With 800,000 women working full or part time, Britain's National Health Service is the biggest employer of women in Europe. But the new market system created by Thatcher's reforms is threatening jobs, pay and conditions, as NHS Trust bosses explore new ways to hold down costs. HARRY SLOAN reports. WAGE CUTS of f25 to £35 per week were the spark that led to the long-running struggle of 56 NHS support staff, most of them Asian women, at Hillingdon Hospital.
The women were by private contractors Pall Mall, who won the contract for catering, cleaning, portering and sterile supplies services at the large West London hospital.
Although the company was legally obliged to take on the existing staffsome of whom had worked there for almost 30 years—it waited only the statutory minimum of six months before announcing a 'rationalisation' of services involving wholesale cuts in the pay and conditions of its 200-strong workforce.
Initially 34 women were sacked for refusing to accept the changes: later another 22 were also sacked for rejecting a brutal cut in their already low pay.
With official support from UNISON, the women have been bravely fighting back, and have picketed the Hospital throughout the bitter winter months.
Hillingdon. Hospital bosses have cynically turned a blind eye to these scandalous practices by their contractors, Nothing matters and ignored the to today's NHS slump in standards of hygiene as Pall bosses except the Mall has bused in scab labour from Belmarsh.
Workers have faced the process of "skill mix review', in which managers analyse just how few qualified staff they feel they could get away with in each department, and seek to make up the numbers with lower-paid, unqualified Health Care Assistants. Numbers of qualified nurses are now declining in the NHS for the first time ever.
Some of the most highly trained (and highly paid health care professionals, health visitors, face a drastic reduction in numbers as cost-cutting Trusts and GPs seek to replace them with less qualified—-and cheaper-'D' grade nurses And if skilled staff are not to be employed, today's lean, mean NHS won't train them either: by 1998 the number of health visitor students will be just 362-less than half the 1991 figure. Nurse training, too is being decimated, with drastic consequences for the women denied vital skills and for the long term future of the NHS.
Those staff who have qualified face a new problem: the lack of permanent, full-time jobs. Hospital Trusts, increasbalance sheet ingly run like supermarkets, are seeking to use staff on an increasingly casualised, part-time basis making it • easier for management to shed workers "flexibly' without paying redundancy. For the women concerned it means a continual lack of job security, threatens their entitlement to the NHS pension scheme, and makes it hard to maintain any continuity or quality of care.
20 per cent of advertised health visitor posts are now offering only short-term contracts, often as short as 12 months or less. Over 40 percent of advertised posts are now part-time.
But for hard-pressed NHS staff, there could be worse to come, in the wake of last year's pay sell-out, which surrendered the principle of national pay negotiations.
One of the selling points of Trust status for many hard-line NHS chiefs was that it offered the opportunity to impose "local' pay and conditions.
Once Trust managers had indulged in a bonanza of big salary increases for themselves, some began to weigh up the balance of forces between themselves and the health unions in each hospital, and debate whether to make an offer, with or without strings.
Last year's fudged formula guarantees health workers only an average of the local deals negotiated with Trusts across the country: if the management gang up, get tough and call the bluff of the unions, the average increase could be next to nothing.
The lesson for health workers from the Hillingdon dispute is that nothing matters to today's NHS bosses except the balance sheet: unless the unions get organised and confront them, Trust chiefs across the country will fancy their chances of slashing a bit more from the pay and conditions of their staff which the insults and hitting started "Murderers', 'bitches", 'whores", "sluts', they yelled, accompanying their words with blows."
Many women in Europe, from countries such as Poland, Spain and Ireland (both North and South) travel in order te obtain an abortion.
But when they return they can still be prosecuted. This Spanish woman, who had her abortion in Portugal, said after being sentenced by a Spanish court to six months in prison "I never expected that the judge would give me such a severe sentence.
"We're in 1996, not the 1950s; this Europe, not the Third World; and we're a democratic country, no longer under General Franco's dictatorship. Children should be born from love, not error, and the last word should always he with the woman".
In more than 69 per cent of countries abortion is either entirely illegal or only available in very exceptional circumstances.
Illegal or unsafe abortions account for about 70,000 deaths annually, according to World Health Organisation couldies Unsuprisingly, most of these deaths oceur in the countries with the repressive anti-abortion laws.
The argument for the right to legal, safe abortion could not be clearer. It is a necessity for improving the welfare and freedom of women.
Socialist Outlook 98 • March 2, 1996.