Civil Society and the NHS
Who is calling for a rethink on NHS reform? Why is the government not listening?
On October 9th, around 2,000 UK Uncut activists and Health Workers staged a mass occupation of Westminster Bridge in protest against the proposed Health and Social Care Bill, which goes before the House of Lords this week. The ‘Block the Bridge, Block the Bill’ demonstration was held to draw attention to the swelling tide of public opposition against government plans to reorganise the NHS.
In drama and scale, this protest was the most impressive so far, although it was by no means the only demonstration held against the shake-up. Marches, occupations and other protests have been held up and down the country this autumn.
Yet the Coalition continues to stay the course.
Has it simply become an uncomfortable truth that our elected representatives are no longer responsive to the demands of civil society?
A central feature of liberal democracy is the presence of a vibrant civil society that articulates the desires and demands of the people and conveys them to government. Our civil society is made up of academia, activist groups, trade unions, community partnerships and consumer organisations, among others. These associations operate outside of state and government, but are supposed to play a vital role in shaping the agenda and tutoring government.
At the moment, however, it seems that no matter how loudly civil society calls for a halt to NHS reform, the government just will not listen.
On March 15th, Doctors attending the British Medical Association’s special representative meeting in London voted overwhelmingly for the withdrawal of the Health and Social Care Bill, stating that “the current plans for reform are too extreme and too rushed and will have a negative effect on the care of patients”.
On April 1st, a variety of organisations held an “All Together for the NHS” day that witnessed a number of unions and campaigners take part in actions in Stafford, Warwickshire, Wolverhampton and Stourbridge in Dudley.
This autumn saw a clamour of expert voices join the already deafening chorus of those opposed to the changes.
On September 6th, Christina McAnea of Unison said the bill at present signals the “end of the NHS”. Her concerns were echoed by representatives of think tank ‘The King’s Fund’, which said there was a “worrying lack of clarity” on the issue of greater competition.
Earlier this month, 400 public health experts signed an open letter to The Daily Telegraph calling on the Lords to reject the reforms, stating: “The government claims that the reforms have the backing of the health professions. They do not. Neither do they have the public’s support.”
This is just the tip of the iceberg. Others who have demanded a halt to the Bill include the NHS Confederation, BMA Chair Dr Hamish Meldrum, representatives of the Royal College of Nurses, Royal College of GPs, Royal College of Midwives and even The Archbishop of York.
When these protests are all listed together, it becomes clear that civil society is sending a loud and urgent message to reverse course.
Yet the government continues to frustrate attempts to kill the bill by exercising its right to manipulate the legislative schedule. In a scandal that has received far too few headlines, the Coalition tried to restrict the time the Lords had to debate the proposals to a single day. This for a piece of legislation that had 1,000 amendments added since its last journey through parliament.
However, the Coalition has listened to the public before and changed policy accordingly. In February, the PM shelved plans to privatise public woodland after 300,000 people signed a petition in protest of the sell-off. Michael Gove’s plan to withdraw funding from 450 school sport partnerships was delayed after Olympic athletes, head teachers and Labour MPs united in opposition against him. These reversals were both forced by the pressure placed on government by civil society.
On the issue of the NHS, however, the government remains stubborn. The reform bill has become a centrepiece of the government’s programme, and the Coalition feels safe in the knowledge that the revolt of civil society has yet to affect their electoral base.
Perhaps it is because this bill has come to symbolise the Coalition’s entire legislative programme that the government feels it cannot yield to public demand. To retreat from this would be to retreat from the whole project of state reform and thus fatally undermine the government’s purpose.
This is a radical, ideologically-driven government facing an angry, well-organised civil society. An unstoppable force is about to hit an immovable object. What will emerge when the dust settles?
Louie Woodall is a member of the Young Fabians and Assistant Editor of The Young Fabians Blog
/>







