Just to be Clear – This is a Social Justice Issue

Following on from my blog earlier this week, I want to be really clear in what I am saying!

  1. The funding formula used in health and social care is weighted towards the wealthy and the well…therefore the north is worse off compared to the south…
  2. We are already at a major deficit in terms of health outcomes, in the north
  3. The cuts affecting northern county councils were deeper and harder – both in terms of public health and social services, with a profound knock on effect to the NHS – therefore the further ‘efficiency savings’ being requested of us have an even more detrimental effect
  4. The actual investment from the government as shown by the King’s fund is not 8-10billion as promised, but only 4.5billion
  5. If you take into account economic growth, inflation and population need, the ‘investment’ is actually a disinvestment…..
  6. On top of this is the fact, shown through HEE (Health Education England) that the NW in particular has a massively reduced investment in recruitment compared to other areas, which flies in the face of what the Nuffield Trust and King’s Fund have shown is needed in areas of higher deprivation and worse health outcomes
  7. Even if we save the £560m we’re being asked to as an STP, our deficit at 2021 is £804m

My argument is this: if the correct investment was made, the formula wasn’t weighted against us and we therefore received the correct allocation of resource according to the task ahead of us, we would actually probably be in surplus and could really make a difference – we are already doing loads of great stuff, but asking us to make bricks with no straw is beyond the pale.…..as it is, what we’re being asked to do may affect the health and wellbeing of our population negatively because we are already at such a deficit, before we start….

 

This is not a political issue – this IS a Social Justice issue.

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What Lies Beneath?

Do you sometimes wonder what is really going on? As the furore around the planned 5-day strikes by junior doctors unfolds, with all the clamour and the noise, the positioning, the power plays, the arguments and the counter-arguments, I wonder where is the truth amidst the madness? How have we reached a stage in which the government and an army of medics, surgeons and psychiatrists are at such loggerheads? What lies beneath all of this?

 

Theresa May, our Prime Minister tell us that “doctors have never had it so good” – I wonder when she last shadowed a Senior Registrar for Acute Medicine on a Friday night in an understaffed hospital? Jeremy Hunt tells us that he is a modern day Aneurin Bevan (I wonder what AB would think of that?!), whilst his shadow counter-part, Diane Abbott retorts that this is a ridiculous suggestion. The PM and the Secretary of State for Health both agree that the junior doctors are playing politics, something the other side refutes, but all agree that this is a disaster and patients lives may well be put at risk. The right wing press tell us it is all about pay and that the doctors are being greedy, whilst the left wing press tell us it is all about an underlying agenda to privatise the NHS. The Junior Doctors admit that some of this is about pay (who would want a significant pay cut for working long and unsociable hours?) but that it is more about resisting a policy to deliver a 24/7, 7/7 NHS, which they believe to be unaffordable and unstaffable due to shortages in funding and recruitment. Senior colleagues appear to be split down the middle in terms of support for the strikes, patient groups are understandably concerned and yet a solution does not appear to be forthcoming.

 

Shouting, anger, fighting, noise, name-calling, power-plays, hate and hollering. So, who will seek the welfare of the people and the nation? Who will make for peace? Both sides tell us this is what they are doing and this is why they stand their ground. The government apparently want to deliver the same standard of service throughout the 7 day week. The Junior Doctors say they are the ones really standing up for the people by resisting that which is unsafe and unfair.

 

So, let us learn from the peacemakers to find a way through. In apartheid South Africa, peace was not reached through hate and vitriol. It took deep courage from men and women to expose lies, to speak truth to power, but most importantly to tell their stories. It was not about the one man, Nelson Mandela, but the many together waking up to an alternative future that was fairer for everybody. In the battle for civil rights in the USA, a nation was awakened to the reality of injustice within its own borders. The story of one woman, Rosa Parks, who refused to be humiliated on a bus became a people movement as numerous as the stars, shining together for an altogether different day. In Rwanda, after the appalling genocide, those who lost everything, found a voice to communicate to their very oppressors, those who had raped and murdered their own families, not only their story, but forgiveness for the atrocities caused and found a way through to a new future. If we want peace and a better future for everybody, then we need to face up to our reality, be willing to really listen and then find that together we can embrace a new future.

 

We have an apartheid of globalisation and free market capitalism across the entire world. Every day, the gap between the rich and the poor is widened. Our entire economic system, founded on the oppression of Empire through expansion (via military violence), the creation of debt (through an errant banking system) and the rule of law (held in place by the state of the exception) is no longer fit for purpose. We see it in the plight of refugees stuck between war and barbed wire fences in a land they cannot call their own. We see it in the disproportionate imprisonment of Black American males in the USA. We see it in the vile island detention centres of Australia. We see it in the slums of New Delhi, the townships of sub-Saharan Africa and the Favelas of South America – in the eyes of children dying from such ridiculous things as diarrhoea and starvation. We encounter it in the streets of Athens and the public squares of Madrid. And yes, we find it in the midst of our NHS and social care system. Our world as we have known it is broken and no matter how much sticky tape or wrapping paper we apply, the centre simply cannot hold. The core is unstable. Everything is shaking. We must have the courage to let go of what we have known and embrace an altogether different future, a future that is fairer for everybody, where things don’t simply trickle down to the poorest, but in which the balances are re-set.

 

We have become slaves of the ‘free market’, fodder of the beast that requires ever more of us. What lies underneath the row over Junior Doctor pay and the forthcoming strikes is a great gaping hole that scares the hell out of many of us. Oh, we can sling mud until the cows come home, but it’s not going to get us anywhere. Top down, pyramidal, heroic leadership that stays its course and demands it’s own way is simply not going to cut the mustard. We must have some brave and difficult conversations about the detrimental effects of making policy from the safety of ivory towers, and learn to really listen to the stories of those affected. We have so much to learn from the Leeds Poverty Truth Challenge, the Homeless Charter in Manchester, the Community Conversations in Morecambe Bay, the Cities of Refuge initiative, the Civil Rights movements, the Mediation work done in Rwanda…..we don’t have the answers right now. The problems facing the NHS are fare more complex than trying to ensure an undeliverable manifesto promise is outworked. We need humility on all sides, collaboration and partnership.

 

It goes deeper than people right across the UK needing to manage their own health and wellbeing more effectively. It is more complex than needing to recognise where there is waste and dealing with it. It isn’t just as straight forward as needing to talk about chronic under-funding and under-recruitment. We face an existential crisis, an ontological question about the future of humanity together. Resting back onto familiar ways of operating or antiquated leadership styles will simply not work for us any more. The black hole we face is either a death or the opportunity for re-birth. A squeeze that will force us into something new. We can’t keep dancing around it forever. We must take the plunge, accept that there is no going back and see what new creation we might just co-create with Love on the other side. Don’t be afraid…….there is light at the other end of the tunnel.

 

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