The Ambulance men were there and the Tenants’ Associations. St. Bartholomew’s turned up and St. Leonards, St. Mathew’s and St. Clement’s.

‘We picked up contingents from Mile End Hospital and The London on the way. Hospital chaplains marched – so did doctors, nurses, social workers, town hall staff, GLC staff, people from the breweries, local industries and teachers. Apologies to anyone left out.

‘If you lost your place in the procession it was hard to find anyone you knew when you went back. Best of all our own staff marched – from every Department in the Hospital’.

Behind that unity lay careful groundwork. 103 local GPs had been canvassed and stated that the closure was ‘a disastrous mistake’. The local community nurses stated ‘it would be difficult for us to cope with a large increase in our work load even if our staffing levels were increased’.

The social workers stated ‘The hospital has greatly enhanced the service we are able to give, its loss would greatly diminish it’. But the 1974 re-organisation scheme has established a pattern of medical autocracy which is virtually impossible to dent with reason and damned hard to affect with force.

After a three month reprieve which was clearly designed to defuse rather than encourage the supporters, instructions were issued for closure of the Casualty, the first step in the change of use, on 1 August at 8.00 p.m.

Once a closure date had been stated, down to the hour the phoney war was over. A Joint Trade Union Co-ordinating Committee elected by the East London Health Shop Stewards had been arguing out the implications of the Green’s closure for the general patterns of cuts in East London and tightening up its own organisation and communications.

When it called strike action, even at notice of days rather than weeks, the response was splendid. The day before the attempted closure nine local hospitals stopped simultaneous, St Barts and The London were solid for 24 hours, and many industrial supporters came out spontaneously too. 300 locals were outside the hospital gates as 8.00 p.m. arrived and at 8.01 a sign went up ‘Casualty OPEN under staff control’. Within minutes, long planned agreements with the ambulance and emergency bed service unions went into action.

Over the next few weeks, the Casualty, which the administration still insisted was closed, saw and treated more patients than in the same month the previous year. And the pickets outside the hospital now really had something to defend. The six point motion moved by Mrs Henrietta Cox of NUPE had done its work in each respect:

The staff of Bethnal Green Hospital declare that the Casualty Department will stay open. We declare we have no confidence in the DMT. We resolve to elect a committee representing all the staff to make sure casualty runs as usual. We call on ambulance staff, the BBS and local GPs to support us. We call on workers in other London hospitals to take any action necessary to support us. We call on our unions to organise supportative action. We ask the people of East London to support us!

It took the management a full month to break the Casualty work in. After early attempts to withdraw staff and victimise the other hospitals and ambulance men who defied their official instruction that the Green was closed, direct and legal pressure was put on the rebel consultants and nursing staff forcibly transferred within the district.

It is important to realise that a work-in is not a universal panacea. Its remarkable success at the EGA depends on the special cases of consultants in the very specialised women-treating-women field, for which no real equivalent alternative can be offered. But in most hospitals, consultants can be only too easily bought off with promises of new, perhaps better, facilities in other hospitals in the districts.

And such is the independent power of the consultant in the NHS structure that medical work simply cannot continue without their approval, even though they are are only on the premises for a small part of the time. Management, too, are learning from the EGA, especially in finding ways to pressurise nursing staff who are most vulnerable to hospital discipline.

The Bethnal Green work-in could never have worked without the very remarkable devotion of a consultant physician John Thomason and the hospital’s casualty officer, Kutty Divakaran.

But the Health Authority still hold the trump card: the ability to transfer staff. Short of running an alternative private health service, paid for by collection, within the hospital there was little to do but protest when an ‘Invisible Hounslow’ took place.

There was further strike and public protest on the day of the final forced closure. But the battle has now moved into a second phase, to prevent the conversion to the all-geriatric dumping ground so many staff and locals oppose because its notorious effect on morale and nursing and medical standards by insisting the remaining medical, postgraduate, X-ray, ECG and outpatient services stay put.

This time round it will be that much more simple to convince the Community Health Council, the Council and the statutory bodies who found the initial package plausible, of the real intent of the management; quite savage cuts in a area which is crying out for more resources. And to prevent the destruction of an excellent community-based hospital with no planned alternative.

Already there are ‘lessons’ galore. DMPs all over the country are finding increasing resistance to their attempts to enforce cuts. Not only are older community hospitals like St Nicks and The Green (which do need change but, with imagination, could find an important inner city role) being forced into closure, but completed new hospitals are unstaffed, and long promised and long needed facilities, such at Hemel Hempstead are postponed. 30 threatened hospitals joined a torchlit vigil on the 30th Birthday of the NHS in London alone.

Despite the BMA and Ennals, medical staff and unions are finding common cause and using sophisticated types of industrial action to force their case – at a time when the rest of the labour movement has its fists firmly in the pocket. Occupations live, it seems, in the NHS, if they have been forgotten in Clydeside. For the Bethnal Green battle and that of the EGA and Hounslow before it, will have to be repeated all over Britain as we descend further, further down the course established by Ennals, who is to British hospitals what Henry the Eighth was to British monasteries.

Here in East London the particular emotional significance of the hospital, and the genuine gratitude felt to the NHS, has given the campaign a moral pungency and unity which have done something to revive the flagging fortunes of East London labour whose greatest days seemed all to be in the Museum. With the steadfastness of the young Bengalis in Brick Lane, the limbering up of the docks unofficial committee and the fightback on the hospital cuts, the sleeping lion of East London labour is stirring.

If hospital workers just plead for passive support, it’s simply a case of wishing them well. But once the hospital unions take strike action or mount a work-in, the question becomes active. We are doing something, what are you going to do? Suddenly the all powerful authorities can look extremely isolated.

As for the politics of the situation, the weakness of the Communist Party is quite startling. Even ten years ago they would have delivered a formidable industrial punch but now their support is well-meaning, inexperienced and a bit airy fairy.

The left of the Labour Party, especially ousted councillors, have been excellent but must face the fact that it is a Labour minister, Roland Moyle who gave the Green the Ministerial Kick in the teeth. Even Mikardo, who has taken up The Green like the fighter he is, may oppose cuts in his constituency but voted for the package nationally. On the ground it has been independent trade union activists, local socialist feminist groups and the SWP who have run the campaign.

The lack of response from the hospital unions at a London level or nationally has been truly scandalous. Reviewing the annual conferences this year, it’s clear that the bureaucracy considers cuts were last year’s thing. It seems even possible that NUPE and the DHSS have an agreement, off the record, to let certain hospitals go without a fight.

Fisher has made not one visit to a hospital where his members are putting their necks on the block against the very cuts that he used to establish his own credibility as a campaigning union leader. The informal networks, Hospital Worker, and now the excellent Fightback co-ordinating committee based on the shell of Hounslow Hospital have been worth 100 times more than another Alan Fisher TV appearance.

The success of the cuts is not just a financial saving and a worse service. It is a code word for a social counter-revolution, a crueller, harsher Britain. The hospital service planned for us will consist of highly centralised (and incidentally absurdly expensive) units run more and more like factories to achieve maximum efficiency in ‘through-put’ and a few sub-hospitals for geriatrics and sub-normality practicing third world third-class custodial medicine. The sick who fall between those two stools will have to trust its luck to something called the community’ which is itself busy being destroyed.

It is this Dismal New World every cuts battles faces head on. And because of the degree to which the Labour Party has become the agent of financial capitalist orthodoxy, that even the most minor closure has to be fought up to cabinet level. The battle against the cuts, like the battle for the right to work, are part of a bigger battle to reshape the priorities of modern Britain. If it seems at times unrewarding, it is where real socialists should be building.

(taken from International Socialism, June 1977)

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Amanda Sebestyen from Spare Rib interviewed several women involved in the Bethnal Green hospital occupation and campaign, for Spare Rib, in December 1978:

Saving the Green

We know that the Health Service is under attack all over the country, from our own experiences —longer queues, more medical mistakes, more harassed staff, less time in a hospital bed, more time looking after sick people at home. And East London is really in the front line. With some of the worst medical provision in England, the Area Health Authority proposes cutting a third of the area’s hospital beds. A new hospital is due for the 1980s — work hasn’t even begun on the site yet.

Bethnal Green has an extremely successful small hospital. Last autumn the Area Health Authority revealed their plan to close down all its general services, and con­ vert the wards for geriatric patients. But the staff and local people had plans of their own. A campaign to Save the Green started right away, beginning with half-a-dozen staff and a local doctor, and growing by Christmas to a meeting of 700.

People are now occupying the hospital 24 hours a day to stop the conversion. Unlike the planners, most campaign members come from Bethnal Green itself. The staff are not only upset about their jobs, but about the decline of a community: “If I had to give up work tomorrow it wouldn’t bother me. But I live in this area, I want to end my days here, and in the 30-odd years that I’ve lived here I’ve seen this borough go down”. Women have been in a majority in the campaign.

Scotty…… works in the hospital laundry, NUPE Shop Steward.
Myrna Shaw……. secretary of the Medical Postgraduate Department, NALGO Shop Steward.
Marjorie Cheskin…….Sister-in-Charge of the Nurses’ Home. Eileen…….lives in the area.
Elizabeth…….works at the London Hospital, Whitechapel,
Lynne…….teacher, from the East London Women’s Health Group

Smaller is Better

There was David Ennals on the tele­ vision saying that the very large hos­pitals are a mistake, “the 300 bedded hospital is the hospital of the future”. Well, this is a 300 bedded hospital. And this is still – or was before they started running it down — a very busy little hospital. I find that the smaller a thing is, the better it runs, the far less expen­sive it is and a much better atmosphere there is for everyone to work in. Marjorie Cheskin.

When my Mum was in here, I used to come up every day with silly excuses like she needed a clean nightdress, just to see her for an extra ten minutes because she was very upset. And the sister knew, she used to say to me “Don’t bother to make excuses, just come in, but don’t stay too long.” And in a big place, you can’t. Over at the London, you stick to visiting hours. Eileen.

1 think the London’s a good example of how a large hospital doesn’t work. It’s too impersonal, and it’s getting larger every day. Elizabeth.

Waiting Forever

It’s true we’re not technical like the London, but we take alot of the strain off them —they had big waiting lists for orthopaedics and we were getting them done here within eight weeks. Marjorie Cheskin

There’s a woman came up to ortho­paedics here and had to be sent over to the London. She’s going to have to wait eleven months —that’s just to see a doc­tor, not to get an operation done. Lynne.

At the moment there’s no fracture clinic locally, there hasn’t been for a long while. If you go down to Mile End they just X-Ray you and refer you to the London. My daughter hurt her arm on Tuesday, she was sent to hospital Wed­nesday morning and told it was nothing serious, but she’d chipped a bone or fractured her shoulder. We couldn’t go up to the London hospital because it was turned twelve o’clock, so they strapped it up at Mile End and sent me on Thursday. Thursday they decided it didn’t really need plastering, but then again the actual fracture doctor wasn’t there, so I had to go back again on Monday. We sat there from about quar­ter to nine till about ten past eleven to see this doctor, and he said,”Oh, yes, yes, we’ll leave it wrapped up as it is and we’ll see you next week”.

Running down the Area

They quote facts and figures, so many beds for so many people living here; but with all the wood factories in Hackney Road it’s surprising how many people from outside come in from accidents at work. Eileen.

There’s no argument for getting rid of this hospital on health grounds or any­ thing else, it’s purely money. This is exactly what the hospital administrator said to us when he was showing con­ tractors around a ward. Lynne.

If they want to save money, how can they justify the conversion? Look at all the money they spent here recently on the operating theatre and orthopaedic. Seven or eight years ago, this hospital had everything. Elizabeth.

The children’s ward went to Hackney Road, the Ear Nose and Throat went to St Leonards. They didn’t go in one big lump, they went gradual, but you were always told that something better was going to be put in their place. Marjorie Cheskin.

The kitchens here were a showplace. People came from different hospitals all over England to see them, because they were a new design for the National Health Service. Elizabeth.

This laundry was going to be the group laundry. We have our own water supply here, we’ve got room for expansion too. Also we’ve got much better ventilation than the London will ever have. Am I angry that the laundry’s going to be closed down? It’s not going to be closed down. Because they’ll close it down over my dead body. Scotty

The Old get Angry

This was a ten year plan, and the popu­lation was getting older. But things change in ten years. The immigrants aren’t geriatric, the squatters aren’t. Marjorie Cheskin.

We gave the elderly the dignity of being in a general hospital, we didn’t stick them in an all-geriatric hospital without the facilities that they’ve got just as much right to as anyone else. Myrna Shaw.

To come out of one ghetto into another —the Area Health Authority aren’t doing the old people a favour. Scotty.

We’re going right back to the very days that this hospital was first built, as a workhouse. I find if you’ve got elderly people with young people, the young people tend to sort of take them under their wing. But when you separate old people from everyone else, then no-one can see what’s going on. It just turns into a dump. Marjorie Cheskin.

The plan says geriatric for four years, and then closure. So where do people go next? And nobody’s asked the old people around here if they want this all- geriatric. They don’t. They support us. Eileen.

The Hackney Pensioners were the first on the scene with a letter of protest. Myrna Shaw.

For most of the elderly people around here, this IS their hospital and without it they can’t go anywhere for help. We hired a coach for a pensioners’ club to come and protest at the Area Health Authority, and they were terrific, sing­ing and dancing and they all had banners. Someone lifted one lady up to the office windows and she was banging on them and saying “Come out here, you miserable old gits”. And when the planners’ cars drew up for the meeting, another lady was waving her stick in the air and saying “If I was younger I’d give you what for!” There were quite a few Policemen up there as usual, and one of them said, “If you younger people were doing what these old ladies are doing, you’d be arrested”. Eileen.

Fighting Back

Every time a ward gets emptied we padlock it up, to stop any conversions into geriatric. We’ve got 102 local GPs on our side; we have local residents picketing, and then the dustmen have been coming, and the brewers. Scotty.

I think the joint shop stewards’ committee is the best thing that’s come out of this campaign. But instead of calling an all-London stewards’ conference, the leaders of our two main Health Service unions have virtually abandoned us. We think that in return for favours elsewhere they’ve agreed to keep quiet about their problems.

Four of us on our shop stewards’ committee are ladies as opposed to one man. We’ve been very very active. Myrna Shaw.

Eileen: The majority of the people who turn up for the rallies are women.

Elizabeth: I think it’s because the men couldn’t care where they go, it’s the women that have to bring the children and things like that. One Saturday they were due to close Casualty, and we got some leaflets out very quick and went in at the pubs; “Oh yes, we’ll be there” – and yet hardly any of them came, the men.

Eileen: It’s nothing to do with the hours, because I work during the day.

Lynne: We all do. The only time it’s more usually men on the picket is when they stay overnight.

Elizabeth: I think it’s because they could probably cope better if there was any violence.

Lynne: I don’t feel I could cope less than a man.

Eileen:I wouldn’t be prepared to stay up here on my own, I would with another girl.

Eileen:We did a leaflet saying, “Mothers Show Your Power” because there’s a lot of people who don’t go to work and when they get given leaflets with “Go to your trades union, Do this and Do that” they feel they’re not really involved because they’re only a mother. The meeting was in a park which wasn’t very dangerous for the road, and it was a time when the children were on holiday. Lynne: A lot of women objected to it because they said they weren’t just mothers they were workers as well and they didn’t like being defined like that.

Eileen: Nothing against people working, it was just to try and get some of the mothers who didn’t go out to work to realise they could still do something.

Another good thing we did which I think was good, we asked five local schools if we could put out leaflets. And they all agreed, in fact they gave them out them selves.

In the summer we went to David Ennals’ house, which was in a very small block of flats but it wasn’t like out flats you know, the door was shut and a porter came out. Rather select. And there was all us people shouting ‘Up the Green, Up the Green!” and all these curtains were opening… And then we went to Downing Street which was also funny because there was a policeman with a walkie-talkie and as the 50 of us walked down towards him he started saying “Help, I need reinforcements, I’ve got a mob assembling!”

And then on the anniversary of the National Health Service there was a pro­ test against the cuts organised country­ wide by the Fight Back organisation. At nine o’clock you stood outside your own hospital and lit torches, but we turned ours into a singsong. We made our own up: “It’s along way to the London”! Eileen.

Some German people came the other night, and played with their banjos out­ side the hospital. I was so amazed I almost burst into tears because there was hardly anyone around, and here were these people all the way from Germany come to support us. Lynne.

Things to Learn

I stood up in the Park and I said, “You have got to go to council meetings. You have got to be seen there”. Because the council knew that this was happening and didn’t bother. If all these people who say they’ll help us now had come to our aid when we asked them, we could possibly have halted this from the very beginning. Marjorie Cheskin.

At first we were a bit nice, like we wrote alot of nice letters saying Please could you meet us, and Please produce this. We waited six months once for an answer from the Area Health Authority We could have been a bit more demand­ing. Eileen.

We should have worked more on getting the Community Health Council to support us, they only came over to our side when it was too late. They’re essen­tial for any hospital campaign, they’ve got the power to hold up closures and get a hearing from the Health Minister Lynne.

You shouldn’t just call round the local papers, it’s the national press you’ve got to get to. Elizabeth.

To my mind the campaign hasn’t involved enough of the ordinary staff in the hospital. I was talking to a Sister today, she said “The meetings have stopped,haven’t they?” and I said “No —you should come along”. No-one had actually asked her. Lynne.

The ancillary workers have been behind us and they’ve been coming to support meetings, but you can’t have a very large committee. You only need one person from each department plus the doctors from outside. Scotty.

I think when you form a committee, you should include someone from out­ side, like an ordinary housewife. I brought my mother along to the first meeting and they said, “You shouldn’t have. She’s not on the committee.” At the beginning they were keeping out the local people, though the attitude’s changing. Elizabeth.

Male Chauvinist Pickets

While I was interviewing Eileen, Elizabeth and Lynne, one of the men on picket duty managed to come into the room FOUR TIMES with increasingly non-existent excuses.

That’s just typical, that he couldn’t leave women alone for five minutes. He had to know what’s going on and why. Most of them are like that. Lynne.

We were getting ready for a march, and somebody said “What shall we do for our last banner, something that’s really eyecatching” and immediately a man — obviously—turned round and said “I know, two women walk topless”. Some body else who was there done her nut, she said “Why must it be women?” and he said “Oh, well, two men walk bottomless then —it was just a joke.” She said, “It isn’t a joke. We’re discuss­ing a campaign for equal people and straight away it’s sensational if women walk topless.” Eileen.

It’s the women who are giving the lead with leafleting and practical things but in all the meetings I’ve been to they’re not listened to so much. The men have more status. Lynne.

We’ve Changed

I’ve never had any time for unions. I’ve always felt they did not give you a chance to say how you feel; but now I’ve joined the Royal College of Nurses for the first time, that’s the nurses’ organisation. And I’m grateful to the other unions for what they’re doing. But I’ve been a little bit dissatisfied because I thought there was far more unity than there actually is. You could make these unions work, but only if everybody was to play their part in them. Marjorie Cheskin.

My father came into this borough in the arms of his parents well over 80 years ago. He was always a very strong trades unionist, my brothers were always into the labour movement and I went in at 14. Then I dropped out when my child­ren were born. Until this campaign started, being a shop steward was a very innocuous job, almost a toy job. Well, I rejoined the Labour Party on Sunday, despite what I’ve said about them. Myma Shaw.

I feel I’ve become more tolerant of people’s attitudes, understood that
people can change and not to write them off if they seem conservative. Lynne.

If it hadn’t been the Green, if it had been somewhere up North, I don’t think I’d have done anything about it. I’d have just said “Terrible, the cuts”. But because this is my local hospital, I’ve been surprised some of the things I’ve found myself doing. When we went up to Westminster, we were all militant. I would have thought. Oh David Ennals is a Minister, you can’t really go up and see him. But it’s your right to go there. Before the campaign I would never have dreamed of it. Elizabeth.

Up until I got involved with this, apart from going to work, that was it. I spent all the evenings indoors. I didn’t belong to any clubs or evening classes. I come out two or three nights a week now, which I didn’t do this time last year.

I think Anne, who does the news­ letter with Lynne, said it to me last week, that when you’ve got children you’re always somebody’s Mum or your’s somebody’s wife, and when you come somewhere like this you become a person, you’re you. My husband and my children, they don’t object to me coming, but you know I couldn’t drag them up here if I tried. They just say “Tara, Love”. Eileen.

The Future

If we win here, I’d join another local hospital campaign. Save St Nick’s. Elizabeth.

I’d definitely join something else after­ wards, because now I’ve done this I’d find it very hard to just go back. This has got me out of the house, meeting new people, different people. It’s been good for me, I don’t know about me being good for the hospital but it’s been very very good for me! Eileen.

I’d like to see this restored as a general hospital. I’d like to see the operating theatre reopened, perhaps just for orthopaedic cases. I’d like to see Casualty reopened – they talk about the new accident and emergency unit at the London, but it’s nowhere near ready yet. Myrna Shaw.

It’s stalemate. We’re stopping the con­ version, but now the Area Health Authority are threatening people’s jobs. But the staff are really angry because they know the conversion will lose jobs anyway. We’re in a stronger position now as ancillary workers in the London and Mile End have promised to work to rule if management moves in. And recently we blocked the main road out­ side the hospital for twenty minutes to show our determination. Lynne.

The Area Health Authority have told us so many bloody lies they don’t know which way to turn now. Apparently the Minister has called back the papers to look them over again because he hasn’t got the truth from them. Personally myself I think it would be better if we could get an all-London stoppage over all the cuts in all the other hospitals. It’s time we all stopped fighting our own little battles and joined together and made the biggest stink that anybody’s ever heard. Scotty.

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In the end, the surgical beds closed in 1978 and the remaining medical beds in 1979.

The Bethnal Green work-in may have been defeated in the most immediate terms. However, as the first occupation of a casualty ward, it received a huge amount of publicity, and encouraged a succession of hospital occupations and work-ins, from the Elizabeth Garrett Anderson work-in onwards.

In 1990 the Hospital closed entirely.  Patients and staff were transferred to the newly opened Bancroft Unit for the Care of the Elderly at the Royal London Hospital (Mile End).

Here’s a short film on the later campaign to keep the rest of the Bethnal Green Hospital open, dating from 1984

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An entry in the
2015 London Rebel History Calendar – Check it out online

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Today in London healthcare history, 1981: work-in launched at St Mary’s Hospital, against closure

In our continuing series documenting hospital occupations in the UK, of which a number took place between the late 1970s and early 1990s… As ever, any more info on this occupation anyone out there has would be great…

In 1981, 400 staff at the Harrow Road site of St Mary’s Hospital, in West London (which served the Paddington and Kilburn area) decided to organise an occupation and work-in to try to prevent the closure of several departments.

St. Mary’s had been under threat for the preceding four years; only the vigorous opposition of the staff had prevented its total closure. Rheumatology and Rehabilitation wards only opened in 1977 (the first in the District) had been shut in 1979, when the first serious financial cuts affected the NHS.

In 1981 the Hospital had 431 beds, but the Area Health Authority decided that there were too many acute beds in the District, and that the service would be concentrated at the Praed Street site and at St Charles’ Hospital.

Threatened with the immediate loss of the Casualty Department and 100 beds, and eventual closure, (with surviving services to be moved to the prestigious St. Mary’s Teaching Hospital in Paddington), staff declared a work-in on June 26 1981. In the course of this workers twice occupied areas of the hospital—the first time the administration offices were occupied for 13 days, and the second time a ward was occupied for five days, to prevent its closure. On both occasions court orders were used to evict the occupiers.

At a press conference in December 1981, Terry Pettifor, NW Convenor of the London Ambulance Service Shop Stewards, described the effects of the run down of the Casualty at Harrow Road (the major accident unit in the

District) and pointed out that the remaining casualty facilities in the District would be inadequate to cope with the number of casualties which could easily arise in an accident at the nearby Paddington Station or in a major fire. Three wards had already been closed by then.

Police and security guards were brought into the hospital at least four times to support management’s plans. A TGWU shop steward was sacked, and a nurse was suspended for a week, for attempting to prevent the forcible removal of patients from a ward.

At least one report claimed that “Throughout this struggle no more than token support has been gained from the unions involved – TGWU, NUPE, COHSE and the failure of the labour movement to evolve its own strategy on health care has been partially responsible for this state of affairs… The leadership of the TGWU – which has been most centrally involved in the struggle – has effectively washed its hands of any responsibility.
Despite policy won at the 1981 BDC it has consistently refused to mobilise its great industrial strength behind this key battle.”

Several trades unionists active in resisting the closure of St Mary’s were targetted, victimised and sacked by management… Rita Maxim, a TGWU shop steward who stood up to management all the way, was threatened with the sack for refusing to do two jobs; a telephonist was also sacked for leaving work at the end of his shift without waiting for a relief.

This occupation succeeded, at least temporarily, in preventing immediate ward closures, but by 1985 St Mary’s had just 166 beds. The Hospital was due to be closed once Phase 1 of the rebuilding of its mother hospital in Praed Street was completed but, due to financial pressures, it closed prematurely. The wards finally closed on 22nd November.

Services were transferred to the St Mary’s Praed Street building.

Part of the Harrow Road site was taken over by the Paddington Community Hospital, the rest was bulldozed and converted into flats, its canalside location making it an attractive proposition for the middle classes (though the developer apparently later went bust, so it never quite achieved its yuppie promise).

NB: In 1993, when the Accident & Emergency Department, at St Charles Hospital was due to be closed, campaigners resisting this move occupied the office of Chief Executive Neil Goodwin, based in the old St Mary’s building in Praed Street.

Today in London healthcare herstory, 1985: occupation of South London hospital for Women violently evicted.

The South London Women’s Hospital Occupation 1984-1985

Rosanne Rabinowitz
[Originally written around 2003]

What does it take to occupy a hospital, to engage in direct action in a workplace that deals with peoples’ lives rather than products? In the first hospital work-ins, people were understandably afraid of putting patients at risk, and aware that someone might not want to have a baby or an operation in the middle of an industrial dispute. It was an unprecedented step, but staff and service users had come to a point where they felt they had to take drastic action or say goodbye to their jobs and healthcare.

A background of cuts and closures provoked this first wave of occupations in the 1970s, often undertaken by people who were not activists. In the early 1970s both the private and private sector were restructured in response to IMF directives. The restructuring was also a move to curtail the improved wages and defences (‘restrictive’ work practices) that workers built up through the years. This took the form of further centralisation, deskilling, redundancies, productivity deals, speed-ups, casualisation and tougher discipline.

Since this restructuring often involved closures, people began occupying workplaces instead of simply going on strike. Some of these actions developed beyond sit-ins to work-ins, which involved continuing production. Briants Colour Printing and Upper Clyde Shipbuilders were among the first work-ins. UCS became a rallying point due to the size and its location in area of militancy and close ties between the workplace and the community. Shop stewards seized control of the yards and controlled the gates on a rota. Those sacked were kept in jobs by rest of workforce who now controlled production. The fact they were already sitting on top of a lot of capital and unfinished work made this possible.

Over 1000 occupations & work-ins took place in 1972. However, in some situations self-management can turn into self-abuse. A cartoon of the time said it all: “Brothers and sisters! If the bosses won’t exploit us, we’ll have to do it ourselves!”

However, work-ins also included community outreach and political organising. For example, at Plessey’s River Don steelworks redundant workers devoted themselves to campaign work rather than completing orders for the plant’s liquidator.

From private to public…

A twist in the tail came when hospital work-ins and occupations extended this tactic to the public sector. In the face of such closures, a strike presents problems unless it takes the form of sympathetic action in other hospitals or workplaces. However, by providing a service that management was trying to cut, workers strived to create a rallying point.

Usually, hospital workers contemplating a work-in discussed it with present or prospective patients. This is more of a possibility in smaller, long-stay hospitals.

As long as patients are in a hospital, the Secretary of State is legally bound under the Health Services Act to ensure that they receive treatment and to pay all the hospital workers; nurses, doctors, technicians, cleaners… So by keeping patients in the facility, hospital occupiers were able to keep the hospital open and functioning.

However, there is the problem of insurance. Insurance rules stipulate that management must be present on the premises and be legally liable and responsible. This could include area health authority representatives or on-site administrators. During the Elizabeth Garrett Anderson Hospital work-in, the on-site management consisted of the hospital secretary.

The employees in a hospital work-in usually acquire more power, but this occurs alongside a functioning administration. Some hospitals did refuse entry to most of management and allowed only a token management force that would not be able to obstruct the work-in.

In order to keep a hospital occupied, you need physicians willing to admit patients and treat them. Some physicians did remain in service in accordance with their concept of professional ethics – if there are patients, they will care for them. But they generally stayed away from political aspects of a campaign.

Two hospital earlier work-ins have particular relevance to what took place at the South London Women’s Hospital: Elizabeth Garrett Anderson Hospital (EGA) and Hounslow Hospital.

The first: Elizabeth Garrett Anderson Hospital (EGA)

Founded by the UK’s first officially practising woman doctor, the EGA aimed to train women doctors and provide treatment for women by women. Closure of the hospital, located on London’s Euston Road, had been contemplated since 1959 on grounds that a woman-only hospital was an anachronism of the Victorian era. The authorities  considered demand limited to small groups of orthodox Muslim & Jewish women who objected to treatment by male doctors for religious reasons. There was also a drive within the NHS to ‘rationalise’ and to close down small hospitals.

However, they hadn’t reckoned with a growing women’s movement that made medical care for women by women a central issue. Debate had also grown about the very nature of women’s healthcare, as seen in publications like Our Bodies Ourselves.

Throughout the 1960s Health Authority ‘ran down’ the EGA by not doing repairs, replacing equipment or hiring new staff. Bed space had declined from 300 to 150. A malfunctioning lift in 1976 brought patients down to 46 and closed off the operating theatre. The hospital faced a succession of closure threats. Demonstrations and a petition signed by 23,000 women forced the nursing council to back down from closure in 1974. However, the EGA maternity hospital had been closed down, and this had angered staff members. They formed an action committee that represented different sections, but it was dominated by the consultants.

EGA was a good place for trying the occupation tactic in a hospital setting – its unique historical legacy as a women’s hospital created ground for support and unity. The women doctors at EGA also tended to be progressive – for example, one had received her medical training as an anti-fascist volunteer in the Spanish Civil War. This committee’s main tactics involved lobbying, petitioning and writing letters.

The rest of the staff got involved after actual closure was announced in 1976. This included the big health unions: the National Union of Public Employees (NUPE), COHSE (representing nursing staff), and ASTMS (paramedical staff). In July 1976 health workers protested against health service cuts and the EGA closure in particular: 700 workers staged a ‘day of action’ and marched to the House of Commons. Others took action in their hospitals, forcing four London hospitals to restrict admissions to emergencies. Some occupied health authority offices. Rank-and-file groups took on a major role organising these actions. Future New Labour health minister Frank Dobson was then leader of Camden council and voiced support. Wonder what he’d say to an occupation on his patch now?

However, health secretary David Ennals claimed that the EGA was ‘small, ageing… can never be developed to fulfill functions of a modern, acute hospital and suggested the EGA become a unit at the Whittington Hospital in Highgate.

The Action Committee replied that the EGA’s present location allowed it to function as a specialised national facility and a centre fulfilling local needs. As a small hospital maintained “a friendly, unthreatening atmosphere, necessary for a hospital interested in educational, preventative and outreach work relevant to the specific health needs of women.” The committee also pointed out that residents in the nearby Somerstown estate were pressing for their own health centre; facilities for women at the EGA could take pressure off the Somerstown health centre. Increasingly Somerstown residents and EGA campaigners worked together.

When Ennals asked the Area Health Authority to close in-patient services at the EGA, staff held an emergency meeting vowing to sit-in or work-in if necessary. The work-in had been urged by community activists (not staff members) on the EGA campaign committee, but was rejected as impractical in a hospital setting. But as closure loomed, the staff and community seized on a work-in as their last chance. It began a few days before the actual closing date with official support from the unions.

In November 100 nurses and 78 ancillary staff began the occupation. Pictures taken outside the EGA on that day show pickets in front of the hospital with a banner declaring: “This hospital is under workers’ control.”

Meetings of all the staff made major decisions, with committees set up by general meetings to do the actual organising. These included the Joint Shop Stewards Committee, the Medical Committee and the Action Committee; the latter made up of elected representatives of all sections of staff, and linked union members and consultants.

The Save the EGA campaign committee consisted of supporters outside the hospital. Though set up by Camden Trades Council, it became autonomous and drew in people from other hospitals, local residents, people involved in childcare and housing campaigns – such as the nearby Huntley St squat – and activists from the women’s movement. One shop steward participated in campaign meetings, and the campaign sent a representative to other groups. This committee main support for working in came from the campaign committee.

Ambulance drivers and workers in referral agencies such as the Emergency Bed Service were vital in opposing management attempts to stop the flow of patients into the hospital – workers notified drivers that the hospital remained open and asked them to bring patients.

More than defence

Work-ins are essentially defensive. They aim to keep the premises in repair, maintain morale and keep equipment and patients in the hospital. They are not set up to implement ‘workers’ control’ or transform social relationships within the hospital. But staff usually do gain more influence as a group, and ancillary workers and nurses develop stronger organisation.

In order to involve more people in the campaign, activists usually need to progress beyond defense to demand extensions or improvements in the public resource. Direct action to preserve a service or facility inspires debate on the role the facility plays in a community, the needs it fulfills and the needs it must be developed to meet.

In the case of the EGA, this expansion took place in the context of the women’s movement, defining the EGA as a women’s hospital and a national and local health facility. This resulted in pushing for a well-woman’s clinic that takes a community-oriented approach to health and act as an information centre as well as medical facility. According to Rachael Langdon of the EGA Well-woman’s Support Group:

“The dissatisfaction experienced by women in health care will not be overcome alone by seeing a doctor of one’s own sex or only by the existence of a women’s hospital. The issues are wider and preventative health is not merely a matter of individual effort. This is where the importance of alternative and women’s movement health groups lies… A well-woman clinic and a women’s hospital which could develop an exchange of ideas and knowledge with alternative and women’s health groups would be a step forward for women’s health.”

Campaigners demanded that the EGA be upgraded to a ‘centre for innovation and research’ in women’s health matters and a resource in the community. Campaigners and workers sponsored well-attended discussions relating to women’s health issues such as menopause and contraception, which often drew over 200 people. Sometimes the discussion between doctors and radical feminists set on challenging the medical establishment got lively.

More closure threats arrived in 1978; in May, a large demonstration in front of the hospital stopped traffic on Euston Road. In 1979 campaigners won the battle to keep the EGA open as a gynaecological hospital. However, the old building closed in 2008 and EGA now operates as a specialised maternity wing within the UCH hospital.[NB: This unit remained open as a separate building in Huntley Street until 2008, when it was moved into the new University College Hospital building just down the road. Your past tense typist’s daughter was among the last people born in the second EGA.]

Both the EGA and later the South London Women’s Hospital campaigners had ongoing debates over whether they should plead as a special case, or defend their hospital as part of an across-the-board opposition to health service cuts.

For example, people in the EGA campaign group believed that campaign should ‘feel free’ to split from the staff action committee if it didn’t not take a direct line against the cuts; they felt the campaign should take the initiative, which hospital workers could follow or not follow. They believed the campaign was responsible to those who used services, which expressed itself in total opposition to the cuts and transcended the interests of workers in saving their particular hospital.

Hounslow Hospital

In contrast to the EGA, West London’s Hounslow Hospital did not have the advantages of national reputation, special support from the women’s movement or supportive consultants. It was a small facility for geriatric and long-stay patients, considered a home as well as a place for treatment. Situated in an industrial area, girdled by two motorways and Heathrow Airport, Hounslow faced more repression and practical disadvantages.

The authorities had backed down from closure threats to EGA at least three times and did not attempt to break the work-in, outside of morale erosion and running down facilities. Hounslow workers faced constant threats and intimidation, a forcible smashing of the work-in.

With less support from doctors, Hounslow staff including nurses, porters and cleaners and took the main initiative and challenged the traditional hospital hierarchy. The work-in only lasted six months, but the community occupation of the hospital that followed lasted two years. Lines were drawn clearly, and there was no special pleading.

The response to proposals for possible closure in 1975 started with admin staff and friends, plus local volunteer and charity organizations, who wrote letters and circulated petitions – usually hand-written sheets passed around the neighbours. Senior nursing staff took an interest, opening communication with ancillaries and porters, and these involved workers from ‘outside’ in the campaign. Activists from the West Middlesex District General Hospital looked into plans and discovered a whole series of cuts planned for the region.

Hounslow’s closure was announced in January 1977, set for August; the work-in started in March. Management tried to transfer staff, and threatened those who refused with sanctions & sacking. They met with GPs, warned them against admitting patients to Hounslow and threatened them with sanctions.

When the August closure date arrived, staff organised a march through Hounslow and a party for the patients. As they pushed past the closure date there was a lot of fear. Workers had no idea if they would get paid; the authorities tried to claim that the AHA did not have to maintain staff and facilities though the law said otherwise.

Comparison and clampdown

The EGA had on-site consultants who could admit patients; Hounslow had none and depended on GPs. They had to tout for more admissions, though August is traditionally a slow time. The authorities tried to turn patients away and cut off the phones. The EGA had been treated as a freak case, but Hounslow indicated a trend of resistance to health service rationalisation. If a small weakly-organised hospital became such a focus for community resistance, they saw obstacles to imposing any cuts and rationalisation. The Hounslow work-in had also gone further to challenge the hierarchical relationships of the hospital. Consultants weren’t around much, and the process of campaigning had broken down traditional boundaries. The campaign and the staff had effectively taken over control of admissions. As one Hounslow Hospital worker put it: “With consultants no longer in control of admissions, the hierarchical system of privilege in the NHS was smashed.”

When threats didn’t succeed, a district team of officers took forcible action on October 26, 1977. If the authorities had to continue funding as long as patients were present, they got around that by forcibly removing the patients. Aided by the private ambulance service (public ambulance staff refused to take part), police administrators, top nursing officers and consultants moved on the hospital. They cut the phonelines, thwarting the emergency phone tree. The raiders pulled 21 patients out of their beds and took them to the private ambulances. Pictures show the scale of destruction – wrecked beds and furniture, the floor strewn with food, torn mattresses, sheets, personal articles. According to a nurse: “Old ladies had to queue up for an hour, crying all the time, as we remonstrated with the AHA people to cover them against the cold.”

The raid provoked a public outcry and led indirectly to the downfall of Hounslow’s Labour leader. A week later 2000 striking hospital workers picketed the Ealing, Hammersmith and Hounslow AHA to protest the raid and demand reopening. The AHA had to censure their own officials and called for a public enquiry, which was turned down by David Ennals. The district administrator later admitted that losing the 66 beds had badly affected geriatric care in the area.

Complete control

Once the hospital was shut, campaigners moved in and took complete control of the building. They had little idea what to do with it now that the patients gone and wards wrecked. Eventually they cleaned it up and used it as a local centre. Some of the original staff continued to be involved with the occupation. With the end of the occupation two years later, five were left.

However, the occupation itself drew in new people and took on a life of its own. Following the raid Hounslow had become a national issue. Nurses, porters and food service workers traveled to hospitals and meetings throughout the UK, discussing their experiences and asking for support. They initiated a national campaign against NHS cuts, called Fightback, based at Hounslow and involving people from the EGA, St Nicholas, Plaistow and Bethnal Green work-ins.

The Fightback production team occupied the matron’s office, the West London Fire Brigades Union used the assistant matron’s office as their headquarters, Maple Ward became a ‘conference hall’ used by local groups. The National Union of Journalists used hospital facilities during a strike.

The occupation became very intense, given the strong emotions provoked by the raid, the length of time the occupation carried on and the variety of groups taking part. Women whose world was defined by husband, family and job found themselves making speeches and going out every night, confronting their husbands to go on tour or to stay overnight at the hospital on night picket. Seven marriages broke up in the course of events, and many new relationships started.

After a year of occupation, AHA backed down on the eviction threats and conceded to negotiations on the occupation committee’s demand that Hounslow Hospital be reopened as an upgraded diversified community hospital, based on plans that had been developed during the occupation. The occupation committee did not negotiate as a special case. The opening of a community hospital meant little if cuts are made elsewhere. These negotiations broke down when management did not give firm dates to provide plans, or guarantee commitment of funds.

However, the committee ended the occupation in November 1978, claiming that ‘no positive political gain’ would come from an eviction. They thought the demands of maintaining a 24-hour picket were draining resources from other kinds of campaigning, and diverting attention from cuts in other areas. They claimed some victories in dislocating the programme of cuts and put forward detailed plans for an expanded community hospital. In its statement, the committee said that work began on redesigning facilities in the new community hospital/health centre after the occupation ended.

In 1976-78 work-ins or occupations took place in at least ten hospitals. About five work-ins were waged over an extended period of time to oppose closure, and the rest were shorter actions to oppose under-staffing and back up other staff demands. There were also sit-ins in administration and health authority offices, including an eight-week occupation at Aberdare Hospital, and in one nursery school and an ambulance station. Occupied hospitals included Plaistow Maternity Hospital, two wards at South Middlesex and one at Bethnal Green, where local people assisted the work-in by occupying the wards that had already been closed.

Some participants pointed out that union officials definitely got in the way during work-ins, hindering rather than helping in open-ended struggles where people need to keep things going and maintain morale. Union officials think in terms of ending it all and negotiating the terms. According to one participant, union officials that came into Hounslow when the work-in was made official “caused more havoc than management.”

South London Women’s Hospital: don’t be so kinky

Many of the occupations of the late ’70s had achieved short-term goals; and some work-ins were defeated due to lack of support from consultants. However, use of the tactics trailed off by the early ’80s. Until…

The Wandsworth Health Authority announced in 1983 that it will close the South London Hospital for Women’s (SLHW). This hospital had some similarities to the EGA and similar issues came up in defending it. However, this time around the authorities couldn’t say that a hospital where women receive treatment by female physicians was a remnant of the Victorian age. Instead, Wandsworth argued in terms of rationalising and budgets.

Staff initiated a work-in late spring 1984, which only lasted a couple of months. Fewer consultants were admitting patients, then the consultants were all offered positions elsewhere and they jumped ship.

But nurses and other staff wanted to fight on. Together with local activists they organised a “lie-in” in July 1984, following the exit of the last patient. The outpatients’ department (housed in an adjoining building) was due to shut later, in spring 1985.

I found out about the campaign to save the hospital when I went to the well-woman clinic and found a stack of leaflets there. This might have been when the work-in was still going on.

A good 200-300 women came to take part in the lie-in. We slept in the wards and maintained a mass picket to stop the authorities from removing equipment. All the large wards were filled. The top wards were kept empty as an example of what the fully-equipped wards could be like.

In the absence of patients, the occupation aimed to keep all the equipment on site in readiness for re-opening. Though a relatively small hospital, SLHW was a large rambling Victorian building with many entrances and exists. We maintained a picket at the main front door, locking the other doors in the main building, and also kept a picket at the gate in the car park.

There was still a lot of coming and going in relation to the outpatients as well as security guards still stationed at the front.

All kinds of women took part in this event – local pensioners, hospital staff, nurses, anarcha-punky girls. It was also racially and culturally mixed. I met a few women who said that they’d been born in that hospital. There was a fun atmosphere, with lots of people sitting outside on picket. It was a warm summer night, so people also relaxed in the garden.

Unfortunately, the next day a few snotty social worker types scolded girls for fooling about on the water-beds when the press was due to arrive. “Don’t be so kinky,” one of them said.

Of course, when no attempt was made to evict us the next day, we had to decide how to continue the occupation and how to organise it. First, what to do about the security guards. During the first few nights of the ‘lie-in’ they were doing rounds throughout the building while we were sleeping, walking around and shining their torches and speaking on their walky-talkies (this was the 80s, remember). We had some tense negotiations about this, but eventually they agreed to stay in their office on the bottom floor.

Numbers were still high for the first couple of weeks, but as you might expect they started to dwindle. It became a strain to maintain the picket. After the third week or so the health authority informed us that they wouldn’t be evicting us while the outpatient facility was still going. Obviously, the authority knew it would be easy for us to get back into the building if part of it remained open to the public. The health authority insisted that the security guards remain downstairs, but as they’d been keeping to their area it wasn’t a problem. Not a bad gig for them really, with the pickets keeping an eye on things they didn’t have much work.

Since the days of the EGA the women’s movement had diversified and grown. Women came from the Greenham Common peace camp to support the occupation. One lot got annoying when they told us we should have non-violence training. It seemed to be imposing their way of organising on us. At the same time, a bunch came from Blue Gate who were more down-to-earth. By this time, each gate at Greenham had their developed its own character and politics.

There had been a lot of Labour lefty influence in the beginning, which might have reflected elements of the campaign before I got involved. We were living in the days of the GLC, after all. We got visited by GLC Women’s Committee chair Valerie Wise, who gave speeches in front of the hospital. She kept saying: ‘My name is Valerie Wise, and I’m here to talk about the GLC.’ Some of the women there were chuffed by this, though her constant self-promotion made me sick. In fact, I was having some doubts about staying on if we’d be hearing a lot of this.

Then I went on holiday for about ten days. Just after I returned, I was in bed recovering from an all-night train and ferry experience. Then I received a phone call that emergency pickets were needed at the hospital. Already? I’d meant to give it a few days before going down again, but my caller said it was very important so I turned up.

A bunch of new people were on picket, and I found out someone was having a baby upstairs with a midwife in attendance. When the baby was born, celebrations ensued and then the TV bods turned up. The baby was a little girl called Scarlet.

A whole new bunch of women infused the campaign. Some had just moved to London, and they made themselves at home in the wards with the private rooms. This inspired a general movement to occupy the wards upstairs, and use the big lower wards as communal and social areas. With the involvement of new and full-time occupiers we entered a new phase.

Taking a tip from the Hounslow experience – among our local supporters was a nurse who had been active in earlier health service struggles – we made the hospital into a campaign centre and a kind of social centre a well. We invited other groups to use the space, and held activities like jumble sales, tea dances and public meetings. We had a big picnic in the garden with performers – among these was Vi Subversa, singer from the anarcho-punk band the Poison Girls. The first jumble sale was massive, with bags & bags of stuff that made us a good £500 and costumed the entire occupation group too.

A radical nurses’ group had been active for some time; an Asian women’s health group also met there and did acupuncture. Some of these activities kicked off quickly, other things took a while to get going.

The occupation went through several reorganisations, but we made decisions at general meetings throughout. When a lot was happening we had general meetings every evening, but this wasn’t always necessary. We set up groups involved with particular tasks _ publicity & propaganda, coordination, outreach & campaigning, looking after the building.

Since we were entering a phase with a definite long-term commitment, everyone eventually moved into the private rooms in the upstairs wards and left the big wards for communal purposes, meetings and events,  And just like the gates at Greenham, each ward took on its own character.

The top floor ward in the main building became known as called Cloud Nine. It was favoured by the spaciest Greenham girls, mostly from Green Gate. Most of these women were great, but some of us got impatient with a few who came to the hospital to chill out (or warm up, during the winter) and didn’t take part in the picket and other activities. From their point of view, they came from the rigours of Greenham to have a rest somewhere warm – with outpatients still open, the central heating and hot water remained still on. Greenham was their main commitment. Yet the long-term occupiers of Clapham felt that maintaining a viable picket was crucial in keeping the building open, and everyone should help with that. It didn’t help when some of our guests seemed to regard the picket as an answering service.

Preston House was a separate annexe reached through a tunnel or a separate front door _ this took the overspill from Cloud Nine. One of the wards – I forget the name – was populated mainly by local campaigners who’d been there at the beginning, including a contingent of nurses.

Chubb Ward, where I stayed, seemed to be popular with young urban-oriented activists.

Coudray was on the ground floor. This turned out to house mainly straight women with babies, though there were lesbian mothers as well in Chubb and other wards. Quite a few of the Coudray women and children were the offspring of a woman called Antonia, who had been involved with squatted street Freston Road or Frestonia.

There were a lot of new relationships going on, amid a high interest in feminist & lesbian politics. With all this going on, sometimes we got inward-looking. However, there were plenty of occasions when we ventured out of the building. We went to most health authority meetings, usually to ask awkward questions and be disruptive. Just after the eviction we went to one meeting and got so enraged at the attempts to ignore the issues brought up by the eviction, we ended up storming the platform and throwing chairs at the authority bods. If there’d been a dominance of polite Labour leftism in the early phases, as time went on the occupation became more militant and radical.

Other hospital occupations had also sprung up, including a work-in at a geriatric hospital in Bradford and occupied A & E at St Andrews Hospital at Bromley-by-Bow. We came out to support these actions. We also supported a picket at Barking Hospital, where an anti-casualisation struggle had been going on for over a year.

During the miners strike of 1984-5 we made contact with Women Against Pit Closures and some of them came to visit the hospital, including women from Rhodesia in Nottinghamshire and from Dinnington in South Yorkshire .

On one hand, we were reaching out to other movements and resistance, but we also faced issues in how we worked within the occupation. Because the building was warm and comfortable and any woman could stay there, it drew many who were fairly vulnerable. So while we defended health service provision, we often found ourselves providing the kind of support that should be coming from these very same services. Women had different attitudes towards this. Some didn’t want to take this on and wanted to concentrate on the political campaigning. Others felt they had enough on their plate and couldn’t take on caring for others even if they wanted to. And then some women got very involved in the ‘caring’ of the campaign and those who didn’t participate were evading their responsibilities.

There were also arguments around sharing childcare. And since this was the ’80s, rows over identity politics broke out. So it wasn’t all fun and parties and solidarity. Certainly, morale was very low about a month before the eviction. Let’s face it, there was a lot of bitching… petty arguments over which ward got the TV, that kind of thing.

We were also worried about how vulnerable women would fare if the place gets stormed by the cops. Most left when they realised that things were going to get hot.

In the case of one woman with mental health issues who wouldn’t or couldn’t leave, her sister came to take her and had her sectioned, fearing she’d fare worse if she waited around and let the cops do it. We resolved to keep tabs on the woman’s care and visit her in hospital. Debates raged over whether this was a positive or thoroughly despicable outcome

It didn’t help that others came along and used the occupation as a hotel: for example, one lot of American women’s studies students kept asking ‘How often do they change the sheets here?’

Meanwhile, the date of the outpatients closure drew closer and eviction became a real threat again. After we publicised the situation, once again new women turned up and they were ready to kick bailiff ass! Rallying from a depressing period, the occupation became vital again.

As soon as the outpatients closed, we took control of the whole building. We went down to the lobby as a group and got the security guards to leave. There were some tense moments, but they left without much argument. Then we took over the phones, the switchboard and the communications network – this included some walky-talkies, which excited us immensely in the olden days before everyone had a mobile phones.

There had been many discussions about tactics. Some women did not want to do barricading and engage in any resistance, or were not in a position to do this. Though they withdrew from the building before the barricades went up, they still put themselves on the phone tree and took part in picketing and demonstrations.

One woman called Sharon insisted that she’d lie down in front of the cops and use her body as a barricade, though she opposed any other kind of barricade. We all thought that would be extremely dangerous, and tried to talk her out of it but she insisted even more and got very shrill and even abusive. At that point, we had to ask her to leave and eventually carried her out bodily. I mention this because it’s important to record the disagreements and fuck-ups.

We planned to barricade the entrances, leaving only the big front door with a movable barricade, a great heavy beam. Women would barricade themselves into particular wards, while a mobile group would turn fire hoses on the bailiffs and chuck sawdust and then go up to the roof of the main building. Another task of this group was to make sure women who wanted to leave got out when the bailiffs arrived.

One thing that sticks in my mind now is how we strived to organise so women could do whatever they were prepared to do and set their own limits as much as possible. For example, those who could not risk arrest volunteered for look-out shifts in a van nearby. There was never any sense that certain actions were more important than the others; we all pulled together.

Every afternoon we held rallies in front of the hospital, passing out leaflets, talking to people, speaking out and singing. Some of us hung out on the balcony over entrance, dressed in hospital uniforms and surgeon’s masks and sang songs like “what shall we do with the cops and bailiffs”. It was very fun and theatrical.

We were in a constant state of alert, and many false alarms came through on the walky talkies. I remember code names like “Merrydown” and “Spikeytop”.

Once we had a report that someone was digging up the electricity in the road, and we swarmed out (with our masks on, of course) to confront the folks alleged to be doing it – and it turned out to be ordinary road works. Most local people were very supportive and people from other hospitals turned up to help picket. A miner who we met in at the Bradford hospital occupation also turned up. He seemed embarrassed when he realised it was a woman-only occupation, but we sorted him out with a local miners’ support group.

However, I should mention we had harassment by homophobic schoolboys. This minor annoyance wasn’t enough to dent our enthusiasm.

The all-out barricading effort continued. We gathered loads of wood and hammering rang out throughout the building. While we were barricading the former outpatients building, we poured vegetable oil on the floor and added dried soybeans to make it all slippy-slidey for the bailiffs.

Since we were very security-conscious, we wore surgeon’s gloves and masks while performing these operations. One evening while we were barricading, a group of alternative video-makers were following us around. We were just about to use some cabinets and trolleys for barricades, then the video-makers insisted we wait for them to film the rows of trolleys to portray “all that is lost”.

I would love to get hold of those videos, but I don’t remember the names of the women who were on the team or the name of their group.

For safety, we all moved out of the private rooms upstairs and everyone slept in the big Nightingale ward again. After many desolate nights when only a few people held the fort, pickets involved over 30 women or so. They became very party-like. The mobile group, which I was in, slept in a room downstairs near the door, so we had the partying near us all night. But sleep? Did we need it? Not then, nah…

Meanwhile, the nurses’ station in the communal ward acquired extra curtains and became known as “the bridal chamber”. Lots of relationships started… ended and started in this period.

The eviction date came and went, and we were still there. We put on a party to celebrate (Sleaze Sisters, regulars at the Bell, did the DJing), and started to make plans again. We turned the first floor ward into a place to relax, painted a mural on one wall and gave each other massages; we disrupted another health authority meeting. Some of the groups that had been running events at the hospital returned to put them on again.

But three weeks later, the hospital was evicted on 27th March 1985 by 100 male cops and 50 female cops. By then our numbers had gone down from about100 to 30, but we still made a good stand. After the usual false alarms a phone call came through the switchboard with a tip-off. This one turned out to be true and the bailiffs arrived at 3.15am.

As planned, women barricaded themselves into wards, while the mobile group barricaded the last door and stairs.

Another group of women occupied the roof of Preston House. Meanwhile, a small crowd had gathered in front, summoned by our phone tree. I’ll mention at this point that we did get support outside the building from men. A local activist called Ernest was very prominent in this – later he took part in Wandsworth anti-Poll Tax organising and went to jail for non-payment. I remember him shouting at the cops: “why do you have to be so macho?”

Our group ran up to the top floor, turned on the waterworks at the cops and bailiffs though sadly the water pressure wasn’t up to much. We went to the roof and threw the last barricades in place and sat on the cover to block the ladder leading up to the roof. We heard women shouting and singing from the Preston House roof and the balconies. Smoke bombs and fireworks went off. Then the banging started below as cops and bailiffs hacked their way through the barricades. It took them about two hours to get to us up off the roof.

In the press a lot was made of the use of women coppers – it was called “the gentle touch”. Not that it matters much, but the policewomen played a subordinate role. Male coppers dragged us down from the roof. Whatever their gender, the cops were big on arm twisting and made a big show of starting to nick us: “Prepare to receive prisoners” then pushed us aside near the vans. However, they did cart off two women. There was lots of pushing and shoving and some fighting in an attempt to save the two women.

Later, we picketed Kennington Police station where the two women were held. They were released after two hours, though they’d been roughed up while in custody. We then picketed Cavendish Road police station where the cops were holding a press conference on the eviction.

After the picket, some of us were walking to a café near the hospital. As we went past cops hanging outside the hospital we saw them arrest one woman and we went to rescue her, which resulted in six of us getting arrested. A bunch of schoolgirls saw what happened and they were so angry about it they tried to help and got arrested too. They were taken to the police station, strip-searched and held for six or seven hours, and released with cautions. The active role of the school pupils in this melee makes me think of the 2003 anti-war school walkouts and more recent agitation over the education maintenance allowance.

Afterwards…

A clause in the hospital’s freehold stipulated that the building must be used for the benefit of women, and it was also a listed building. Wandsworth Council had tried a number of plans – one was to turn it into a hotel – but the clause got in the way. It was empty for over twenty years after the eviction.

The last plan was building a Tesco’s on the site, which is on the border of Lambeth and Wandworth, but within Lambeth jurisdiction. There’d been local opposition and an appeal against the permission was lodged, but it was turned down and the Tescos went ahead. The development included flats above the supermarket – I’m not sure if it is private or social housing – which might have something to with how the project got past the conditions.

We did make an attempt to continue a health-oriented action group. We managed to get a very small grant and a meeting place in a disused bunker in front of St Matthews Meeting Place in Brixton. We had a public meeting that was reasonably well-attended. But it is most memorable because it took place on the day a riot broke out in Brixton after Cherry Gross was shot (and permanently paralysed) during a police raid.

But this group fell apart. Perhaps, with the end of the occupation itself, the transforming element of the action was gone. Political and personal differences affected the group more, and it seemed time to move on…

However, I won’t end on a totally downbeat note. The eviction of the hospital led to an influx of women settling and getting active in the Brixton area. Much of this was around squatting and housing, and the growth of a new feminist and lesbian community inspired by that. A host of DIY and feminist projects sprang up. Culturally, this was important to women who’d been alienated from boy-dominated politics and the ‘official’ lesbian and feminist scene.

In retrospect, several things distinguished this occupation. The nine-month time span of the occupation allowed it to grow into an important point of contact between groups who might not have worked together otherwise.

In the EGA campaign there had been disagreement over whether to promote the hospital as a special case – a women’s hospital. Or to take it up in terms of opposing all cuts. Though it took some time to arrive at this point, at SLWH we included both the feminist dimension and a strong anti-cuts class struggle element. Our banners said ‘Stop these murderous cuts’. We stressed the women’s health angle as a central part of this opposition and organised events and workshops relating to this.

Another thing that strikes me is that we were able to arrive at consensus in our most heated discussions and everyone had opportunities to speak and express themselves. Given some of the excruciating, highly extended experiences of consensus decision-making I’ve been involved with since then, this seems incredible now. Or am I looking at this through a rose-coloured telescope?

We were ahead of our time with our planning for ‘diversity of tactics’ – allowing for more confrontational tactics alongside ‘fluffy’ ones. Back in the ’80s this wasn’t really done. So I’m proud that we made a break with the binary of pacifism vs ‘violence’. Within the diversity, we placed equal importance on the different tactics and didn’t elevate one above the other. In the early 2000s anti-capitalists planned actions with different blocks using their choice of tactics; several years later the particular blocs and tactics may have become stuck in a rut and lost their effectiveness. However, the core principle of tactical diversity is still a good one.

More recently, Greek health workers have occupied a hospital in response to austerity and health cuts. And with further cuts and privatisation going ahead here, this is a good time to look into this history and see what lessons can be applied now.

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This text originated in a talk at the South London Radical History Group in 2003. It was later updated and published in a past tense dossier on UK hospital occupations, Occupational Hazards. Which is still available to buy in paper form here, or can be downloaded as a PDF here

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Today in London healthcare history: Second in a series of occupations at University College Hospital, 1993

Occupational therapy – the incomplete story of the University College Hospital strikes and occupations of 1992-3.

The story of the (ultimately unsuccessful) struggle to keep a hospital open despite the efforts of the government, the Area Health Authority, management, University College London and the Wellcome Foundation and Trust.

Put together by a number of individals in the UCH occupation together with help and suggestions from others, London 1995.

[NB: on what actually happened to UCH after the occupations and campaigns related here, see Appendix 2]

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The First UCH Strike

(late November/early December 1992)

The first strike at UCH comprising of an occupation cum work-in against the phasing out of the hospital took place in late November/early December 1992. It was said at the time that it was the first occupation of a hospital in the UK.(1) Everyone who worked at UCH knew that some kind of crunch was coming. Staff had been accused of “over-performing” and it was mooted that 60 nurses were to be sacked. The purchasing authority had let it be known that they found UCH too pricey and also, in the background, the Tomlinson Report had pointed some kind of unspecific finger at the hospital.

The strike started simply enough. One day in late November some managers marched on Ward 2/1 — a general surgical ward — to close it. There was an immediate spontaneous response as nurses linked arms to form a human chain at the ward’s entrance. as one nurse said, “We decided as a Ward, without any union involvement, that as nurses we could not leave Ward 211.” From there, it escalated into an indefinite strike as more and differing people were sucked into the conflict Patients refused to leave the threatened Ward and porters refused to move them. Briefly, the traffic on Gower Street and Tottenham Court Road was blocked by strikers and within no time there was a lot of support from other workers, mainly in the form of generous donations to the strike fund. COHSE was to make the strike official but NUPE didn’t.

It was something of a breakthrough as effectively the threatened part of the hospital was soon run by time health workers themselves. As one said, “management where being completely circumvented.” Unlike the later occupation in September 1993, the first one took place in a functioning situation where all kinds of day to day nursing practicalities had to be considered. For a brief moment, many of the quite nasty divide and rule mechanisms in the hospital hierarchy were diverted and perhaps the most important obstacle of all was overcome. A hospital occupation/work-in cannot succeed without the support of junior doctors and this, it appears, was forthcoming. Generally junior doctors are loathe to support or take any action as they are utterly dependent on consultants good reports and are prepared to take shit waiting for that fat salary at the end of the 72 hour per week work rainbow (there was however, a junior doctors’ strike in the 1970s and this might be worth looking into). Equally (or not so equally), experienced nurses tend to give junior doctors hell as they know that they’ll be handing it out like hell when in a consultants position. All such understandable pettiness aside, finally and most importantly, the harassment of junior doctors is largely to do with worries about cock-ups on the ward. Although responsible for everything on the ward, the nurse-in-charge is under medical supervision from the doctor. The usual situation is inexperienced juniors having responsibility over and above their skill and age. The subsequent panic felt by the nurse-in-charge who usually knows the score in a potentially life or death situation translates into hassling and nagging juniors.

But in a subversive dynamic, everyday relationships quickly change, affecting even the most hidebound. In the UCH occupation, it seems that the consultants’ attitude bad changed too and was sympathetic to the action taking place. To the annoyance of managers, consultant Dr. M Adishia even transferred a patient to Ward 2/1 a day after the occupation began. This kind of thing was unheard of. Prior to the free market reforms consultants ‘ran’ the hospitals. They were seemingly all powerful, often terribly arrogant and, inevitably, hated by all. Thus it was easy for the new hard-nosed management to take power away from the consultants as no one was prepared to defend them. Having created such (unheard of) unity among the hospital staff it wasn’t surprising that one UCH striker had cause to say in early December 1992, “we need workers councils in hospitals.”

The only force pitted against them was the new, economically insecure, limited contract, cadre management employees. These managers didn’t ideologically believe any longer in what they’re doing but are scared stiff to do anything else knowing that the dole could be in waiting for them tomorrow. Blindly ruled by money terrorism, they’ve seen their proletarianisation on the horizon and they don’t like what they see. A nurse at UCH whose ward was closed by management in the space of two minutes without any medical consultation or warning commented, “the manager said she knew it was wrong but there are other managers waiting to take her place.” Shits though they may be, they’re hardly the stuff who could make a solid defence based on conviction come a more concerted, more general attack. Headless chickens come to mind.(2)

The strike was successful though and the management backed off giving oily-written undertakings that all wards due to close for Xmas would re-open on January 4th and dropping all disciplinaries against strikers. Probably they were nervous after all the tumult (hot air really) about miners a month previously. Possibly too, they were nervous about the rank’n’file Health workers Co-ordinating Committee, a body boycotted by the Health Unions themselves, thinking it was a more potent body than it was. In reality, the Health Workers Co-ordinating Committee was a made up/fake co-ordination (in comparison to the rather more genuine co-ordinations in the UK strikes in 1988/89) pick’n’mix of various Trotskyist factions each running their own party recruiting campaigns and little demonstrations – a unified, on the ground response being the last thing on their minds.

Of course, as a lot of people knew, UCH management were biding their time when they could hit a lot harder and nastier… And how!… read on…

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The 1993 Strike

On August 17th 1993 about 50 nurses and porters at University College Hospital in central London came out on indefinite strike against management plans to begin closing down the hospital.

From the beginning the 50 strikers were – and remained – a minority of the total work force of the hospital; this was one of the main weaknesses of the struggle. In the original strike ballot well over 50 voted to strike – but UCH management announced that those taking industrial action would be banned from the building, so making it impossible to provide a rota for emergency cover for patients as had been done in the December ‘92 action. This discouraged some nurses from striking – and numbers were further reduced by the divisions of the trade union structure — i.e. ambulance drivers were to be balloted separately, some nurses were RCN members (with a no-strike agreement) while others were casual/temp staff employed via agencies.

Once the strike began there was some support from other workers — ambulance workers refused to move patients out of closing wards; British Telecom and other workers would not crass the picket line to dismantle closed wards; postmen and women leafleted their rounds; and tube workers at nearby Goodge St used the station tannoy to report and publicise the strike. There were a couple of one day strikes by catering, ancillary and clerical staff at UCH – and also by staff at the nearby EGA and Middlesex hospitals. Same public sector workers – teachers, posties, DSS and council workers – came out unofficially for the Day of Action on September 16th (the teachers despite being threatened with disciplinary action by their union if they did so).

Local people and other supporters also turned up to the marches and rallies during the strike — in fact the best marches were the ones that formed themselves spontaneously from the rallies and went streaming off through the central London traffic. With the cops unprepared and confused but not wanting to be publicly seen getting heavy with a nurses-led march, Tottenham Court Road was brought to a standstill in the rush hour a couple of times by 150 people.

Other marches were more tame, controlled and less effective — due mainly to the union branch officials getting afraid that the rowdiness would upset the union bosses too much.(3) Nevertheless, the September 16th march still managed to completely block Whitehall for a while – or at least the riot cops did, so as to make sure we didn’t get to Downing Street or Parliament.

Although UNISON had apparently said they would back the strike even before balloting for it had begun, it was obvious all the way through that they did not want it to be effective or help the strikers in any way. They obviously wanted, at the most, to negotiate some kind of structured closure program for the hospital with maybe a few token concessions thrown in — and parade this as some kind of victory (see leaflet). UNISON only officially came into existence on July 1st 1993 through a merger of the NALGO, NUPE and COHSE unions – so forming the largest public sector union in Western Europe, with 1.4 million members. This was their first major dispute and they were keen to prove to management that they were worth negotiating with and could do the job – i.e. by proving they had control over their members and could deliver an obedient work force to the bosses. The union disassociated themselves from any “unofficial” actions (such as a brief occupation of hospital chief executive Charles Marshal’s office) and sent circulars to other hospitals ordering workers not to support it. UNISON withheld all strike pay for 6 weeks. It was finally paid the day after the union had forced the strikers to return to work.

The strikers tried to get support from other workers – they were constantly visiting different workplaces. But it was nearly always done through union structures — i.e. by approaching shop stewards rather than by talking to workers face to face. All this usually resulted in was a resolution of support being passed at the next branch meeting, a money donation and a promise to send a few people down to the next rally.

In 1982 in Yorkshire nurses were able to bring out thousands of miners and car workers by bypassing the union structure, by simply standing outside the workplace and appealing directly to the workers for solidarity. This should have been tried by UCH nurses and porters, but the prevailing faith in the unions (encouraged by SWP ideology) prevented it. In Leeds, in 1982, support came from engineers and public sector workers. The best example was some construction workers who were building miners’ baths at Wooley Colliery. The shop steward there had a brother in a hospital in Leeds (long stay)and got in touch with the nurses at the hospital to picket himself and other workers out. When striking nurses arrived they had no difficulty in stopping the construction site, although there was a visible chillness from local NUM officials. One of the construction workers drove straight through the nurses picket line. This led to an extension of the construction workers’ strike for three days. It all ended when the builders caught the scab, took the wheels off his car and emptied his wallet into the health workers’ collection bucket. In 1982, there was still too much reliance on union structures – mainly on a shop steward rather than full time official level. This was because of inexperience and workers being over-awed by the myth of the shop steward. Defeat was ensured by reliance on the union structures and ideology, with unions turning militancy on and off like a tap, leading to disillusion. But 11 years on at UCH, so many defeats later and in a Central London workplace — there was much less chance of repeating such a success.

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And then the occupation

Ward 2/3 in the Cruciform building of UCH was occupied on September 15th – it had recently been emptied of patients as part of an ongoing closure of this wing of the hospital. The idea was first suggested to some local people on the picket line by someone who we later found out to be a full time Socialist Workers Party official. The occupation was originally planned to end after one night, merely being a publicity stunt to coincide with the Day of Action occurring the next day — but it was eventually decided that the occupation should continue indefinitely.

The majority of the strike committee were initially against an occupation, although 3 nurses did take part on the first night. It’s very likely that some were against the idea simply because it was promoted by those strikers who were SWP members — there was already some resentment about SWP manipulation within the strike committee and this was probably thought to be another example or vehicle for it, same of them at first assumed that we occupiers were all SWP Members.(4)

Those in occupation decided during the night to argue for not leaving the next day; this was mainly in response to full-time UNISON official Eddie Coulson turning up at l a.m. with hospital managers (who he’d been in conference with for over an hour before hand) to try and make everyone leave. Coulson stated in front of hospital chief executive Marshal and two strikers that UNISON members would be disciplined; he said that he wouldn’t be surprised if there were further management disciplinaries; he was prepared to drop all the demands of the strike, some of which he was only paying lip service to anyway, if Marshal would drop the disciplinary threats. He said he could guarantee a return to work within 24-36 hours if Marshal did this. He also talked with Marshal about the “damage” the dispute had done to UNISON, and how be would be looking at ways of disciplining UNISON members through the machinery of the union (these are almost direct quotes from a letter of complaint sent by the UCH branch to their union leadership). At the end of the strike Coulson was quoted in a paper as saying that UNISON had “lost control” of the dispute, giving the “unauthorised” occupation as an example.

Still, at the time, the strike committee were divided about the occupation — some now not only wanted to continue in Ward 2/3, but also to open another ward (the rest of the 2nd floor was empty). During the rally on the 16th September all the strikers came up to the occupation — initially just to protect the 3 nurses already present from disciplinaries and to walk out with us down to the rally. But when we told them we didn’t want to leave this started an emergency meeting. It was an urgent situation —if we were going to take another ward it should have been then, with all those people outside. The whole rally of 1,000 or more people should have been encouraged to enter the hospital and become a mass occupation, taking over empty wards.

In the middle of all this, in walks Tony Benn, and as he waffles on, the rally marches off towards Whitehall… Somebody went out of the occupation to try to get the march to turn around — they did manage to stop the march for a bit but, amid the confusion and argument, the march eventually continued on to Whitehall.

Back at the hospital, the strikers took a vote about continuing the occupation – they were divided half and half for and against. It was decided that for the moment we wouldn’t open another ward and that the fate of ward 2/3 would be put off for now until it could be discussed further.

Most of the strikers then went off to join the march, while we waited in 2/3 for the marchers’ return and the strikers decision. While waiting we heard that UNISON bad cancelled the National Day of Action they’d planned for November 11th — this was in response to our occupation. We also learned that management were taking advantage of the fact that the march bad moved off, leaving nobody behind to carry on picketing: they had immediately begun to close another ward. This news was relayed to the marchers, who were by now blocking Whitehall, and the march set off back to the hospital.

When the marchers returned some quickly stormed into the hospital chief executive’s office, occupying it for a while. Some others came up and joined the occupation. Meanwhile the strikers went into their meeting – it was 6 hours before their decision to hold on to Ward 2/3 came back to us.

The best day of the strike and the strikers spent most of it in meetings!

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Early leaflet supporting strikers by soon-to-be occupiers:

SAVE OUR HOSPITALS

WHAT IS HAPPENING AT UCH?

Predicting the future of any hospital has become almost impossible since the government forced their ‘internal market’ — competition for less resources – on the health service. NO HOSPITAL IS SAFE, and the situation at UCH is increasingly unsafe.

Under the new rules, an increasing number of well-paid managers, many of whom have no knowledge of health matters, are trying to cut costs, while pretending that all is we11. The local health authority, through which government money comes, is having its funding cut by £21 million, with other cuts not yet decided. The health authority, whose members are appointed, not elected, recently complained that UCH was ‘over-performing’ – carrying cut too many operations! Apart from private patients, those with ‘fundholding’ GPs have been able to jump queues while there is ‘no money’ for others.

THE MARKET MAKES US SICK

Between them they plan to reduce UCH to a skeleton emergency service — those considered non-emergency or needing more than 2 days care will be sent elsewhere, and GPs will not be able to send patients. This skeleton service will not work because the Accident & Emergency section has always been dependent on the wide specialist knowledge of the other sections. Any cuts mean a reduction in the range of skills available to bring us back to health.

A reduced service also means more pressure to classify patients as non-emergency, and that any major tragedy, like the Kings X fire, will simply not be catered for. Their idea for sending people somewhere else doesn’t make sense anyway, when these other hospitals are also under threat.

HEALTH NOT WEALTH

As for the other parts of UCH and its associates, the Cruciform building is being emptied, to be bought up by UCL and Wellcome (the drug company that made billions out of expensive dodgy drugs tested on AIDS sufferers) for medical research, to add to Wellcome’s coffers (and with the local poor, and our pets, as guinea pigs?). The latest leaflet from management says that the Middlesex is not closing, but that everything is going to move to the UCH site, which means it is! The private patient section is of course safe.

Last year. over 20,000 patients from Camden and lslinqton, mainly from the poorer parts, were treated at UCH etc. and we are dependent on it. Me don’t need this chaos and these closures. He need a general, local health service, responding to our needs, not the needs of the market, and controlled by the people who use it and work in it, not by a bunch of managerial parasites.

DRIVE OUT THE HEALTH BUTCHERS

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Life is a hospital (for a while)

Although determined, aggressive tactics are going to be increasingly necessary if we are to keep some kind of free (albeit through national insurance contributions) Health Service intact, the occupation of Ward 2/3 wasn’t about “militancy” as such. Weren’t we there basically because it made you feel good (good enough to want to fight rather than just fulfilling a dull political duty) and gave you one hell of a lift? A new world begins (or is at least glimpsed) instantly in such actions — simply in meeting, laughing and messing about with barricades etc. with people you’ve largely never met before. Quick as a flash, that horrible imposed isolation knot – an isolation much worse today than its ever been – is loosened and that single factor could possibly be the most important in any future occupations.

For the first few days of the occupation we were more or less left to organise ourselves. Leaflets were written and distributed; a picketing rota was put in operation (which meant for the first time there were to be some 24 hour pickets); developing local contacts brought in more people and donations of food, cash, etc.. A great atmosphere and infectious buzz was in the air for those first few days and everybody involved felt the occupation had great potential as a focus for the struggle — people were openly discussing things and coming up with new ideas all the time. A hardcore of a dozen or so people were so involved in what was happening that we were basically living on the ward for a while.

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Early occupation leaflet:

EMERGENCY – WARD 2/3!

SUPPORT THE UCH OCCUPATION

Ward 2/3 at University College Hospital has been occupied by striking health workers and supporters, angry at the destruction of the health service. The strike has been on since 17th August and the occupation since 15th September.

Since the strike began management have closed down 4 wards as part of their plan to close the whole hospital. Because the government is trying to force our hospitals to compete against each other for smaller crumbs of a smaller cake, hospitals have been starved of cash — resulting in indefinite waiting lists, unnecessary deaths and increasing chaos for staff and the public.

This is part of management’s reign of terror in the health service, with staff being victimised and intimidated and patients being treated like prisoners as they try to close hospitals.

The success of this occupation and strike depend massively on outside support — which means YOU! So get your finger out, get stuck in and come on down and Join us! We can’t win this struggle any other way — people are needed on the picket lines and at the occupation. We also need food to keep us going, messages of support, donations etc.

If we can wipe the smug grins off the faces of these health butchers, just think how healthy it’s gonna make you feel!

(The occupied Ward 2/3 is on the corner of Grafton way and Huntley St — easily recognisable by the banners outside!)

JOIN THE LOBBY OF CAMDEN & ISLINGTON HEALTH AUTHORITY 4.30 – 5.3Opm Tuesday 21 September @ Friends Meeting House, Euston Rd (opposite Euston station)

POPULAR COMMITTEE FOR MAINTAINING THE UCH OCCUPATION

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COMING DOWN WITH A DOSE OF THE TROTS

But, alas, the spell was soon broken. We had been requesting a meeting with the strikers for a couple of days, and one was eventually arranged between the full strike committee (i.e. all available strikers) and the occupiers; but instead we were met by just a few union shop stewards who were all SWP members. One of these SWerPs was also the union branch secretary at UCH, and although she was not even on strike – she was one of the clerical workers and they had not come out – she very much used her union status to play a dominant and often manipulative role during the strike. They proceeded to tell us of their plans for completely restructuring how the occupation was to function – we were led to believe (wrongly as it turned out) that they were speaking for the strike committee as a whole and only relaying to us what had been decided by it. In fact it was an SWP engineered coup, done behind the strike committee’s back as much as ours’.

They wanted vetting to decide who should be allowed into the occupation — this was to be carded out by the branch secretary and chairperson – both SWP members. People would have to book themselves onto a formalised rota days in advance just to be able to spend a night in the occupation — reducing it to a duty and a chore, killing off the social dynamic going on. They also intended that there should be at least 6 strikers on the ward at any time and that there must always be at least one striker on the picket line with us. They justified all this by saying that if anything bad happened in the occupation or if things got “out of control” this would jeopardise the strikers — by giving management an excuse to legally evict the occupation and to victimise the strikers (6 of them already faced disciplinary actions due to activities in the strike).

By the time this meeting occurred, most of the occupiers were tired out from a lack of enough sleep due to late night picketing, leafleting and generally running around trying to organise stuff. We were stunned by these sudden proposed changes (although in retrospect we should have been expecting something like this) and did not resist them as we should have done; this was partly due to simple fatigue but also because we were being guilt tripped about the necessity of protecting the strikers’ interests as a priority. The implication was “but would you feel if a nurse lost her job because you lot fucked up?” The answer was obvious but the likelihood of it happening was exaggerated and used as a weapon against us.

Although none of us were happy about all this, we weren’t able to respond effectively — and as we mistakenly thought that these were decisions taken by the strike committee as a whole we didn’t feel in much of a position to argue. We should have said we would consider these proposals and then discuss them with the full strike committee as soon as possible, instead of just capitulating. If we had known that these issues had not even been properly discussed by the strike committee and that there had already been strong disagreements within the strike committee about SWP manipulation then we wouldn’t have felt so isolated with so few options. It was also partly unfamiliarity with what was a pretty unusual situation as well as a (not unrelated) lack of confidence and assertiveness in ourselves and other simple personal failings that led to our downfall. It can’t just be explained by the supposed absence of enough organisation or of a certain kind of organisation, as some have tried to do (see Appendix for more on this).

Their plan was to make the occupation a centre for union and SWP organising and to fill the place with SWerPs. Having seen that we were good at organising ourselves and developing our autonomy the union/SWP hacks felt threatened — partly because they judged us by their own miserable standards and thought we were really some secret anarchist group (possibly Class War!) come to try to take things over. Rumours were flying amongst the strike committee that this was the case.

They also wanted to reduce the occupation to a publicity exercise – i.e. getting media celebrities and MPs to visit and be photographed there. In fact it seemed they had decided that getting public opinion on the side of the strikers was going to be the main weapon to win the strike with. Some occupiers now felt they were being treated as a token pensioner, a token mother and child, etc. to be displayed for the cameras. One woman was even offered a spare nurses uniform to wear in case there were no real nurses around when an MP came to visit!

The effects of these changes being imposed were several: a lot of people, particularly locals who visited regularly, were put off coming to the occupation. And there seemed little point in giving out leaflets encouraging people to come to the occupation if they’d all have to be vetted first. The atmosphere was totally changed, with people now feeling they were only there with the permission or tolerance of certain officials and no longer as joint partners in the struggle. The openness of the occupation, with free debate flowing back and forth informally, was replaced by an atmosphere of intrigue and secret whisperings…

“In those early days one related to the occupiers as strikers, local or non-local or all mixed up together. You were curious about their lives, background, last night’s binge, learning about hospital jobs, what immediate tasks had to be earned out, etc. Ideology just didn’t really count and you couldn’t give much of a fuck what political persuasion anybody had. It was only after the attempted SWP mini-coup that you really started relating to strikers as SWerPs or not And that was REAL BAD. After that, paranoia, whispered conversations (from them) with doors closing behind you as if you were an unwelcome intruder. And so hypocritical! A poster then appeared: “NO DRUGS OR ALCOHOL IN THE WARD.” And yet it was only a few nights previously that an SWerP had been openly rolling up spliffs. Previous to this laying down of the law there was no trouble at all with anybody getting out of their heads. In fact even occupiers who were regular boozers had hardly touched a drop, being so occupied with what was going on. It was only after the SWP coup that people were drunk on the ward — and they were mainly SWerPs come back from the pub. After that occupying was more like work; a duty; a painful task to be undertaken. Wage labour felt freer than this! Better to occupy the Morgue which was just below Ward 2/3 — at least that would have been a bit of life in death.”

The SWP’s plan was to draft in large numbers of SWP foot soldiers, but this was never very successful — some did turn up (although a lot who were told to didn’t) but never in sufficient numbers to completely dominate or alienate the rest of us; as they usually only came for one night they still had to ask those of us staying there for information about the general functioning of the place. Some rank ‘n’ file SWerPs were fine to be with (5) and we could talk and relax with them but the real hacks were often vile — functionaries and mere appendages of the party machine, mouth pieces for faithfully parroting the banalities of the party line, with no social graces or warmth at all.

In fact it might be said that leftist militancy is a diagnosable disease in itself, with definite schizophrenic behavioural tendencies! The personality split between political duty and real desires, voluntary submission to party lines and hierarchies with repression of doubts and contradictions, obsession with manipulation of others and conversion of others to one’s own rigid beliefs, etc…

In the early days of the occupation it was the Trots who’d left bunches of Socialist Worker around (along with the Revolutionary Communist Party etc. leaving their rags lying about) ready for piling propaganda in the occupiers’ heads. At the same time these politicos spotted in a flash one Class War newspaper lying innocently about and what’s this? — a man called Vienet’s book on the French occupation movement in May ‘68 – things that somebody had bought or nicked for one’s own personal enjoyment on the day. So an ideological construct was fearfully assembled: “Its Class war anarchists in there”; “Is that a destructive lunatic fringe?”; “Should we Kronstadt the bastards?” The mind boggles at the lurid fantasies possibly conjured up.

The bunch that became the mainstay of the occupation were a mixed bag – partly determined by the fact that we were the ones who could devote most time to it. On the dole or on the sick, single mums, pensioners, casual/part-time workers or those whose jobs were flexible enough to take time off (builders, dispatch riders, etc.). Some had known each other before, some hadn’t, but most had some involvement with the strike from the beginning; some who already knew each other had been involved in producing their own leaflet and poster for the Day of Action prior to the occupation, having been inspired by some striking nurses. People came from a wide variety of social and ‘political’ backgrounds and experiences — most had been involved in other struggles in the past. Different people had served time with various political groupings, ranging from the Labour Party through Trot groups, ultra-left marxism and beyond. Others had never touched politics with a barge pole. None were hacks or Party animals (in the political sense!) and there was a consensus of distaste for such beasts. One or two of the more ‘eccentric’ characters could at times get to be a pain in the arse but generally they were responsive enough to get the message if you told them so; unlike some of the devious lefties who had the cheek to call these people “disruptive.”

Some of the strike committee at least had a stereotypical view of just who they wanted as permanent overnight occupiers. Lots of worker delegations carrying TU banners or representative of community/tenant organisations, etc.. What they got was just what they didn’t want: the ‘freak’ or mongrel proletariat — those not that much into work and who largely had never seen the inside of a trade union but who were prepared to put their heart and soul into the occupation. Instead of the ‘straight’ working class (at least as the leftists saw it) they got those without the correct image.

The SWP turned the occupation into a political arena where all other forces were seen either as rivals or subjects to be submitted to their will. In an atmosphere of intrigue, plots and manipulations we were forced into being less open and more secretive ourselves as protection against totally losing our ground. This is often the effect on struggles of self interested political factions with a separate agenda for themselves — to combat them you are often forced to adopt some of their tactics – resulting in the social dynamics of the struggle being stalled and energy being wasted on simply trying to stand your ground and contain the effects and spread of the Trotskyist virus.

But it’s too simplistic to blame the SWP for everything – another sect could have played the same role, as could any other union bureaucrats or a group of timid, conservative workers in different circumstances. It’s no good seeing the SWP cadres as the shit part and the rest of the strike committee as pure light – sometimes the SWerPs took the more radical initiatives, in opposition to more conservative strikers. But it’s important to remember that the non-SWerPs were never as inflexible and ideological and therefore could be more imaginative in many ways.

Avoiding the routinisation of struggles seems to be a real challenge. All sorts of forces combine to turn an occupation or strike into just a different kind of work. The Trots are usually the visible cause, but it’s often that they are filling a vacuum created by people’s own uncertainty — it’s inevitable in any genuine autonomous struggle – but the way in which vanguard groups use that uncertainty means they turn it into a weakness. Ideally they could be wrong-footed by a bit of playfulness and craziness, but when the situation becomes tense and ‘serious’ and people start worrying and falling back into the workday mechanisms, autonomy gives way to ‘common sense.’ At least in this experience at UCH people got out and about which lifted the weight a bit — a lot of occupations become sieges and in that context the vanguard and all the other military metaphors start giving the appearance of making sense. Isolation is another problem — especially if the occupiers are seen to be a ‘minority.’

It’s true to say that the SWP’s goal is not firstly to advance a struggle, but to advance their influence on a struggle, and it is this which determines their choice of tactics: this was illustrated by the way their attitude to the occupation was to change.

Although of course the SWP strikers at UCH sincerely wanted to win the strike, its nevertheless true that the Party’s tactics are generally determined not by how to advance or win struggles but by how to prove that if everyone had listened to and followed them then things would have worked out better – this often entails directing struggles and demands at the union bureaucrats, so that when (inevitably) they don’t do what they’re asked to, they can be shown to be wrong and the SWP “correct” (this cynical attitude to the working class was spelled out yonks ago by their arch-guru Trotsky with his theories of the “transitional demand” etc.).(6)

But even in their own terms, none of their own plans for the occupation ever worked well. They could never draft in sufficient numbers for a total coup: very few union officials turned up; and only 3 or 4 ‘left’ Labour MPs turned up, attracting very little press coverage. (It was laughable to later read Socialist Worker’s claim that, due to pressure of public opinion and the strike highlighting the health issue, the Labour Party had been “forced” to send some prominent MPs down to the Ward. They had been phoning up loads of celebrities and these were the only ones who ever bothered to come).

The political vetting they’d wanted became impractical as it turned out that the branch officials were too busy to impose it — and as the Party faithful failed to materialise in sufficient strength we were needed to make up numbers anyway.

The picket line was another main casualty of the imposed changes. It was impossible for the strikers alone to mount successful picketing — there were 10 or 11 different exits all connected by underground tunnels that the management could use to sneak patients and equipment out as they closed more wards. During the occupation we had begun to organise 24 hour pickets with walkie-talkie contact between the picket and our Ward; we still didn’t have enough people to cover every exit but it was certainly an improvement. But it seemed that part of the reason for the reorganisation of the occupation was that the union/SWP officials had given up on trying to develop effective picketing in favour of getting public sympathy on their side through publicity stunts. We had shown that we were serious about trying to make the picket effective and more than just a token show of strength — and possibly it was thought that this could lead to a clash on the picket line that would have further pissed off the union and would not have looked good in the media (‘Picket Line Fight at the UCH” etc.). The officials had demonstrated no real enthusiasm for the idea of mass pickets at the hospital — and the possibility of growing numbers of local people and others organising themselves independently (in co-operation with strikers) on the picket line would not have appealed to them (just as it didn’t in the occupation). They eventually discouraged us from all night picketing by saying that management would not bother moving stuff at night – shortly after we stopped night picketing they did start moving things at night.

We wrote a leaflet to the strike committee outlining our concern about how the occupation had been changed but is was never actually distributed to them; the strikers found out that UNISON had been going behind their backs to stitch up a deal with management to try to get them back to work. So the strike meetings were too busy trying ideal with all that to time to discuss the occupation with us .-. we were advised by a sympathetic striker that this was not a good time to distribute our leaflet.

But a lot of these conflicts might not have happened (or at least not so quickly) if more people, especially from the council estates nearby, had joined the occupation. If there had simply been a big toing and froing of 200 people or so (or even of less) then the event could have taken on a momentum of its own whereby other empty wards would have been taken over as a matter of course as more beds were needed to sleep on at night, etc.. This would have made it harder for the officials to dominate events.

UNISON eventually issued an effective ultimatum to the strikers – to go back to work or the union would withdraw support for the strike; which would have left the strikers wide open to dismissal and possible legal action against them. In their iso­lation without wider effective support, this didn’t seem like a risk worth taking.

The union bosses said that with only a minority of the UCH work force out the strike could never win. Not that UNISON wanted other workers to support it – their attitude towards the strike was hardly going to encourage more workers to gel involved. The union machinery did its job of keeping the strikers isolated from other sections of the working class who could have given the active solidarity needed for victory; and the strikers were not capable of overcoming this isolation. The strikers met and voted to accept the deal whereby they went back to work in return for all disciplinaries being dropped and full trade union rights to organise in the hospital being restored.

The strike committee held its last meeting where two delegates for the occupiers were finally able to attend. A large number of strikers were elected as shop stewards at this meeting, this being proposed by the branch chairperson and the secrets (both SWP). This was a way of trying to re-integrate disaffected workers back into the union structure and to re-kindle faith in it – some of those elected had earlier thrown their UNISON badges in the bin in disgust. Obviously workers must “radicalise the unions,” “push the leadership leftwards,” “force the TUC to call a general str… blab blab yawn” – in SWerP speak this translates (they hope) into more positions of influence in the unions for the SWP “workers vanguard.”

After all that was settled the occupation was discussed. We said why we thought the occupation should continue — the main arguments are set out in our leaflet [below] (which, again, was never actually distributed because during the first part of the meeting a union bureaucrat from UNISON head office was present and obviously we didn’t want him to see it. When he left, the occupation was discussed and it was eventually voted to end it. After that, there seemed little point in giving out our leaflet).

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Undistributed leaflet:

TO THE STRIKERS FROM SOME OF THE OCCUPIERS IN SOLIDARITY

We have written this statement because we want to sort out where we stand, to clarify our relationship to the strike committee and to the struggle to keep UCH open, which is also our struggle.

We have been involved in the occupation as NHS users, getting involved either from the start or from the Thursday demo, and have been trying to build the occupation as part of the struggle. We have helped build support in the local community, getting more people to join in and to widen the distribution of leaflets, getting local shops to donate food and display campaign material, along with community centres and others.

We produced our own leaflet, in consultation with a number of strikers, to put the case from the perspective of the community, of service users, calling for people to get involved. We have found that people, like us, do want to get involved, directly in the struggle for their health service, not just signing petitions or marching, and the occupation has given them a focus and an opportunity to start to get involved. We have also joined in the picket and enabled it to be extended a few times to 24 hours.

But it now appears that members of the community are at best to be tolerated, rather than allowed our own ideas and initiative. Even though a rota was being successfully developed, a formal rota has been imposed, controlled by the branch officials, making it more difficult for people to be involved on their own terms. Some people already felt they were being treated as ‘token’ pensioners, etc;, and these changes have discouraged some people from returning.

More general involvement by local people and workers is being substituted by party political contacts. Occupiers have been forced into a position of passive observers as decisions taken elsewhere are carried out. These changes were presented to us on Sunday by a few branch leaders who seemed to be speaking for the strike committee, though it appears they weren’t. On the grounds that we cannot be allowed to do anything to jeopardise the strikers or the strike (which we have no intention of doing) we have in face been prevented from doing anything for ourselves. If allowing us any initiative is a threat, then the occupation should be staffed by cardboard cut-outs, not real people. Replacing the active solidarity of local people and other supporters by a strategy of using the occupation merely for public sympathy and visiting celebrities will not win our struggle. The miners had plenty of this sympathy and have still been destroyed.

Another justification mentioned in passing for dealing behind our (and others’) backs was the problem with the union. We recognise there are problems – we just want to be able to discuss these things openly, we want to help.

We are not suggesting the occupation be separate from the strike – we want to work with the strikers to save the hospital, not just be assigned tasks as if we were workers and the union officials our managers. We are not here to disrupt, we are not a political group come to muscle in, we want to fight with you, for our health service.

We would like to meet and discuss all this with the full strike committee A.S.A.P.

– IN SOLIDARITY

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The debate eventually became a political argument – the SWP putting their line forward that community action like our occupation can only be useful and successful as secondary, supportive action for worker’s industrial action. They didn’t like it when we put forward the obvious example of the Poll Tax to contradict them. At the time the SWP’s line was that workers would defeat the Poll Tax by refusing to process the information, handle the paperwork, taking strike action, etc… Such actions happened only on a very small scale. It was what was happening outside the workplace that defeated the Poll Tax. It’s significant that the only mass struggle in over a decade that in any sense could be called a victory was community based; neither union sabotage nor anti-strike legislation nor isolation could be used to restrict the movement. At this meeting and another later on in Ward 2/3 with more occupiers we managed to add some discord to the familiar refrain of the SWP union chairman giving a summing up lecture on what lessons could be drawn from the strike (7). He claimed it as some kind of victory that management had been shaken by (a defeated Arthur Scargill put it this way: “The struggle is the victory”). This desperate line from brave strikers has gained momentum since the miners’ defeat in ‘85, as the defeats pile up as each group of workers is picked off in isolation one by one. With every defeat the bosses are inspired to tighten the screw a little more.

The occupiers later held their own meeting where we voted by a narrow margin to accept the wishes of the strikers and so end the occupation.

But the fight goes on and we can at least reflect on our failures in the hope of making our position stronger as we wait for the next cut of the Health Butcher’s scalpel.

The strikers and occupiers walked out together, with one occupier being pushed out in his bed, and went their separate ways. Now calling ourselves the “UCH Community Action Committee” the occupiers headed straight for the nearby head offices of UNISON. A crowd of us pushed our way in to the building, leafleted workers and vented our anger at some bureaucrats for the union’s role in sabotaging the struggle. They didn’t call the cops on us, thereby avoiding more bad publicity for them. The building’s entrance was later grafittied with “UNISCUM” and another wall saying “Unison sold out UCH nurses and porters”. A stranger later added underneath “so what’s new? NALGO sold out the Shaw workers” (i.e. workers in the nearby Shaw library).

The Action Committee kept holding regular meetings and did some actions. We decided to visit Wellcome, the multinational drug company involved in the sell-off of UCH. As luck would have it, when we arrived we discovered that a board meeting was then in progress. Fifteen of us snuck up the stairs and stormed straight into the Wellcome boardroom. Much to the shock of both them and us, there we were, in the heart of the dealers’ den, facing the biggest and slimiest drug pushing cartel in the world(8). We immediately started haranguing and shouting at the bow-tied and blue-rinsed board members, demanding that they pull out of any deal to buy the UCH Cruciform building. We stayed for half an hour, arguing with them and eventually forcing them to leave and hold their meeting in another room. Then three van loads of cops arrived outside, including riot cops. Once they saw we were a motley crew including toddlers and pensioners, and not a gang of terrorists, they sent in a few to tamely escort us off the premises.

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Leaflet for Wellcome action;

SAVE OUR HOSPITALS

NO WELCOME TO WELLCOME

We have come to Wellcome because we object to their involvement in the closure of our local hospital, UCH. The UCH Cruciform is being closed to make way for a muti-million pound bio-medical research centre, with funding from the ‘charitable’ wing of WELLCOME (the multinational drug company), in association with University College London (UCL). A ‘replacement’ hospital, if it happens at all, is planned for “within the next TEN YEARS”. In the meantime, WELLCOME and other businesses UCL have links with can rake in the profits while we suffer as the NHS is dismantled.

The Cruciform must stay a much needed hospital, and not become another site for business, even if it is medical research. What is the use of such research when our hospitals are closing,

We also question the nature of the research, including the testing of dangerous drugs on animals. WELLCOME have made £billions from the manufacture of the faulty drug AZT, at the expense of AIDS sufferers. Although they were reported to the Department of Health in 1992 for “false and misleading” claims about AZT, and also condemned by the Committee on the Safety of Medicines for the same, they are still managing to make profits from this drug, which some claim is not only useless but highly toxic. WELLCOME are in an extremely powerful position, having got AZT recognised as the main treatment for AIDS in the USA, which means other potential cures are being ignored.

WELLCOME are vampires on the NHS. At Leeds general infirmary, for every pint of bloods given by donors to the NHS, the NHS gets only 10% and WELLCOME get the rest for profiteering bloodsucking research…No welcome for Wellcome!

Although the strike and occupation at UCH were forced to end,; the struggle to keep our hospital open continues. Half the Cruciform is still being used as a hospital. It is not too late to re-open the empty wards and stop UCL/WELLCOME dancing on all our graves.

SUPPORT THE DEMONSTRATION/VIGIL OUTSIDE UCH ON THURSDAY 14th OCTOBER? ALL DAY? AGAINST THE HOSPITAL CLOSURE.

For more information contact:

UCH Community Action Committee, c/o BM CRL, London WC1.

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Later that day we gate-crashed the UCL Provost’s office, interrupting his lunch and puncturing his self-importance to the point where he was reduced to calling us names and shouting at us to “get stuffed”. We then moved on to the nearby offices of UCH boss Charles Marshall, which we invaded, disrupting a business meeting in the process. A few of us stayed for a while to argue the toss with him. All in all, not a bad day’s work.

We also kept demonstrating once or twice a week outside the hospital and tried to organise to resist more wards being moved out, but we were never strong enough or well informed enough of management’s plans. In the run up to November 5th a Virginia Bottomley guy was taken round the local area to raise money and a few laughs. We also attended and heckled meetings of the local Health Authority; who were discussing plans to deal with a £21 million cut in their budget by not sending any more patients to UCH; this would leave only a casualty department without adequate back-up facilities, with patients allowed a maximum 48 hour stay before being moved on. In order to compete with other hospitals for patients, UCH management announced a 10% price cut. This was to be achieved mainly by the axing of 700 jobs – but even this wasn’t enough to satisfy the “Internal Market”. Ex-strikers we talked to said there was no mood for a strike against these cuts amongst UCH workers.

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A Second Occupation

An NHS “Day of Action” had been organised by the TUC for November 20th, basically as a token safety valve to dissipate the growing anger and pressure from health workers and others. Originally planned for Thursday 18th, it was changed to Saturday 20th – this was decided during the UCH strike in September, apparently due to union fears of a growing militancy amongst health workers. For the unions, the unpleasant possibility of effective action being taken – such as solidarity strikes or at least the major disruption of central London weekday traffic – would be greatly lessened by holding the demonstration on a Saturday. The unions’ publicity for November 20th was very low key and half hearted – neither the demo nor any other real activity was emphasised, just the symbolic slogan “NHS Day of Action”, with the demo mentioned in small letters at the bottom of the posters. The unions obviously have the resources to organise a massive demonstration to defend free health care if they want to, but this was not on their agenda.

Members of the UCHCAC decided to use the Day of Action as a way of combating the inactivity planned by the unions. We also wanted to do something to try stop the imminent closure of the Cruciform building. So we arranged for a group of us to reoccupy Ward 2/3 on the night before the Day of Action. Seventeen of us and some friends waited while a few people cracked open the ward. We all eventually sneaked in to find a bare ward: no beds or furniture this time.

The next morning we hung out some banners from the windows, as people began arriving for the UCH feeder march which would link up later with the main demo. At about 10.30am the hospital security guards finally noticed us. They came and asked what we were doing and then disappeared.

Most of us went off to join the demo, leaving a handful to “guard the fort” and stay put. Our faction marched under an anti-TUC banner saying “Tories Unofficial Cops sabotaging struggles.” It was a boring march with 20-25,000 people on it; but the rally at Trafalgar Square was more interesting. We heckled a lot through a megaphone at the TU bureaucrats and celebrities, taking the piss and expressing our anger at the pathetic farce. It was ridiculous to see actors from the TV soap “Casualty” being invited to make guest appearances and talk crap on the platform while real nurses who wanted to speak were prevented from doing so by the union bosses.

We also handed out leaflets at the demo explaining the UCH situation and asking people to come and join the occupation. About 25 people responded by coming to the ward after the demo — some SWP and Class War members and the other half various non-aligned individuals – 25 out of 25,000 – pathetic. We had a meeting and all these people expressed support for the occupation but most left never to return. Four or five stayed the weekend with about eight of us, and a friendly hospital worker managed to smuggle us in plenty of spare bedding to make us more comfortable. Some of the visitors went off to attempt their own occupation in south London but were apparently quickly evicted without any legal formalities by the cops.

Within a few days we were reliant on the same old familiar faces to maintain and publicise the occupation — our aim of using the occupation as a base to get more people involved was not succeeding. It was becoming a strain on the dozen or so hard core of people involved to keep things going and the lack of response was depressing. Sometimes there were just 2 people in the occupation and the boredom weighed heavy. We had a few supporters dropping in and some donations of food but very few people willing to become actively involved – even staying overnight occasionally was too much of a commitment for most people.

Although we had been very clear from the start that the occupation should not just be another token publicity stunt, we were now getting desperate and the brick walls of apathy around us were beginning to close in. So it was decided to contact the media in order to spread the word that we were here — our own local leafleting and flyposting having bad so little effect. But we were agreed that no media people would be allowed inside the ward as this would create a totally different and unwanted atmosphere and would also be a great security risk (but not everybody stuck strictly to this agreement).

Management tried at first to ignore the occupation, fearing that any action against us might give it more publicity, but responded immediately once we contacted the media. Carlton TV said they’d come down and interview from outside while we talked to them from a window on the ward. Carlton phoned UCH management just beforehand to get their side of the story – which prompted management to cut off our electricity just before the cameras arrived. But the interview went ahead and was shown on London-wide TV news. We made sure our mobile phone number was prominently displayed to the cameras. This led to three people phoning us, two very supportive and one abusive. Considering that millions of people saw the interview and phone number on prime-time TV news this seemed to be one more example of how apathetic people felt. But in all our statements to the media we emphasised that our main goal was to help spread and inspire more occupations; we can only hope that we have planted some seeds that have yet to grow.

The SWP were even less supportive than the rest of the bourgeois press — it was only after we got some media coverage that they mentioned the occupation at all in Socialist Worker – and only after we had been evicted!

There were attempts to involve more people by holding a weekly under-5s afternoon, alternative health workshops, an acoustic music session, etc.. But general conditions plus the impossibility of long term planning made these hard to develop.

The few remaining wards in the building had been steadily closing during the occupation — and without the active support of staff or large numbers of other people there was nothing we could do to try and stop them closing down the building. Once the last patients had been moved out the management also cut off our heating. Now without heat or electricity we nonetheless stuck it out; we stubbornly dug our heels in and just wore more clothes and used candles, lanterns and camping gas stoves.

During this time we had a public meeting at Conway Hall – 22 people turned up, including a few militant health workers. We all had a good discussion with interesting ideas being suggested. It was generally felt that more effort should be put into making links with like minded groups and individuals. But again, only one or two people showed any willingness to get involved with the occupation. Still, we did make contact with some good people.

It was no surprise when we eventually received a High Court summons notifying us that proceedings were underway for management to regain possession of the ward. We went to the court hearing and, joined by a crowd of friends and supporters (including a few ex-strikers), we picketed outside the court with banners and leaflets. We lost the case, despite our solicitors arguing that the management were unable to produce any title deeds or clear evidence that they had any right to the building. The court case also attracted more TV, radio and press coverage.

We had a small but noisy spontaneous march back to the hospital – afterwards a few of us climbed on a flat roof opposite the UCH Chief Executive’s office windows and blared out a tape of the old working class anthem “The Internationale” at the management for a laugh, while waving banners saying “Spread the Occupations”. At around this time we received a couple of amusing phone calls; we had managed to get an article published in Pi, the UCL student magazine, about UCH and University College London’s involvement in the sell-off of the Cruciform building:

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Student magazine article; Pi 553

The Provost Makes Us Sick

Students at UCL might like to hear about the involvement of UCL, and of the Provost, Derek Roberts, in particular, in the closing down of our local hospital UCH. They might also like to hear about an action taken against Roberts in protest at this involvement.

Derek Roberts is one of a committee appointed to close the main (“Cruciform”) building. Others on this committee are Charles Marshall (former Private Secretary to minister John Biffen and Chief Executive at UCH), Sir Ronald Mason (Chief Scientific Adviser to the Ministry of Defence) , Professor Laurence Martin (Director of the right-wing think tank, The Institute for International Affairs) and John Mitchell (Fellow King’s Fund College).

Once the UCH Cruciform building is fully cleared of patients, UCL management have plans to turn the building into a multi-million pound “biomedical research centre” with money from the “charitable” wing of the multinational drugs company Wellcome. (Wellcome, it might be remembered, wee responsible for the dodgy drug AZT, which made them billions at the expense of people with AIDS). With the involvement of Wellcome, the Ministry of Defence, and the institute for International Affairs (though by some to be an MI5 front organisation), it is open to question what sort of “biomedical research” UCL intend to carry out at the vacated hospital. But even if it were “legitimate research” (you know, that stuff where they drop chemicals into rabbits’ eyes), this would still be no argument for closing down a hospital in it its favour, when hospital waiting lists all over the country are growing.

In reality, the closure and expansion into the UCH Cruciform building are part of UCL’s moves to strengthen connections with business and commerce. UCL is trying to get funding for research through two companies – UCL Initiatives Ltd. and UCL Ventures Ltd. Naturally, like any other business concerns, these two companies care nothing at all about the welfare of people with no hospital to go to and no private medical insurance.

It is not that “now the Cruciform building is closing UCL are making use of it by moving in”. The plans for UCL’s expansion into the Cruciform were floated long before the closure was made public. This is why the Provost was so against the 6-week strike by nurses trying to prevent the closure. Roberts has said “the strike was counter to the interests of patients, the future of UCL Hospitals, and indeed, the future of UCL….there should be great relief that it is over.” If UCH was kept open, Roberts wouldn’t have such an ideal location for empire-building – of course, he was relieved when the strike finished!

But the struggle against the closure isn’t over despite the ending of the strike. In protest at Roberts’ activities, members of UCH Community Action Committee – a group formed out of a previous 11 day occupation of an empty ward at UCH by angry local residents – occupied Roberts’ office for an hour, while Roberts and two of his associates were trying to eat their lunch. Roberts became increasingly flustered as we plied him with questions about UCH, and he became even more uncomfortable when it was evidents that we weren’t about to leave in a hurry. Soon Roberts, this shining representative of liberal academic tolerance, was resorting to one-liners like, “Get stuffed!”, “Shut your mouth!” and “You’re a child!” (this latter remark being particularly ironic considering that many of the occupiers were older, and obviously wiser, than himself). All in all this mini-occupation was a success, and as we were escorted off the premises by security guards we felt some satisfaction in the fact that we’d made Roberts squirm, and messed up his afternoon.

However, this occupation was nowhere near enough. We call upon all students, whether they are concerned about the hospital into political activism or just bored with the misery of meaningless studies, to take direct action against the Provost and management of UCL. Go for indefinite occupations, or imaginative acts of sabotage. And don’t wait for the next union meeting where everything will get bogged down in bureaucracy. Do it now! You will have our active support.

Guy Debord

Note 1: You can contact UCHCAC outside the hospital main entrance from 12-2 every Friday, or c/o BM CRL, London, WC1N 3XX.

Note 2: There is a national demo against hospital closures in London, Nov. 20, with one contingent leaving from UCH, 11 a.m.

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We had then reprinted it as a leaflet and distributed it outside UCH and UCL, which was just across the road from the Cruciform. We also stuck it up inside the college. A few days later we received an angry telephone call from a whingeing student journalist insisting that we stop distributing the article as it was “all lies” and we were infringing Pi magazine’s copyright. Realising she was failing to intimidate us, as we laughed and insulted her for being a pathetic crawling lackey for the college authorities, she slammed the phone down. Shortly afterwards we were phoned by a member of UCL management who demanded (unsuccessfully) to know who we were and threatened to sue us — we told him to sue if he wanted to, as we had no money to lose. And if they took us to court for making false statements about UCL’s involvement in the closure and sell-off of UCH then they would have to reveal what the truth of the matter was – something we’d all like to hear! The editor of the mag also phoned the author to complain that she’d been called into the Provost’s office and given a furious bollocking for publishing it. (The Provost also mentioned that he had checked the student register for the name of the author — and there was not even a “Guy Debord” listed there!). It was clear we were beginning to make them feel vulnerable.

Word had got out that Health Minister Bottomley was due to visit Arlington House, a hostel for homeless men in Camden Town. She was to be launching a new government video about ways to help the homeless be more healthy (of course, this didn’t actually include giving them a home). We publicised her visit the best we could, calling on people to demonstrate outside the hostel. Shortly before the visit we heard that Bottomley would not now be attending and would be substituted by Junior Health Minister Baroness Cumberlege. Unfortunately it was too late to change our publicity from “Give Bottomley a lobotomy” to “Give Cumberlege a haemorrhage”. The night before, a wall opposite the hostel was graffitied with “Bottomley bottled out” but it was painted over before the Baroness arrived. When she did come she was immediately surrounded by us as she got out of her car — surprisingly she kept her nerve quite well and stopped briefly to argue with us. As the abuse and accusations intensified she was hustled away by cops to shouts of “murderer!”.

Once again the great silent majority had stayed silent and absent, not responding to our flyposting and leafleting or mention of the visit in local papers. Only about twenty people turned up, most of them already known to us, plus three residents of the hostel. One told us they’d graffittied inside the building but that had been painted over too.

We went back to the ward and had a party that night. We were evicted by bailiffs, cops and security guards at 7.45 the next morning, twenty days after the start of the occupation.

So now the Cruciform lies empty, with the loss of around 350 beds, while in other hospitals people suffer and die in corridors for want of a bed. But a few days after the end of the occupation Bottomley announced that the UCH was “saved” – all that this meant was that there would still be a casualty department (which hadn’t been under threat anyway) and a renowned centre for medical research (meaning that the plan to sell it off to the likes of UCL and Wellcome was still to go ahead). This grand announcement was presented in the media as a great act of charity and a big concession; when in fact all that they were saying was that nothing had changed and their plans were still the same. That was newspeak at its most effective – people kept saying to us how great it was that UCH had been saved – when they had just closed down the main building with the loss of 350 beds and 700 jobs to follow! Bottomley also said that she might give some extra money as a temporary subsidy, on the condition that management make even more cuts. This was a way to avoid the embarrassment of UCH finally collapsing due to the pressures of competition in the Internal Market — the money could also be seen as a reward to UCH management for its cuts package of 700 jobs.

Then, to cap it all, three weeks later it was announced that the latest plan being considered was to sell off the whole UCH site (like other hospitals, the land would fetch millions on the property market) and to move parts of the UCH to various other hospitals. Who knows what they’ll come up with next?

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Post-occupation leaflet;

UCH – SAVAGED NOT SAVED

The SWP – doing Bottomley’s dirty work for her:

Q: What have Virginia Bottomley and the SWP got in common?

A: Amongst other things, they both claim that University College Hospital (UCH) has been saved.

About 700 jobs and hundreds of beds have been lost, and the main Cruciform building – which everyone associated with UCH – has been closed. Yet for different, equally-manipulative reasons, the “Health” Minister and the “Socialist” Workers’ Party are both agreed on the lie that “UCH has been saved”. Goebells – “The bigger the lie, the more it is believed” – would have been proud.

What’s left of UCH?

Well – now merged with the Middlesex, there’s the administration – really useful if you’ve had a heart attack. And there the Accident & Emergency – but that was never scheduled for closure in the first place. Instead, as with all A & E’s without a hospital attached, it’s been left without adequate back-up, giving patients just 48 hours to stay before being moved on. There are, however, 40 or so extra beds for those who need intensive care, who can now stay on a bit longer. Nevertheless, staff are now complaining that whereas before it used to take just a couple of minutes to move such patients to a specialist ward in the old Cruciform building, now it takes up to half an hour to get to the Middlesex because of heavy traffic. What’s more, the recent death of a six-month-old baby at UCH A&E shows how dangerous it is to have an A&E separate from the specialists (now based in Middlesex) who were previously on site; at the same time the cuts ensured that the equipment for monitoring the baby wasn’t working. It looks like the parents are going to sue the over-worked nurses involved, using the Patients’ Charter. The much-lauded Charter is used intentionally to blame individual health workers in order to fend off attacks on the real murders: the managers and accountants who push through the cuts demanded by Bottomley and her genocidal government.

Apart from this, there’s a private wing (great!). Also “saved” (we’re not sure they were planning it for closure originally anyway) are the Urology department (much reduced), the clap clinic and Obstetrics. And there’s a new children’s ward: however, at the Middlesex there used to be two children’s wards, and now there’s only one – which means that between them, one children’s ward has been lost, even though on paper UCH’s has been “saved”. Similarly, by classifying some beds which were previously the Middlesex’s, and by counting the beds existing towards the end of the run-down of the UCH, the health authorities can claim that UCH has lost “only” 70 beds instead of the 300+ that have really been lost. Lies, damned lies and statistics. Moreover, three weeks after Bottomley said the UCH had been saved, it was announced that the latest plan was to sell off the whole UCH site (the land fetching millions on the property market) and to move parts of the UCH to various other hospitals. If this comes about UCH will merely be an administrative label on some bureaucrat’s door.

To say all this means the hospital has been saved is like saying that a formerly healthy adults, aho has had both legs and arms amputated and is on a life support machine, has been saved. Well, technically yes – but it hardly constitutes the victory the SWP like to make it out to be.

With saviours like these, who needs grave-diggers?

During the Vietnam war, an American general declared, “In order to save the village, it had to be destroyed.” With UCH it’s more a case of “in order to destroy the hospital, it had to look like it was saved.”

Virginia Bottomley says the UCH has been saved, for similar reasons to the government saving coal mines in 1992 – to stop people fighting together, to reinforce the ignorance and confusion about what’s happening to the hospitals and to divide up the fight to save them into isolated campaigns for each hospital, separated from a more general movement.

But why does the SWP proclaim “We saved UCH” when those SWP members who have worked and struggled at UCH – some of whom are genuinely fighting to win – know perfectly well this is bullshit? As in all hierarchies, the individual has to repress their point of view and preach “the party line”. During the strike, SWP strategy was designed to gain the maximum publicity and to show how radical they were compared to the union leadership, by pushing for demands that they knew the leaders would not meet. The predictable sell-out of the strike by Unison was the “victory” the SWP wanted: confirmation of something they knew beforehand would happen; but did nothing to undermine. In fact, they had encouraged a faith in the union which they knew would inevitably be betrayed. It was only afterwards that they needed to find a happy ending, so that they could encourage others to repeat the tragedy at other hospitals. The SWP’s main concern was recruitment to a self-proclaimed image of themselves heroically and successfully leading the working class to victory, even if this victory is a myth. For them this is more vital than the development of any real struggle by the poor, honestly facing the horrific extent of their defeats and the reasons for them.

The struggles at UCH

During the struggles at UCH the SWP did everything to minimise the efforts of non-SWP members. During the work-in aimed at stopping the closure of Ward 2/1 in Nov – Dec ’92, SWP members played as much a part as anyone else involved in the struggle – though it was probably the support of the junior doctors which really won this battle, admittedly only a temporary reprieve. In the strike of Aug – Sept ’93 they played a more significant part – not all of it helpful by any means. For instance, they did much to ensure that the cheerful demos which had previously disrupted traffic got turned into boring routine affairs. And in the occupation of Ward 2/3 in September, admittedly suggested by an SWP member, though broken into by a non-party hospital campaigner, they did much to dampen the high-spirited atmosphere. When occupiers met with a few SWP union stewards to discuss the occupation, the occupiers were told the stewards represented the decisions of the strike committee, and these decisions were: vetting to decide who should be allowed into the occupation, to be carried out by the branch secretary and chair, both SWP members. People would have to book themselves onto a formalised rota days in advance just to be able to spend a night there, reducing the occupation to a chore and duty, killing off the social dynamic going on. The effect of these changes was miserable: a lot of people, particularly locals who visited regularly, were put off from coming. And there seemed little point in giving out leaflets encouraging people to come, if they had to be vetted first. People now felt they were only there with the tolerance of certain officials, and no longer joint partners in the struggle.

The openness of the occupation; with free debate flowing back and forth informally, was replaced with an atmosphere of intrigue and secret whispering. It was only later found out that these demands of the SWP union officials weren’t at all proposed by the strike committee: it had been an SWP manipulation from the very beginning.

The second occupation of Ward 2/3 was organised by us – UCH Community Action Committee – without, unfortunately, a strike at UCH, and completely independently of any political party. We had hoped to extend the occupation of one ward by getting loads of people back from a TUC Health Service demo on November 20th. We failed, even though the occupation took nearly three weeks to be evicted. During this time, the SWP were even less supportive than the rest of the media – the occupation only got a mention after the evictions. We could never, of course, pretend that “we saved UCH” – not just because it hasn’t been saved but, more vitally, because if UCH had been saved it could not have been down to us, but due to a more general and much more combative movement, involving a considerably greater section of the working class than the few people who initiated the occupation. Unlike the SWP, we have no pretension to being an indispensable vanguard, able to win victories on our own. And, of course, UCH has been, by and large, a defeat, and to ignore that is to confuse and demoralise any chance of a fightback, which is where the SWP and Bottomley have so much in common.

If a fight is to develop to save the hospitals or to stop the horrific attacks on the poor, it will not only have to bypass the parties and unions, but attack them as enemies and obstacles to our struggle. Our health and our lives cannot be “saved by the professional liars of the Left, Right or Centre, but only ourselves organising not just an organisation with a name on a banner or logo on a leaflet, which is just an image, but organising specific actions and critiques, correcting our weaknesses and failures.

UCH Community Action Committee, c/o BM CRL, London WC1N 3XX

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Victory prepared by a series of defeats?

As we go to press (1995) it seems that some kind of active campaign may be starting up at Guy’s Hospital to try and save it from the Health Butchers. From what we have seen so far it seems that the same old mistakes made at the UCH are doomed to be repeated at Guy’s; many of the hospital staff appear to have the same naive faith ‘their’ unions and ‘their’ MPs etc. – and once again they are encouraged in this by the SWP – who have set up their own community campaign front group, as have two other rival political factions. The SWP now even claim that they saved UCH (see leaflet below). The campaigning appears to be about one hospital only – all the easier to be defeated in isolation. And only a few hundred turned out for a demo, although this is the local hospital for many thousands of people. But these are early days and hopefully things will develop beyond these limits.

So what lessons can we draw from the UCH strike and two occupations that are worth passing on to those who may find themselves in a similar situation?

Well, basically, never trust those who want to represent you and speak for you – fight to preserve your own autonomy if you have it and fight to gain it if you don’t. Never trust the unions and lefty parties (despite the fact that there are OK individual rank’n’file members within them) – they’ll always try to use you for their own ends.

If you want to gain support then go and get it yourselves — going through official channels is generally useless. Workers need to speak face-to-face with other workers – the union reps will try to fob you off with excuses and tie you up with official procedures.

If strike action is to be effective it will have to be organised outside and against the unions — and ideally there will need to be prior commitment of solidarity from sufficient numbers of workers so as to make it impossible for the bosses to victim small groups of workers in isolation.

And do all you can to immediately spread all strikes and occupations; such may seem wildly optimistic at the moment, but if each hospital is to avoid being picked off one by one in isolation (just as so many sectors of workers have been) then we need a growing movement of occupations and strikes.

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Our hospital was saved by the kind of action that this bill will seek to criminalise. We occupied, we picketed, we slept outside and we won. All that is under attack. We must stop this bill.

– Candy Udwin, UNISON branch secretary, University College Hospital

Quote from an SWP anti-Criminal Justice Bill leaflet: Ms Udwin is an SWP member who, during the strike, loudly condemned the dangerous consequences if the Cruciform building was closed with hundred of jobs to be lost. Yet now all this has happened, she faithfully parrots the party lie that this outcome is a victory won by the SWP!

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LIFE IN THE VOID

[NB, typists’ note: This was published in 1995, so some of the ‘current’ issues and developments mentioned are history or present problems to us now…]

Alongside other attacks, the Health Service is being torn apart around our but where is the resistance on the scale necessary to turn things around? The last years of accelerating defeat, demoralisation and hardship seems to have created ai extreme cynicism about being able to change anything for the better, or even that worth trying to. People have retreated largely into an isolation centred on the struggle for survival day-to-day. The war of all-against-all for shrinking resources ha made everyone a casualty — resignation rules. The health service is an issue that effects everybody and yet the amount of active resistance to its destruction is so far pathetically small.

There is at present little strike action taking place in the UK; but when it happens there is more and more criticism by workers of the role of “their” unions in the struggle. UCH, Burnsall and Timex are the most recent examples of this (interestingly, in each case it was a predominantly female work force confronting a typically male union bureaucracy).

The early ’70s were often marked by a strong belief in the union as the real sister/brotherhood that would bring about radical social change. Most of that sad faith has now gone although there’s still a fair amount of “if only we could get rid of the bureaucrats things would be okay” type platitude – with little recognition that the union structure is designed to be a control mechanism, or that trying to “radicalise” the unions is as futile as trying to radicalise any other capitalist institution. Yet, despite mounting criticism, people feel more compelled to obey the union than in the 60’s/70’s period when there were rank’n’file movements jumping in and out of the trade union form (almost always to end up in it again) and often initiating wildcat actions that bypassed the union bureaucracy whilst making use of union resources for their own ends: but the bottom line was still that of quite strong TU beliefs.

But all these contradictions reflect the changing role of the unions. why people obey the union today is because of its role as an economic provider: as a cheaper kind of building or insurance society (literally — the unions now provide low cost insurance deals and mortgages to staff); as an issuer of strike pay when you can’t get anything off the State; as a provider of legal skills (solicitors, etc.) in an increasingly litigation oriented society where Law Centres are often no longer available for low paid workers; and the union as the place where bitter divorce proceedings or future funeral expenses cost you nothing more than the renewal of a years subscription. In short, working in harmony with the money terrorism of a free market cash-and-carry UK. Thus to get thrown out of the union for engaging in wildcat actions or whatever (a threat increasingly employed by union bureaucrat fat cats) might have serious financial consequences.

UNISON is only the latest but perhaps the most significant example of unions extending their influence from the workplace to other areas of life. Maybe this should be looked at more closely because it may reveal a new stage in the unions’ role in society (i.e. extending the disciplinary role, or at least their role of social recuperation in the community). There does seem to be a tendency of unions pursuing a more “consumerist” role, looking after its people on all fronts – no doubt, they would say, the better to integrate people back into the present system. Its different from the old German model of holiday camps and trekking, in that the whole set up is based upon private consumption, leisure and social services. The last thing the unions could (or want to) do is bring people together in a real physical closeness.

At UCH the strikers never received strike pay until after they had agreed to call off the strike. No doubt the accountants are instructed to keep money in the bank, making interest until the very last moment. Although nurses are paid monthly, the porters are paid weekly and they were particularly hard hit during the strike by the union’s mean approach. This union strike pay sabotage is widespread: in 1988 striking civil servants in London never received a penny until their thirteen week strike had come to an end.

All the measures listed above are a great form of blackmail – no wonder then that the unions are now such superb organisers of constant and almost total defeat. But again, we can’t simply blame the bureaucrats for our own failures – they thrive on our isolation and passivity – and their strength is based largely on what we let them get away with.

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Derailing a runaway train

If we look at the policies promoted by the Tory State in the last few years, it seems that increasingly they do not even serve the long term interests of the ruling class. The fast money, free market “privatise everything that moves” ideology is like a runaway train mowing down anything in its path but having no clear idea of where its going. The destruction of industrial manufacturing in favour of financial capital, the creation of a boom and then bust property market, the lack of investment in training for a skilled work force; these are all measures that have given them short term gains (at the expense of the working class) but have inevitably created deeper problems as they mature later on. The State is not capable of planning logical long term strategy in its own interests – only more cuts, more repression.

This short-sightedness is mirrored in the State’s plans for the health service. There is a strategy of wanting to destroy the popular principle and tradition of free health care for all, but the way they are pursuing it means that they could end up wrecking all kinds of health care provision.

At the present time all doctors and nurses are trained within the NHS. With continual closures of so many hospitals, including the best teaching institutions, the effects are likely to be catastrophic for health care in general.

Private health care takes place mainly in NHS hospitals – so the BUPA alternative will be no solution. Being dependent on the NHS for facilities and staff training, it may crash with it. The big increase in BUPA advertising is just a sign of desperation. BUPA is now in serious financial crisis – gone are its eighties hey-days when, for a cheap rate, a BUPA subscription was lodged into many a middle management contract. Now BUPA are desperately revising their services and moving to a position whereby those who are likely candidates for any major illness can get lost/drop dead.

But could we even expect a future total collapse of BUPA to cause the government to pause and rethink its policies on health services? What other country in Western world is making such attacks on the general health of its population? The government recently began running a series of adverts in British medical journals c behalf of the United Arab Emirates government – the ads were aimed at convincing thousands of NHS medical staff to start a new career abroad working for much better wages in the UAE. The government has announced that it plans to cut sick pay – another attempt to force those who can afford it into private health insurance. And since the introduction of water meters in trial schemes thousands of people who could not pay the much higher bills have been disconnected – outbreaks of dysentery and other health problems have been caused by the rising cost of water (it is planned that water meters will soon be compulsory for all). It’s worth remembering that one of the main reasons better public sanitation was originally introduced was because the diseases that developed from the filthy slums of the 19th Century showed no class prejudice and would eventually hit the richer parts of town.

It’s possible that there’s real disarray in the ruling class; crudely put, a conflict between ‘finance capitalists’ (who are blind to social consequences) and a more socially concerned professional capitalist class. The finance capitalist faction looking for a repeat of ‘80s privatisation sell-off bonanzas – as they are also aware (rightly) that capitalism can never satisfy all the needs it creates. So they pursue cut-back strategies, with little regard for the social consequences, almost taking a social Darwinist position. On the other side is a professional class which finds some sort of common ground with One Nation Tories. This faction is both trying to secure own sectional interests (more money for managers, administrators, professional etc.) and appealing to a wider social consensus around a program of managerial capitalism. They are, however, under-represented at the top and exist as a middle management of the chaos. What they don’t appear to realise is that the system cannot fill all the needs they have set themselves to manage – so they are in a permanent state of frustration, and are becoming somewhat deranged as a consequence.

The most likely outcome of imposing the internal market will be a vastly reduced NHS run as a skeleton service for those with no other options, maybe with a sliding scale of charges according to income. Already Leicester Health Authority is requiring people to pay for non-emergency operations since their annual budget ran out half-way through the financial year. So now everybody will have to wait six months for a free operation – and by then the queue will be so long they will probably use up the funds allocated for the whole year in a month or so. So each year the queue will become more and more endless. This is one way of gradually introducing payment for treatment by the back door.

To conclude: the question mark that hangs over the NHS, to be or not to be, raises a number of related matters which can only be hinted at here.

Can capital overall dispense with an NHS given that powerful chemical companies depend on State revenues to underwrite their profitability? It was commonplace in the 70s to argue against dismantling the NHS on the aforementioned ground as well as emphasising that taking a vast amount of purchasing power (jobs) out of the economy would be a deflationary move amounting to the suicidal. The Thatcherite legacy is fully prepared to explode this piece of economic logic not by refuting the conclusions but rather by accepting the consequences.

What part did war and war time play in the setting up of the NHS, particularly in the need to have a fighting fit workforce able to wage war on capital’s behalf? Except locally, conventional warfare on a large scale is a thing of the past hence a further argument against an NHS, but an argument that would have been conducted behind closed doors. Undoubtedly, however, the ideology of a “people’s war” (1939-45) helped shape the comprehensive nature of the NHS — so today, its continued existence is probably more of a political than an economic imperative with a political class using the issue to garner votes, especially from the ageing part of the population. It’s conceivable a government could buy out a person’s right to free health care by offering a once-and-for-all cash payment This could appeal to young, healthy people with no money nor perspective on the future.

The potential for political deception and manipulation is enormous. A cull of the old and sick cannot be dismissed Out of hand though doubtless it would have to be left to the “hidden hand” of market forces rather than be achieved through mass execution. The prescribing of inferior and cheaper medicine, and the withholding of health care for people over a certain age not only underlines the economic burden of health care and the cost of an ageing population, but the problem of valorisation of capital. A youthful workforce could be turned against the old and sick on the grounds that they act as a depressant on wages. All family social ties would have to be virtually sundered for this program of wrinkly-cleansing to have a chance of social success. The human consequences of the actual workings of the internal market are, however, a taste of things to come. On occasion, competing trusts award contracts to health authorities some hundreds of miles distant The Bradford Trust won the contract for Virginia Bottomley’s (Secretary of Ill-Health) constituency in the south of England, which means patients run the very real risk of being isolated from family and friends in a moment of real crisis. This example reflects the way in which isolation accumulates in society at large — just seeming to happen – without anyone shouldering responsibility or cold-bloodedly anticipating the end result. But it suits capital’s needs perfectly and a comparison with the practice of moving prisoners away from familiar localities springs to mind.

It would be instructive to draw up a list of property magnates on the boards NHS trusts. Hospitals tend to occupy prime sites, and the conversion of St Georges hospital at Hyde Park Corner during the late 70s and early 80s into a swish hotel ranks as a forerunner. Similarly, the Harrow Road hospital in west London was bulldozed and yuppie apartment blocks constructed on the site overlooking the canal. By good fortune, the building company and developer, Declan Kelly. became a victim of the property crash and to this day the wretched place has the air of a building site. There is talk of converting Charing Cross Hospital into a hotel for senior staff at Heathrow airport. It’s possible too that Withington hospital in south Manchester could be used for similar purposes serving Ringway airport. Recently, St James’ University hospital in Leeds concluded a £25 million deal with private developers over 13.5 acres of their site. Doubtless it will be treated as badly needed “proof” that the property wheeler dealings of the trusts do work, with apologists eager to point out how the deal will finance a new paediatric unit and a “ninety bed patient ‘hotel’ for low intensity care cases” – which does hint that only private patients will eventually be welcome. Nor was any mention made of a likely bonus payable to trust managers. Leeds is however a special case and the fact that land values have risen in Leeds has more to do with its runaway success as a financial centre able to challenge the City of London in some respects (going on for half of all mortgages in UK are lent by building societies based within a thirty mile radius of Leeds). In Leeds too, Tony Clegg, the ex-chair of Mountleigh property consortium, who pulled out just before its financial potential nose-dived, is still chair of Leeds General Infirmary trust after the preliminary arrangements were put together by the boss of Centaur Clothes store in Leeds.

The presence of property developers on trusts is witness to the determination to recreate all that was associated with yuppie culture. There is some recovery in commercial property but not enough to stop the majority of closed hospitals from being boarded up and left to await the return of the roaring 80s and the stratospheric property values. It could be the trusts are biding their time and drawing some hope from the wave of privatisations sweeping Europe. The majority of States – with France and Italy in the lead – seek to expand by some 20-30% the market capitalisation of Europe’s largest stock markets. However, it’s not accompanied by fanfares of “popular capitalism” to anything like the same degree as under Thatcher.

The increasingly precarious nature of NHS schemes needs to be situated the multi-nationalisation of the global economy and the reduced significance of nation State as a pro-active economic force. Globalisation is, however, fraught with competing interests and in this present phase the flow of capital vastly outweighs flow of trade. Private insurance ties in with the contemporary dominance of finance capital so different from that described by Hilferding (basically as banker to industry). Its short-termism, money making money, detracts from the goals of industrial capitalism whose relationship with the nation State is somewhat less ambivalent, needing the State as a consumer, an enactor of labour legislation and as an educator. The whole issue however remains highly complex: e.g. money markets eagerly snap up treasury auctions in credit worthy countries and therefore have a vested interest in maintaining a manageable level of government overspend which includes expenditure of health and social security.

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SOME FURTHER REFLECTIONS

When comparing the different Health Services in Europe and North America, economically the most important point to grasp is the weight accorded to insurance companies versus the degree of state subsidy. In France, each individual is charged for hospital treatment but up to 70% is then reimbursed by the state — the rest is usually paid for by the Health Insurance deducted at source by your employers. The Balladur government wants to increase the role of the insurance companies and is meeting resistance both on behalf of the employees and the employers because it will add to the wages bill. It could also be used as an argument by employers to cut wages. Superficially, when comparing Britain and France things look better here regarding treatment irrespective of ability to pay. In France, each individual is charged a nominal sum for each day they spend in hospital but this money is refunded. Ideas along French lines have been floated in Britain but, at the same time, doctors in France are given an additional increment to their salaries every time they see a patient. So it is in their interest to continually follow up patients and in that sense primary care is better in France. Some attempt will be made to limit the amount of money spent on the French Health Service because it would appear that health spending in France is, in comparison to other countries, “out of control” (but doesn’t every government say the same thing???).

In North America, feeble attempts have been made in the last thirty years or so to limit the control of insurance companies over health care. Most recently, President Clinton wanted to reduce the role of insurance companies to 80% of health care costs by 1997/8; which shows just how tepid Hilary Clinton’s reforms were before they completely collapsed. (It took less than two years in Attlee’s post WWII reforming government for a “free” NHS to come into existence in Britain)(9). In the US, it has been reckoned that the only institutional group interested in preserving the American Health Service status quo are the huge insurance companies. Many powerful industrial conglomerates in the US want a form of NHS so as to ease the burden of medical insurance for their employees. Capitalist arguments are wheeled out in support of an American NHS along the lines of firms will become more internationally competitive freed of a medical insurance burden. Firms also seek to minimise health insurance cover as part of cost cutting, and such ploys have led to strikes such as the Pittston miners’ strike of 1989. There is also a current of opinion that the control of the insurance companies in America is leading to a degree of inertia with doctors fearing writs will be taken out charging them with medical negligence in case mishap. Compensation can reach astronomical sums and lawyers love pursuing medical claims (c/f “The Verdict”, the Paul Newman film about a beat-up lawyer pursuing a claim). The whole thing becomes a never-ending spiral of increased premiums to cover law suits, with the insurance companies the main beneficiaries isn’t this, more or less, how it must be under finance capital; the final “antediluvian form of capital” as Marx put it: is it possible to return health care to an earlier more rational form of capital? All in all isn’t it the rough equation: health care funded through equity culture — with the insurance companies along with pension funds playing big on the stock exchange???).

There is another shady area – the amount spent on administration. In comparison to the NHS in Britain, the ratio of administrative cost was something percent here to twenty percent in America. The admin costs are increasing dramatically in Britain as more and more accountants are being employed, particularly fund-holding GPs. In one estimate quoted by the Economist magazine, a former personal director of the NHS, Eric Caines, has calculated that it often takes seven a half weeks(!) worth of administration to deliver an hour and half of care to patients.

The importance of insurance companies in relation to health care, and who also related to the tempo of class struggle, must be linked to notions of popular capitalism, equity culture and a recognition of the role of insurance companies in driving stock exchanges forward. Concomitant with casino capitalism, beyond the risk-taking and rapacious short-termism, is the notion that on an individual level, a person takes full responsibility for the failure of capitalism; that one introjects and moralises its desperate shortcomings; that its failure is your failure. Not to be covered by private insurance is to be guilty even though its limitations are becoming painfully obvious to more and more people (BUPA has recently removed several medical conditions from the insurance cover, such as Alzheimer’s disease). demand “free medicine” is tantamount to being a fraudster, to want “something for nothing” and hence an aspect of “welfarism” to be bracketed alongside dole scroungers, single parents, travellers and, as the net expands, the ‘sick’ and people on State pensions. Amid the hysteria over the public sector borrowing requirement, it’s forgotten that an individual’s State health insurance contribution is exactly that of BUPA assuming that the individual is employed. And what is forgotten as the welfare blitz shows no sign of abating is that one aspect of modem welfarism, as expressed within the NHS, grew out of the armies of Empire and, secondly, the need for the bourgeoisie to protect themselves from cholera epidemics etc. through general environmental improvements. Does Mrs. Bottomley seriously believe Flo Nightingale went amongst the wounded soldiery of the Crimea inspecting BUPA cards by the light of the lamp before administering treatment?

The position of the staff nurse with its faint militaristic ring has been replaced by that of the “ward manager” resonant of a business appointment. The “line manager” of an Accident and Emergency Department approximates to that of an “assembly line manager” with patients substituting for the throughput of cars. Terminally ill cancer patients receive chilling letters concerning their admission to hospital from “marketing managers.” It’s as if a fatal disease has become a marketable commodity, something henceforth to be touted on the market. A hospital closure is referred to as a “market exit”, not to carry out a life saving operation is called a “budget under-spend”. This impenetrable language is redolent with symbolist abstruseness – a stay in a hospital becomes an “episode in care” a sort of “après-midi d’un NHS” bizarrely evoked by the estranged wordsmiths of monetarism – whose aim is not to concoct some ideal reality through a language torn from its functional context – but to cover up the unspeakable. The circle closes: this inverted apocalypse of language is indebted to the euphemisms of modem warfare where to kill was to “terminate with extreme prejudice” and where villages were destroyed “in order to save them.”

The closing down of the NHS, i.e. its privatisation, inevitably forms part of the Tory government’s privatisation program. However, the economic context and the circumstances of class struggle in which the first privatisations took place and today’s projected privatisations are very different. Privatisation, beginning with British Telecom, was an ad-hoc strategy. The foot-dragging “consensus” propping up subsequent privatisations was largely manufactured through economic sweeteners. The State crudely rigged “market” price, and sections of the working class throughout the ‘80s were able to get in on asset inflation. However, other than insurance companies, no one will get rich out of the pnvatisation of the NHS. Such a thing literally tramples into dust any notion of a share owning democracy and a popular capitalism, because all the money goes straight to the fat cats as private insurance schemes are taken up. “Popular” intermediaries are dispensed with who, in previous privatisations, would sell their shares to institutions in order to make a quick buck. The privatisation of the NHS brutally emphasises the concentration of capital, not its pretended democratisation. Misguided individuals may beef about waste in the NHS – the enormous amounts of food surplus to requirements disposed of everyday is still a familiar complaint – but there isn’t even the shreds of a consensus supporting the dismantling of the NHS. The mass of people, including middle class professionals, have been bludgeoned into accepting it and behind every hospital closure, in the not too distant past, is the defeat of section after section of the working class fighting to the death in isolation. True, criticisms of the formerly “fully operational” NHS were broad and manifold, but the ease and speed with which it is being dismantled is different from the “willingness” of factory workers to accept redundancy and closure previously. Then there was an element of gladness to have done with alienated labour – now the attitude is one of resignation and the feeling all protest is hopeless. The public’s attitude is not one of “medical nemesis” — the actual shortening of life through too much medical interference – but the aghast realisation one could literally be left to die in the not too distant future. Whatever the future of the NHS – and a nurse in the UCH occupation did ask for alternative ideas on the NHS to make it more appealing — any renationalisation of health care must necessarily involve re-regulation and a hands on approach in other spheres as well, like, for instance, the stamping out of currency speculation favoured by more rational capitalists out of which insurance companies along with bank, pension and investment funds can do very well. Instead of a minimalist State, more of a maximalist State — all of which evades the vexed question of an autonomous medicine going beyond the rapidly fading institutions of the NHS. No matter how airy fairy such a notion now seems, the realisation of the good life through autonomous class struggle is inseparable from good health.

Both in psychiatry and general health care the recuperation of the everyday is very visible. (This recuperation is not merely carried out in terms of an idealised healthy person – it also carries a political meaning:— the restoration of the power of the status quo). Hospital wards at times come to resemble a homely sitting room with visitors sitting on beds, portable TVs flickering, music blaring, easy chairs at random. Nurses are far less starchy and doctors and consultants are not so sniffy. Belatedly the trauma of a stay in hospital has been recognised and a patient seen to have human and emotional needs. At the same time the gain in informality cannot cover up the dust collecting in corners, the stains, the peeling paint, the dilapidated state of the premises, the clapped out beds. In fact the informality has developed alongside reductions in staff levels. It is as if recuperation has been permitted to exist with the proviso that everything will shortly be gone – doctors, nurses, ancillary staff, equipment, even the bricks and mortar. Here, to kill is to cure. Waiting lists are abolished by closing all hospitals in an insanity which knows no bounds, and strikes are abolished by shutting down industry.

There are a myriad of other matters one could glance on. The misery of doctors enveloped in a world of serial sickness, endlessly seeing one patient after another, their loneliness, self-doubt and recrimination resulting in breakdown; disastrous love lives often leading them in middle age to pounce upon the first available member of the opposite sex. And then there are the drug company reps that prey on doctors, offering inducements like holidays in the sun, to demonstrate the virtues of some new supadrug – their stylish clothing, large salaries, persuasive selling techniques and at the end of the day nothing but the sting of conscience and alcohol.

And why haven’t doctors, consultants and hospital administrators laid bare their professional unhappiness and told it like it was? This failing they share in common with most other professional people who similarly maintain a vow of silence, leaving the rest of us to try and do it for them. It is noteworthy that Dr Chris Pallis of “Solidarity” — a member of one of the best revolutionary group/mags of the 60s – never voiced his unease at being a top consultant, as though clinical practice was immune from the vicissitudes of class struggle. When he came to write on the NHS, he used it as a vehicle to demonstrate the Cardanite thesis of ever increasing bureaucracy. And where NHS staff have written from the eye of the storm it has tended to come from within a Trotskyist perspective (e.g. “Memoirs of a Callous Picket” written by Jonathan Neale, an SWP ancillary worker (Pluto Press, 1983) and Dave Widgery’s account “Some Lives” of what it was like to be a GP in a poverty stricken East London borough), Only recently have more autonomous critiques started to appear, and let’s hope we’ll see a lot more of them when things really start to come to the boil…

Unfortunately, most people (and with all the so-called ‘reforms’ the numbers grow by the minute) still have some kind of faith that the Labour Party, once in power, is going to ride into the fray on a white charger and clear up the mess, bringing about free health care, building hospitals everywhere. Don’t believe it. Basically, they are going to take over the ‘reforms’ managing the ‘unaccountable’ trusts with a phalanx of the their own personnel. After all, it was ad hoc Labour Party initiatives (pretending to be grass roots and independent) on urban regeneration and single issues in the 60s and 70s that brought to prominence the para—state (as it was then known) which became the precursors of the now notorious and much more powerful (lucratively funded) quangos, staffed with failed government cadres. Obviously, the Labour Party will change to some degree the form and content of the trusts, making them more publicly acceptable (perhaps doing away with the two-tier system and GP fundholding practices?), but any real rebellion from below concerning wages, staffing levels, etc., will the direction of health care, some Leeds health workers asked John Battle – a Leeds Labour MP and Labour left winger — if the Party on coming to power would abolish the trusts. Battle looked as though he’d swallowed a bee accusing them of being wreckers destroying the Health Service – and this at a time when the same health workers were daily facing the new brutalism of trust management… Is this the shape of things to come?

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Appendix 1

Shortly after the first occupation ended, one of the occupiers, who is a member of Wildcat (a ‘revolutionary journal’) wrote an article about the events (“Managers and unions act in unison” — by “RB”). The article was originally intended to be published in the next issue (no.17) of Wildcat but in the end it was left out. The article is quite critical of the occupiers and our failures – and there’s nothing wrong with that, except that unfortunately most of the criticism is based on a misunderstanding of the real facts of the situation. But never mind about that – we respond to a more important point of view in the article, concerning the question of organisation.

In Wildcat no.17 several pages were devoted to the journal defending it against accusations from others that they are vanguardists; that is, that they believe the working class is in need of their political leadership. Wildcat, who are neither Leninists or anarchists but call themselves (anti-State) communists, say in their defence, “the most vehement anti-Leninists usually share many of the conceptions of Leninism. In particular they share an obsession with the division between politically conscious people (such as themselves) and the masses. They see the central question as being how the former relate to the latter. Do they lead them organisationally? (Leninism); do they lead them on the plane of ideas? (Anarchism); do they refuse to lead them? (councilism)… They assume that everyone else is obsessed with the question as well: ‘Wildcat have evidently found that their ideas and attitudes little impact on the mass of workers around them…’ Who do they think we are – the SWP?” Now contrast this with their statements in their article about the UCH occupation: “We should have set up an occupation committee, and tried to ensure its domination by the more politically advanced people involved, in other words, by ourselves.” This hard-talk after the event is a mask for an inability to transcend the limits of the situation any more than anyone else. In fact, RB waited until after the strikers were forced back to work by Unison before distributing to some of them Wildcat’s “Outside and Against the Unions” pamphlet – again copying the ‘I-told-you-so’ arrogant attitude of the leftists.

Its not surprising this article was left out of the magazine — it wouldn’t have sat very well next to their claims of not being vanguardist. These sentiments, plus Wildcat’s own usual obsession with “the division between politically conscious people… and the masses” were echoed by other statements in their UCH article.

“If the working class can be led into socialism, then they can just as easily be led out of it again.” – Eugene Debs

For us, we hate the left because their tactics always seek to destroy the subversive, autonomous content of struggles – and without that content the struggle is headed for defeat. But for Wildcat it seems that the left is a problem simply because their ideas and long term goals are wrong: they want to use similar tactics towards different ends. We know that the left’s influence on struggles often alienates, drains and demoralises people who have to deal with their manipulations — but RB obviously thinks it’s not important if the mass of the working class has a relationship to its own struggles similar to that of a passive TV viewer to their set — as long as they can be prodded and made to act in a prescribed way the “politically advanced” can win struggles by their domination. This is a logic shared by trade unionists, the SWP and political specialists in general.

We know that the leftist party machines always have a separate hidden agenda to pursue in struggles — recruitment, self-publicity, etc., and they believe they are the necessary vanguard that must lead the masses. It seems that RB would like to be the ultra leftist vanguard that outflanks the left – instead of a rigid party machine, a more fluid structure of ultra leftist militants dominating struggles, like “invisible pilots at the centre of the storm.” Wildcat often say they are against democracy, partly because it submits all activity to the will of a majority. But to counter this by seeking to submit all activity to the will of a “politically advanced” minority is no solution at all.

RB rightly says that the SWP managed to “destroy the atmosphere of the occupation, an intangible but important thing” – one wonders what kind of appealing atmosphere his plans for an occupation dominated by the politically advanced would create?

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UCH Songs (by Jean)

To the tune of “John Brown’s Body”

Verse 1

The crisis at the UCH is looking very grave,
They want to close the hospital for the pennies it will save,
But we won’t forget the union for the support they never gave,
When they would not back the strike.

Chorus

Un-i-son sold out the nurses
Un-i-son sold out the nurses
Un-i-son sold out the nurses
Cos that’s what scum they are.

Verse 2

Now Marshal down in management is looking very smug,
But when he dealt with nurses he was acting like a thug,
If he thinks he’ll get away with that, then he must be a mug,
‘Cos he cannot blackmail us.

Chorus 2

Marshal blackmailed all the nurses
Marshal blackmailed all the nurses
Marshal blackmailed all the nurses
‘Cos that’s the scum he is.

Verse 3

Now its up to the people, to do what we think right,
Nothing’s going to close again without a bloody fight,
If we have to occupy, we’ll be there day and night,
For we shall not give in.

Chorus 3

UCH is for the people
UCH is for the people
UCH is for the people
So we’re going to take it back.

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To the tune of “Daisy, Daisy”

Marshal, Marshal, give in your notice, do,
We’re quite crazy, ‘cos of the likes of you,
You’re too busy protecting your purses,
When you should be supporting your nurses,
Resign – resign – you waste of time,
And the rest of your management too.
Unison, Unison, give us your answer, do,
We’re quite crazy, ‘cos of the likes of you,
If you won’t back the hospital strike,
You’d better get on your bike,
Get real, get real, or else you’ll feel,
Some action directed at you.

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To the tune of “My old man said follow the van”

Uni-son said, “We’ll back your strike,
And we won’t dilly dally with your pay,”
But six weeks later they withdrew support,
Then they dillied and dallied
Dallied and they dillied,
Done some deals with Marshal on the way,
Now they can’t trust the union,
Not to stitch them up,
Or blackmail them to stay.

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Dedicated (2006) to Jean Blache, RIP, Beattie, RIP, and to all others who also participated in the UCH struggle.

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FOOTNOTES

slightly edited by past tense

1) This wasn’t the first occupation of a hospital: there are other incidences worthy of a mention. The women’s hospital, the Elizabeth Garret Anderson, close by UCH, was the scene of a long and successful work-in in the mid to late 70s, and it would be worth getting together some of the real analysis of that struggle. Also, Thornton View nursing home in Bradford was occupied during 1984/5 when faced with closure. The strike lasted marginally longer than the miners’ strike taking place at the same time. Leaflets given out by the strikers constantly called for an open picket but despite this, health care wasn’t revolutionised by the occupation — a nursing officer continued to visit to keep an eye on the nursing, and strict divisions were maintained between staff, patients and general public – although this is a very difficult problem in such a life or death situation. The occupation was brutally broken at night just after the miners’ strike was finished off. Worse than that, it was also done in a snow storm and allegedly one or two patients died after the ordeal. Also, in 1979, there had been an occupation of a geriatric community hospital in Oxon.

past tense note: Some 20 hospitals were occupied in the late 1970s-mid 1980s, including the Elizabeth Garret Anderson Women’s Hospital (over the Euston Road from UCH), Hounslow, Hayes, Northwood & Pinner, the South London Women’s Hospital, St Leonards Hackney… See also: Occupational Hazards, a past tense dossier on UK hospital occupations, which is still available to buy in paper form here, or can be downloaded as a PDF here

2) A nurse from Yorkshire isn’t so sure about this and likens the managers he’s come across as having some sort of Christian Fundamentalist look about them and seem to act from a conviction that is quite crazy. Some of the courses they go on operate very much like “psychobabble cults” creating in the manager a personal dependence on the managerial culture to the extent that breaking with it summons up imaginings of self-annihilation.

3) On one occasion a rally was led indoors for a “meeting” (in fact a speech from a UCH union branch secretary – a SWerP who was not on strike) ensuring that the march started in an orderly way and ended up in a nice quiet rally with a variety of SWP speakers. For a later one, large enough to be interesting, the union had a car ready which drove through to the front to take control — just as some nurses were about to march off without waiting for their orders. At the end of this march nurses and others continued past the rally to block Victoria Embankment The cops were willing to stop the traffic but the branch stewards called everyone back to listen to boring Frank Dobson MP with the excuse that the union had threatened to drop support for any future actions.

4) Other people who we met much later on, after the occupation, and who had been to some of the very early UCH rallies and seen large numbers of SWerPs drafted in to attend them – they also assumed that the occupation was merely another SWP publicity stunt, and so not worth getting involved in.

5) There was one nice guy, an SWP member who had been in the occupation since the beginning, who felt the same way as the rest of us about the Party hacks coming in and spoiling things – he walked off in disgust saying he was finished with the Party.

6) For a good examination of the SWP’s crass opportunism see Carry On Recruiting! byTrotwatch; AK Press and Trotwatch 1993.

7) We were also able to get some strikers (including even one or two of the more open minded SWerPs) to question how relationships between them and us, health workers and health users, between different kinds of groups, etc., could work better.

8) For more information on Welcome, see Dirty Medicine by Martin Walker; available from Slingshot Publications, BM Box 8314, London WC1N 3XX — price £15 (729 pages). This book is sub-titled “Science, Big Business and the assault on Natural Health Care” and describes the harassment, persecution and dirty tricks used against those who seek to offer alternative health treatments that could challenge the domination of industrial-medical giants like Wellcome. The persecuted have included those who come from orthodox medical backgrounds and also those patients who have received effective treatment after conventional drug-based medicine had given up on them. It also details the scandals surrounding the introduction of the “anti-AIDS” drug AZT, its lack of proper testing and the dubious claims made for it. (One criticism of the book is that it misses out the complexities and strengths of the struggles by AIDS activists in the USA. See for example Larry Kramer’s Reports From the Holocaust.) It reveals the systematic attacks and slanders made on the producers of health foods, vitamin supplements and alternative treatments, very often orchestrated by those directly or indirectly in the pay of the processed food industry and drug companies. (Duncan Campbell, the investigative “journalist”, although not with any obvious financial interest, has been particularly active in these shady activities). Wellcome, with their extensive contacts amongst the British ruling elite, dominate medical education and research here – and therefore have a very strong influence on the functioning of the NHS and the nature of its treatment. The author has recently said that “Although, as a socialist, I am committed to the NHS, I’m also in favour of choice and I know that for many of our present-day illnesses, drugs cannot be the answer” (Evening Standard, l4/2/94). Reading his book has only reinforced our feelings that the slogan “Defend the NHS” is far too simplistic in the long run. We must fight for what we have plus a whole lot more, but eventually we have to ask — what kind of free health care do we need and how do we get it? The often toxic and dangerous, profit motivated production line treatment promoted by the scientific-medical establishment is mainly concerned with the maintenance of people to keep them functioning as efficient, productive members of capitalist society. This has nothing to do with healthy living. The book Dirty Medicine is highly recommended.

9) Although it was the Labour Party that brought in the NHS, it was originally the idea of Beveridge, a Liberal and an extension of the post-1906 Liberal government’s introduction of health insurance. Moreover, Bevan, Attlee’s Health Minister, did a deal with the pro-Tory British Medical Association to retain private patients and private beds within NHS hospitals. Bevan said “I stuffed their mouths with gold”: doctors were now being paid for work they’d done in the voluntary hospitals for free, plus they kept the fees for their private work. And this has been the basis for the more fully fledged two-tier system we have today.

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Appendix 2

UCH post 1995: The Cruciform building was purchased by UCL, for use as the home for the Wolfson Institute for Biomedical Research and the teaching facility for UCL bioscience and medical students UCL Medical School.

A new 75,822 m² hospital, UCLH, procured under the Private Finance Initiative in 2000, designed by Llewelyn Davies Yeang and built by a joint venture of AMEC and Balfour Beatty at a cost of £422 million, opened in 2005. 

In November 2008, the £70 million Elizabeth Garrett Anderson Wing was opened, allowing the hospital to offer all women’s health services in one place (except some breast and gynaecology services).

SO – yes, a hospital stands roughly where UCH stood. But the PFI deal under which it was built is making vast profits – money being removed from the NHS. Health Management (UCLH) Ltd., which runs the new UCH, made £139.7 million in pre-tax profits between 2010 and 2015 alone. Between 2005 – 2015 the NHS Trust responsible for UCH paid £724.8 million for it, out of which Health Management made £190.4 million. The capital value of the hospital according to the Treasury is £292 million. Typically PFI deals are taking some 25-50 years to pay back, the interest on the initial funding dwarfing the amount ‘lent’ at the start. A lovely New Labour idea.
The returns for PFI contracts are high even though the risks are low once construction is completed, as the government guarantees the payments, save in exceptional circumstances.

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An entry in the
2018 London Rebel History Calendar

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Today in London healthcare history, 1979: St Benedict’s Hospital, Tooting, occupied by its workers.

The staff at St Benedict’s Hospital, Tooting, South London, began an official work-in to prevent closure of their hospital on November 15th 1979. A strong support committee was organised in the local community with backing from Battersea and Wandsworth Trades Council, local pensioners and others who wanted to maintain the high level of geriatric care at St Ben’s. Local London Ambulance Service ambulance drivers pledged their support and refused to cross the picket line except for normal transport.

“We could have gone on for ever” recalled leading light of the occupation, COHSE delegate Arthur Hautot, “They had to end the occupation because we were doing the work better and so much cheaper.” Also involved in the occupation, on a daily basis, was Ernest Rodker, who was later a supporter of the South London Women’s Hospital occupation 1984-5, and was later still a mainstay of the anti poll tax campaign in Wandsworth, being jailed for non-payment of the poll tax.

The success of the Work-in led management (with the agreement of Patrick Jenkin, secretary of state for Health and Social Security) to resort to intimidation, confrontation and violence to break the staff and campaign organisation, and force closure of the hospital. Wandsworth, Sutton and East Merton Area Health Authority (AHA) took legal action, serving injunctions against eight leading members of the work-in. This included 4 staff members (from COHSE, NUPE and the RCN), 3 union officials (NUPE and COHSE) and 1 local campaigner.

The injunctions prevented those named from doing any thing to prevent the removal of patients and to prevent the union-officials from entering the building.

For six days in mid-September 1980, the Hospital was raided, and patients moved out, by force by the AHA, backed by a large force of police and a scab private ambulance company, Junesco.

Under the new Employment Act, the police were able to impose an arbitrary limit of two pickets on picket lines outside St Benedict’s…

Then on the fourth day of the raids, they refused to allow any pickets on the gate at all, and the private ambulances got through.

By September 19th, sixty three patients had been forcibly removed from the friendly security of their beds and wards and dispersed in chaos to a variety of other hospitals in the area. Twenty-three pickets were arrested during the raids, and charged with a number of offences, ranging from wilful obstruction to criminal damages. One woman who worked in admin at a nearby hospital was suspended from duty, although she was at the picket line on her day off.

After the closure of the long stay geriatric hospitals, reports began to emerge of the devastating impact on patient care of “relocation effects” – the impact of speedy closures on patients. Close to a third of patients forcibly moved in the “raids” on St Benedict’s died within the following six months.

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An entry in the
2015 London Rebel History Calendar – Check it out online

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Today in London health care history: Workers occupy St Leonards Hospital, Hackney, 1984.

In 1979, despite opposition in the form of a day of action and a march attended by over a thousand people, St Leonard’s Hospital Accident & Emergency Department was closed.

By the early 1980’s the future of the whole hospital was looking bleak; by late 1983 the Health Authority was actively looking to close the hospital under pressure from a Conservative Government keen to make cuts.

At a Health Authority meeting to ratify the cuts and closures at Hackney Town hall on 26th September 1983, the Health Authority and its multi millionaire, Jockey Club chairman Louis Freedman were overwhelmed in a turbulent day of protest, (later described as a “riot”) which ended with them being forced to abandon the meeting after the town hall was surrounded by thousands of angry locals opposing the closure plans. Freedman refused to use his casting vote to settle the closure issue; demonstrators demanded increasingly vocally that he use his vote to save the hospital.

As he dithered, the doors to the Council chamber were barred and padlocked, and after a 20 minute stand off he was escorted out of the building with the help of local Labour MP Brian Sedgemore.

Freeman, who lived in a central London penthouse, and had private health insurance, said in the Daily Mail “We might as well be living in a dictatorship”.

The incident was labelled a riot in the Evening Standard and Daily Mirror, though no-one was reported as being injured on either side. Admittedly there was an attempt to keep the Board members in the meeting and to stop them voting in private…

The disturbance was carried on all the main news channels that night and newspapers the next day and ensured health moved nationally up the political agenda.

On the 7th June 1984 Norman Fowler, Tory Secretary of State announced his decision to close all wards and remove all beds at St Leonard’s and leave just a first aid unit and a handful of community based services.

In response a small working group was established by the staff and Hackney health emergency to look into the possibility of the 180 staff working at St Leonard’s organising an occupation or work-in of the hospital. A decision was made to occupy the hospital on the 3rd July 1984. The occupation was ratified by a staff meeting of eighty staff on 4th July.

But by the 5th July (NHS Day) the management had somehow managed to secure and issue writs and summons against the key stewards. As NUPE had not made the occupation official, and fearing an injunction (similar to that used against the Miners) NUPE officers removed NUPE placards and began to distance themselves from the occupation.

Despite this thousands of people in Hackney were supportive of the occupation.

On the 16th July management repossessed the hospital, sending in security staff and bailiffs (probably illegally) to end the occupation. In the next three days management systematically interviewed staff and reps and suspended key stewards. Disciplinary action was taken against Andrea Campbell, a shop steward for COHSE, and Geoffrey Craig, a NUPE shop steward. They were dismissed as a result of that disciplinary hearing, and they then appealed.

However, local trade unionists organised a 24-hour picket line outside the hospital and the drivers from the London Ambulance Station refused to move the patients out.

On top of targeting union representatives and other members of staff involved in the occupation, the management also made life uncomfortable as possible for the patients remaining in the hospital (who refused to move) by threatening legal action. Frail, elderly patients were bundled out in the early morning or late at night, driven to other hospitals, torn away from staff they knew and their possessions being sent on much later because they hadn’t been told they were to be permanently moved.

After the Occupation was smashed, management employed a whole private army of security guards to ‘protect’ the building, costing the Health Authority almost £1,000 a day, money clearly better spent this way rather than used to maintain the crumbling local health services.

Much more on Hospitals occupations can be found in past tense’s pamphlet, Occupational Hazards, available from our publications page.

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An entry in the 2016 London Rebel History Calendar – check it out online

Today in London herstory: Elizabeth Garrett Anderson born, pioneering woman doctor & suffragist, Whitechapel, 1836.

Elizabeth Garrett Anderson, the daughter of Newson Garrett (1812–1893) and Louise Dunnell (1813–1903), was born in Whitechapel, London on 9th June 1836.

Elizabeth’s father had originally ran a pawnbroker’s shop in London, but by the time she was born he owned a corn and coal warehouse in Aldeburgh, Suffolk. The business was a great success and by the 1850s Garrett could afford to send his children away to be educated.

After two years at a school in Blackheath, Elizabeth was expected to stay in the family home until she found a man to marry. However, Elizabeth was more interested in obtaining employment. While visiting a friend in London in 1854, Elizabeth met Emily Davies, a young women with strong opinions about women’s rights. Davies introduced Elizabeth to other young feminists living in London.

In 1859 Garrett met Elizabeth Blackwell, the first woman in the United States to qualify as a doctor. Elizabeth decided she also wanted a career in medicine. Her parents were initially hostile to the idea but eventually her father, Newson Garrett, agreed to support her attempts to become Britain’s first woman doctor.

Garrett tried to study in several medical schools but they all refused to accept a woman student. Garrett therefore became a nurse at Middlesex Hospital and attended lectures that were provided for the male doctors. After complaints from male students Elizabeth was forbidden entry to the lecture hall.

Garrett discovered that the Society of Apothecaries did not specify that females were banned for taking their examinations. In 1865 Garrett sat and passed the Apothecaries examination. As soon as Garrett was granted the certificate that enabled her to become a doctor, the Society of Apothecaries changed their regulations to stop other women from entering the profession in this way. With the financial support of her father, Elizabeth Garrett was able to establish a medical practice in London.

Elizabeth Garrett was now a committed feminist and in 1865 she joined with her friends Emily Davies,Barbara Bodichon, Bessie Rayner Parkes, Dorothea Beale and Francis Mary Buss to form a woman’s discussion group called the Kensington Society. The following year the group organized a petition asking Parliament to grant women the vote.

Although Parliament rejected the petition, the women did receive support from Liberals such as John Stuart Mill and Henry Fawcett. Elizabeth became friendly with Fawcett, the blind MP for Brighton, but she rejected his marriage proposal, as she believed it would damage her career. Fawcett later married her younger sister Millicent Garrett.

In 1866 Garrett established a dispensary for women in London (later renamed the Elizabeth Garrett Anderson Hospital) and four years later was appointed a visiting physician to the East London Hospital. Elizabeth was determined to obtain a medical degree and after learning French, went to the University of Paris where she sat and passed the required examinations. However, the British Medical Register refused to recognise her MD degree.

During this period Garrett became involved in a dispute with Josephine Butler over the Contagious Diseases Acts. Josephine believed these acts discriminated against women and felt that all feminists should support their abolition. Garrett took the view that the measures provided the only means of protecting innocent women and children.

Although she was a supporter of the National Union of Women’s Suffrage Societies (NUWSS) she was not an active member during this period. According to her daughter, Louisa Garrett Anderson, she thought “it would be unwise to be identified with a second unpopular cause. Nevertheless she gave her whole-hearted adherence.”

The 1870 Education Act allowed women to vote and serve on School Boards. Garrett stood in London and won more votes than any other candidate. The following year she married James Skelton Anderson, a co-owner of the of the Orient Steamship Company, and the financial adviser to the East London Hospital.

Like other feminists at the time, Elizabeth Garrett retained her own surname. Although James Anderson supported Elizabeth’s desire to continue as a doctor the couple became involved in a dispute when he tried to insist that he should take control of her earnings.

Elizabeth had three children, Louisa Garrett Anderson, Margaret who died of meningitis, and Alan. This did not stop her continuing her medical career and in 1872 she opened the New Hospital for Women inLondon, a hospital that was staffed entirely by women. Elizabeth Blackwell, the woman who inspired her to become a doctor, was appointed professor of gynecology.

Elizabeth Garrett Anderson also joined with Sophia Jex-Blake to establish a London Medical School for Women. Jex-Blake expected to put in charge but Garrett believed that her temperament made her unsuitable for the task and arranged for Isabel Thorne to be appointed instead. In 1883 Garrett Anderson was elected Dean of the London School of Medicine. Sophia Jex-Blake was the only member of the council who voted against this decision.

After the death of Lydia Becker in 1890, Elizabeth’s sister, Millicent Garrett Fawcett was elected president of the National Union of Women’s Suffrage Societies. By this time Elizabeth was a member of the Central Committee of the NUWSS.

In 1902 Garrett Anderson retired to Aldeburgh. Garrett Anderson continued her interest in politics and in 1908 she was elected mayor of the town – the first woman mayor in England. When Garret Anderson was seventy-two, she became a member of the militant Women’s Social and Political Union. In 1908 was lucky not to be arrested after she joined with other members of the WSPU to storm the House of Commons. In October 1909 she went on a lecture tour with Annie Kenney.

However, Elizabeth left the WSPU’s in 1911 as she objected to their arson campaign. Her daughter Louisa Garrett Anderson remained in the WSPU and in 1912 was sent to prison for her militant activities. Millicent Garrett Fawcett was upset when she heard the news and wrote to her sister: “I am in hopes she will take her punishment wisely, that the enforced solitude will help her to see more in focus than she always does.” However, the authorities realised the dangers of her going on hunger strike and released her.

Evelyn Sharp spent time with Elizabeth and Louisa Garrett Anderson at their cottage in the Highlands: “Dr. Elizabeth Garrett Anderson, who had a summer cottage in that beautiful part of the Highlands. I went there on both occasions with her daughter Dr. Louisa Garrett Anderson, and we had great times together climbing the easier mountains and revelling in wonderful effects of colour that I have seen nowhere else except possibly in parts of Ireland…. It was, however, so entertaining to meet both these famous public characters in the more intimate and human surroundings of a summer holiday that we did not grudge the time given to working up a suffrage meeting in the village instead of tramping about the hills. Old Mrs. Garrett Anderson-old only in years, for there was never a younger woman in heart and mind and outlook than she was when I knew her before the war was a fascinating combination of the autocrat and the gracious woman of the world.”

Elizabeth Garrett Anderson died on 17th December 1917.

(This post was stolen wholesale from Spartacus Educational… because they said what had to be said)

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An entry in the 2016 London Rebel History Calendar – check it out online

Today in London’s radical history: hospital campaigners occupy chief exec’s office, 1993

On 11th January 1993: Activists from the St Charles Hospital (in West London) Campaign occupied the office of Chief Executive Neil Goodwin, (in St Mary’s Hospital, in Praed Street, Paddington), in protest at impending closure of the Accident & Emergency Department, at St Charles, due to be implemented on 1st February.

Through 1992-3 there had been a local campaign to try and prevent the planned closure, which had involved candle lit vigils outside hospital, among other tactics. Despite the mass local support the campaigners enjoyed, the A&E did close in February that year…

It was suspected locally that the A&E closure was a prelude to the eventual shutting down of the whole hospital… Though it still exists, services were gradually run down in the succeeding years.

More on the history of St Charles Hospital at http://www.ezitis.myzen.co.uk/stcharles.html

That’s all we know… We’d welcome more info on this campaign if anyone out there knows more or was involved…

A past tense dossier on some UK hospital occupations can be found at:

Click to access occupational-hazards.pdf