ONLY THE TIMING of the announcement of 600 job losses and the axing of 25 medical specialities in a 12m cuts package by the Board of Guy's Hospital Trust came as any real surprise. Tory ministers were far from pleased that these cuts, followed quickly by another 300 jobs axed in Bradford, have pushed the NHS back on to the agenda in the run-up to the local elections. Worse, this salvo fired by the 'flagship' of opting out hospitals could seriously damage or even sink the efforts to push through another 100 or more hospital opt-outs this Less than a month after floating free from any local control or accountability as a self-contained business, Guy's 90,000 a year chief executive Peter Griffiths has moved faster than many had expected to apply the traditional profit-seeking methods of FRE EXIT Aark Salmon the private sector as he confronts an accumulated 6.8m deficit. The Guy's cuts were announced just the day after the first redundancies were decided in the newly-privatised Powergen: but while the electricity industry represents a licence to print money, the urgency to cut staff in the new NHS Trusts is a measure of the huge financial problems at the centre of the health service. Guy's and Bradford are not alone: more Trusts will be setting the pace in cutbacks, while many directlymanaged hospitals will be following closely behind as the brutal realities of the new 'internal market' in health care inflict arbitrary closures. Campaigners against opting out have always warned that the Trusts' much-vaunted 'flexibility' on pay and staffing levels would be used by management to award themselves sky-high salaries while attacking the pay and conditions of front-line health workers. Many campaigners also stressed with every item of information cloaked in commercial confidentiality, would feel free to axe specialities which they saw as unprofitable, without any need to consult or even inform health authorities, staff or the local community. These dangers have now been vividly confirmed, making life more difficult for managers trying to push through another wave of opt-outs. But few campaigners looked in detail at the financial viability of each Trust. Health Secretary William Waldegrave paid city analysts Coopers and Lybrand a reported 500,000 for a highly embarrassing report which he ignored and has refused to publish: it showed that only a dozen of the 65 opt-out applicants were viable. Pressure group London Health Emergency published a much cheaper (10) report showing much the same thing. Most Trust applications were based on ludicrously opHOSPITAL timistic assumptions on levels of activity, inflation and increased income from private beds: even then 31 of the 65 applicants were expecting a total surplus of just 49m in the first year, with many of these expecting as little as a few thousand pounds. The government then announced regulations which forced many Trusts to pay 50% more interest on their multi-million pound assets than they had hoped, bringing immediate losses of 1m or more to Trusts in Leeds, Bradford, Sheffield, Manchester and Epsom as well as several in London. With huge unresolved problems in the new NHS 'internal market, and many health authorities still making cuts to resolve last year's overspends, no Trusts and precious few directly- managed hospitals have A leading member of the Fourth International's Indian Section, the ICS, has arrived in Britain for a six week speaking tour.
Achin Vaniak is a prominent marxist activist who, from his base in Delhi, has written extensively on the crisis facing the Indian workers and peasants.
International attention is turning to the Indian election campaign which, in this country of 850 million, is on a huge scale with many regional variations. The recent terrible violence be tween religious communities will probably be cynically stirred up by local and national politicians. But the main problem, as always, is any financial stability. The 'smooth take-off' has already produced its first crash-landings: the task of the labour is now to turn this to advantage by redoubling the campaign against the second wave of opt-outs, which begins its consultation stage in May, to be completed in July: • New leaflets one explaining Trust finances, and Ten Good Reasons against opting out, along with a new issue of the tabloid newspaper Health Emergency are now available (1) from Hands Off Our NHS, 446, Uxbridge Rd, London W12 ONS.
economic development and on this front the workers and peasants of India stand to gain little, whatever the result of the election.
Achin Vaniak will be talking about the struggle of the Indian people to audiences across Britain, ranging from academic seminars to trade union meetings. His tour has been organised by the International Forum on Asia and the Southall Monitoring Group. It includes fringe meetings at the National Union of Students Conference, Trades Councils meetings, including the Birmingham May Day rally and meetings with British Asian community organisations.
For details ring 081 843 2333.