MOUTHS STUFFED WITH GOLD: the consultants and their private patients

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Consultants use NHS fac ities free The National Health Service is now the scene of great battles, which will decide whether or not it survives. At a time when it is struggling from day to day on critically short finances, wor kers are now demanding an end to the parasitic private practice that continuously drains the NHS resources.

The presence of pay beds mean that the half-a-million people waiting for treatment on nonurgent lists (where the patient will not die, but may suffer a long period of discomfort or disability) are subjected to a form of blackmail: If they pay they can be treated almost immediately This is a powerful argument since the average wait is 3% months, and one in three has to wait over a year a long time to watch private patients jump the queue.

It is intolerable to health workers to see two standards of medi cal care, and a boom in private treatment while the NHS is starved, especially when the former is riddled with abuse.

Private patients get, besides far superior amenities, more medical care to the point where it is alleg ed that consultants neglect their NHS patients for the lure of private fees. Certainly they can use their position as hospital top-dog to stifle any criticism by their junior doctors.

MONOPOLY

The consultants, top-paid hospital doctors, have a monopoly of the right to treat private patients in NHS hospitals, treely using the wide range of specialis service and equipment available in a large modern hospital, but which no private finance could provide.

They can pocket the fees - the 12,000 consultants carnt 20m this way last year - but have no expenses.

One Midland surgeon does one private operation a week which earns him an extra €5,000 a year and as a part-time consultant in the NHS, he can offset 52,000 of this, his car, private secretary and consulting room at home against tax.

In fact private care is subsidised by the Government - an average charge for a pay bed is E174 per week, while fees at the private London Clinic range from C182 to €252, and start at £371 per week at the luxury Wellington Hospital, where suites cost 6100 a day, and the cellar is full of Chateau Mouton Rothschild at €23.60 a bottle.

The director. Dr. Arthur Levin.

admitted If they (the NHS) accounted properly, their costs would be much higher'. The fees do not benefit the NHS anyway, but go straight to the Treasury.

It was the cowardice of the Labour Party that put pay beds in the NHS. The Labour government had a 200 majority when, in 1946. Bevan moved the NHS Act through Parliament, for a Health Service free at time of use and financed out of National Insurance and general taxation. In July 1948 the Minister of Health duly took over 3,600 hospitals and clinics in England and Wales.

But the consultants were furiou Their organisation, the BMA, complained that this over-rode local authority responsibility, an thereby their power and that of other Tories: that the voluntary principle' had gone (the situation where the country's health deended on flag-days for charity (ospitals) and that consultants had to take state patients. Strike action was threatened.

The BMA had always been extremely reactionary - in 1911 it had even objected to the introduction of National Insurance on the same grounds of freedom fo the profession'!

Bevan gave in. "TIl stuff their mouths with gold" he said as he made teaching hospitals independent (to give consultants more power), put a Tory-dominated burcaucracy in charge, and gave them private beds to make their fortunes with.

The Tories always loved private practice - the Heath governmen encouraged BUPA by giving com panies tax benefits against their insurance in industry and commerce, and more private wards were opened while Barber cut £111m from the NHS budget.

CASTLE: Minister of Health.. .. and private patient!

They produced a White Paper in 1973 which concluded that pay beds were to the overall bene fit of the NHS. It claimed, incre dibly, that NHS patients had the same medical care, and that abolition of pay beds would not alfect waiting lists - a complete lie since the turnover of private patients (122,000 a year) would reduce the list by 25% a year until it vanished.

The whitewash was perhaps not surprising since most who drafted the report were Tories, one of them Timothy Raison,a Tory MP and director of Private Patients Plan, second largest private health insurance company!

But a new force was to arise to challenge the Tories determined defence of privilege. The months since early 1973 had seen an unprecedented series of wage strug gles in the NHS, involving ancillar workers, technicians, ambulancemen, nurses, junior doctors and radiographers. These workers fought, many for the first time.

with great determination and a new enthusiasm to end their chronic low pay, and were successful to the extent that they burst through the compromisin and delaying policies of their union leaders.

N.U.P.E. BAN Last summer this confident movement came to the defence the Health Service when in May, at the height of the nurses struggie, the first ban on private patients in NHS hospitals was started in 40 hospitals around Newcastle by the local NUPE branches. Caning 480,0 or this notarie and local government workers, were taken aback at this enactment of official union policy, and its spread was discouraged and mpeded by local officials d, five weeks lases, union, deided to ban all private patients and agency staff in the NHS, and ne national headlines were caught hen on July 2nd the NUPE on the private 15th floor, and deCASTLE As the ban spread to Manchester Blackpool, Norfolk and 7 hospital: in London, the consultants threatened to treat only emergency cases if their pay beds were ended.

On July 6th Barbara Castle, herself recently emerged from the private ward of Guys Hospital in London, made both sides call off action with the promise that pay beds would be dealt with by the Owen Working Party, then enquiring into consultant salaries. Pay beds would stay till then.

Albert Spanswick of COHSE led the retreat: "Private practice has no home within the NHS. This agreement with Mrs. Castle has in effect, whether the BMA likes it or not, put private practice on notice to quit".

But Castle did not reduce pay beds at Charing Cross, did not support the action there and had no intention of "arbitrarily reducing numbers of pay beds"

However, she would cut the NHS - only £47m of the E111m cut by the Tories was replaced, and inflation is doing even more damage.

The NHS is presently being sabc taged by the work-to-contract of the consultants which started on January 2nd. This is no ordinary pay claim, but a deeply reactionary rearguard action.

The consultants, now earning between £5,433 and £7,947 asked Barbara Castle for a new contract early last year to eliminate unpaid overtime due to increased work-load. The Owen Working Party was set up in Apri 1974 and Castle reported the new contract on December 20th.

This pays for extra sessions (overtime) but is far more generous to whole-time consultants not allowed private practice income than to part-timers who de private work.

NEW CONTRAC For example, whole-timers will get a 'total commitment allowance of possibly £1,700 p.a..private practice brings in an average of 22,000 p.a. Additional extra effort' awards and extra work will go mainly to whoretimers.

This would cut the income of 57% of consultants who do private work so much that the BMA estimates that 8055 of them woul give it up.

It has rallied its members under the old banner of freedome for the profession' which means the right to knock up huge fortunes at the expense of the NHS:

Since January 2nd the consultants have heen penalising NHS patients to demand that their lu crative private practice carries o.

This has severely hit the already crisis-ridden health service.

In Crewe the sanctions started practice, tive.

ing. ecember 11th and outpatient ng times are now 1 months; rmingham there is a 70% reon in eon-acute treatments. Labour Government cannot I up to the consultants be: they will not abolish private ice, which is why the health •unions must take the initia:consultants" bluff of resigncom the NHS must be called. NHS gives them their reputatheir full medical back-up. access to both NHS and pripatients under the same roof t is the cost of private treattand poor facilities of prinursing homes means the i gets most acute illnesses and or operations. Said one conint: "I don't do an acute pyivately unless it's easy e consultants wield power their junior doctors by the cation of merit awards ting from £1,506 to £7,947 termed by one ASTMS doca political weapon to keep ple in line". se in him system they pe system they preover in hospitals which obcts promotion of medical fand means juniors are deper t on them for references, ie whole progress or their trainley oppose the expansion of ir grade because it will mean y have to share the local prie practice revenuc. > call their bluff means to abu the post of consultant and lace it with groups of specialin which there is continuous ›motion of doctors for seniorit I actual skills. either can the Provident Assoions and the other companies llowed to reap fat profits i nursing homes for the weal/ run on NHS-trained personne 1 on agencies hiring such nurse ok to the short-staffed NHS at twice the rate an NHS paid.

Allied Investments, a tin mining group, has three nursing homes and the British Nursing Associatio the biggest nursing agency. BUPA has not only an income of €28m a year from its insurance subscribers, but 24 nursing homes with 800 beds in the Nuffield Nursing Homes Trust, and a nursing agency.

The Harley Street Clinic, 75% owned by Americal Medical Internationa, which wanted to put up wings of NHS hospitals for private care, has a C/m turnover.

Only the expropriation of these private agencies, hospitals and clinics and of the monopoly drugs and equipment suppliers can guarantee the provision of a free med cal service of the highest quality for all.

This situation calls for action by all workers.

To defend the Health Service, health workers must demand that all private admissions be stopped immediately and that private wards be made public.

The Labourites are quite willing to preside over the collapse of the NHS, which in many areas had not the finance to replace workers who leave or to continue to keep wards open. The fight against pay beds, to defend the NHS, to defend standards of living for health wor kers must raise more and more the ownership and control of the whole health service.

Joint committees must be set up of all health service unions to look at the accounts of the Area and Regiona. Health Authorities, and to fight for a controlling voice in the allocation of finance.

This fight must begin in the Labour and trade union movement without delay. Every day that nothing is done, more workers and their families are put at risk by the collapse of the NHS

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rom consciousness,i.e. PRESS, Thursday, exclusively by its own effort, is exclusively by its able to develop only trade-unior consciousness, i.e., the convictio that it is necessar that it is necessary to combine

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branch at Charing Cross Hospital stopped all services to the patients